pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	mrx_tier_id	mrx_tier_lbl	mrx_tier_gap_cost_share	mrx_tier_gap_drug_type_lmtd	mrx_tier_gap_all_drug_yn
H0046	001	0	1	04	01	H0046_001_0	6	1	Generic			
H0046	001	0	1	04	01	H0046_001_0	6	2	Preferred Brand			
H0046	001	0	1	04	01	H0046_001_0	6	3	Non-Preferred Brand			
H0046	001	0	1	04	01	H0046_001_0	6	4	Specialty	2		
H0046	001	0	1	04	01	H0046_001_0	6	3	Non-Preferred Brand	2		
H0046	001	0	1	04	01	H0046_001_0	6	2	Preferred Brand	2		
H0046	001	0	1	04	01	H0046_001_0	6	1	Generic	1		1
H0046	001	0	1	04	01	H0046_001_0	6	4	Specialty			
H0084	001	0	1	04	01	H0084_001_0	9	4	Formulary Specialty			
H0084	001	0	1	04	01	H0084_001_0	9	3	Formulary Non-Preferred Brand			
H0084	001	0	1	04	01	H0084_001_0	9	1	Formulary Generic			
H0084	001	0	1	04	01	H0084_001_0	9	2	Formulary Preferred Brand			
H0097	002	0	1	09	04	H0097_002_0	8	3	Non-Preferred Brand	2		
H0097	002	0	1	09	04	H0097_002_0	8	2	Preferred Brand	2		
H0097	002	0	1	09	04	H0097_002_0	8	1	Generic	1		1
H0097	002	0	1	09	04	H0097_002_0	8	4	Specialty			
H0097	002	0	1	09	04	H0097_002_0	8	3	Non-Preferred Brand			
H0097	002	0	1	09	04	H0097_002_0	8	2	Preferred Brand			
H0097	002	0	1	09	04	H0097_002_0	8	1	Generic			
H0097	002	0	1	09	04	H0097_002_0	8	4	Specialty	2		
H0104	002	0	1	04	01	H0104_002_0	8	1	Generic			
H0104	002	0	1	04	01	H0104_002_0	8	2	Preferred Brand			
H0104	002	0	1	04	01	H0104_002_0	8	3	Non-Preferred Brand			
H0104	002	0	1	04	01	H0104_002_0	8	4	Specialty			
H0104	004	0	1	04	01	H0104_004_0	7	2	Preferred Brand	2		
H0104	004	0	1	04	01	H0104_004_0	7	3	Non-Preferred Brand	2		
H0104	004	0	1	04	01	H0104_004_0	7	4	Specialty	2		
H0104	004	0	1	04	01	H0104_004_0	7	1	Generic	1		1
H0104	004	0	1	04	01	H0104_004_0	7	4	Specialty			
H0104	004	0	1	04	01	H0104_004_0	7	1	Generic			
H0104	004	0	1	04	01	H0104_004_0	7	2	Preferred Brand			
H0104	004	0	1	04	01	H0104_004_0	7	3	Non-Preferred Brand			
H0104	006	0	1	04	01	H0104_006_0	5	1	Generic			
H0104	006	0	1	04	01	H0104_006_0	5	2	Preferred Brand			
H0104	006	0	1	04	01	H0104_006_0	5	3	Non-Preferred Brand			
H0104	006	0	1	04	01	H0104_006_0	5	4	Specialty			
H0104	008	0	1	04	01	H0104_008_0	6	2	Preferred Brand	2		
H0104	008	0	1	04	01	H0104_008_0	6	1	Generic			
H0104	008	0	1	04	01	H0104_008_0	6	4	Specialty	2		
H0104	008	0	1	04	01	H0104_008_0	6	1	Generic	1		1
H0104	008	0	1	04	01	H0104_008_0	6	4	Specialty			
H0104	008	0	1	04	01	H0104_008_0	6	3	Non-Preferred Brand			
H0104	008	0	1	04	01	H0104_008_0	6	2	Preferred Brand			
H0104	008	0	1	04	01	H0104_008_0	6	3	Non-Preferred Brand	2		
H0117	004	0	1	01	01	H0117_004_0	10	4	Tier 4	2		
H0117	004	0	1	01	01	H0117_004_0	10	3	Tier 3	2		
H0117	004	0	1	01	01	H0117_004_0	10	2	Tier 2	2		
H0117	004	0	1	01	01	H0117_004_0	10	1	Tier 1			
H0117	004	0	1	01	01	H0117_004_0	10	2	Tier 2			
H0117	004	0	1	01	01	H0117_004_0	10	3	Tier 3			
H0117	004	0	1	01	01	H0117_004_0	10	4	Tier 4			
H0117	004	0	1	01	01	H0117_004_0	10	1	Tier 1	1		1
H0117	005	0	1	01	01	H0117_005_0	7	4	Tier 4	2		
H0117	005	0	1	01	01	H0117_005_0	7	3	Tier 3	2		
H0117	005	0	1	01	01	H0117_005_0	7	2	Tier 2	2		
H0117	005	0	1	01	01	H0117_005_0	7	1	Tier 1	1		1
H0117	005	0	1	01	01	H0117_005_0	7	1	Tier 1			
H0117	005	0	1	01	01	H0117_005_0	7	2	Tier 2			
H0117	005	0	1	01	01	H0117_005_0	7	3	Tier 3			
H0117	005	0	1	01	01	H0117_005_0	7	4	Tier 4			
H0117	007	0	1	01	01	H0117_007_0	7	1	Tier 1			
H0117	007	0	1	01	01	H0117_007_0	7	4	Tier 4			
H0117	007	0	1	01	01	H0117_007_0	7	3	Tier 3			
H0117	007	0	1	01	01	H0117_007_0	7	2	Tier 2			
H0117	008	0	1	01	01	H0117_008_0	7	4	Tier 4			
H0117	008	0	1	01	01	H0117_008_0	7	3	Tier 3			
H0117	008	0	1	01	01	H0117_008_0	7	2	Tier 2			
H0117	008	0	1	01	01	H0117_008_0	7	1	Tier 1			
H0117	009	0	1	01	01	H0117_009_0	7	1	Tier 1			
H0117	009	0	1	01	01	H0117_009_0	7	2	Tier 2			
H0117	009	0	1	01	01	H0117_009_0	7	3	Tier 3			
H0117	009	0	1	01	01	H0117_009_0	7	4	Tier 4			
H0141	001	0	1	01	01	H0141_001_0	6	1	Tier 1			
H0141	001	0	1	01	01	H0141_001_0	6	4	Tier 4			
H0141	001	0	1	01	01	H0141_001_0	6	3	Tier 3			
H0141	001	0	1	01	01	H0141_001_0	6	2	Tier 2			
H0150	001	0	1	01	01	H0150_001_0	5	1	Preferred Generic			
H0150	001	0	1	01	01	H0150_001_0	5	2	Generic			
H0150	001	0	1	01	01	H0150_001_0	5	5	Specialty	2		
H0150	001	0	1	01	01	H0150_001_0	5	4	Non-Preferred Brand	2		
H0150	001	0	1	01	01	H0150_001_0	5	3	Preferred Brand	2		
H0150	001	0	1	01	01	H0150_001_0	5	2	Generic	1		1
H0150	001	0	1	01	01	H0150_001_0	5	1	Preferred Generic	1		1
H0150	001	0	1	01	01	H0150_001_0	5	5	Specialty			
H0150	001	0	1	01	01	H0150_001_0	5	4	Non-Preferred Brand			
H0150	001	0	1	01	01	H0150_001_0	5	3	Preferred Brand			
H0150	017	0	1	01	01	H0150_017_0	5	1	Preferred Generic			
H0150	017	0	1	01	01	H0150_017_0	5	4	Non-Preferred Brand	2		
H0150	017	0	1	01	01	H0150_017_0	5	3	Preferred Brand	2		
H0150	017	0	1	01	01	H0150_017_0	5	2	Generic	1		1
H0150	017	0	1	01	01	H0150_017_0	5	5	Specialty	2		
H0150	017	0	1	01	01	H0150_017_0	5	5	Specialty			
H0150	017	0	1	01	01	H0150_017_0	5	4	Non-Preferred Brand			
H0150	017	0	1	01	01	H0150_017_0	5	3	Preferred Brand			
H0150	017	0	1	01	01	H0150_017_0	5	2	Generic			
H0150	017	0	1	01	01	H0150_017_0	5	1	Preferred Generic	1		1
H0150	019	0	1	01	01	H0150_019_0	2	1	Preferred Generic			
H0150	019	0	1	01	01	H0150_019_0	2	2	Generic			
H0150	019	0	1	01	01	H0150_019_0	2	5	Specialty	2		
H0150	019	0	1	01	01	H0150_019_0	2	4	Non-Preferred Brand	2		
H0150	019	0	1	01	01	H0150_019_0	2	3	Preferred Brand	2		
H0150	019	0	1	01	01	H0150_019_0	2	2	Generic	1	00001000	2
H0150	019	0	1	01	01	H0150_019_0	2	1	Preferred Generic	1		1
H0150	019	0	1	01	01	H0150_019_0	2	5	Specialty			
H0150	019	0	1	01	01	H0150_019_0	2	4	Non-Preferred Brand			
H0150	019	0	1	01	01	H0150_019_0	2	3	Preferred Brand			
H0150	021	0	1	01	01	H0150_021_0	4	1	Preferred Generic	1		1
H0150	021	0	1	01	01	H0150_021_0	4	2	Generic	1		1
H0150	021	0	1	01	01	H0150_021_0	4	3	Preferred Brand	2		
H0150	021	0	1	01	01	H0150_021_0	4	4	Non-Preferred Brand			
H0150	021	0	1	01	01	H0150_021_0	4	4	Non-Preferred Brand	2		
H0150	021	0	1	01	01	H0150_021_0	4	1	Preferred Generic			
H0150	021	0	1	01	01	H0150_021_0	4	2	Generic			
H0150	021	0	1	01	01	H0150_021_0	4	3	Preferred Brand			
H0150	021	0	1	01	01	H0150_021_0	4	5	Specialty	2		
H0150	021	0	1	01	01	H0150_021_0	4	5	Specialty			
H0151	001	0	1	01	01	H0151_001_0	9	1	Preferred Generic			
H0151	001	0	1	01	01	H0151_001_0	9	4	Specialty			
H0151	001	0	1	01	01	H0151_001_0	9	3	Non Preferred			
H0151	001	0	1	01	01	H0151_001_0	9	2	Preferred Brand			
H0151	017	0	1	01	01	H0151_017_0	7	1	Preferred Generic			
H0151	017	0	1	01	01	H0151_017_0	7	2	Preferred Brand			
H0151	017	0	1	01	01	H0151_017_0	7	3	Non Preferred			
H0151	017	0	1	01	01	H0151_017_0	7	4	Specialty			
H0151	023	0	1	01	01	H0151_023_0	6	2	Preferred Brand			
H0151	023	0	1	01	01	H0151_023_0	6	1	Preferred Generic			
H0151	023	0	1	01	01	H0151_023_0	6	1	Preferred Generic	1		1
H0151	023	0	1	01	01	H0151_023_0	6	4	Specialty			
H0151	023	0	1	01	01	H0151_023_0	6	3	Non Preferred			
H0151	023	0	1	01	01	H0151_023_0	6	3	Non Preferred	2		
H0151	023	0	1	01	01	H0151_023_0	6	2	Preferred Brand	2		
H0151	023	0	1	01	01	H0151_023_0	6	4	Specialty	2		
H0154	001	0	1	01	01	H0154_001_0	5	3	Tier 3			
H0154	001	0	1	01	01	H0154_001_0	5	4	Tier 4			
H0154	001	0	1	01	01	H0154_001_0	5	1	Tier 1			
H0154	001	0	1	01	01	H0154_001_0	5	2	Tier 2			
H0154	009	0	1	01	01	H0154_009_0	6	3	Tier 3			
H0154	009	0	1	01	01	H0154_009_0	6	4	Tier 4			
H0154	009	0	1	01	01	H0154_009_0	6	2	Tier 2			
H0154	009	0	1	01	01	H0154_009_0	6	1	Tier 1			
H0154	011	0	1	01	01	H0154_011_0	4	1	Tier 1			
H0154	011	0	1	01	01	H0154_011_0	4	4	Tier 4	2		
H0154	011	0	1	01	01	H0154_011_0	4	3	Tier 3	2		
H0154	011	0	1	01	01	H0154_011_0	4	2	Tier 2			
H0154	011	0	1	01	01	H0154_011_0	4	1	Tier 1	1		1
H0154	011	0	1	01	01	H0154_011_0	4	4	Tier 4			
H0154	011	0	1	01	01	H0154_011_0	4	3	Tier 3			
H0154	011	0	1	01	01	H0154_011_0	4	2	Tier 2	2		
H0245	001	0	1	01	01	H0245_001_0	7	1	Preferred Generic			
H0245	001	0	1	01	01	H0245_001_0	7	4	Non-Preferred			
H0245	001	0	1	01	01	H0245_001_0	7	3	Specialty			
H0245	001	0	1	01	01	H0245_001_0	7	2	Preferred Brand			
H0245	002	0	1	01	01	H0245_002_0	7	1	Preferred Generic	1		1
H0245	002	0	1	01	01	H0245_002_0	7	4	Non-Preferred			
H0245	002	0	1	01	01	H0245_002_0	7	3	Specialty			
H0245	002	0	1	01	01	H0245_002_0	7	2	Preferred Brand			
H0245	002	0	1	01	01	H0245_002_0	7	1	Preferred Generic			
H0245	002	0	1	01	01	H0245_002_0	7	2	Preferred Brand	2		
H0245	002	0	1	01	01	H0245_002_0	7	4	Non-Preferred	2		
H0245	002	0	1	01	01	H0245_002_0	7	3	Specialty	2		
H0248	001	0	1	04	01	H0248_001_0	6	1	Preferred Generic			
H0248	001	0	1	04	01	H0248_001_0	6	2	Preferred Brand			
H0248	001	0	1	04	01	H0248_001_0	6	3	Non-Preferred Brand			
H0248	001	0	1	04	01	H0248_001_0	6	4	Specialty			
H0248	001	0	1	04	01	H0248_001_0	6	1	Preferred Generic	1	00001000	2
H0248	001	0	1	04	01	H0248_001_0	6	3	Non-Preferred Brand	1	10000000	2
H0248	001	0	1	04	01	H0248_001_0	6	2	Preferred Brand	1	10000000	2
H0248	001	0	1	04	01	H0248_001_0	6	4	Specialty	1	10001000	2
H0302	001	0	1	01	01	H0302_001_0	4	5	Specialty	2		
H0302	001	0	1	01	01	H0302_001_0	4	1	Value Generics			
H0302	001	0	1	01	01	H0302_001_0	4	2	Generic			
H0302	001	0	1	01	01	H0302_001_0	4	3	Preferred Brand			
H0302	001	0	1	01	01	H0302_001_0	4	4	Non-Preferred Brand			
H0302	001	0	1	01	01	H0302_001_0	4	5	Specialty			
H0302	001	0	1	01	01	H0302_001_0	4	1	Value Generics	1		1
H0302	001	0	1	01	01	H0302_001_0	4	2	Generic	1		1
H0302	001	0	1	01	01	H0302_001_0	4	3	Preferred Brand	2		
H0302	001	0	1	01	01	H0302_001_0	4	4	Non-Preferred Brand	2		
H0302	004	0	1	01	01	H0302_004_0	4	5	Specialty	2		
H0302	004	0	1	01	01	H0302_004_0	4	1	Value Generics			
H0302	004	0	1	01	01	H0302_004_0	4	2	Generic			
H0302	004	0	1	01	01	H0302_004_0	4	3	Preferred Brand			
H0302	004	0	1	01	01	H0302_004_0	4	4	Non-Preferred Brand	2		
H0302	004	0	1	01	01	H0302_004_0	4	5	Specialty			
H0302	004	0	1	01	01	H0302_004_0	4	1	Value Generics	1		1
H0302	004	0	1	01	01	H0302_004_0	4	2	Generic	1		1
H0302	004	0	1	01	01	H0302_004_0	4	3	Preferred Brand	2		
H0302	004	0	1	01	01	H0302_004_0	4	4	Non-Preferred Brand			
H0303	013	0	1	01	01	H0303_013_0	6	4	Specialty			
H0303	013	0	1	01	01	H0303_013_0	6	3	Non-Preferred			
H0303	013	0	1	01	01	H0303_013_0	6	2	Preferred Brand			
H0303	013	0	1	01	01	H0303_013_0	6	1	Preferred Generic			
H0303	015	0	1	01	01	H0303_015_0	5	3	Non-Preferred			
H0303	015	0	1	01	01	H0303_015_0	5	2	Preferred Brand			
H0303	015	0	1	01	01	H0303_015_0	5	1	Preferred Generic			
H0303	015	0	1	01	01	H0303_015_0	5	4	Specialty			
H0303	039	0	1	01	01	H0303_039_0	5	4	Specialty			
H0303	039	0	1	01	01	H0303_039_0	5	3	Non-Preferred			
H0303	039	0	1	01	01	H0303_039_0	5	2	Preferred Brand			
H0303	039	0	1	01	01	H0303_039_0	5	1	Preferred Generic			
H0307	008	0	1	01	01	H0307_008_0	7	4	Specialty	1	10001000	2
H0307	008	0	1	01	01	H0307_008_0	7	2	Preferred Brand			
H0307	008	0	1	01	01	H0307_008_0	7	1	Preferred Generic			
H0307	008	0	1	01	01	H0307_008_0	7	2	Preferred Brand	1	10000000	2
H0307	008	0	1	01	01	H0307_008_0	7	1	Preferred Generic	1	00001000	2
H0307	008	0	1	01	01	H0307_008_0	7	3	Non-Preferred Brand	1	10000000	2
H0307	008	0	1	01	01	H0307_008_0	7	3	Non-Preferred Brand			
H0307	008	0	1	01	01	H0307_008_0	7	4	Specialty			
H0307	009	0	1	02	01	H0307_009_0	7	1	Preferred Generic			
H0307	009	0	1	02	01	H0307_009_0	7	2	Preferred Brand			
H0307	009	0	1	02	01	H0307_009_0	7	3	Non-Preferred Brand			
H0307	009	0	1	02	01	H0307_009_0	7	4	Specialty	1	10001000	2
H0307	009	0	1	02	01	H0307_009_0	7	1	Preferred Generic	1		1
H0307	009	0	1	02	01	H0307_009_0	7	4	Specialty			
H0307	009	0	1	02	01	H0307_009_0	7	2	Preferred Brand	1	10000000	2
H0307	009	0	1	02	01	H0307_009_0	7	3	Non-Preferred Brand	1	10000000	2
H0307	010	0	1	02	01	H0307_010_0	7	2	Preferred Brand	1	10000000	2
H0307	010	0	1	02	01	H0307_010_0	7	1	Preferred Generic	1		1
H0307	010	0	1	02	01	H0307_010_0	7	4	Specialty			
H0307	010	0	1	02	01	H0307_010_0	7	3	Non-Preferred Brand			
H0307	010	0	1	02	01	H0307_010_0	7	3	Non-Preferred Brand	1	10000000	2
H0307	010	0	1	02	01	H0307_010_0	7	4	Specialty	1	10001000	2
H0307	010	0	1	02	01	H0307_010_0	7	2	Preferred Brand			
H0307	010	0	1	02	01	H0307_010_0	7	1	Preferred Generic			
H0316	002	0	1	01	01	H0316_002_0	5	3	Non-Preferred			
H0316	002	0	1	01	01	H0316_002_0	5	2	Preferred Brand			
H0316	002	0	1	01	01	H0316_002_0	5	1	Preferred Generic			
H0316	002	0	1	01	01	H0316_002_0	5	4	Specialty			
H0316	013	0	1	01	01	H0316_013_0	4	4	Specialty			
H0316	013	0	1	01	01	H0316_013_0	4	1	Preferred Generic			
H0316	013	0	1	01	01	H0316_013_0	4	2	Preferred Brand			
H0316	013	0	1	01	01	H0316_013_0	4	3	Non Preferred			
H0316	014	0	1	01	01	H0316_014_0	7	4	Specialty			
H0316	014	0	1	01	01	H0316_014_0	7	3	Non-Preferred			
H0316	014	0	1	01	01	H0316_014_0	7	1	Preferred Generic			
H0316	014	0	1	01	01	H0316_014_0	7	2	Preferred Brand			
H0317	001	0	1	04	01	H0317_001_0	6	1	Preferred Generic			
H0317	001	0	1	04	01	H0317_001_0	6	2	Preferred Brand			
H0317	001	0	1	04	01	H0317_001_0	6	3	Non-Preferred Brand			
H0317	001	0	1	04	01	H0317_001_0	6	4	Specialty			
H0317	001	0	1	04	01	H0317_001_0	6	1	Preferred Generic	1		1
H0317	001	0	1	04	01	H0317_001_0	6	2	Preferred Brand	1	10000000	2
H0317	001	0	1	04	01	H0317_001_0	6	3	Non-Preferred Brand	1	10000000	2
H0317	001	0	1	04	01	H0317_001_0	6	4	Specialty	1	10001000	2
H0317	002	0	1	04	01	H0317_002_0	7	2	Preferred Brand			
H0317	002	0	1	04	01	H0317_002_0	7	1	Preferred Generic			
H0317	002	0	1	04	01	H0317_002_0	7	4	Specialty	1	10001000	2
H0317	002	0	1	04	01	H0317_002_0	7	3	Non-Preferred Brand	1	10000000	2
H0317	002	0	1	04	01	H0317_002_0	7	2	Preferred Brand	1	10000000	2
H0317	002	0	1	04	01	H0317_002_0	7	1	Preferred Generic	1		1
H0317	002	0	1	04	01	H0317_002_0	7	4	Specialty			
H0317	002	0	1	04	01	H0317_002_0	7	3	Non-Preferred Brand			
H0317	004	0	1	04	01	H0317_004_0	8	1	Preferred Generic			
H0317	004	0	1	04	01	H0317_004_0	8	3	Non-Preferred Brand	1	10000000	2
H0317	004	0	1	04	01	H0317_004_0	8	2	Preferred Brand	1	10000000	2
H0317	004	0	1	04	01	H0317_004_0	8	1	Preferred Generic	1	00001000	2
H0317	004	0	1	04	01	H0317_004_0	8	4	Specialty			
H0317	004	0	1	04	01	H0317_004_0	8	3	Non-Preferred Brand			
H0317	004	0	1	04	01	H0317_004_0	8	2	Preferred Brand			
H0317	004	0	1	04	01	H0317_004_0	8	4	Specialty	1	10001000	2
H0318	001	0	1	01	01	H0318_001_0	5	2	Tier 2 - Non-Preferred Generic			
H0318	001	0	1	01	01	H0318_001_0	5	1	Tier 1 - Preferred Generic			
H0318	001	0	1	01	01	H0318_001_0	5	3	Tier 3 - Preferred Brand			
H0318	001	0	1	01	01	H0318_001_0	5	5	Tier 5 - Specialty			
H0318	001	0	1	01	01	H0318_001_0	5	4	Tier 4 - Non-Preferred Brand			
H0318	002	0	1	01	01	H0318_002_0	4	3	Tier 3 - Preferred Brand			
H0318	002	0	1	01	01	H0318_002_0	4	2	Tier 2 - Non-Preferred Generic			
H0318	002	0	1	01	01	H0318_002_0	4	1	Tier 1 - Preferred Generic			
H0318	002	0	1	01	01	H0318_002_0	4	4	Tier 4 - Non-Preferred Brand			
H0318	002	0	1	01	01	H0318_002_0	4	5	Tier 5 - Specialty			
H0319	001	0	1	04	01	H0319_001_0	5	3	Non Preferred			
H0319	001	0	1	04	01	H0319_001_0	5	2	Preferred Brand			
H0319	001	0	1	04	01	H0319_001_0	5	1	Preferred Generic			
H0319	001	0	1	04	01	H0319_001_0	5	4	Specialty			
H0319	004	0	1	04	01	H0319_004_0	4	1	Preferred Generic			
H0319	004	0	1	04	01	H0319_004_0	4	2	Preferred Brand			
H0319	004	0	1	04	01	H0319_004_0	4	3	Non Preferred			
H0319	004	0	1	04	01	H0319_004_0	4	4	Specialty			
H0319	005	0	1	04	01	H0319_005_0	3	1	Preferred Generic			
H0319	005	0	1	04	01	H0319_005_0	3	3	Non Preferred			
H0319	005	0	1	04	01	H0319_005_0	3	2	Preferred Brand			
H0319	005	0	1	04	01	H0319_005_0	3	4	Specialty			
H0320	001	0	1	01	01	H0320_001_0	9	2	Tier 2 - Preferred Brand			
H0320	001	0	1	01	01	H0320_001_0	9	3	Tier 3 - Non-Preferred Brand			
H0320	001	0	1	01	01	H0320_001_0	9	4	Tier 4 - Specialty Drug			
H0320	001	0	1	01	01	H0320_001_0	9	1	Tier 1 - Generic	1		1
H0320	001	0	1	01	01	H0320_001_0	9	2	Tier 2 - Preferred Brand	2		
H0320	001	0	1	01	01	H0320_001_0	9	3	Tier 3 - Non-Preferred Brand	2		
H0320	001	0	1	01	01	H0320_001_0	9	4	Tier 4 - Specialty Drug	2		
H0320	001	0	1	01	01	H0320_001_0	9	1	Tier 1 - Generic			
H0320	005	0	1	01	01	H0320_005_0	10	1	Tier 1 - Generic			
H0320	005	0	1	01	01	H0320_005_0	10	2	Tier 2 - Preferred Brand			
H0320	005	0	1	01	01	H0320_005_0	10	3	Tier 3 - Non-Preferred Brand			
H0320	005	0	1	01	01	H0320_005_0	10	4	Tier 4 - Specialty Drug			
H0320	005	0	1	01	01	H0320_005_0	10	1	Tier 1 - Generic	1		1
H0320	005	0	1	01	01	H0320_005_0	10	2	Tier 2 - Preferred Brand	2		
H0320	005	0	1	01	01	H0320_005_0	10	4	Tier 4 - Specialty Drug	2		
H0320	005	0	1	01	01	H0320_005_0	10	3	Tier 3 - Non-Preferred Brand	2		
H0320	006	0	1	01	01	H0320_006_0	9	3	Tier 3 - Non-Preferred Brand	2		
H0320	006	0	1	01	01	H0320_006_0	9	4	Tier 4 - Specialty Drug	2		
H0320	006	0	1	01	01	H0320_006_0	9	2	Tier 2 - Preferred Brand	2		
H0320	006	0	1	01	01	H0320_006_0	9	1	Tier 1 - Generic	1		1
H0320	006	0	1	01	01	H0320_006_0	9	4	Tier 4 - Specialty Drug			
H0320	006	0	1	01	01	H0320_006_0	9	3	Tier 3 - Non-Preferred Brand			
H0320	006	0	1	01	01	H0320_006_0	9	2	Tier 2 - Preferred Brand			
H0320	006	0	1	01	01	H0320_006_0	9	1	Tier 1 - Generic			
H0322	002	0	1	04	01	H0322_002_0	6	4	Tier 4 - Non-Preferred Brand			
H0322	002	0	1	04	01	H0322_002_0	6	3	Tier 3 - Preferred Brand			
H0322	002	0	1	04	01	H0322_002_0	6	5	Tier 5 - Specialty			
H0322	002	0	1	04	01	H0322_002_0	6	1	Tier 1 - Preferred Generic			
H0322	002	0	1	04	01	H0322_002_0	6	2	Tier 2 - Non-Preferred Generic			
H0322	006	0	1	04	01	H0322_006_0	6	4	Tier 4 - Non-Preferred Brand	2		
H0322	006	0	1	04	01	H0322_006_0	6	3	Tier 3 - Preferred Brand	2		
H0322	006	0	1	04	01	H0322_006_0	6	1	Tier 1 - Preferred Generic	1		1
H0322	006	0	1	04	01	H0322_006_0	6	1	Tier 1 - Preferred Generic			
H0322	006	0	1	04	01	H0322_006_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H0322	006	0	1	04	01	H0322_006_0	6	3	Tier 3 - Preferred Brand			
H0322	006	0	1	04	01	H0322_006_0	6	5	Tier 5 - Specialty	2		
H0322	006	0	1	04	01	H0322_006_0	6	5	Tier 5 - Specialty			
H0322	006	0	1	04	01	H0322_006_0	6	4	Tier 4 - Non-Preferred Brand			
H0322	006	0	1	04	01	H0322_006_0	6	2	Tier 2 - Non-Preferred Generic			
H0332	002	0	1	01	01	H0332_002_0	9	4	Specialty			
H0332	002	0	1	01	01	H0332_002_0	9	3	Non-Preferred Brand			
H0332	002	0	1	01	01	H0332_002_0	9	2	Preferred Brand	2		
H0332	002	0	1	01	01	H0332_002_0	9	3	Non-Preferred Brand	2		
H0332	002	0	1	01	01	H0332_002_0	9	4	Specialty	2		
H0332	002	0	1	01	01	H0332_002_0	9	1	Generic	1		1
H0332	002	0	1	01	01	H0332_002_0	9	2	Preferred Brand			
H0332	002	0	1	01	01	H0332_002_0	9	1	Generic			
H0332	004	0	1	02	01	H0332_004_0	9	4	Specialty			
H0332	004	0	1	02	01	H0332_004_0	9	1	Generic	1		1
H0332	004	0	1	02	01	H0332_004_0	9	2	Preferred Brand	2		
H0332	004	0	1	02	01	H0332_004_0	9	3	Non-Preferred Brand	2		
H0332	004	0	1	02	01	H0332_004_0	9	4	Specialty	2		
H0332	004	0	1	02	01	H0332_004_0	9	3	Non-Preferred Brand			
H0332	004	0	1	02	01	H0332_004_0	9	2	Preferred Brand			
H0332	004	0	1	02	01	H0332_004_0	9	1	Generic			
H0351	014	0	1	01	01	H0351_014_0	4	1	Preferred Generic			
H0351	014	0	1	01	01	H0351_014_0	4	4	Injectable			
H0351	014	0	1	01	01	H0351_014_0	4	5	Specialty			
H0351	014	0	1	01	01	H0351_014_0	4	3	Non-Preferred Brand			
H0351	014	0	1	01	01	H0351_014_0	4	2	Preferred Brand			
H0351	029	0	1	01	01	H0351_029_0	6	1	Preferred Generic			
H0351	029	0	1	01	01	H0351_029_0	6	3	Non-Preferred Brand			
H0351	029	0	1	01	01	H0351_029_0	6	4	Injectable			
H0351	029	0	1	01	01	H0351_029_0	6	5	Speciality			
H0351	029	0	1	01	01	H0351_029_0	6	2	Preferred Brand			
H0351	032	0	1	01	01	H0351_032_0	6	5	Injectable	2		
H0351	032	0	1	01	01	H0351_032_0	6	4	Non-Preferred Brand	2		
H0351	032	0	1	01	01	H0351_032_0	6	3	Preferred Brand	2		
H0351	032	0	1	01	01	H0351_032_0	6	2	Preferred Generic	2		
H0351	032	0	1	01	01	H0351_032_0	6	1	Preferred Generic	1		1
H0351	032	0	1	01	01	H0351_032_0	6	6	Specialty			
H0351	032	0	1	01	01	H0351_032_0	6	5	Injectable			
H0351	032	0	1	01	01	H0351_032_0	6	4	Non-Preferred Brand			
H0351	032	0	1	01	01	H0351_032_0	6	3	Preferred Brand			
H0351	032	0	1	01	01	H0351_032_0	6	2	Preferred Generic			
H0351	032	0	1	01	01	H0351_032_0	6	6	Specialty	2		
H0351	032	0	1	01	01	H0351_032_0	6	1	Preferred Generic			
H0351	033	0	1	01	01	H0351_033_0	6	3	Non-Preferred Brand			
H0351	033	0	1	01	01	H0351_033_0	6	2	Preferred Brand			
H0351	033	0	1	01	01	H0351_033_0	6	1	Preferred Generic			
H0351	033	0	1	01	01	H0351_033_0	6	4	Injectable			
H0351	033	0	1	01	01	H0351_033_0	6	5	Specialty			
H0351	034	0	1	01	01	H0351_034_0	6	1	Preferred Generic			
H0351	034	0	1	01	01	H0351_034_0	6	2	Preferred Brand			
H0351	034	0	1	01	01	H0351_034_0	6	3	Non-Preferred Brand			
H0351	034	0	1	01	01	H0351_034_0	6	4	Injectable			
H0351	034	0	1	01	01	H0351_034_0	6	5	Specialty			
H0354	001	0	1	01	01	H0354_001_0	11	4	Tier 4			
H0354	001	0	1	01	01	H0354_001_0	11	5	Tier 5	2		
H0354	001	0	1	01	01	H0354_001_0	11	4	Tier 4	2		
H0354	001	0	1	01	01	H0354_001_0	11	3	Tier 3	2		
H0354	001	0	1	01	01	H0354_001_0	11	2	Tier 2	1		1
H0354	001	0	1	01	01	H0354_001_0	11	1	Tier 1	1		1
H0354	001	0	1	01	01	H0354_001_0	11	5	Tier 5			
H0354	001	0	1	01	01	H0354_001_0	11	3	Tier 3			
H0354	001	0	1	01	01	H0354_001_0	11	2	Tier 2			
H0354	001	0	1	01	01	H0354_001_0	11	1	Tier 1			
H0354	014	0	1	01	01	H0354_014_0	11	1	Tier 1			
H0354	014	0	1	01	01	H0354_014_0	11	5	Tier 5			
H0354	014	0	1	01	01	H0354_014_0	11	1	Tier 1	1		1
H0354	014	0	1	01	01	H0354_014_0	11	4	Tier 4			
H0354	014	0	1	01	01	H0354_014_0	11	2	Tier 2	1		1
H0354	014	0	1	01	01	H0354_014_0	11	2	Tier 2			
H0354	014	0	1	01	01	H0354_014_0	11	5	Tier 5	2		
H0354	014	0	1	01	01	H0354_014_0	11	4	Tier 4	2		
H0354	014	0	1	01	01	H0354_014_0	11	3	Tier 3	2		
H0354	014	0	1	01	01	H0354_014_0	11	3	Tier 3			
H0370	001	0	1	04	01	H0370_001_0	11	3	Non-Preferred Generic/Non-Preferred Brand			
H0370	001	0	1	04	01	H0370_001_0	11	2	Preferred Brand			
H0370	001	0	1	04	01	H0370_001_0	11	1	Preferred Generic			
H0370	001	0	1	04	01	H0370_001_0	11	4	Specialty - Generic and Brand	2		
H0370	001	0	1	04	01	H0370_001_0	11	3	Non-Preferred Generic/Non-Preferred Brand	2		
H0370	001	0	1	04	01	H0370_001_0	11	2	Preferred Brand	2		
H0370	001	0	1	04	01	H0370_001_0	11	1	Preferred Generic	1		1
H0370	001	0	1	04	01	H0370_001_0	11	4	Specialty - Generic and Brand			
H0370	002	0	1	04	01	H0370_002_0	12	3	Non-Preferred Generic/Non-Preferred Brand			
H0370	002	0	1	04	01	H0370_002_0	12	2	Preferred Brand			
H0370	002	0	1	04	01	H0370_002_0	12	1	Preferred Generic			
H0370	002	0	1	04	01	H0370_002_0	12	4	Specialty - Generic and Brand	2		
H0370	002	0	1	04	01	H0370_002_0	12	3	Non-Preferred Generic/Non-Preferred Brand	2		
H0370	002	0	1	04	01	H0370_002_0	12	4	Specialty - Generic and Brand			
H0370	002	0	1	04	01	H0370_002_0	12	1	Preferred Generic	1		1
H0370	002	0	1	04	01	H0370_002_0	12	2	Preferred Brand	2		
H0401	002	0	1	02	01	H0401_002_0	4	4	Specialty			
H0401	002	0	1	02	01	H0401_002_0	4	3	Non Preferred			
H0401	002	0	1	02	01	H0401_002_0	4	2	Preferred Brand			
H0401	002	0	1	02	01	H0401_002_0	4	1	Preferred Generic			
H0401	005	0	1	02	01	H0401_005_0	3	4	Specialty			
H0401	005	0	1	02	01	H0401_005_0	3	3	Non Preferred			
H0401	005	0	1	02	01	H0401_005_0	3	2	Preferred Brand			
H0401	005	0	1	02	01	H0401_005_0	3	1	Preferred Generic			
H0408	001	0	1	02	01	H0408_001_0	5	1	Preferred Generic			
H0408	001	0	1	02	01	H0408_001_0	5	2	Preferred Brand			
H0408	001	0	1	02	01	H0408_001_0	5	3	Non Preferred			
H0408	001	0	1	02	01	H0408_001_0	5	4	Specialty			
H0408	002	0	1	02	01	H0408_002_0	5	2	Preferred Brand			
H0408	002	0	1	02	01	H0408_002_0	5	3	Non Preferred			
H0408	002	0	1	02	01	H0408_002_0	5	4	Specialty			
H0408	002	0	1	02	01	H0408_002_0	5	1	Preferred Generic			
H0410	001	0	1	37	05	H0410_001_0	4	4	Specialty			
H0410	001	0	1	37	05	H0410_001_0	4	3	Non Preferred			
H0410	001	0	1	37	05	H0410_001_0	4	2	Preferred Brand			
H0410	001	0	1	37	05	H0410_001_0	4	1	Preferred Generic			
H0410	003	0	1	37	05	H0410_003_0	3	2	Preferred Brand			
H0410	003	0	1	37	05	H0410_003_0	3	3	Non Preferred			
H0410	003	0	1	37	05	H0410_003_0	3	4	Specialty			
H0410	003	0	1	37	05	H0410_003_0	3	1	Preferred Generic			
H0410	004	0	1	37	05	H0410_004_0	4	4	Specialty			
H0410	004	0	1	37	05	H0410_004_0	4	3	Non Preferred			
H0410	004	0	1	37	05	H0410_004_0	4	2	Preferred Brand			
H0410	004	0	1	37	05	H0410_004_0	4	1	Preferred Generic			
H0427	001	0	1	02	01	H0427_001_0	7	4	Specialty			
H0427	001	0	1	02	01	H0427_001_0	7	3	Non-Preferred Brand			
H0427	001	0	1	02	01	H0427_001_0	7	1	Generic			
H0427	001	0	1	02	01	H0427_001_0	7	2	Preferred Brand			
H0427	002	0	1	02	01	H0427_002_0	7	2	Brand			
H0427	002	0	1	02	01	H0427_002_0	7	1	Generic			
H0427	002	0	1	02	01	H0427_002_0	7	3	Specialty			
H0490	001	0	1	01	01	H0490_001_0	6	4	Specialty Drugs			
H0490	001	0	1	01	01	H0490_001_0	6	3	Non-Preferred Brand			
H0490	001	0	1	01	01	H0490_001_0	6	2	Preferred Brand			
H0490	001	0	1	01	01	H0490_001_0	6	1	Generic			
H0490	002	0	1	01	01	H0490_002_0	6	1	Generic			
H0490	002	0	1	01	01	H0490_002_0	6	2	Preferred Brand			
H0490	002	0	1	01	01	H0490_002_0	6	3	Non-Preferred Brand			
H0490	002	0	1	01	01	H0490_002_0	6	4	Specialty Drugs			
H0490	003	0	1	01	01	H0490_003_0	6	3	Non-Preferred Brand			
H0490	003	0	1	01	01	H0490_003_0	6	2	Preferred Brand			
H0490	003	0	1	01	01	H0490_003_0	6	1	Generic			
H0490	003	0	1	01	01	H0490_003_0	6	4	Specialty Drugs			
H0504	015	0	1	01	01	H0504_015_0	9	4	Injectables			
H0504	015	0	1	01	01	H0504_015_0	9	3	Non-Preferred Brand			
H0504	015	0	1	01	01	H0504_015_0	9	2	Formulary Brand			
H0504	015	0	1	01	01	H0504_015_0	9	1	Formulary Generic			
H0504	015	0	1	01	01	H0504_015_0	9	5	Formulary Specialty (Unique High Cost Drugs)	2		
H0504	015	0	1	01	01	H0504_015_0	9	1	Formulary Generic	1		1
H0504	015	0	1	01	01	H0504_015_0	9	2	Formulary Brand	1		1
H0504	015	0	1	01	01	H0504_015_0	9	3	Non-Preferred Brand	2		
H0504	015	0	1	01	01	H0504_015_0	9	4	Injectables	2		
H0504	015	0	1	01	01	H0504_015_0	9	5	Formulary Specialty (Unique High Cost Drugs)			
H0504	017	0	1	01	01	H0504_017_0	8	4	Injectables			
H0504	017	0	1	01	01	H0504_017_0	8	3	Non-Preferred Brand			
H0504	017	0	1	01	01	H0504_017_0	8	2	Formulary Brand			
H0504	017	0	1	01	01	H0504_017_0	8	1	Formulary Generic			
H0504	017	0	1	01	01	H0504_017_0	8	5	Formulary Specialty (Unique High Cost Drugs)			
H0504	017	0	1	01	01	H0504_017_0	8	5	Formulary Specialty (Unique High Cost Drugs)	2		
H0504	017	0	1	01	01	H0504_017_0	8	4	Injectables	2		
H0504	017	0	1	01	01	H0504_017_0	8	3	Non-Preferred Brand	2		
H0504	017	0	1	01	01	H0504_017_0	8	2	Formulary Brand	2		
H0504	017	0	1	01	01	H0504_017_0	8	1	Formulary Generic	1		1
H0504	021	0	1	01	01	H0504_021_0	8	1	Formulary Insulin and Generics			
H0504	021	0	1	01	01	H0504_021_0	8	2	Formulary Brand			
H0504	021	0	1	01	01	H0504_021_0	8	3	Non-Preferred Brand			
H0504	021	0	1	01	01	H0504_021_0	8	4	Injectables			
H0504	021	0	1	01	01	H0504_021_0	8	5	Formulary  Specialty (Unique High Cost Drugs)	2		
H0504	021	0	1	01	01	H0504_021_0	8	3	Non-Preferred Brand	2		
H0504	021	0	1	01	01	H0504_021_0	8	2	Formulary Brand	1		1
H0504	021	0	1	01	01	H0504_021_0	8	1	Formulary Insulin and Generics	1		1
H0504	021	0	1	01	01	H0504_021_0	8	5	Formulary  Specialty (Unique High Cost Drugs)			
H0504	021	0	1	01	01	H0504_021_0	8	4	Injectables	2		
H0523	002	0	1	01	01	H0523_002_0	6	1	Tier 1 - Preferred Generic			
H0523	002	0	1	01	01	H0523_002_0	6	2	Tier 2 - Non-Preferred Generic			
H0523	002	0	1	01	01	H0523_002_0	6	3	Tier 3 - Preferred Brand			
H0523	002	0	1	01	01	H0523_002_0	6	4	Tier 4 - Non-Preferred Brand			
H0523	002	0	1	01	01	H0523_002_0	6	5	Tier 5 - Specialty			
H0523	022	0	1	01	01	H0523_022_0	7	5	Tier 5 - Specialty			
H0523	022	0	1	01	01	H0523_022_0	7	4	Tier 4 - Non-Preferred Brand			
H0523	022	0	1	01	01	H0523_022_0	7	1	Tier 1 - Preferred Generic			
H0523	022	0	1	01	01	H0523_022_0	7	2	Tier 2 - Non-Preferred Generic			
H0523	022	0	1	01	01	H0523_022_0	7	3	Tier 3 - Preferred Brand			
H0523	031	0	1	01	01	H0523_031_0	5	5	Tier 5 - Specialty			
H0523	031	0	1	01	01	H0523_031_0	5	4	Tier 4 - Non-Preferred Brand			
H0523	031	0	1	01	01	H0523_031_0	5	3	Tier 3 - Preferred Brand			
H0523	031	0	1	01	01	H0523_031_0	5	2	Tier 2 - Non-Preferred Generic			
H0523	031	0	1	01	01	H0523_031_0	5	1	Tier 1 - Preferred Generic			
H0523	032	0	1	01	01	H0523_032_0	5	5	Tier 5 - Specialty			
H0523	032	0	1	01	01	H0523_032_0	5	4	Tier 4 - Non-Preferred Brand			
H0523	032	0	1	01	01	H0523_032_0	5	1	Tier 1 - Preferred Generic			
H0523	032	0	1	01	01	H0523_032_0	5	2	Tier 2 - Non-Preferred Generic			
H0523	032	0	1	01	01	H0523_032_0	5	3	Tier 3 - Preferred Brand			
H0523	034	0	1	01	01	H0523_034_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H0523	034	0	1	01	01	H0523_034_0	4	1	Tier 1 - Preferred Generic	1		1
H0523	034	0	1	01	01	H0523_034_0	4	4	Tier 4 - Non-Preferred Brand	2		
H0523	034	0	1	01	01	H0523_034_0	4	5	Tier 5 - Specialty	2		
H0523	034	0	1	01	01	H0523_034_0	4	3	Tier 3 - Preferred Brand	2		
H0523	034	0	1	01	01	H0523_034_0	4	1	Tier 1 - Preferred Generic			
H0523	034	0	1	01	01	H0523_034_0	4	2	Tier 2 - Non-Preferred Generic			
H0523	034	0	1	01	01	H0523_034_0	4	3	Tier 3 - Preferred Brand			
H0523	034	0	1	01	01	H0523_034_0	4	4	Tier 4 - Non-Preferred Brand			
H0523	034	0	1	01	01	H0523_034_0	4	5	Tier 5 - Specialty			
H0523	047	0	1	01	01	H0523_047_0	7	2	Tier 2 - Non-Preferred Generic	1		1
H0523	047	0	1	01	01	H0523_047_0	7	1	Tier 1 - Preferred Generic			
H0523	047	0	1	01	01	H0523_047_0	7	4	Tier 4 - Non-Preferred Brand	2		
H0523	047	0	1	01	01	H0523_047_0	7	5	Tier 5 - Specialty	2		
H0523	047	0	1	01	01	H0523_047_0	7	3	Tier 3 - Preferred Brand	2		
H0523	047	0	1	01	01	H0523_047_0	7	2	Tier 2 - Non-Preferred Generic			
H0523	047	0	1	01	01	H0523_047_0	7	3	Tier 3 - Preferred Brand			
H0523	047	0	1	01	01	H0523_047_0	7	4	Tier 4 - Non-Preferred Brand			
H0523	047	0	1	01	01	H0523_047_0	7	5	Tier 5 - Specialty			
H0523	047	0	1	01	01	H0523_047_0	7	1	Tier 1 - Preferred Generic	1		1
H0523	048	0	1	01	01	H0523_048_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H0523	048	0	1	01	01	H0523_048_0	6	1	Tier 1 - Preferred Generic			
H0523	048	0	1	01	01	H0523_048_0	6	4	Tier 4 - Non-Preferred Brand	2		
H0523	048	0	1	01	01	H0523_048_0	6	5	Tier 5 - Specialty	2		
H0523	048	0	1	01	01	H0523_048_0	6	3	Tier 3 - Preferred Brand	2		
H0523	048	0	1	01	01	H0523_048_0	6	2	Tier 2 - Non-Preferred Generic			
H0523	048	0	1	01	01	H0523_048_0	6	3	Tier 3 - Preferred Brand			
H0523	048	0	1	01	01	H0523_048_0	6	4	Tier 4 - Non-Preferred Brand			
H0523	048	0	1	01	01	H0523_048_0	6	5	Tier 5 - Specialty			
H0523	048	0	1	01	01	H0523_048_0	6	1	Tier 1 - Preferred Generic	1		1
H0523	051	0	1	01	01	H0523_051_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H0523	051	0	1	01	01	H0523_051_0	5	3	Tier 3 - Preferred Brand	2		
H0523	051	0	1	01	01	H0523_051_0	5	4	Tier 4 - Non-Preferred Brand	2		
H0523	051	0	1	01	01	H0523_051_0	5	5	Tier 5 - Specialty	2		
H0523	051	0	1	01	01	H0523_051_0	5	1	Tier 1 - Preferred Generic			
H0523	051	0	1	01	01	H0523_051_0	5	5	Tier 5 - Specialty			
H0523	051	0	1	01	01	H0523_051_0	5	4	Tier 4 - Non-Preferred Brand			
H0523	051	0	1	01	01	H0523_051_0	5	3	Tier 3 - Preferred Brand			
H0523	051	0	1	01	01	H0523_051_0	5	2	Tier 2 - Non-Preferred Generic			
H0523	051	0	1	01	01	H0523_051_0	5	1	Tier 1 - Preferred Generic	1		1
H0524	002	0	2	01	01	H0524_002_0	6	2	Brand	2		
H0524	002	0	2	01	01	H0524_002_0	6	3	Specialty	2		
H0524	002	0	2	01	01	H0524_002_0	6	1	Generic			
H0524	002	0	2	01	01	H0524_002_0	6	2	Brand			
H0524	002	0	2	01	01	H0524_002_0	6	3	Specialty			
H0524	002	0	2	01	01	H0524_002_0	6	1	Generic	1		1
H0524	003	0	1	01	01	H0524_003_0	7	2	Brand			
H0524	003	0	1	01	01	H0524_003_0	7	1	Generic			
H0524	003	0	1	01	01	H0524_003_0	7	3	Specialty			
H0524	003	0	1	01	01	H0524_003_0	7	1	Generic	1		1
H0524	003	0	1	01	01	H0524_003_0	7	2	Brand	2		
H0524	003	0	1	01	01	H0524_003_0	7	3	Specialty	2		
H0524	008	0	1	01	01	H0524_008_0	9	1	Generic			
H0524	008	0	1	01	01	H0524_008_0	9	2	Brand			
H0524	008	0	1	01	01	H0524_008_0	9	3	Specialty			
H0524	008	0	1	01	01	H0524_008_0	9	1	Generic	1		1
H0524	008	0	1	01	01	H0524_008_0	9	2	Brand	2		
H0524	008	0	1	01	01	H0524_008_0	9	3	Specialty	2		
H0524	010	0	2	01	01	H0524_010_0	5	2	Brand			
H0524	010	0	2	01	01	H0524_010_0	5	1	Generic			
H0524	010	0	2	01	01	H0524_010_0	5	3	Specialty			
H0524	010	0	2	01	01	H0524_010_0	5	3	Specialty	2		
H0524	010	0	2	01	01	H0524_010_0	5	2	Brand	2		
H0524	010	0	2	01	01	H0524_010_0	5	1	Generic	1		1
H0524	013	0	1	01	01	H0524_013_0	5	1	Generic			
H0524	013	0	1	01	01	H0524_013_0	5	2	Brand			
H0524	013	0	1	01	01	H0524_013_0	5	3	Specialty			
H0524	013	0	1	01	01	H0524_013_0	5	1	Generic	1		1
H0524	013	0	1	01	01	H0524_013_0	5	2	Brand	2		
H0524	013	0	1	01	01	H0524_013_0	5	3	Specialty	2		
H0524	015	0	1	01	01	H0524_015_0	5	1	Generic			
H0524	015	0	1	01	01	H0524_015_0	5	2	Brand			
H0524	015	0	1	01	01	H0524_015_0	5	2	Brand	2		
H0524	015	0	1	01	01	H0524_015_0	5	1	Generic	1		1
H0524	015	0	1	01	01	H0524_015_0	5	3	Specialty			
H0524	015	0	1	01	01	H0524_015_0	5	3	Specialty	2		
H0524	029	0	1	01	01	H0524_029_0	5	1	Generic			
H0524	029	0	1	01	01	H0524_029_0	5	2	Brand			
H0524	029	0	1	01	01	H0524_029_0	5	3	Specialty			
H0524	030	0	1	01	01	H0524_030_0	5	1	Generic			
H0524	030	0	1	01	01	H0524_030_0	5	3	Specialty			
H0524	030	0	1	01	01	H0524_030_0	5	2	Brand			
H0524	031	0	1	01	01	H0524_031_0	5	1	Generic	1		1
H0524	031	0	1	01	01	H0524_031_0	5	3	Specialty			
H0524	031	0	1	01	01	H0524_031_0	5	2	Brand			
H0524	031	0	1	01	01	H0524_031_0	5	1	Generic			
H0524	031	0	1	01	01	H0524_031_0	5	2	Brand	2		
H0524	031	0	1	01	01	H0524_031_0	5	3	Specialty	2		
H0524	032	0	1	01	01	H0524_032_0	5	1	Generic			
H0524	032	0	1	01	01	H0524_032_0	5	2	Brand			
H0524	032	0	1	01	01	H0524_032_0	5	3	Specialty			
H0524	032	0	1	01	01	H0524_032_0	5	1	Generic	1		1
H0524	032	0	1	01	01	H0524_032_0	5	2	Brand	2		
H0524	032	0	1	01	01	H0524_032_0	5	3	Specialty	2		
H0524	033	0	1	01	01	H0524_033_0	5	1	Generic			
H0524	033	0	1	01	01	H0524_033_0	5	2	Brand			
H0524	033	0	1	01	01	H0524_033_0	5	3	Specialty	2		
H0524	033	0	1	01	01	H0524_033_0	5	2	Brand	2		
H0524	033	0	1	01	01	H0524_033_0	5	1	Generic	1		1
H0524	033	0	1	01	01	H0524_033_0	5	3	Specialty			
H0524	034	0	1	01	01	H0524_034_0	6	1	Generic			
H0524	034	0	1	01	01	H0524_034_0	6	2	Brand			
H0524	034	0	1	01	01	H0524_034_0	6	3	Specialty			
H0524	034	0	1	01	01	H0524_034_0	6	1	Generic	1		1
H0524	034	0	1	01	01	H0524_034_0	6	2	Brand	2		
H0524	034	0	1	01	01	H0524_034_0	6	3	Specialty	2		
H0524	035	0	1	01	01	H0524_035_0	5	1	Generic			
H0524	035	0	1	01	01	H0524_035_0	5	2	Brand	2		
H0524	035	0	1	01	01	H0524_035_0	5	1	Generic	1		1
H0524	035	0	1	01	01	H0524_035_0	5	3	Specialty			
H0524	035	0	1	01	01	H0524_035_0	5	2	Brand			
H0524	035	0	1	01	01	H0524_035_0	5	3	Specialty	2		
H0532	001	0	1	01	01	H0532_001_0	8	3	Tier 3 Non-Preferred Brand Drugs	2		
H0532	001	0	1	01	01	H0532_001_0	8	4	Tier 4 Specialty Drugs	2		
H0532	001	0	1	01	01	H0532_001_0	8	1	Tier 1 Generic Drugs			
H0532	001	0	1	01	01	H0532_001_0	8	2	Tier 2 Preferred Brand Drugs	2		
H0532	001	0	1	01	01	H0532_001_0	8	3	Tier 3 Non-Preferred Brand Drugs			
H0532	001	0	1	01	01	H0532_001_0	8	4	Tier 4 Specialty Drugs			
H0532	001	0	1	01	01	H0532_001_0	8	1	Tier 1 Generic Drugs	1		1
H0532	001	0	1	01	01	H0532_001_0	8	2	Tier 2 Preferred Brand Drugs			
H0540	020	0	1	09	04	H0540_020_0	7	1	Tier 1 Preferred Generic			
H0540	020	0	1	09	04	H0540_020_0	7	2	Tier 2 Preferred Brand			
H0540	020	0	1	09	04	H0540_020_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H0540	020	0	1	09	04	H0540_020_0	7	4	Tier 4 Non-Specialty Injectable			
H0540	020	0	1	09	04	H0540_020_0	7	2	Tier 2 Preferred Brand	2		
H0540	020	0	1	09	04	H0540_020_0	7	1	Tier 1 Preferred Generic	1		1
H0540	020	0	1	09	04	H0540_020_0	7	5	Tier 5 Specialty	2		
H0540	020	0	1	09	04	H0540_020_0	7	4	Tier 4 Non-Specialty Injectable	2		
H0540	020	0	1	09	04	H0540_020_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H0540	020	0	1	09	04	H0540_020_0	7	5	Tier 5 Specialty			
H0540	089	0	1	09	04	H0540_089_0	9	5	Tier 5 Specialty	2		
H0540	089	0	1	09	04	H0540_089_0	9	4	Tier 4 Non-Specialty Injectable	2		
H0540	089	0	1	09	04	H0540_089_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H0540	089	0	1	09	04	H0540_089_0	9	2	Tier 2 Preferred Brand	2		
H0540	089	0	1	09	04	H0540_089_0	9	4	Tier 4 Non-Specialty Injectable			
H0540	089	0	1	09	04	H0540_089_0	9	5	Tier 5 Specialty			
H0540	089	0	1	09	04	H0540_089_0	9	1	Tier 1 Preferred Generic	1		1
H0540	089	0	1	09	04	H0540_089_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H0540	089	0	1	09	04	H0540_089_0	9	2	Tier 2 Preferred Brand			
H0540	089	0	1	09	04	H0540_089_0	9	1	Tier 1 Preferred Generic			
H0540	091	0	1	09	04	H0540_091_0	7	1	Tier 1 Preferred Generic	1		1
H0540	091	0	1	09	04	H0540_091_0	7	5	Tier 5 Specialty			
H0540	091	0	1	09	04	H0540_091_0	7	4	Tier 4 Non-Specialty Injectable			
H0540	091	0	1	09	04	H0540_091_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H0540	091	0	1	09	04	H0540_091_0	7	5	Tier 5 Specialty	2		
H0540	091	0	1	09	04	H0540_091_0	7	1	Tier 1 Preferred Generic			
H0540	091	0	1	09	04	H0540_091_0	7	2	Tier 2 Preferred Brand	2		
H0540	091	0	1	09	04	H0540_091_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H0540	091	0	1	09	04	H0540_091_0	7	4	Tier 4 Non-Specialty Injectable	2		
H0540	091	0	1	09	04	H0540_091_0	7	2	Tier 2 Preferred Brand			
H0543	001	0	1	01	01	H0543_001_0	8	1	Preferred Generic			
H0543	001	0	1	01	01	H0543_001_0	8	4	Specialty			
H0543	001	0	1	01	01	H0543_001_0	8	3	Non-Preferred			
H0543	001	0	1	01	01	H0543_001_0	8	2	Preferred Brand			
H0543	004	0	1	01	01	H0543_004_0	7	4	Specialty			
H0543	004	0	1	01	01	H0543_004_0	7	3	Non-Preferred			
H0543	004	0	1	01	01	H0543_004_0	7	2	Preferred Brand			
H0543	004	0	1	01	01	H0543_004_0	7	1	Preferred Generic			
H0543	007	0	1	01	01	H0543_007_0	4	1	Preferred Generic			
H0543	007	0	1	01	01	H0543_007_0	4	2	Preferred Brand			
H0543	007	0	1	01	01	H0543_007_0	4	3	Non-Preferred			
H0543	007	0	1	01	01	H0543_007_0	4	4	Specialty			
H0543	013	0	1	01	01	H0543_013_0	5	1	Preferred Generic	1		1
H0543	013	0	1	01	01	H0543_013_0	5	4	Specialty			
H0543	013	0	1	01	01	H0543_013_0	5	3	Non Preferred			
H0543	013	0	1	01	01	H0543_013_0	5	2	Preferred Brand			
H0543	013	0	1	01	01	H0543_013_0	5	1	Preferred Generic			
H0543	013	0	1	01	01	H0543_013_0	5	2	Preferred Brand	2		
H0543	013	0	1	01	01	H0543_013_0	5	4	Specialty	2		
H0543	013	0	1	01	01	H0543_013_0	5	3	Non Preferred	2		
H0543	019	0	1	01	01	H0543_019_0	5	1	Preferred Generic			
H0543	019	0	1	01	01	H0543_019_0	5	2	Preferred Brand			
H0543	019	0	1	01	01	H0543_019_0	5	3	Non-Preferred			
H0543	019	0	1	01	01	H0543_019_0	5	4	Specialty			
H0543	022	0	1	01	01	H0543_022_0	4	1	Preferred Generic			
H0543	022	0	1	01	01	H0543_022_0	4	2	Preferred Brand			
H0543	022	0	1	01	01	H0543_022_0	4	4	Specialty			
H0543	022	0	1	01	01	H0543_022_0	4	3	Non-Preferred			
H0543	028	0	1	01	01	H0543_028_0	5	3	Non-Preferred			
H0543	028	0	1	01	01	H0543_028_0	5	2	Preferred Brand			
H0543	028	0	1	01	01	H0543_028_0	5	1	Preferred Generic			
H0543	028	0	1	01	01	H0543_028_0	5	4	Specialty			
H0543	029	0	1	01	01	H0543_029_0	3	3	Non-Preferred			
H0543	029	0	1	01	01	H0543_029_0	3	4	Specialty			
H0543	029	0	1	01	01	H0543_029_0	3	1	Preferred Generic			
H0543	029	0	1	01	01	H0543_029_0	3	2	Preferred Brand			
H0543	032	0	1	01	01	H0543_032_0	5	1	Preferred Generic			
H0543	032	0	1	01	01	H0543_032_0	5	4	Specialty			
H0543	032	0	1	01	01	H0543_032_0	5	3	Non-Preferred			
H0543	032	0	1	01	01	H0543_032_0	5	2	Preferred Brand			
H0543	035	0	1	01	01	H0543_035_0	4	1	Preferred Generic	1		1
H0543	035	0	1	01	01	H0543_035_0	4	4	Specialty			
H0543	035	0	1	01	01	H0543_035_0	4	3	Non Preferred			
H0543	035	0	1	01	01	H0543_035_0	4	2	Preferred Brand			
H0543	035	0	1	01	01	H0543_035_0	4	1	Preferred Generic			
H0543	035	0	1	01	01	H0543_035_0	4	2	Preferred Brand	2		
H0543	035	0	1	01	01	H0543_035_0	4	4	Specialty	2		
H0543	035	0	1	01	01	H0543_035_0	4	3	Non Preferred	2		
H0543	036	0	1	01	01	H0543_036_0	5	1	Preferred Generic			
H0543	036	0	1	01	01	H0543_036_0	5	2	Preferred Brand			
H0543	036	0	1	01	01	H0543_036_0	5	3	Non-Preferred			
H0543	036	0	1	01	01	H0543_036_0	5	4	Specialty			
H0543	046	0	1	01	01	H0543_046_0	4	1	Preferred Generic			
H0543	046	0	1	01	01	H0543_046_0	4	3	Non-Preferred			
H0543	046	0	1	01	01	H0543_046_0	4	2	Preferred Brand			
H0543	046	0	1	01	01	H0543_046_0	4	4	Specialty			
H0543	049	0	1	01	01	H0543_049_0	4	1	Preferred Generic			
H0543	049	0	1	01	01	H0543_049_0	4	2	Preferred Brand			
H0543	049	0	1	01	01	H0543_049_0	4	3	Non-Preferred			
H0543	049	0	1	01	01	H0543_049_0	4	4	Specialty			
H0543	060	0	1	01	01	H0543_060_0	3	1	Preferred Generic			
H0543	060	0	1	01	01	H0543_060_0	3	2	Preferred Brand			
H0543	060	0	1	01	01	H0543_060_0	3	3	Non-Preferred			
H0543	060	0	1	01	01	H0543_060_0	3	4	Specialty			
H0543	065	0	1	01	01	H0543_065_0	4	1	Preferred Generic			
H0543	065	0	1	01	01	H0543_065_0	4	2	Preferred Brand			
H0543	065	0	1	01	01	H0543_065_0	4	4	Specialty			
H0543	065	0	1	01	01	H0543_065_0	4	3	Non-Preferred			
H0543	070	0	1	01	01	H0543_070_0	3	1	Preferred Generic			
H0543	070	0	1	01	01	H0543_070_0	3	3	Non-Preferred			
H0543	070	0	1	01	01	H0543_070_0	3	2	Preferred Brand			
H0543	070	0	1	01	01	H0543_070_0	3	4	Specialty			
H0543	072	0	1	01	01	H0543_072_0	3	1	Preferred Generic			
H0543	072	0	1	01	01	H0543_072_0	3	2	Preferred Brand			
H0543	072	0	1	01	01	H0543_072_0	3	4	Specialty			
H0543	072	0	1	01	01	H0543_072_0	3	3	Non-Preferred			
H0543	077	0	1	01	01	H0543_077_0	6	1	Preferred Generic			
H0543	077	0	1	01	01	H0543_077_0	6	2	Preferred Brand			
H0543	077	0	1	01	01	H0543_077_0	6	3	Non-Preferred			
H0543	077	0	1	01	01	H0543_077_0	6	4	Specialty			
H0543	077	0	1	01	01	H0543_077_0	6	1	Preferred Generic	1		1
H0543	077	0	1	01	01	H0543_077_0	6	2	Preferred Brand	1		1
H0543	077	0	1	01	01	H0543_077_0	6	4	Specialty	2		
H0543	077	0	1	01	01	H0543_077_0	6	3	Non-Preferred	2		
H0543	082	0	1	01	01	H0543_082_0	6	1	Preferred Generic			
H0543	082	0	1	01	01	H0543_082_0	6	2	Preferred Brand			
H0543	082	0	1	01	01	H0543_082_0	6	3	Non-Preferred			
H0543	082	0	1	01	01	H0543_082_0	6	4	Specialty			
H0543	083	0	1	01	01	H0543_083_0	5	1	Preferred Generic	1		1
H0543	083	0	1	01	01	H0543_083_0	5	2	Preferred Brand	2		
H0543	083	0	1	01	01	H0543_083_0	5	3	Non Preferred	2		
H0543	083	0	1	01	01	H0543_083_0	5	4	Specialty	2		
H0543	083	0	1	01	01	H0543_083_0	5	1	Preferred Generic			
H0543	083	0	1	01	01	H0543_083_0	5	2	Preferred Brand			
H0543	083	0	1	01	01	H0543_083_0	5	3	Non Preferred			
H0543	083	0	1	01	01	H0543_083_0	5	4	Specialty			
H0543	084	0	1	01	01	H0543_084_0	5	3	Non-Preferred			
H0543	084	0	1	01	01	H0543_084_0	5	2	Preferred Brand			
H0543	084	0	1	01	01	H0543_084_0	5	1	Preferred Generic			
H0543	084	0	1	01	01	H0543_084_0	5	4	Specialty			
H0543	085	0	1	01	01	H0543_085_0	5	1	Preferred Generic			
H0543	085	0	1	01	01	H0543_085_0	5	2	Preferred Brand			
H0543	085	0	1	01	01	H0543_085_0	5	4	Specialty			
H0543	085	0	1	01	01	H0543_085_0	5	3	Non-Preferred			
H0543	086	0	1	01	01	H0543_086_0	4	1	Preferred Generic			
H0543	086	0	1	01	01	H0543_086_0	4	3	Non-Preferred			
H0543	086	0	1	01	01	H0543_086_0	4	2	Preferred Brand			
H0543	086	0	1	01	01	H0543_086_0	4	4	Specialty			
H0543	089	0	1	01	01	H0543_089_0	3	3	Non-Preferred			
H0543	089	0	1	01	01	H0543_089_0	3	2	Preferred Brand			
H0543	089	0	1	01	01	H0543_089_0	3	1	Preferred Generic			
H0543	089	0	1	01	01	H0543_089_0	3	4	Specialty			
H0543	091	0	1	01	01	H0543_091_0	5	3	Non-Preferred			
H0543	091	0	1	01	01	H0543_091_0	5	2	Preferred Brand			
H0543	091	0	1	01	01	H0543_091_0	5	1	Preferred Generic			
H0543	091	0	1	01	01	H0543_091_0	5	4	Specialty			
H0543	093	0	1	01	01	H0543_093_0	4	3	Non-Preferred			
H0543	093	0	1	01	01	H0543_093_0	4	2	Preferred Brand			
H0543	093	0	1	01	01	H0543_093_0	4	1	Preferred Generic			
H0543	093	0	1	01	01	H0543_093_0	4	4	Specialty			
H0543	095	0	1	01	01	H0543_095_0	5	1	Preferred Generic			
H0543	095	0	1	01	01	H0543_095_0	5	2	Preferred Brand			
H0543	095	0	1	01	01	H0543_095_0	5	3	Non Preferred			
H0543	095	0	1	01	01	H0543_095_0	5	4	Specialty			
H0543	095	0	1	01	01	H0543_095_0	5	1	Preferred Generic	1		1
H0543	095	0	1	01	01	H0543_095_0	5	2	Preferred Brand	2		
H0543	095	0	1	01	01	H0543_095_0	5	3	Non Preferred	2		
H0543	095	0	1	01	01	H0543_095_0	5	4	Specialty	2		
H0543	122	0	1	01	01	H0543_122_0	5	3	Non Preferred	2		
H0543	122	0	1	01	01	H0543_122_0	5	4	Specialty			
H0543	122	0	1	01	01	H0543_122_0	5	3	Non Preferred			
H0543	122	0	1	01	01	H0543_122_0	5	2	Preferred Brand			
H0543	122	0	1	01	01	H0543_122_0	5	1	Preferred Generic	1		1
H0543	122	0	1	01	01	H0543_122_0	5	2	Preferred Brand	2		
H0543	122	0	1	01	01	H0543_122_0	5	1	Preferred Generic			
H0543	122	0	1	01	01	H0543_122_0	5	4	Specialty	2		
H0543	125	0	1	01	01	H0543_125_0	7	1	Preferred Generic			
H0543	125	0	1	01	01	H0543_125_0	7	4	Specialty			
H0543	125	0	1	01	01	H0543_125_0	7	3	Non-Preferred			
H0543	125	0	1	01	01	H0543_125_0	7	2	Preferred Brand			
H0543	126	0	1	01	01	H0543_126_0	6	2	Preferred Brand			
H0543	126	0	1	01	01	H0543_126_0	6	3	Non-Preferred			
H0543	126	0	1	01	01	H0543_126_0	6	4	Specialty			
H0543	126	0	1	01	01	H0543_126_0	6	1	Preferred Generic			
H0543	127	0	1	01	01	H0543_127_0	4	2	Preferred Brand			
H0543	127	0	1	01	01	H0543_127_0	4	3	Non Preferred			
H0543	127	0	1	01	01	H0543_127_0	4	4	Specialty			
H0543	127	0	1	01	01	H0543_127_0	4	1	Preferred Generic	1		1
H0543	127	0	1	01	01	H0543_127_0	4	2	Preferred Brand	2		
H0543	127	0	1	01	01	H0543_127_0	4	3	Non Preferred	2		
H0543	127	0	1	01	01	H0543_127_0	4	4	Specialty	2		
H0543	127	0	1	01	01	H0543_127_0	4	1	Preferred Generic			
H0543	128	0	1	01	01	H0543_128_0	6	3	Non Preferred	2		
H0543	128	0	1	01	01	H0543_128_0	6	4	Specialty	2		
H0543	128	0	1	01	01	H0543_128_0	6	2	Preferred Brand	2		
H0543	128	0	1	01	01	H0543_128_0	6	1	Preferred Generic	1		1
H0543	128	0	1	01	01	H0543_128_0	6	4	Specialty			
H0543	128	0	1	01	01	H0543_128_0	6	3	Non Preferred			
H0543	128	0	1	01	01	H0543_128_0	6	2	Preferred Brand			
H0543	128	0	1	01	01	H0543_128_0	6	1	Preferred Generic			
H0543	129	0	1	01	01	H0543_129_0	5	2	Preferred Brand			
H0543	129	0	1	01	01	H0543_129_0	5	3	Non-Preferred			
H0543	129	0	1	01	01	H0543_129_0	5	4	Specialty			
H0543	129	0	1	01	01	H0543_129_0	5	1	Preferred Generic	1		1
H0543	129	0	1	01	01	H0543_129_0	5	2	Preferred Brand	1		1
H0543	129	0	1	01	01	H0543_129_0	5	3	Non-Preferred	2		
H0543	129	0	1	01	01	H0543_129_0	5	1	Preferred Generic			
H0543	129	0	1	01	01	H0543_129_0	5	4	Specialty	2		
H0543	131	0	1	01	01	H0543_131_0	6	4	Specialty			
H0543	131	0	1	01	01	H0543_131_0	6	2	Preferred Brand			
H0543	131	0	1	01	01	H0543_131_0	6	3	Non Preferred			
H0543	131	0	1	01	01	H0543_131_0	6	1	Preferred Generic			
H0543	133	0	1	01	01	H0543_133_0	7	1	Preferred Generic			
H0543	133	0	1	01	01	H0543_133_0	7	2	Preferred Brand			
H0543	133	0	1	01	01	H0543_133_0	7	3	Non Preferred			
H0543	133	0	1	01	01	H0543_133_0	7	4	Specialty			
H0543	133	0	1	01	01	H0543_133_0	7	1	Preferred Generic	1		1
H0543	133	0	1	01	01	H0543_133_0	7	2	Preferred Brand	2		
H0543	133	0	1	01	01	H0543_133_0	7	4	Specialty	2		
H0543	133	0	1	01	01	H0543_133_0	7	3	Non Preferred	2		
H0543	134	0	1	01	01	H0543_134_0	6	1	Preferred Generic			
H0543	134	0	1	01	01	H0543_134_0	6	2	Preferred Brand			
H0543	134	0	1	01	01	H0543_134_0	6	3	Non Preferred			
H0543	134	0	1	01	01	H0543_134_0	6	4	Specialty			
H0543	134	0	1	01	01	H0543_134_0	6	4	Specialty	2		
H0543	134	0	1	01	01	H0543_134_0	6	3	Non Preferred	2		
H0543	134	0	1	01	01	H0543_134_0	6	2	Preferred Brand	2		
H0543	134	0	1	01	01	H0543_134_0	6	1	Preferred Generic	1		1
H0543	135	0	1	01	01	H0543_135_0	6	1	Preferred Generic	1		1
H0543	135	0	1	01	01	H0543_135_0	6	2	Preferred Brand	2		
H0543	135	0	1	01	01	H0543_135_0	6	3	Non Preferred	2		
H0543	135	0	1	01	01	H0543_135_0	6	4	Specialty	2		
H0543	135	0	1	01	01	H0543_135_0	6	1	Preferred Generic			
H0543	135	0	1	01	01	H0543_135_0	6	2	Preferred Brand			
H0543	135	0	1	01	01	H0543_135_0	6	3	Non Preferred			
H0543	135	0	1	01	01	H0543_135_0	6	4	Specialty			
H0543	136	0	1	01	01	H0543_136_0	6	1	Preferred Generic			
H0543	136	0	1	01	01	H0543_136_0	6	2	Preferred Brand			
H0543	136	0	1	01	01	H0543_136_0	6	3	Non Preferred			
H0543	136	0	1	01	01	H0543_136_0	6	4	Specialty			
H0543	137	0	1	01	01	H0543_137_0	7	2	Preferred Brand			
H0543	137	0	1	01	01	H0543_137_0	7	1	Preferred Generic			
H0543	137	0	1	01	01	H0543_137_0	7	4	Specialty	2		
H0543	137	0	1	01	01	H0543_137_0	7	3	Non Preferred	2		
H0543	137	0	1	01	01	H0543_137_0	7	2	Preferred Brand	2		
H0543	137	0	1	01	01	H0543_137_0	7	1	Preferred Generic	1		1
H0543	137	0	1	01	01	H0543_137_0	7	4	Specialty			
H0543	137	0	1	01	01	H0543_137_0	7	3	Non Preferred			
H0543	138	0	1	01	01	H0543_138_0	6	2	Preferred Brand			
H0543	138	0	1	01	01	H0543_138_0	6	1	Preferred Generic			
H0543	138	0	1	01	01	H0543_138_0	6	1	Preferred Generic	1		1
H0543	138	0	1	01	01	H0543_138_0	6	2	Preferred Brand	1		1
H0543	138	0	1	01	01	H0543_138_0	6	3	Non-Preferred	2		
H0543	138	0	1	01	01	H0543_138_0	6	3	Non-Preferred			
H0543	138	0	1	01	01	H0543_138_0	6	4	Specialty			
H0543	138	0	1	01	01	H0543_138_0	6	4	Specialty	2		
H0543	139	0	1	01	01	H0543_139_0	7	4	Specialty	2		
H0543	139	0	1	01	01	H0543_139_0	7	2	Preferred Brand	2		
H0543	139	0	1	01	01	H0543_139_0	7	3	Non Preferred	2		
H0543	139	0	1	01	01	H0543_139_0	7	1	Preferred Generic	1		1
H0543	139	0	1	01	01	H0543_139_0	7	4	Specialty			
H0543	139	0	1	01	01	H0543_139_0	7	1	Preferred Generic			
H0543	139	0	1	01	01	H0543_139_0	7	2	Preferred Brand			
H0543	139	0	1	01	01	H0543_139_0	7	3	Non Preferred			
H0543	140	0	1	01	01	H0543_140_0	6	1	Preferred Generic			
H0543	140	0	1	01	01	H0543_140_0	6	2	Preferred Brand			
H0543	140	0	1	01	01	H0543_140_0	6	3	Non-Preferred			
H0543	140	0	1	01	01	H0543_140_0	6	4	Specialty			
H0544	002	0	1	01	01	H0544_002_0	9	1	Preferred Generic Drugs			
H0544	002	0	1	01	01	H0544_002_0	9	2	Generic Drugs			
H0544	002	0	1	01	01	H0544_002_0	9	7	Specialty Drugs			
H0544	002	0	1	01	01	H0544_002_0	9	6	Injectable Drugs			
H0544	002	0	1	01	01	H0544_002_0	9	5	Brand Drugs			
H0544	002	0	1	01	01	H0544_002_0	9	4	Preferred Brand Drugs			
H0544	002	0	1	01	01	H0544_002_0	9	3	Enhanced Care Brand Drugs			
H0544	003	0	1	01	01	H0544_003_0	8	5	Brand Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	8	6	Injectable Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	8	7	Specialty Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	8	4	Preferred Brand Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	8	3	Enhanced Care Brand Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	8	2	Generic Drugs	1		1
H0544	003	0	1	01	01	H0544_003_0	8	1	Preferred Generic Drugs	1		1
H0544	003	0	1	01	01	H0544_003_0	8	7	Specialty Drugs			
H0544	003	0	1	01	01	H0544_003_0	8	6	Injectable Drugs			
H0544	003	0	1	01	01	H0544_003_0	8	5	Brand Drugs			
H0544	003	0	1	01	01	H0544_003_0	8	4	Preferred Brand Drugs			
H0544	003	0	1	01	01	H0544_003_0	8	3	Enhanced Care Brand Drugs			
H0544	003	0	1	01	01	H0544_003_0	8	2	Generic Drugs			
H0544	003	0	1	01	01	H0544_003_0	8	1	Preferred Generic Drugs			
H0544	004	0	1	01	01	H0544_004_0	9	6	Injectable Drugs			
H0544	004	0	1	01	01	H0544_004_0	9	5	Brand Drugs			
H0544	004	0	1	01	01	H0544_004_0	9	1	Preferred Generic Drugs			
H0544	004	0	1	01	01	H0544_004_0	9	7	Specialty Drugs			
H0544	004	0	1	01	01	H0544_004_0	9	2	Generic Drugs			
H0544	004	0	1	01	01	H0544_004_0	9	3	Enhanced Care Brand Drugs			
H0544	004	0	1	01	01	H0544_004_0	9	4	Preferred Brand Drugs			
H0544	005	0	1	01	01	H0544_005_0	9	4	Preferred Brand Drugs			
H0544	005	0	1	01	01	H0544_005_0	9	3	Enhanced Care Brand Drugs			
H0544	005	0	1	01	01	H0544_005_0	9	2	Generic Drugs			
H0544	005	0	1	01	01	H0544_005_0	9	6	Injectable Drugs			
H0544	005	0	1	01	01	H0544_005_0	9	5	Brand Drugs			
H0544	005	0	1	01	01	H0544_005_0	9	7	Specialty Drugs			
H0544	005	0	1	01	01	H0544_005_0	9	1	Preferred Generic Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	3	Enhanced Care Brand Drugs	1		1
H0544	007	0	1	01	01	H0544_007_0	8	2	Generic Drugs	1		1
H0544	007	0	1	01	01	H0544_007_0	8	7	Specialty Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	6	Injectable Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	5	Brand Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	4	Preferred Brand Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	3	Enhanced Care Brand Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	2	Generic Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	1	Preferred Generic Drugs			
H0544	007	0	1	01	01	H0544_007_0	8	1	Preferred Generic Drugs	1		1
H0544	007	0	1	01	01	H0544_007_0	8	4	Preferred Brand Drugs	2		
H0544	007	0	1	01	01	H0544_007_0	8	5	Brand Drugs	2		
H0544	007	0	1	01	01	H0544_007_0	8	6	Injectable Drugs	2		
H0544	007	0	1	01	01	H0544_007_0	8	7	Specialty Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	6	2	Generic Drugs	1		1
H0544	008	0	1	01	01	H0544_008_0	6	1	Preferred Generic Drugs	1		1
H0544	008	0	1	01	01	H0544_008_0	6	4	Preferred Brand Drugs			
H0544	008	0	1	01	01	H0544_008_0	6	3	Enhanced Care Brand Drugs			
H0544	008	0	1	01	01	H0544_008_0	6	2	Generic Drugs			
H0544	008	0	1	01	01	H0544_008_0	6	1	Preferred Generic Drugs			
H0544	008	0	1	01	01	H0544_008_0	6	7	Specialty Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	6	7	Specialty Drugs			
H0544	008	0	1	01	01	H0544_008_0	6	6	Injectable Drugs			
H0544	008	0	1	01	01	H0544_008_0	6	3	Enhanced Care Brand Drugs	1		1
H0544	008	0	1	01	01	H0544_008_0	6	4	Preferred Brand Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	6	5	Brand Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	6	6	Injectable Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	6	5	Brand Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	1	Preferred Generic Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	2	Generic Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	3	Enhanced Care Brand Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	4	Preferred Brand Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	5	Brand Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	6	Injectable Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	7	Specialty Drugs			
H0544	009	0	1	01	01	H0544_009_0	7	1	Preferred Generic Drugs	1		1
H0544	009	0	1	01	01	H0544_009_0	7	2	Generic Drugs	1		1
H0544	009	0	1	01	01	H0544_009_0	7	3	Enhanced Care Brand Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	7	4	Preferred Brand Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	7	5	Brand Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	7	6	Injectable Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	7	7	Specialty Drugs	2		
H0544	010	0	1	01	01	H0544_010_0	8	1	Preferred Generic Drugs			
H0544	010	0	1	01	01	H0544_010_0	8	2	Generic Drugs			
H0544	010	0	1	01	01	H0544_010_0	8	7	Specialty Drugs	2		
H0544	010	0	1	01	01	H0544_010_0	8	6	Injectable Drugs	2		
H0544	010	0	1	01	01	H0544_010_0	8	5	Brand Drugs	2		
H0544	010	0	1	01	01	H0544_010_0	8	4	Preferred Brand Drugs	2		
H0544	010	0	1	01	01	H0544_010_0	8	3	Enhanced Care Brand Drugs	1		1
H0544	010	0	1	01	01	H0544_010_0	8	2	Generic Drugs	1		1
H0544	010	0	1	01	01	H0544_010_0	8	1	Preferred Generic Drugs	1		1
H0544	010	0	1	01	01	H0544_010_0	8	7	Specialty Drugs			
H0544	010	0	1	01	01	H0544_010_0	8	6	Injectable Drugs			
H0544	010	0	1	01	01	H0544_010_0	8	5	Brand Drugs			
H0544	010	0	1	01	01	H0544_010_0	8	4	Preferred Brand Drugs			
H0544	010	0	1	01	01	H0544_010_0	8	3	Enhanced Care Brand Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	1	Preferred Generic Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	6	Injectable Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	8	5	Brand Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	8	4	Preferred Brand Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	8	3	Enhanced Care Brand Drugs	1		1
H0544	012	0	1	01	01	H0544_012_0	8	2	Generic Drugs	1		1
H0544	012	0	1	01	01	H0544_012_0	8	7	Specialty Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	8	7	Specialty Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	6	Injectable Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	5	Brand Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	4	Preferred Brand Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	3	Enhanced Care Brand Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	2	Generic Drugs			
H0544	012	0	1	01	01	H0544_012_0	8	1	Preferred Generic Drugs	1		1
H0545	001	0	1	01	01	H0545_001_0	9	4	Non-Preferred Brand	2		
H0545	001	0	1	01	01	H0545_001_0	9	2	Non-Preferred Generic			
H0545	001	0	1	01	01	H0545_001_0	9	3	Preferred Brand			
H0545	001	0	1	01	01	H0545_001_0	9	4	Non-Preferred Brand			
H0545	001	0	1	01	01	H0545_001_0	9	5	Injectables			
H0545	001	0	1	01	01	H0545_001_0	9	6	Specialty Drugs			
H0545	001	0	1	01	01	H0545_001_0	9	6	Specialty Drugs	2		
H0545	001	0	1	01	01	H0545_001_0	9	5	Injectables	2		
H0545	001	0	1	01	01	H0545_001_0	9	1	Preferred Generic			
H0545	001	0	1	01	01	H0545_001_0	9	3	Preferred Brand	2		
H0545	001	0	1	01	01	H0545_001_0	9	2	Non-Preferred Generic	2		
H0545	001	0	1	01	01	H0545_001_0	9	1	Preferred Generic	1		1
H0545	008	0	1	01	01	H0545_008_0	7	1	Preferred Generic			
H0545	008	0	1	01	01	H0545_008_0	7	2	Non-Preferred Generic			
H0545	008	0	1	01	01	H0545_008_0	7	3	Preferred Brand			
H0545	008	0	1	01	01	H0545_008_0	7	4	Non-Preferred Brand			
H0545	008	0	1	01	01	H0545_008_0	7	5	Injectables			
H0545	008	0	1	01	01	H0545_008_0	7	6	Specialty Drugs			
H0545	009	0	1	01	01	H0545_009_0	8	6	Injectables	2		
H0545	009	0	1	01	01	H0545_009_0	8	7	Specialty Drugs	2		
H0545	009	0	1	01	01	H0545_009_0	8	5	Non-Preferred Brand	2		
H0545	009	0	1	01	01	H0545_009_0	8	4	Preferred Brand	2		
H0545	009	0	1	01	01	H0545_009_0	8	3	Other Special Needs	1		1
H0545	009	0	1	01	01	H0545_009_0	8	2	Non-Preferred Generic	2		
H0545	009	0	1	01	01	H0545_009_0	8	1	Preferred Generic	1		1
H0545	009	0	1	01	01	H0545_009_0	8	7	Specialty Drugs			
H0545	009	0	1	01	01	H0545_009_0	8	6	Injectables			
H0545	009	0	1	01	01	H0545_009_0	8	5	Non-Preferred Brand			
H0545	009	0	1	01	01	H0545_009_0	8	4	Preferred Brand			
H0545	009	0	1	01	01	H0545_009_0	8	3	Other Special Needs			
H0545	009	0	1	01	01	H0545_009_0	8	2	Non-Preferred Generic			
H0545	009	0	1	01	01	H0545_009_0	8	1	Preferred Generic			
H0545	011	0	1	01	01	H0545_011_0	8	5	Injectables			
H0545	011	0	1	01	01	H0545_011_0	8	1	Preferred Generic			
H0545	011	0	1	01	01	H0545_011_0	8	2	Non-Preferred Generic			
H0545	011	0	1	01	01	H0545_011_0	8	3	Preferred Brand			
H0545	011	0	1	01	01	H0545_011_0	8	4	Non-Preferred Brand			
H0545	011	0	1	01	01	H0545_011_0	8	6	Specialty Drugs			
H0545	012	0	1	01	01	H0545_012_0	4	1	Preferred Generic	1		1
H0545	012	0	1	01	01	H0545_012_0	4	2	Non-Preferred Generic	2		
H0545	012	0	1	01	01	H0545_012_0	4	3	Preferred Brand	2		
H0545	012	0	1	01	01	H0545_012_0	4	4	Non-Preferred Brand	2		
H0545	012	0	1	01	01	H0545_012_0	4	5	Injectables	2		
H0545	012	0	1	01	01	H0545_012_0	4	6	Specialty Drugs			
H0545	012	0	1	01	01	H0545_012_0	4	5	Injectables			
H0545	012	0	1	01	01	H0545_012_0	4	4	Non-Preferred Brand			
H0545	012	0	1	01	01	H0545_012_0	4	6	Specialty Drugs	1		1
H0545	012	0	1	01	01	H0545_012_0	4	2	Non-Preferred Generic			
H0545	012	0	1	01	01	H0545_012_0	4	1	Preferred Generic			
H0545	012	0	1	01	01	H0545_012_0	4	3	Preferred Brand			
H0562	002	0	1	01	01	H0562_002_0	5	1	Preferred Generic			
H0562	002	0	1	01	01	H0562_002_0	5	2	Preferred Brand			
H0562	002	0	1	01	01	H0562_002_0	5	5	Specialty	2		
H0562	002	0	1	01	01	H0562_002_0	5	4	Injectable	2		
H0562	002	0	1	01	01	H0562_002_0	5	3	Non-Preferred	2		
H0562	002	0	1	01	01	H0562_002_0	5	2	Preferred Brand	2		
H0562	002	0	1	01	01	H0562_002_0	5	3	Non-Preferred			
H0562	002	0	1	01	01	H0562_002_0	5	4	Injectable			
H0562	002	0	1	01	01	H0562_002_0	5	5	Specialty			
H0562	002	0	1	01	01	H0562_002_0	5	1	Preferred Generic	1		1
H0562	009	0	1	01	01	H0562_009_0	5	4	Injectable			
H0562	009	0	1	01	01	H0562_009_0	5	3	Non-Preferred			
H0562	009	0	1	01	01	H0562_009_0	5	2	Preferred Brand			
H0562	009	0	1	01	01	H0562_009_0	5	1	Preferred Generic			
H0562	009	0	1	01	01	H0562_009_0	5	5	Specialty			
H0562	010	0	1	01	01	H0562_010_0	5	2	Preferred Brand			
H0562	010	0	1	01	01	H0562_010_0	5	1	Preferred Generic			
H0562	010	0	1	01	01	H0562_010_0	5	3	Non-Preferred			
H0562	010	0	1	01	01	H0562_010_0	5	4	Injectable			
H0562	010	0	1	01	01	H0562_010_0	5	5	Specialty			
H0562	011	0	1	01	01	H0562_011_0	5	1	Preferred Generic			
H0562	011	0	1	01	01	H0562_011_0	5	2	Preferred Brand			
H0562	011	0	1	01	01	H0562_011_0	5	3	Non-Preferred			
H0562	011	0	1	01	01	H0562_011_0	5	4	Injectable			
H0562	011	0	1	01	01	H0562_011_0	5	5	Specialty			
H0562	012	0	1	01	01	H0562_012_0	5	2	Preferred Brand			
H0562	012	0	1	01	01	H0562_012_0	5	1	Preferred Generic			
H0562	012	0	1	01	01	H0562_012_0	5	3	Non-Preferred			
H0562	012	0	1	01	01	H0562_012_0	5	5	Specialty	2		
H0562	012	0	1	01	01	H0562_012_0	5	4	Injectable	2		
H0562	012	0	1	01	01	H0562_012_0	5	3	Non-Preferred	2		
H0562	012	0	1	01	01	H0562_012_0	5	2	Preferred Brand	2		
H0562	012	0	1	01	01	H0562_012_0	5	4	Injectable			
H0562	012	0	1	01	01	H0562_012_0	5	5	Specialty			
H0562	012	0	1	01	01	H0562_012_0	5	1	Preferred Generic	1		1
H0562	017	0	1	01	01	H0562_017_0	6	1	Preferred Generic			
H0562	017	0	1	01	01	H0562_017_0	6	4	Injectable			
H0562	017	0	1	01	01	H0562_017_0	6	3	Non-Preferred			
H0562	017	0	1	01	01	H0562_017_0	6	2	Preferred Brand			
H0562	017	0	1	01	01	H0562_017_0	6	5	Specialty			
H0562	036	0	1	01	01	H0562_036_0	5	1	Preferred Generic			
H0562	036	0	1	01	01	H0562_036_0	5	2	Preferred Brand			
H0562	036	0	1	01	01	H0562_036_0	5	5	Specialty			
H0562	036	0	1	01	01	H0562_036_0	5	4	Injectable			
H0562	036	0	1	01	01	H0562_036_0	5	3	Non-Preferred			
H0562	037	0	1	01	01	H0562_037_0	5	3	Non-Preferred			
H0562	037	0	1	01	01	H0562_037_0	5	4	Injectable			
H0562	037	0	1	01	01	H0562_037_0	5	5	Specialty			
H0562	037	0	1	01	01	H0562_037_0	5	2	Preferred Brand			
H0562	037	0	1	01	01	H0562_037_0	5	1	Preferred Generic			
H0562	039	0	1	01	01	H0562_039_0	5	2	Preferred Brand			
H0562	039	0	1	01	01	H0562_039_0	5	1	Preferred Generic			
H0562	039	0	1	01	01	H0562_039_0	5	3	Non-Preferred			
H0562	039	0	1	01	01	H0562_039_0	5	4	Injectable			
H0562	039	0	1	01	01	H0562_039_0	5	5	Specialty			
H0562	040	0	1	01	01	H0562_040_0	5	1	Preferred Generic			
H0562	040	0	1	01	01	H0562_040_0	5	2	Preferred Brand			
H0562	040	0	1	01	01	H0562_040_0	5	5	Specialty			
H0562	040	0	1	01	01	H0562_040_0	5	4	Injectable			
H0562	040	0	1	01	01	H0562_040_0	5	3	Non-Preferred			
H0562	053	0	1	01	01	H0562_053_0	5	2	Preferred Brand			
H0562	053	0	1	01	01	H0562_053_0	5	1	Preferred Generic			
H0562	053	0	1	01	01	H0562_053_0	5	5	Specialty			
H0562	053	0	1	01	01	H0562_053_0	5	4	Injectable			
H0562	053	0	1	01	01	H0562_053_0	5	3	Non-Preferred			
H0562	056	0	1	01	01	H0562_056_0	3	1	Preferred Generic	1		1
H0562	056	0	1	01	01	H0562_056_0	3	2	Preferred Brand	2		
H0562	056	0	1	01	01	H0562_056_0	3	5	Specialty			
H0562	056	0	1	01	01	H0562_056_0	3	4	Injectable			
H0562	056	0	1	01	01	H0562_056_0	3	3	Non-Preferred			
H0562	056	0	1	01	01	H0562_056_0	3	2	Preferred Brand			
H0562	056	0	1	01	01	H0562_056_0	3	1	Preferred Generic			
H0562	056	0	1	01	01	H0562_056_0	3	3	Non-Preferred	2		
H0562	056	0	1	01	01	H0562_056_0	3	5	Specialty	2		
H0562	056	0	1	01	01	H0562_056_0	3	4	Injectable	2		
H0562	058	0	1	01	01	H0562_058_0	5	1	Preferred Generic			
H0562	058	0	1	01	01	H0562_058_0	5	2	Preferred Brand			
H0562	058	0	1	01	01	H0562_058_0	5	3	Non-Preferred			
H0562	058	0	1	01	01	H0562_058_0	5	4	Injectable			
H0562	058	0	1	01	01	H0562_058_0	5	5	Specialty			
H0562	059	0	1	01	01	H0562_059_0	5	1	Preferred Generic			
H0562	059	0	1	01	01	H0562_059_0	5	2	Preferred Brand			
H0562	059	0	1	01	01	H0562_059_0	5	4	Injectable			
H0562	059	0	1	01	01	H0562_059_0	5	3	Non-Preferred			
H0562	059	0	1	01	01	H0562_059_0	5	5	Specialty			
H0562	060	0	1	01	01	H0562_060_0	5	5	Specialty			
H0562	060	0	1	01	01	H0562_060_0	5	4	Injectable			
H0562	060	0	1	01	01	H0562_060_0	5	3	Non-Preferred			
H0562	060	0	1	01	01	H0562_060_0	5	2	Preferred Brand			
H0562	060	0	1	01	01	H0562_060_0	5	1	Preferred Generic			
H0562	061	0	1	01	01	H0562_061_0	5	5	Specialty			
H0562	061	0	1	01	01	H0562_061_0	5	4	Injectable			
H0562	061	0	1	01	01	H0562_061_0	5	3	Non-Preferred			
H0562	061	0	1	01	01	H0562_061_0	5	2	Preferred Brand			
H0562	061	0	1	01	01	H0562_061_0	5	1	Preferred Generic			
H0562	062	0	1	01	01	H0562_062_0	5	5	Specialty			
H0562	062	0	1	01	01	H0562_062_0	5	4	Injectable			
H0562	062	0	1	01	01	H0562_062_0	5	3	Non-Preferred			
H0562	062	0	1	01	01	H0562_062_0	5	2	Preferred Brand			
H0562	062	0	1	01	01	H0562_062_0	5	1	Preferred Generic			
H0562	068	0	1	01	01	H0562_068_0	5	1	Preferred Generic			
H0562	068	0	1	01	01	H0562_068_0	5	5	Specialty			
H0562	068	0	1	01	01	H0562_068_0	5	4	Injectable			
H0562	068	0	1	01	01	H0562_068_0	5	3	Non-Preferred			
H0562	068	0	1	01	01	H0562_068_0	5	2	Preferred Brand			
H0562	071	0	1	01	01	H0562_071_0	4	1	Preferred Generic			
H0562	071	0	1	01	01	H0562_071_0	4	2	Preferred Brand			
H0562	071	0	1	01	01	H0562_071_0	4	3	Non-Preferred			
H0562	071	0	1	01	01	H0562_071_0	4	4	Injectable			
H0562	071	0	1	01	01	H0562_071_0	4	5	Specialty			
H0562	071	0	1	01	01	H0562_071_0	4	1	Preferred Generic	1		1
H0562	071	0	1	01	01	H0562_071_0	4	2	Preferred Brand	2		
H0562	071	0	1	01	01	H0562_071_0	4	3	Non-Preferred	2		
H0562	071	0	1	01	01	H0562_071_0	4	4	Injectable	2		
H0562	071	0	1	01	01	H0562_071_0	4	5	Specialty	2		
H0562	072	0	1	01	01	H0562_072_0	8	6	Specialty	2		
H0562	072	0	1	01	01	H0562_072_0	8	3	Preferred Brand	2		
H0562	072	0	1	01	01	H0562_072_0	8	4	Non-Preferred	2		
H0562	072	0	1	01	01	H0562_072_0	8	5	Injectable	2		
H0562	072	0	1	01	01	H0562_072_0	8	2	Preferred Generic	1		1
H0562	072	0	1	01	01	H0562_072_0	8	1	Preferred Generics	1		1
H0562	072	0	1	01	01	H0562_072_0	8	6	Specialty			
H0562	072	0	1	01	01	H0562_072_0	8	5	Injectable			
H0562	072	0	1	01	01	H0562_072_0	8	4	Non-Preferred			
H0562	072	0	1	01	01	H0562_072_0	8	3	Preferred Brand			
H0562	072	0	1	01	01	H0562_072_0	8	2	Preferred Generic			
H0562	072	0	1	01	01	H0562_072_0	8	1	Preferred Generics			
H0562	076	0	1	01	01	H0562_076_0	6	1	Preferred Generic			
H0562	076	0	1	01	01	H0562_076_0	6	2	Preferred Brand			
H0562	076	0	1	01	01	H0562_076_0	6	3	Non-Preferred			
H0562	076	0	1	01	01	H0562_076_0	6	4	Injectable			
H0562	076	0	1	01	01	H0562_076_0	6	5	Specialty			
H0562	077	0	1	01	01	H0562_077_0	5	1	Preferred Generic			
H0562	077	0	1	01	01	H0562_077_0	5	2	Preferred Brand			
H0562	077	0	1	01	01	H0562_077_0	5	3	Non-Preferred			
H0562	077	0	1	01	01	H0562_077_0	5	4	Injectable			
H0562	077	0	1	01	01	H0562_077_0	5	5	Specialty			
H0562	079	0	1	01	01	H0562_079_0	5	5	Specialty	2		
H0562	079	0	1	01	01	H0562_079_0	5	2	Preferred Brand	2		
H0562	079	0	1	01	01	H0562_079_0	5	3	Non-Preferred	2		
H0562	079	0	1	01	01	H0562_079_0	5	4	Injectable	2		
H0562	079	0	1	01	01	H0562_079_0	5	1	Preferred Generic	1		1
H0562	079	0	1	01	01	H0562_079_0	5	5	Specialty			
H0562	079	0	1	01	01	H0562_079_0	5	4	Injectable			
H0562	079	0	1	01	01	H0562_079_0	5	3	Non-Preferred			
H0562	079	0	1	01	01	H0562_079_0	5	2	Preferred Brand			
H0562	079	0	1	01	01	H0562_079_0	5	1	Preferred Generic			
H0564	006	0	1	01	01	H0564_006_0	12	3	Tier 3 Non-Preferred Brand or Generic			
H0564	006	0	1	01	01	H0564_006_0	12	2	Tier 2 Preferred Brand			
H0564	006	0	1	01	01	H0564_006_0	12	1	Tier 1 Preferred Generic			
H0564	006	0	1	01	01	H0564_006_0	12	4	Tier 4 Non-Specialty Injectable			
H0564	006	0	1	01	01	H0564_006_0	12	5	Tier 5 Specialty	2		
H0564	006	0	1	01	01	H0564_006_0	12	1	Tier 1 Preferred Generic	1		1
H0564	006	0	1	01	01	H0564_006_0	12	2	Tier 2 Preferred Brand	2		
H0564	006	0	1	01	01	H0564_006_0	12	3	Tier 3 Non-Preferred Brand or Generic	2		
H0564	006	0	1	01	01	H0564_006_0	12	4	Tier 4 Non-Specialty Injectable	2		
H0564	006	0	1	01	01	H0564_006_0	12	5	Tier 5 Specialty			
H0571	001	0	1	01	01	H0571_001_0	5	1	Generic			
H0571	001	0	1	01	01	H0571_001_0	5	2	Brand			
H0571	002	0	2	01	01	H0571_002_0	5	1	Generic			
H0571	002	0	2	01	01	H0571_002_0	5	2	Brand			
H0571	006	0	1	01	01	H0571_006_0	4	1	Generic			
H0571	006	0	1	01	01	H0571_006_0	4	2	Brand			
H0602	017	0	1	18	06	H0602_017_0	9	3	Non-preferred Brand drugs			
H0602	017	0	1	18	06	H0602_017_0	9	2	Preferred Brand drugs			
H0602	017	0	1	18	06	H0602_017_0	9	4	Specialty drugs			
H0602	017	0	1	18	06	H0602_017_0	9	1	Generic drugs			
H0602	018	0	1	18	06	H0602_018_0	10	3	Non-preferred Brand drugs			
H0602	018	0	1	18	06	H0602_018_0	10	1	Generic drugs			
H0602	018	0	1	18	06	H0602_018_0	10	1	Generic drugs	1		1
H0602	018	0	1	18	06	H0602_018_0	10	2	Preferred Brand drugs	2		
H0602	018	0	1	18	06	H0602_018_0	10	3	Non-preferred Brand drugs	2		
H0602	018	0	1	18	06	H0602_018_0	10	4	Specialty drugs	2		
H0602	018	0	1	18	06	H0602_018_0	10	4	Specialty drugs			
H0602	018	0	1	18	06	H0602_018_0	10	2	Preferred Brand drugs			
H0602	019	0	1	18	06	H0602_019_0	9	3	Non-preferred Brand drugs			
H0602	019	0	1	18	06	H0602_019_0	9	1	Generic drugs			
H0602	019	0	1	18	06	H0602_019_0	9	1	Generic drugs	1		1
H0602	019	0	1	18	06	H0602_019_0	9	2	Preferred Brand drugs	2		
H0602	019	0	1	18	06	H0602_019_0	9	3	Non-preferred Brand drugs	2		
H0602	019	0	1	18	06	H0602_019_0	9	4	Specialty drugs	2		
H0602	019	0	1	18	06	H0602_019_0	9	4	Specialty drugs			
H0602	019	0	1	18	06	H0602_019_0	9	2	Preferred Brand drugs			
H0602	020	0	1	18	06	H0602_020_0	10	3	Non-preferred Brand drugs			
H0602	020	0	1	18	06	H0602_020_0	10	1	Generic drugs			
H0602	020	0	1	18	06	H0602_020_0	10	4	Specialty drugs			
H0602	020	0	1	18	06	H0602_020_0	10	2	Preferred Brand drugs			
H0602	021	0	1	18	06	H0602_021_0	9	3	Non-preferred Brand drugs			
H0602	021	0	1	18	06	H0602_021_0	9	1	Generic drugs			
H0602	021	0	1	18	06	H0602_021_0	9	1	Generic drugs	1		1
H0602	021	0	1	18	06	H0602_021_0	9	2	Preferred Brand drugs	2		
H0602	021	0	1	18	06	H0602_021_0	9	3	Non-preferred Brand drugs	2		
H0602	021	0	1	18	06	H0602_021_0	9	4	Specialty drugs	2		
H0602	021	0	1	18	06	H0602_021_0	9	4	Specialty drugs			
H0602	021	0	1	18	06	H0602_021_0	9	2	Preferred Brand drugs			
H0602	022	0	1	18	06	H0602_022_0	13	3	Non-preferred Brand drugs			
H0602	022	0	1	18	06	H0602_022_0	13	1	Generic drugs			
H0602	022	0	1	18	06	H0602_022_0	13	4	Specialty drugs			
H0602	022	0	1	18	06	H0602_022_0	13	2	Preferred Brand drugs			
H0602	023	0	1	18	06	H0602_023_0	10	3	Non-preferred Brand drugs			
H0602	023	0	1	18	06	H0602_023_0	10	1	Generic drugs			
H0602	023	0	1	18	06	H0602_023_0	10	4	Specialty drugs			
H0602	023	0	1	18	06	H0602_023_0	10	2	Preferred Brand drugs			
H0602	024	0	1	18	06	H0602_024_0	10	3	Non-preferred Brand drugs			
H0602	024	0	1	18	06	H0602_024_0	10	1	Generic drugs			
H0602	024	0	1	18	06	H0602_024_0	10	1	Generic drugs	1		1
H0602	024	0	1	18	06	H0602_024_0	10	2	Preferred Brand drugs	2		
H0602	024	0	1	18	06	H0602_024_0	10	3	Non-preferred Brand drugs	2		
H0602	024	0	1	18	06	H0602_024_0	10	4	Specialty drugs	2		
H0602	024	0	1	18	06	H0602_024_0	10	4	Specialty drugs			
H0602	024	0	1	18	06	H0602_024_0	10	2	Preferred Brand drugs			
H0602	036	0	1	18	06	H0602_036_0	11	3	Non-preferred Brand drugs			
H0602	036	0	1	18	06	H0602_036_0	11	1	Generic drugs			
H0602	036	0	1	18	06	H0602_036_0	11	4	Specialty drugs			
H0602	036	0	1	18	06	H0602_036_0	11	2	Preferred Brand drugs			
H0602	037	0	1	18	06	H0602_037_0	11	2	Preferred Brand drugs			
H0602	037	0	1	18	06	H0602_037_0	11	1	Generic drugs			
H0602	037	0	1	18	06	H0602_037_0	11	3	Non-preferred Brand drugs			
H0602	037	0	1	18	06	H0602_037_0	11	4	Specialty drugs			
H0602	038	0	1	18	06	H0602_038_0	12	3	Non-preferred Brand drugs			
H0602	038	0	1	18	06	H0602_038_0	12	2	Preferred Brand drugs			
H0602	038	0	1	18	06	H0602_038_0	12	1	Generic drugs			
H0602	038	0	1	18	06	H0602_038_0	12	4	Specialty drugs			
H0602	039	0	1	18	06	H0602_039_0	11	3	Non-preferred Brand drugs			
H0602	039	0	1	18	06	H0602_039_0	11	4	Specialty drugs			
H0602	039	0	1	18	06	H0602_039_0	11	1	Generic drugs			
H0602	039	0	1	18	06	H0602_039_0	11	2	Preferred Brand drugs			
H0609	002	0	1	01	01	H0609_002_0	6	3	Non Preferred	2		
H0609	002	0	1	01	01	H0609_002_0	6	2	Preferred Brand			
H0609	002	0	1	01	01	H0609_002_0	6	3	Non Preferred			
H0609	002	0	1	01	01	H0609_002_0	6	4	Specialty			
H0609	002	0	1	01	01	H0609_002_0	6	4	Specialty	2		
H0609	002	0	1	01	01	H0609_002_0	6	1	Preferred Generic			
H0609	002	0	1	01	01	H0609_002_0	6	2	Preferred Brand	2		
H0609	002	0	1	01	01	H0609_002_0	6	1	Preferred Generic	1		1
H0609	006	0	1	01	01	H0609_006_0	5	1	Preferred Generic			
H0609	006	0	1	01	01	H0609_006_0	5	2	Preferred Brand			
H0609	006	0	1	01	01	H0609_006_0	5	3	Non Preferred			
H0609	006	0	1	01	01	H0609_006_0	5	4	Specialty			
H0609	007	0	1	01	01	H0609_007_0	5	3	Non Preferred			
H0609	007	0	1	01	01	H0609_007_0	5	4	Specialty			
H0609	007	0	1	01	01	H0609_007_0	5	2	Preferred Brand			
H0609	007	0	1	01	01	H0609_007_0	5	1	Preferred Generic			
H0609	011	0	1	01	01	H0609_011_0	7	3	Non Preferred			
H0609	011	0	1	01	01	H0609_011_0	7	1	Preferred Generic			
H0609	011	0	1	01	01	H0609_011_0	7	2	Preferred Brand			
H0609	011	0	1	01	01	H0609_011_0	7	4	Specialty			
H0609	012	0	1	01	01	H0609_012_0	5	1	Preferred Generic			
H0609	012	0	1	01	01	H0609_012_0	5	2	Preferred Brand			
H0609	012	0	1	01	01	H0609_012_0	5	3	Non Preferred			
H0609	012	0	1	01	01	H0609_012_0	5	4	Specialty			
H0609	013	0	1	01	01	H0609_013_0	5	1	Preferred Generic			
H0609	013	0	1	01	01	H0609_013_0	5	4	Specialty			
H0609	013	0	1	01	01	H0609_013_0	5	2	Preferred Brand			
H0609	013	0	1	01	01	H0609_013_0	5	3	Non Preferred			
H0609	020	0	1	01	01	H0609_020_0	6	1	Preferred Generic			
H0609	020	0	1	01	01	H0609_020_0	6	2	Preferred Brand			
H0609	020	0	1	01	01	H0609_020_0	6	3	Non Preferred			
H0609	020	0	1	01	01	H0609_020_0	6	4	Specialty			
H0620	002	0	1	04	01	H0620_002_0	5	3	Non Preferred			
H0620	002	0	1	04	01	H0620_002_0	5	2	Preferred Brand			
H0620	002	0	1	04	01	H0620_002_0	5	1	Preferred Generic			
H0620	002	0	1	04	01	H0620_002_0	5	4	Specialty			
H0621	004	0	1	01	01	H0621_004_0	8	3	Tier 3			
H0621	004	0	1	01	01	H0621_004_0	8	2	Tier 2			
H0621	004	0	1	01	01	H0621_004_0	8	1	Tier 1			
H0621	004	0	1	01	01	H0621_004_0	8	1	Tier 1	1		1
H0621	004	0	1	01	01	H0621_004_0	8	4	Tier 4			
H0621	004	0	1	01	01	H0621_004_0	8	2	Tier 2	1		1
H0621	004	0	1	01	01	H0621_004_0	8	3	Tier 3	1		1
H0621	004	0	1	01	01	H0621_004_0	8	4	Tier 4	1		1
H0621	005	0	1	01	01	H0621_005_0	8	3	Tier 3	1		1
H0621	005	0	1	01	01	H0621_005_0	8	2	Tier 2	1		1
H0621	005	0	1	01	01	H0621_005_0	8	1	Tier 1	1		1
H0621	005	0	1	01	01	H0621_005_0	8	4	Tier 4			
H0621	005	0	1	01	01	H0621_005_0	8	3	Tier 3			
H0621	005	0	1	01	01	H0621_005_0	8	2	Tier 2			
H0621	005	0	1	01	01	H0621_005_0	8	4	Tier 4	1		1
H0621	005	0	1	01	01	H0621_005_0	8	1	Tier 1			
H0621	006	0	1	01	01	H0621_006_0	7	1	Tier 1			
H0621	006	0	1	01	01	H0621_006_0	7	3	Tier 3			
H0621	006	0	1	01	01	H0621_006_0	7	2	Tier 2			
H0621	006	0	1	01	01	H0621_006_0	7	4	Tier 4			
H0621	007	0	1	01	01	H0621_007_0	6	4	Tier 4	2		
H0621	007	0	1	01	01	H0621_007_0	6	3	Tier 3	2		
H0621	007	0	1	01	01	H0621_007_0	6	2	Tier 2	2		
H0621	007	0	1	01	01	H0621_007_0	6	1	Tier 1	1		1
H0621	007	0	1	01	01	H0621_007_0	6	4	Tier 4			
H0621	007	0	1	01	01	H0621_007_0	6	3	Tier 3			
H0621	007	0	1	01	01	H0621_007_0	6	1	Tier 1			
H0621	007	0	1	01	01	H0621_007_0	6	2	Tier 2			
H0623	001	0	1	04	01	H0623_001_0	6	1	Preferred Generic			
H0623	001	0	1	04	01	H0623_001_0	6	2	Preferred Brand			
H0623	001	0	1	04	01	H0623_001_0	6	3	Non-Preferred Brand			
H0623	001	0	1	04	01	H0623_001_0	6	4	Specialty			
H0623	001	0	1	04	01	H0623_001_0	6	1	Preferred Generic	1		1
H0623	001	0	1	04	01	H0623_001_0	6	2	Preferred Brand	1	10000000	2
H0623	001	0	1	04	01	H0623_001_0	6	3	Non-Preferred Brand	1	10000000	2
H0623	001	0	1	04	01	H0623_001_0	6	4	Specialty	1	10001000	2
H0623	005	0	1	04	01	H0623_005_0	5	4	Specialty	1	10001000	2
H0623	005	0	1	04	01	H0623_005_0	5	1	Preferred Generic			
H0623	005	0	1	04	01	H0623_005_0	5	2	Preferred Brand			
H0623	005	0	1	04	01	H0623_005_0	5	3	Non-Preferred Brand			
H0623	005	0	1	04	01	H0623_005_0	5	4	Specialty			
H0623	005	0	1	04	01	H0623_005_0	5	1	Preferred Generic	1		1
H0623	005	0	1	04	01	H0623_005_0	5	2	Preferred Brand	1	10000000	2
H0623	005	0	1	04	01	H0623_005_0	5	3	Non-Preferred Brand	1	10000000	2
H0623	007	0	1	04	01	H0623_007_0	5	2	Preferred Brand			
H0623	007	0	1	04	01	H0623_007_0	5	1	Preferred Generic			
H0623	007	0	1	04	01	H0623_007_0	5	4	Specialty	1	10001000	2
H0623	007	0	1	04	01	H0623_007_0	5	4	Specialty			
H0623	007	0	1	04	01	H0623_007_0	5	1	Preferred Generic	1		1
H0623	007	0	1	04	01	H0623_007_0	5	2	Preferred Brand	1	10000000	2
H0623	007	0	1	04	01	H0623_007_0	5	3	Non-Preferred Brand	1	10000000	2
H0623	007	0	1	04	01	H0623_007_0	5	3	Non-Preferred Brand			
H0624	004	0	1	01	01	H0624_004_0	7	4	Specialty			
H0624	004	0	1	01	01	H0624_004_0	7	1	Preferred Generic			
H0624	004	0	1	01	01	H0624_004_0	7	3	Non Preferred			
H0624	004	0	1	01	01	H0624_004_0	7	2	Preferred Brand			
H0624	005	0	1	01	01	H0624_005_0	4	4	Specialty			
H0624	005	0	1	01	01	H0624_005_0	4	3	Non Preferred			
H0624	005	0	1	01	01	H0624_005_0	4	2	Preferred Brand			
H0624	005	0	1	01	01	H0624_005_0	4	1	Preferred Generic			
H0630	013	0	1	01	01	H0630_013_0	8	2	Brand Drugs			
H0630	013	0	1	01	01	H0630_013_0	8	1	Generic Drugs			
H0630	013	0	1	01	01	H0630_013_0	8	3	Specialty Drugs			
H0630	013	0	1	01	01	H0630_013_0	8	1	Generic Drugs	1		1
H0630	013	0	1	01	01	H0630_013_0	8	2	Brand Drugs	2		
H0630	013	0	1	01	01	H0630_013_0	8	3	Specialty Drugs	2		
H0630	015	0	1	01	01	H0630_015_0	6	1	Generic Drugs			
H0630	015	0	1	01	01	H0630_015_0	6	2	Brand Drugs			
H0630	015	0	1	01	01	H0630_015_0	6	3	Specialty Drugs			
H0630	015	0	1	01	01	H0630_015_0	6	1	Generic Drugs	1		1
H0630	015	0	1	01	01	H0630_015_0	6	2	Brand Drugs	2		
H0630	015	0	1	01	01	H0630_015_0	6	3	Specialty Drugs	2		
H0630	016	0	1	01	01	H0630_016_0	7	2	Brand Drugs			
H0630	016	0	1	01	01	H0630_016_0	7	1	Generic Drugs			
H0630	016	0	1	01	01	H0630_016_0	7	3	Specialty Drugs			
H0630	016	0	1	01	01	H0630_016_0	7	3	Specialty Drugs	2		
H0630	016	0	1	01	01	H0630_016_0	7	2	Brand Drugs	2		
H0630	016	0	1	01	01	H0630_016_0	7	1	Generic Drugs	1		1
H0630	017	0	1	01	01	H0630_017_0	8	1	Generic Drugs			
H0630	017	0	1	01	01	H0630_017_0	8	2	Brand Drugs			
H0630	017	0	1	01	01	H0630_017_0	8	3	Specialty Drugs			
H0630	017	0	1	01	01	H0630_017_0	8	1	Generic Drugs	1		1
H0630	017	0	1	01	01	H0630_017_0	8	2	Brand Drugs	2		
H0630	017	0	1	01	01	H0630_017_0	8	3	Specialty Drugs	2		
H0630	018	0	1	01	01	H0630_018_0	5	1	Generic Drugs			
H0630	018	0	1	01	01	H0630_018_0	5	2	Brand Drugs			
H0630	018	0	1	01	01	H0630_018_0	5	2	Brand Drugs	2		
H0630	018	0	1	01	01	H0630_018_0	5	1	Generic Drugs	1		1
H0630	018	0	1	01	01	H0630_018_0	5	3	Specialty Drugs			
H0630	018	0	1	01	01	H0630_018_0	5	3	Specialty Drugs	2		
H0710	001	0	1	04	01	H0710_001_0	6	3	Non Preferred			
H0710	001	0	1	04	01	H0710_001_0	6	4	Specialty			
H0710	001	0	1	04	01	H0710_001_0	6	2	Preferred Brand			
H0710	001	0	1	04	01	H0710_001_0	6	1	Preferred Generic			
H0710	003	0	1	04	01	H0710_003_0	4	1	Preferred Generic			
H0710	003	0	1	04	01	H0710_003_0	4	3	Non Preferred			
H0710	003	0	1	04	01	H0710_003_0	4	4	Specialty			
H0710	003	0	1	04	01	H0710_003_0	4	2	Preferred Brand			
H0712	001	0	1	02	01	H0712_001_0	8	2	Tier 2			
H0712	001	0	1	02	01	H0712_001_0	8	3	Tier 3			
H0712	001	0	1	02	01	H0712_001_0	8	4	Tier 4			
H0712	001	0	1	02	01	H0712_001_0	8	1	Tier 1			
H0712	005	0	1	01	01	H0712_005_0	9	3	Tier 3			
H0712	005	0	1	01	01	H0712_005_0	9	4	Tier 4			
H0712	005	0	1	01	01	H0712_005_0	9	2	Tier 2			
H0712	005	0	1	01	01	H0712_005_0	9	1	Tier 1			
H0712	011	0	1	02	01	H0712_011_0	8	3	Tier 3			
H0712	011	0	1	02	01	H0712_011_0	8	2	Tier 2			
H0712	011	0	1	02	01	H0712_011_0	8	1	Tier 1			
H0712	011	0	1	02	01	H0712_011_0	8	4	Tier 4			
H0712	018	0	1	02	01	H0712_018_0	8	4	Tier 4			
H0712	018	0	1	02	01	H0712_018_0	8	1	Tier 1			
H0712	018	0	1	02	01	H0712_018_0	8	3	Tier 3			
H0712	018	0	1	02	01	H0712_018_0	8	2	Tier 2			
H0747	007	0	1	09	04	H0747_007_0	5	4	Specialty			
H0747	007	0	1	09	04	H0747_007_0	5	3	Non-Preferred Brand			
H0747	007	0	1	09	04	H0747_007_0	5	1	Generic			
H0747	007	0	1	09	04	H0747_007_0	5	2	Preferred Brand			
H0747	008	0	1	09	04	H0747_008_0	6	1	Generic			
H0747	008	0	1	09	04	H0747_008_0	6	2	Preferred Brand			
H0747	008	0	1	09	04	H0747_008_0	6	3	Non-Preferred Brand			
H0747	008	0	1	09	04	H0747_008_0	6	4	Specialty			
H0747	010	0	1	09	04	H0747_010_0	4	1	Generic			
H0747	010	0	1	09	04	H0747_010_0	4	2	Preferred Brand			
H0747	010	0	1	09	04	H0747_010_0	4	3	Non-Preferred Brand			
H0747	010	0	1	09	04	H0747_010_0	4	4	Specialty			
H0752	002	0	1	01	01	H0752_002_0	11	3	Non Preferred	2		
H0752	002	0	1	01	01	H0752_002_0	11	2	Preferred Brand	2		
H0752	002	0	1	01	01	H0752_002_0	11	1	Preferred Generic	1		1
H0752	002	0	1	01	01	H0752_002_0	11	4	Specialty			
H0752	002	0	1	01	01	H0752_002_0	11	3	Non Preferred			
H0752	002	0	1	01	01	H0752_002_0	11	2	Preferred Brand			
H0752	002	0	1	01	01	H0752_002_0	11	1	Preferred Generic			
H0752	002	0	1	01	01	H0752_002_0	11	4	Specialty	2		
H0755	001	0	1	01	01	H0755_001_0	5	1	Preferred Generic			
H0755	001	0	1	01	01	H0755_001_0	5	2	Preferred Brand			
H0755	001	0	1	01	01	H0755_001_0	5	3	Non-Preferred Brand			
H0755	001	0	1	01	01	H0755_001_0	5	4	Injectable			
H0755	001	0	1	01	01	H0755_001_0	5	5	Specialty			
H0755	001	0	1	01	01	H0755_001_0	5	1	Preferred Generic	1		1
H0755	001	0	1	01	01	H0755_001_0	5	2	Preferred Brand	2		
H0755	001	0	1	01	01	H0755_001_0	5	3	Non-Preferred Brand	2		
H0755	001	0	1	01	01	H0755_001_0	5	4	Injectable	2		
H0755	001	0	1	01	01	H0755_001_0	5	5	Specialty	2		
H0755	020	0	1	02	01	H0755_020_0	5	1	Preferred Generic			
H0755	020	0	1	02	01	H0755_020_0	5	2	Preferred Brand			
H0755	020	0	1	02	01	H0755_020_0	5	3	Non-Preferred Brand			
H0755	020	0	1	02	01	H0755_020_0	5	4	Injectable			
H0755	020	0	1	02	01	H0755_020_0	5	5	Specialty	2		
H0755	020	0	1	02	01	H0755_020_0	5	1	Preferred Generic	1		1
H0755	020	0	1	02	01	H0755_020_0	5	2	Preferred Brand	2		
H0755	020	0	1	02	01	H0755_020_0	5	3	Non-Preferred Brand	2		
H0755	020	0	1	02	01	H0755_020_0	5	4	Injectable	2		
H0755	020	0	1	02	01	H0755_020_0	5	5	Specialty			
H0755	022	0	1	01	01	H0755_022_0	4	1	Preferred Generic			
H0755	022	0	1	01	01	H0755_022_0	4	5	Specialty			
H0755	022	0	1	01	01	H0755_022_0	4	4	Injectable			
H0755	022	0	1	01	01	H0755_022_0	4	3	Non-Preferred Brand			
H0755	022	0	1	01	01	H0755_022_0	4	2	Preferred Brand			
H0755	027	0	1	01	01	H0755_027_0	6	6	Specialty	2		
H0755	027	0	1	01	01	H0755_027_0	6	1	Preferred Generic	1		1
H0755	027	0	1	01	01	H0755_027_0	6	4	Non-Preferred Brand	2		
H0755	027	0	1	01	01	H0755_027_0	6	3	Preferred Brand	2		
H0755	027	0	1	01	01	H0755_027_0	6	2	Preferred Generic	2		
H0755	027	0	1	01	01	H0755_027_0	6	5	Injectable	2		
H0755	027	0	1	01	01	H0755_027_0	6	6	Specialty			
H0755	027	0	1	01	01	H0755_027_0	6	5	Injectable			
H0755	027	0	1	01	01	H0755_027_0	6	4	Non-Preferred Brand			
H0755	027	0	1	01	01	H0755_027_0	6	3	Preferred Brand			
H0755	027	0	1	01	01	H0755_027_0	6	1	Preferred Generic			
H0755	027	0	1	01	01	H0755_027_0	6	2	Preferred Generic			
H0755	028	0	1	01	01	H0755_028_0	4	4	Injectable			
H0755	028	0	1	01	01	H0755_028_0	4	3	Non-Preferred Brand			
H0755	028	0	1	01	01	H0755_028_0	4	2	Preferred Brand			
H0755	028	0	1	01	01	H0755_028_0	4	1	Preferred Generic			
H0755	028	0	1	01	01	H0755_028_0	4	5	Specialty			
H0768	001	0	1	04	01	H0768_001_0	6	2	Tier 2 - Non-Preferred Generic			
H0768	001	0	1	04	01	H0768_001_0	6	1	Tier 1 - Preferred Generic			
H0768	001	0	1	04	01	H0768_001_0	6	3	Tier 3 - Preferred Brand			
H0768	001	0	1	04	01	H0768_001_0	6	4	Tier 4 - Non-Preferred Brand			
H0768	001	0	1	04	01	H0768_001_0	6	5	Tier 5 - Specialty			
H0768	002	0	1	04	01	H0768_002_0	6	1	Tier 1 - Preferred Generic			
H0768	002	0	1	04	01	H0768_002_0	6	2	Tier 2 - Non-Preferred Generic			
H0768	002	0	1	04	01	H0768_002_0	6	3	Tier 3 - Preferred Brand			
H0768	002	0	1	04	01	H0768_002_0	6	4	Tier 4 - Non-Preferred Brand			
H0768	002	0	1	04	01	H0768_002_0	6	5	Tier 5 - Specialty			
H0806	001	0	1	02	01	H0806_001_0	5	3	Non-Preferred Generic/Non-Preferred Brand	2		
H0806	001	0	1	02	01	H0806_001_0	5	2	Preferred Brand	2		
H0806	001	0	1	02	01	H0806_001_0	5	1	Preferred Generic	1		1
H0806	001	0	1	02	01	H0806_001_0	5	4	Specialty - Generic and Brand			
H0806	001	0	1	02	01	H0806_001_0	5	3	Non-Preferred Generic/Non-Preferred Brand			
H0806	001	0	1	02	01	H0806_001_0	5	2	Preferred Brand			
H0806	001	0	1	02	01	H0806_001_0	5	1	Preferred Generic			
H0806	001	0	1	02	01	H0806_001_0	5	4	Specialty - Generic and Brand	2		
H0806	002	0	1	02	01	H0806_002_0	5	1	Preferred Generic			
H0806	002	0	1	02	01	H0806_002_0	5	2	Preferred Brand			
H0806	002	0	1	02	01	H0806_002_0	5	3	Non-Preferred Generic/Non-Preferred Brand			
H0806	002	0	1	02	01	H0806_002_0	5	4	Specialty - Generic and Brand			
H0806	002	0	1	02	01	H0806_002_0	5	1	Preferred Generic	1		1
H0806	002	0	1	02	01	H0806_002_0	5	2	Preferred Brand	2		
H0806	002	0	1	02	01	H0806_002_0	5	4	Specialty - Generic and Brand	2		
H0806	002	0	1	02	01	H0806_002_0	5	3	Non-Preferred Generic/Non-Preferred Brand	2		
H0806	003	0	1	02	01	H0806_003_0	5	3	Non-Preferred Generic/Non-Preferred Brand			
H0806	003	0	1	02	01	H0806_003_0	5	4	Specialty - Generic and Brand			
H0806	003	0	1	02	01	H0806_003_0	5	2	Preferred Brand			
H0806	003	0	1	02	01	H0806_003_0	5	1	Preferred Generic			
H0846	014	0	1	09	04	H0846_014_0	5	4	Specialty-Generic and Brand			
H0846	014	0	1	09	04	H0846_014_0	5	3	Non Preferred Generic/Non Preferred Brand			
H0846	014	0	1	09	04	H0846_014_0	5	2	Preferred Brand			
H0846	014	0	1	09	04	H0846_014_0	5	1	Preferred Generic			
H0846	015	0	1	09	04	H0846_015_0	5	1	Preferred Generic			
H0846	015	0	1	09	04	H0846_015_0	5	2	Preferred Brand			
H0846	015	0	1	09	04	H0846_015_0	5	3	Non Preferred Generic/Non Preferred Brand			
H0846	015	0	1	09	04	H0846_015_0	5	4	Specialty-Generic and Brand			
H0901	002	0	1	01	01	H0901_002_0	6	2	Tier 2 - Non-Preferred Generic			
H0901	002	0	1	01	01	H0901_002_0	6	1	Tier 1 - Preferred Generic			
H0901	002	0	1	01	01	H0901_002_0	6	3	Tier 3 - Preferred Brand			
H0901	002	0	1	01	01	H0901_002_0	6	4	Tier 4 - Non-Preferred Brand			
H0901	002	0	1	01	01	H0901_002_0	6	5	Tier 5 - Specialty	2		
H0901	002	0	1	01	01	H0901_002_0	6	1	Tier 1 - Preferred Generic	1		1
H0901	002	0	1	01	01	H0901_002_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H0901	002	0	1	01	01	H0901_002_0	6	3	Tier 3 - Preferred Brand	2		
H0901	002	0	1	01	01	H0901_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H0901	002	0	1	01	01	H0901_002_0	6	5	Tier 5 - Specialty			
H0901	004	0	1	01	01	H0901_004_0	6	2	Tier 2 - Non-Preferred Generic			
H0901	004	0	1	01	01	H0901_004_0	6	1	Tier 1 - Preferred Generic			
H0901	004	0	1	01	01	H0901_004_0	6	3	Tier 3 - Preferred Brand			
H0901	004	0	1	01	01	H0901_004_0	6	5	Tier 5 - Specialty			
H0901	004	0	1	01	01	H0901_004_0	6	4	Tier 4 - Non-Preferred Brand			
H0901	005	0	1	01	01	H0901_005_0	6	1	Tier 1 - Preferred Generic			
H0901	005	0	1	01	01	H0901_005_0	6	2	Tier 2 - Non-Preferred Generic			
H0901	005	0	1	01	01	H0901_005_0	6	3	Tier 3 - Preferred Brand			
H0901	005	0	1	01	01	H0901_005_0	6	4	Tier 4 - Non-Preferred Brand			
H0901	005	0	1	01	01	H0901_005_0	6	5	Tier 5 - Specialty			
H0901	007	0	1	01	01	H0901_007_0	6	1	Tier 1 - Preferred Generic			
H0901	007	0	1	01	01	H0901_007_0	6	2	Tier 2 - Non-Preferred Generic			
H0901	007	0	1	01	01	H0901_007_0	6	4	Tier 4 - Non-Preferred Brand			
H0901	007	0	1	01	01	H0901_007_0	6	3	Tier 3 - Preferred Brand			
H0901	007	0	1	01	01	H0901_007_0	6	5	Tier 5 - Specialty			
H0902	002	0	1	04	01	H0902_002_0	9	5	Tier 5 - Specialty	2		
H0902	002	0	1	04	01	H0902_002_0	9	1	Tier 1 - Preferred Generic			
H0902	002	0	1	04	01	H0902_002_0	9	2	Tier 2 - Non-Preferred Generic			
H0902	002	0	1	04	01	H0902_002_0	9	3	Tier 3 - Preferred Brand			
H0902	002	0	1	04	01	H0902_002_0	9	4	Tier 4 - Non-Preferred Brand			
H0902	002	0	1	04	01	H0902_002_0	9	5	Tier 5 - Specialty			
H0902	002	0	1	04	01	H0902_002_0	9	1	Tier 1 - Preferred Generic	1		1
H0902	002	0	1	04	01	H0902_002_0	9	2	Tier 2 - Non-Preferred Generic	1		1
H0902	002	0	1	04	01	H0902_002_0	9	3	Tier 3 - Preferred Brand	2		
H0902	002	0	1	04	01	H0902_002_0	9	4	Tier 4 - Non-Preferred Brand	2		
H0908	001	0	1	01	01	H0908_001_0	6	3	Non-Preferred Brand			
H0908	001	0	1	01	01	H0908_001_0	6	2	Brand			
H0908	001	0	1	01	01	H0908_001_0	6	1	Generic			
H0908	001	0	1	01	01	H0908_001_0	6	4	Injectable			
H0913	001	0	1	01	01	H0913_001_0	9	4	Tier 4	2		
H0913	001	0	1	01	01	H0913_001_0	9	3	Tier 3	2		
H0913	001	0	1	01	01	H0913_001_0	9	2	Tier 2	2		
H0913	001	0	1	01	01	H0913_001_0	9	1	Tier 1	1		1
H0913	001	0	1	01	01	H0913_001_0	9	4	Tier 4			
H0913	001	0	1	01	01	H0913_001_0	9	3	Tier 3			
H0913	001	0	1	01	01	H0913_001_0	9	2	Tier 2			
H0913	001	0	1	01	01	H0913_001_0	9	1	Tier 1			
H0913	002	0	1	01	01	H0913_002_0	7	1	Tier 1			
H0913	002	0	1	01	01	H0913_002_0	7	2	Tier 2			
H0913	002	0	1	01	01	H0913_002_0	7	4	Tier 4	2		
H0913	002	0	1	01	01	H0913_002_0	7	3	Tier 3	2		
H0913	002	0	1	01	01	H0913_002_0	7	2	Tier 2	2		
H0913	002	0	1	01	01	H0913_002_0	7	1	Tier 1	1		1
H0913	002	0	1	01	01	H0913_002_0	7	4	Tier 4			
H0913	002	0	1	01	01	H0913_002_0	7	3	Tier 3			
H0913	003	0	1	01	01	H0913_003_0	7	1	Tier 1			
H0913	003	0	1	01	01	H0913_003_0	7	3	Tier 3			
H0913	003	0	1	01	01	H0913_003_0	7	2	Tier 2			
H0913	003	0	1	01	01	H0913_003_0	7	4	Tier 4			
H0913	004	0	1	01	01	H0913_004_0	8	2	Tier 2			
H0913	004	0	1	01	01	H0913_004_0	8	3	Tier 3			
H0913	004	0	1	01	01	H0913_004_0	8	4	Tier 4			
H0913	004	0	1	01	01	H0913_004_0	8	1	Tier 1			
H0913	005	0	1	01	01	H0913_005_0	7	4	Tier 4			
H0913	005	0	1	01	01	H0913_005_0	7	3	Tier 3			
H0913	005	0	1	01	01	H0913_005_0	7	2	Tier 2			
H0913	005	0	1	01	01	H0913_005_0	7	1	Tier 1			
H0967	001	0	1	04	01	H0967_001_0	8	4	Tier 4			
H0967	001	0	1	04	01	H0967_001_0	8	3	Tier 3			
H0967	001	0	1	04	01	H0967_001_0	8	1	Tier 1			
H0967	001	0	1	04	01	H0967_001_0	8	2	Tier 2			
H0979	005	0	1	09	04	H0979_005_0	11	4	Specialty			
H0979	005	0	1	09	04	H0979_005_0	11	3	Brand			
H0979	005	0	1	09	04	H0979_005_0	11	1	Generic			
H0979	005	0	1	09	04	H0979_005_0	11	2	Preferred Brand			
H0979	007	0	1	09	04	H0979_007_0	9	1	Generic			
H0979	007	0	1	09	04	H0979_007_0	9	2	Preferred Brand			
H0979	007	0	1	09	04	H0979_007_0	9	4	Specialty			
H0979	007	0	1	09	04	H0979_007_0	9	3	Brand			
H0979	022	0	1	09	04	H0979_022_0	11	2	Preferred Brand			
H0979	022	0	1	09	04	H0979_022_0	11	4	Specialty			
H0979	022	0	1	09	04	H0979_022_0	11	3	Brand			
H0979	022	0	1	09	04	H0979_022_0	11	1	Generic			
H1013	011	0	1	01	01	H1013_011_0	7	3	Non-Preferred Brand			
H1013	011	0	1	01	01	H1013_011_0	7	2	Preferred Brand	2		
H1013	011	0	1	01	01	H1013_011_0	7	1	Preferred Generic and Select Brand	1		1
H1013	011	0	1	01	01	H1013_011_0	7	4	Specialty Drugs			
H1013	011	0	1	01	01	H1013_011_0	7	4	Specialty Drugs	2		
H1013	011	0	1	01	01	H1013_011_0	7	1	Preferred Generic and Select Brand			
H1013	011	0	1	01	01	H1013_011_0	7	2	Preferred Brand			
H1013	011	0	1	01	01	H1013_011_0	7	3	Non-Preferred Brand	2		
H1013	021	0	1	01	01	H1013_021_0	8	4	Specialty Drugs			
H1013	021	0	1	01	01	H1013_021_0	8	1	Preferred Generic and Select Brand	1		1
H1013	021	0	1	01	01	H1013_021_0	8	2	Preferred Brand	2		
H1013	021	0	1	01	01	H1013_021_0	8	3	Non-Preferred Brand	2		
H1013	021	0	1	01	01	H1013_021_0	8	1	Preferred Generic and Select Brand			
H1013	021	0	1	01	01	H1013_021_0	8	2	Preferred Brand			
H1013	021	0	1	01	01	H1013_021_0	8	3	Non-Preferred Brand			
H1013	021	0	1	01	01	H1013_021_0	8	4	Specialty Drugs	2		
H1013	024	0	1	01	01	H1013_024_0	6	3	Non-Preferred Brand			
H1013	024	0	1	01	01	H1013_024_0	6	4	Specialty Drugs	2		
H1013	024	0	1	01	01	H1013_024_0	6	3	Non-Preferred Brand	2		
H1013	024	0	1	01	01	H1013_024_0	6	2	Preferred Brand	2		
H1013	024	0	1	01	01	H1013_024_0	6	1	Preferred Generic and Select Brand	1		1
H1013	024	0	1	01	01	H1013_024_0	6	4	Specialty Drugs			
H1013	024	0	1	01	01	H1013_024_0	6	2	Preferred Brand			
H1013	024	0	1	01	01	H1013_024_0	6	1	Preferred Generic and Select Brand			
H1013	028	0	1	01	01	H1013_028_0	6	4	Specialty Drugs	2		
H1013	028	0	1	01	01	H1013_028_0	6	2	Preferred Brand	2		
H1013	028	0	1	01	01	H1013_028_0	6	3	Non-Preferred Brand	2		
H1013	028	0	1	01	01	H1013_028_0	6	3	Non-Preferred Brand			
H1013	028	0	1	01	01	H1013_028_0	6	2	Preferred Brand			
H1013	028	0	1	01	01	H1013_028_0	6	1	Preferred Generic and Select Brand			
H1013	028	0	1	01	01	H1013_028_0	6	4	Specialty Drugs			
H1013	028	0	1	01	01	H1013_028_0	6	1	Preferred Generic and Select Brand	1		1
H1016	001	0	1	01	01	H1016_001_0	9	2	Preferred Brand Name			
H1016	001	0	1	01	01	H1016_001_0	9	1	Generic			
H1016	001	0	1	01	01	H1016_001_0	9	3	Non-Preferred Brand Name	2		
H1016	001	0	1	01	01	H1016_001_0	9	1	Generic	1		1
H1016	001	0	1	01	01	H1016_001_0	9	4	Specialty			
H1016	001	0	1	01	01	H1016_001_0	9	3	Non-Preferred Brand Name			
H1016	001	0	1	01	01	H1016_001_0	9	4	Specialty	2		
H1016	001	0	1	01	01	H1016_001_0	9	2	Preferred Brand Name	2		
H1016	002	0	1	01	01	H1016_002_0	11	4	Specialty			
H1016	002	0	1	01	01	H1016_002_0	11	3	Non-Preferred Brand Name	2		
H1016	002	0	1	01	01	H1016_002_0	11	2	Preferred Brand Name	2		
H1016	002	0	1	01	01	H1016_002_0	11	1	Generic	1		1
H1016	002	0	1	01	01	H1016_002_0	11	4	Specialty	2		
H1016	002	0	1	01	01	H1016_002_0	11	3	Non-Preferred Brand Name			
H1016	002	0	1	01	01	H1016_002_0	11	2	Preferred Brand Name			
H1016	002	0	1	01	01	H1016_002_0	11	1	Generic			
H1016	017	0	2	01	01	H1016_017_0	10	4	Specialty			
H1016	017	0	2	01	01	H1016_017_0	10	3	Non-Preferred Brand Name			
H1016	017	0	2	01	01	H1016_017_0	10	2	Preferred Brand Name			
H1016	017	0	2	01	01	H1016_017_0	10	1	Generic			
H1016	017	0	2	01	01	H1016_017_0	10	4	Specialty	2		
H1016	017	0	2	01	01	H1016_017_0	10	3	Non-Preferred Brand Name	2		
H1016	017	0	2	01	01	H1016_017_0	10	2	Preferred Brand Name	2		
H1016	017	0	2	01	01	H1016_017_0	10	1	Generic	1		1
H1019	001	0	1	01	01	H1019_001_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	001	0	1	01	01	H1019_001_0	4	2	Preferred Brand	1	10000000	2
H1019	001	0	1	01	01	H1019_001_0	4	1	Other (Gen/Brand)	1		1
H1019	001	0	1	01	01	H1019_001_0	4	4	Specialty			
H1019	001	0	1	01	01	H1019_001_0	4	3	Non-Preferred Brand			
H1019	001	0	1	01	01	H1019_001_0	4	4	Specialty	1	10001000	2
H1019	001	0	1	01	01	H1019_001_0	4	1	Other (Gen/Brand)			
H1019	001	0	1	01	01	H1019_001_0	4	2	Preferred Brand			
H1019	002	0	1	01	01	H1019_002_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	002	0	1	01	01	H1019_002_0	4	4	Specialty	1	10001000	2
H1019	002	0	1	01	01	H1019_002_0	4	1	Other (Gen/Brand)			
H1019	002	0	1	01	01	H1019_002_0	4	2	Preferred Brand			
H1019	002	0	1	01	01	H1019_002_0	4	3	Non-Preferred Brand			
H1019	002	0	1	01	01	H1019_002_0	4	4	Specialty			
H1019	002	0	1	01	01	H1019_002_0	4	1	Other (Gen/Brand)	1		1
H1019	002	0	1	01	01	H1019_002_0	4	2	Preferred Brand	1	10000000	2
H1019	004	0	1	01	01	H1019_004_0	4	1	Other (Gen/Brand)			
H1019	004	0	1	01	01	H1019_004_0	4	2	Preferred Brand			
H1019	004	0	1	01	01	H1019_004_0	4	4	Specialty	1	10001000	2
H1019	004	0	1	01	01	H1019_004_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	004	0	1	01	01	H1019_004_0	4	2	Preferred Brand	1	10000000	2
H1019	004	0	1	01	01	H1019_004_0	4	1	Other (Gen/Brand)	1	10001000	2
H1019	004	0	1	01	01	H1019_004_0	4	4	Specialty			
H1019	004	0	1	01	01	H1019_004_0	4	3	Non-Preferred Brand			
H1019	005	0	1	01	01	H1019_005_0	3	2	Preferred Brand	1	10000000	2
H1019	005	0	1	01	01	H1019_005_0	3	3	Non-Preferred Brand	1	10000000	2
H1019	005	0	1	01	01	H1019_005_0	3	4	Specialty	1	10001000	2
H1019	005	0	1	01	01	H1019_005_0	3	1	Other (Gen/Brand)	1	10001000	2
H1019	005	0	1	01	01	H1019_005_0	3	4	Specialty			
H1019	005	0	1	01	01	H1019_005_0	3	3	Non-Preferred Brand			
H1019	005	0	1	01	01	H1019_005_0	3	2	Preferred Brand			
H1019	005	0	1	01	01	H1019_005_0	3	1	Other (Gen/Brand)			
H1019	006	0	1	01	01	H1019_006_0	2	2	Preferred Brand			
H1019	006	0	1	01	01	H1019_006_0	2	1	Other (Gen/Brand)			
H1019	006	0	1	01	01	H1019_006_0	2	3	Non-Preferred Brand			
H1019	006	0	1	01	01	H1019_006_0	2	4	Specialty			
H1019	006	0	1	01	01	H1019_006_0	2	1	Other (Gen/Brand)	1		1
H1019	006	0	1	01	01	H1019_006_0	2	2	Preferred Brand	1	10000000	2
H1019	006	0	1	01	01	H1019_006_0	2	3	Non-Preferred Brand	1	10000000	2
H1019	006	0	1	01	01	H1019_006_0	2	4	Specialty	1	10001000	2
H1019	010	0	1	01	01	H1019_010_0	4	3	Non-Preferred Brand			
H1019	010	0	1	01	01	H1019_010_0	4	2	Preferred Brand			
H1019	010	0	1	01	01	H1019_010_0	4	1	Other (Gen/Brand)			
H1019	010	0	1	01	01	H1019_010_0	4	4	Specialty			
H1019	010	0	1	01	01	H1019_010_0	4	1	Other (Gen/Brand)	1		1
H1019	010	0	1	01	01	H1019_010_0	4	2	Preferred Brand	1	10000000	2
H1019	010	0	1	01	01	H1019_010_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	010	0	1	01	01	H1019_010_0	4	4	Specialty	1	10001000	2
H1019	011	0	1	01	01	H1019_011_0	5	3	Non-Preferred Brand			
H1019	011	0	1	01	01	H1019_011_0	5	2	Preferred Brand			
H1019	011	0	1	01	01	H1019_011_0	5	1	Other (Gen/Brand)			
H1019	011	0	1	01	01	H1019_011_0	5	4	Specialty			
H1019	011	0	1	01	01	H1019_011_0	5	4	Specialty	1	10001000	2
H1019	011	0	1	01	01	H1019_011_0	5	3	Non-Preferred Brand	1	10000000	2
H1019	011	0	1	01	01	H1019_011_0	5	2	Preferred Brand	1	10000000	2
H1019	011	0	1	01	01	H1019_011_0	5	1	Other (Gen/Brand)	1	10001000	2
H1019	014	0	1	01	01	H1019_014_0	6	1	Preferred Generic			
H1019	014	0	1	01	01	H1019_014_0	6	2	Preferred Brand			
H1019	014	0	1	01	01	H1019_014_0	6	3	Non-Preferred Brand			
H1019	014	0	1	01	01	H1019_014_0	6	3	Non-Preferred Brand	1	10000000	2
H1019	014	0	1	01	01	H1019_014_0	6	2	Preferred Brand	1	10000000	2
H1019	014	0	1	01	01	H1019_014_0	6	1	Preferred Generic	1		1
H1019	014	0	1	01	01	H1019_014_0	6	4	Specialty			
H1019	014	0	1	01	01	H1019_014_0	6	4	Specialty	1	10001000	2
H1019	023	0	1	01	01	H1019_023_0	5	1	Other (Gen/Brand)			
H1019	023	0	1	01	01	H1019_023_0	5	3	Non-Preferred Brand			
H1019	023	0	1	01	01	H1019_023_0	5	2	Preferred Brand			
H1019	023	0	1	01	01	H1019_023_0	5	4	Specialty			
H1019	023	0	1	01	01	H1019_023_0	5	1	Other (Gen/Brand)	1	10001000	2
H1019	023	0	1	01	01	H1019_023_0	5	2	Preferred Brand	1	10000000	2
H1019	023	0	1	01	01	H1019_023_0	5	3	Non-Preferred Brand	1	10000000	2
H1019	023	0	1	01	01	H1019_023_0	5	4	Specialty	1	10001000	2
H1019	024	0	1	01	01	H1019_024_0	4	4	Specialty			
H1019	024	0	1	01	01	H1019_024_0	4	1	Other (Gen/Brand)	1	10001000	2
H1019	024	0	1	01	01	H1019_024_0	4	2	Preferred Brand	1	10000000	2
H1019	024	0	1	01	01	H1019_024_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	024	0	1	01	01	H1019_024_0	4	4	Specialty	1	10001000	2
H1019	024	0	1	01	01	H1019_024_0	4	1	Other (Gen/Brand)			
H1019	024	0	1	01	01	H1019_024_0	4	2	Preferred Brand			
H1019	024	0	1	01	01	H1019_024_0	4	3	Non-Preferred Brand			
H1019	025	0	1	01	01	H1019_025_0	3	3	Non-Preferred Brand	1	10000000	2
H1019	025	0	1	01	01	H1019_025_0	3	2	Preferred Brand	1	10000000	2
H1019	025	0	1	01	01	H1019_025_0	3	1	Other (Gen/Brand)	1	10001000	2
H1019	025	0	1	01	01	H1019_025_0	3	4	Specialty			
H1019	025	0	1	01	01	H1019_025_0	3	3	Non-Preferred Brand			
H1019	025	0	1	01	01	H1019_025_0	3	4	Specialty	1	10001000	2
H1019	025	0	1	01	01	H1019_025_0	3	2	Preferred Brand			
H1019	025	0	1	01	01	H1019_025_0	3	1	Other (Gen/Brand)			
H1019	026	0	1	01	01	H1019_026_0	4	2	Preferred Brand	1	10000000	2
H1019	026	0	1	01	01	H1019_026_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	026	0	1	01	01	H1019_026_0	4	4	Specialty	1	10001000	2
H1019	026	0	1	01	01	H1019_026_0	4	1	Preferred Generic	1	00001000	2
H1019	026	0	1	01	01	H1019_026_0	4	4	Specialty			
H1019	026	0	1	01	01	H1019_026_0	4	3	Non-Preferred Brand			
H1019	026	0	1	01	01	H1019_026_0	4	2	Preferred Brand			
H1019	026	0	1	01	01	H1019_026_0	4	1	Preferred Generic			
H1019	027	0	1	01	01	H1019_027_0	4	4	Specialty			
H1019	027	0	1	01	01	H1019_027_0	4	1	Preferred Generic	1	00001000	2
H1019	027	0	1	01	01	H1019_027_0	4	2	Preferred Brand	1	10000000	2
H1019	027	0	1	01	01	H1019_027_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	027	0	1	01	01	H1019_027_0	4	4	Specialty	1	10001000	2
H1019	027	0	1	01	01	H1019_027_0	4	2	Preferred Brand			
H1019	027	0	1	01	01	H1019_027_0	4	1	Preferred Generic			
H1019	027	0	1	01	01	H1019_027_0	4	3	Non-Preferred Brand			
H1019	028	0	1	01	01	H1019_028_0	4	1	Preferred Generic			
H1019	028	0	1	01	01	H1019_028_0	4	2	Preferred Brand			
H1019	028	0	1	01	01	H1019_028_0	4	3	Non-Preferred Brand			
H1019	028	0	1	01	01	H1019_028_0	4	4	Specialty	1	10001000	2
H1019	028	0	1	01	01	H1019_028_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	028	0	1	01	01	H1019_028_0	4	2	Preferred Brand	1	10000000	2
H1019	028	0	1	01	01	H1019_028_0	4	4	Specialty			
H1019	028	0	1	01	01	H1019_028_0	4	1	Preferred Generic	1	00001000	2
H1019	029	0	1	01	01	H1019_029_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	029	0	1	01	01	H1019_029_0	4	2	Preferred Brand	1	10000000	2
H1019	029	0	1	01	01	H1019_029_0	4	1	Preferred Generic	1	00001000	2
H1019	029	0	1	01	01	H1019_029_0	4	4	Specialty			
H1019	029	0	1	01	01	H1019_029_0	4	3	Non-Preferred Brand			
H1019	029	0	1	01	01	H1019_029_0	4	4	Specialty	1	10001000	2
H1019	029	0	1	01	01	H1019_029_0	4	2	Preferred Brand			
H1019	029	0	1	01	01	H1019_029_0	4	1	Preferred Generic			
H1019	030	0	1	01	01	H1019_030_0	6	3	Non-Preferred Brand			
H1019	030	0	1	01	01	H1019_030_0	6	2	Preferred Brand			
H1019	030	0	1	01	01	H1019_030_0	6	1	Preferred Generic			
H1019	030	0	1	01	01	H1019_030_0	6	4	Specialty			
H1019	030	0	1	01	01	H1019_030_0	6	4	Specialty	1	10001000	2
H1019	030	0	1	01	01	H1019_030_0	6	3	Non-Preferred Brand	1	10000000	2
H1019	030	0	1	01	01	H1019_030_0	6	2	Preferred Brand	1	10000000	2
H1019	030	0	1	01	01	H1019_030_0	6	1	Preferred Generic	1	00001000	2
H1019	032	0	1	01	01	H1019_032_0	5	2	Preferred Brand	1	10000000	2
H1019	032	0	1	01	01	H1019_032_0	5	4	Specialty	1	10001000	2
H1019	032	0	1	01	01	H1019_032_0	5	3	Non-Preferred Brand	1	10000000	2
H1019	032	0	1	01	01	H1019_032_0	5	1	Other (Gen/Brand)	1		1
H1019	032	0	1	01	01	H1019_032_0	5	4	Specialty			
H1019	032	0	1	01	01	H1019_032_0	5	3	Non-Preferred Brand			
H1019	032	0	1	01	01	H1019_032_0	5	2	Preferred Brand			
H1019	032	0	1	01	01	H1019_032_0	5	1	Other (Gen/Brand)			
H1019	033	0	1	01	01	H1019_033_0	5	1	Other (Gen/Brand)			
H1019	033	0	1	01	01	H1019_033_0	5	2	Preferred Brand			
H1019	033	0	1	01	01	H1019_033_0	5	3	Non-Preferred Brand			
H1019	033	0	1	01	01	H1019_033_0	5	4	Specialty			
H1019	033	0	1	01	01	H1019_033_0	5	1	Other (Gen/Brand)	1		1
H1019	033	0	1	01	01	H1019_033_0	5	2	Preferred Brand	1	10000000	2
H1019	033	0	1	01	01	H1019_033_0	5	4	Specialty	1	10001000	2
H1019	033	0	1	01	01	H1019_033_0	5	3	Non-Preferred Brand	1	10000000	2
H1019	035	0	1	01	01	H1019_035_0	5	3	Non-Preferred Brand			
H1019	035	0	1	01	01	H1019_035_0	5	4	Specialty			
H1019	035	0	1	01	01	H1019_035_0	5	1	Other (Gen/Brand)	1		1
H1019	035	0	1	01	01	H1019_035_0	5	2	Preferred Brand	1	10000000	2
H1019	035	0	1	01	01	H1019_035_0	5	2	Preferred Brand			
H1019	035	0	1	01	01	H1019_035_0	5	4	Specialty	1	10001000	2
H1019	035	0	1	01	01	H1019_035_0	5	3	Non-Preferred Brand	1	10000000	2
H1019	035	0	1	01	01	H1019_035_0	5	1	Other (Gen/Brand)			
H1019	036	0	1	01	01	H1019_036_0	5	1	Other (Gen/Brand)			
H1019	036	0	1	01	01	H1019_036_0	5	2	Preferred Brand			
H1019	036	0	1	01	01	H1019_036_0	5	2	Preferred Brand	1	10000000	2
H1019	036	0	1	01	01	H1019_036_0	5	1	Other (Gen/Brand)	1		1
H1019	036	0	1	01	01	H1019_036_0	5	4	Specialty			
H1019	036	0	1	01	01	H1019_036_0	5	3	Non-Preferred Brand			
H1019	036	0	1	01	01	H1019_036_0	5	4	Specialty	1	10001000	2
H1019	036	0	1	01	01	H1019_036_0	5	3	Non-Preferred Brand	1	10000000	2
H1019	037	0	1	01	01	H1019_037_0	4	2	Preferred Brand			
H1019	037	0	1	01	01	H1019_037_0	4	1	Other (Gen/Brand)			
H1019	037	0	1	01	01	H1019_037_0	4	3	Non-Preferred Brand			
H1019	037	0	1	01	01	H1019_037_0	4	4	Specialty			
H1019	037	0	1	01	01	H1019_037_0	4	1	Other (Gen/Brand)	1		1
H1019	037	0	1	01	01	H1019_037_0	4	2	Preferred Brand	1	10000000	2
H1019	037	0	1	01	01	H1019_037_0	4	4	Specialty	1	10001000	2
H1019	037	0	1	01	01	H1019_037_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	038	0	1	01	01	H1019_038_0	4	2	Preferred Brand	1	10000000	2
H1019	038	0	1	01	01	H1019_038_0	4	1	Other (Gen/Brand)	1		1
H1019	038	0	1	01	01	H1019_038_0	4	4	Specialty			
H1019	038	0	1	01	01	H1019_038_0	4	3	Non-Preferred Brand			
H1019	038	0	1	01	01	H1019_038_0	4	2	Preferred Brand			
H1019	038	0	1	01	01	H1019_038_0	4	1	Other (Gen/Brand)			
H1019	038	0	1	01	01	H1019_038_0	4	3	Non-Preferred Brand	1	10000000	2
H1019	038	0	1	01	01	H1019_038_0	4	4	Specialty	1	10001000	2
H1019	040	0	1	01	01	H1019_040_0	6	1	Preferred Generic			
H1019	040	0	1	01	01	H1019_040_0	6	2	Preferred Brand			
H1019	040	0	1	01	01	H1019_040_0	6	3	Non-Preferred Brand			
H1019	040	0	1	01	01	H1019_040_0	6	4	Specialty			
H1019	040	0	1	01	01	H1019_040_0	6	4	Specialty	1	10001000	2
H1019	040	0	1	01	01	H1019_040_0	6	3	Non-Preferred Brand	1	10000000	2
H1019	040	0	1	01	01	H1019_040_0	6	2	Preferred Brand	1	10000000	2
H1019	040	0	1	01	01	H1019_040_0	6	1	Preferred Generic	1		1
H1019	041	0	1	01	01	H1019_041_0	5	4	Specialty	1	10001000	2
H1019	041	0	1	01	01	H1019_041_0	5	3	Non-Preferred Brand	1	10000000	2
H1019	041	0	1	01	01	H1019_041_0	5	4	Specialty			
H1019	041	0	1	01	01	H1019_041_0	5	1	Preferred Generic	1		1
H1019	041	0	1	01	01	H1019_041_0	5	2	Preferred Brand	1	10000000	2
H1019	041	0	1	01	01	H1019_041_0	5	3	Non-Preferred Brand			
H1019	041	0	1	01	01	H1019_041_0	5	2	Preferred Brand			
H1019	041	0	1	01	01	H1019_041_0	5	1	Preferred Generic			
H1019	043	0	1	01	01	H1019_043_0	6	4	Specialty			
H1019	043	0	1	01	01	H1019_043_0	6	3	Non-Preferred Brand			
H1019	043	0	1	01	01	H1019_043_0	6	2	Preferred Brand			
H1019	043	0	1	01	01	H1019_043_0	6	1	Preferred Generic			
H1019	043	0	1	01	01	H1019_043_0	6	1	Preferred Generic	1	00001000	2
H1019	043	0	1	01	01	H1019_043_0	6	2	Preferred Brand	1	10000000	2
H1019	043	0	1	01	01	H1019_043_0	6	3	Non-Preferred Brand	1	10000000	2
H1019	043	0	1	01	01	H1019_043_0	6	4	Specialty	1	10001000	2
H1026	001	0	1	01	01	H1026_001_0	7	3	Tier 3 - Covered Brand			
H1026	001	0	1	01	01	H1026_001_0	7	2	Tier 2 - Covered Preferred Brand			
H1026	001	0	1	01	01	H1026_001_0	7	1	Tier 1 - Covered Generic			
H1026	001	0	1	01	01	H1026_001_0	7	4	Tier S - Covered Specialty			
H1026	001	0	1	01	01	H1026_001_0	7	1	Tier 1 - Covered Generic	1		1
H1026	001	0	1	01	01	H1026_001_0	7	2	Tier 2 - Covered Preferred Brand	2		
H1026	001	0	1	01	01	H1026_001_0	7	3	Tier 3 - Covered Brand	2		
H1026	001	0	1	01	01	H1026_001_0	7	4	Tier S - Covered Specialty	2		
H1026	033	0	1	01	01	H1026_033_0	7	3	Tier 3 - Covered Brand			
H1026	033	0	1	01	01	H1026_033_0	7	2	Tier 2 - Covered Preferred Brand			
H1026	033	0	1	01	01	H1026_033_0	7	1	Tier 1 - Covered Generic			
H1026	033	0	1	01	01	H1026_033_0	7	4	Tier S - Covered Specialty			
H1026	035	0	1	01	01	H1026_035_0	6	3	Tier 3 - Covered Brand			
H1026	035	0	1	01	01	H1026_035_0	6	2	Tier 2 - Covered Preferred Brand			
H1026	035	0	1	01	01	H1026_035_0	6	1	Tier 1 - Covered Generic			
H1026	035	0	1	01	01	H1026_035_0	6	4	Tier S - Covered Specialty			
H1026	038	0	1	01	01	H1026_038_0	7	1	Tier 1 - Covered Generic	1		1
H1026	038	0	1	01	01	H1026_038_0	7	2	Tier 2 - Covered Preferred Brand	2		
H1026	038	0	1	01	01	H1026_038_0	7	3	Tier 3 - Covered Brand	2		
H1026	038	0	1	01	01	H1026_038_0	7	4	Tier S - Covered Specialty			
H1026	038	0	1	01	01	H1026_038_0	7	3	Tier 3 - Covered Brand			
H1026	038	0	1	01	01	H1026_038_0	7	4	Tier S - Covered Specialty	2		
H1026	038	0	1	01	01	H1026_038_0	7	1	Tier 1 - Covered Generic			
H1026	038	0	1	01	01	H1026_038_0	7	2	Tier 2 - Covered Preferred Brand			
H1032	002	0	1	02	01	H1032_002_0	11	1	Tier 1			
H1032	002	0	1	02	01	H1032_002_0	11	2	Tier 2			
H1032	002	0	1	02	01	H1032_002_0	11	4	Tier 4	2		
H1032	002	0	1	02	01	H1032_002_0	11	3	Tier 3	2		
H1032	002	0	1	02	01	H1032_002_0	11	2	Tier 2	2		
H1032	002	0	1	02	01	H1032_002_0	11	1	Tier 1	1		1
H1032	002	0	1	02	01	H1032_002_0	11	4	Tier 4			
H1032	002	0	1	02	01	H1032_002_0	11	3	Tier 3			
H1032	008	0	1	02	01	H1032_008_0	7	1	Tier 1			
H1032	008	0	1	02	01	H1032_008_0	7	3	Tier 3	2		
H1032	008	0	1	02	01	H1032_008_0	7	2	Tier 2	2		
H1032	008	0	1	02	01	H1032_008_0	7	1	Tier 1	1		1
H1032	008	0	1	02	01	H1032_008_0	7	4	Tier 4			
H1032	008	0	1	02	01	H1032_008_0	7	3	Tier 3			
H1032	008	0	1	02	01	H1032_008_0	7	2	Tier 2			
H1032	008	0	1	02	01	H1032_008_0	7	4	Tier 4	2		
H1032	010	0	1	02	01	H1032_010_0	6	3	Tier 3	2		
H1032	010	0	1	02	01	H1032_010_0	6	2	Tier 2	2		
H1032	010	0	1	02	01	H1032_010_0	6	4	Tier 4	2		
H1032	010	0	1	02	01	H1032_010_0	6	1	Tier 1	1		1
H1032	010	0	1	02	01	H1032_010_0	6	4	Tier 4			
H1032	010	0	1	02	01	H1032_010_0	6	3	Tier 3			
H1032	010	0	1	02	01	H1032_010_0	6	2	Tier 2			
H1032	010	0	1	02	01	H1032_010_0	6	1	Tier 1			
H1032	012	0	1	02	01	H1032_012_0	6	3	Tier 3	2		
H1032	012	0	1	02	01	H1032_012_0	6	1	Tier 1			
H1032	012	0	1	02	01	H1032_012_0	6	4	Tier 4	2		
H1032	012	0	1	02	01	H1032_012_0	6	2	Tier 2			
H1032	012	0	1	02	01	H1032_012_0	6	3	Tier 3			
H1032	012	0	1	02	01	H1032_012_0	6	4	Tier 4			
H1032	012	0	1	02	01	H1032_012_0	6	1	Tier 1	1		1
H1032	012	0	1	02	01	H1032_012_0	6	2	Tier 2	2		
H1032	014	0	1	02	01	H1032_014_0	6	3	Tier 3	2		
H1032	014	0	1	02	01	H1032_014_0	6	1	Tier 1			
H1032	014	0	1	02	01	H1032_014_0	6	4	Tier 4	2		
H1032	014	0	1	02	01	H1032_014_0	6	2	Tier 2			
H1032	014	0	1	02	01	H1032_014_0	6	3	Tier 3			
H1032	014	0	1	02	01	H1032_014_0	6	4	Tier 4			
H1032	014	0	1	02	01	H1032_014_0	6	1	Tier 1	1		1
H1032	014	0	1	02	01	H1032_014_0	6	2	Tier 2	2		
H1032	019	0	1	02	01	H1032_019_0	6	3	Tier 3	2		
H1032	019	0	1	02	01	H1032_019_0	6	4	Tier 4	2		
H1032	019	0	1	02	01	H1032_019_0	6	2	Tier 2	2		
H1032	019	0	1	02	01	H1032_019_0	6	1	Tier 1	1		1
H1032	019	0	1	02	01	H1032_019_0	6	4	Tier 4			
H1032	019	0	1	02	01	H1032_019_0	6	3	Tier 3			
H1032	019	0	1	02	01	H1032_019_0	6	2	Tier 2			
H1032	019	0	1	02	01	H1032_019_0	6	1	Tier 1			
H1032	025	0	1	02	01	H1032_025_0	6	3	Tier 3			
H1032	025	0	1	02	01	H1032_025_0	6	2	Tier 2			
H1032	025	0	1	02	01	H1032_025_0	6	1	Tier 1			
H1032	025	0	1	02	01	H1032_025_0	6	4	Tier 4			
H1032	028	0	1	02	01	H1032_028_0	6	1	Tier 1	1		1
H1032	028	0	1	02	01	H1032_028_0	6	2	Tier 2	2		
H1032	028	0	1	02	01	H1032_028_0	6	3	Tier 3	2		
H1032	028	0	1	02	01	H1032_028_0	6	4	Tier 4			
H1032	028	0	1	02	01	H1032_028_0	6	3	Tier 3			
H1032	028	0	1	02	01	H1032_028_0	6	4	Tier 4	2		
H1032	028	0	1	02	01	H1032_028_0	6	1	Tier 1			
H1032	028	0	1	02	01	H1032_028_0	6	2	Tier 2			
H1032	031	0	1	02	01	H1032_031_0	6	3	Tier 3			
H1032	031	0	1	02	01	H1032_031_0	6	2	Tier 2			
H1032	031	0	1	02	01	H1032_031_0	6	1	Tier 1			
H1032	031	0	1	02	01	H1032_031_0	6	4	Tier 4			
H1032	032	0	1	02	01	H1032_032_0	6	1	Tier 1			
H1032	032	0	1	02	01	H1032_032_0	6	2	Tier 2			
H1032	032	0	1	02	01	H1032_032_0	6	3	Tier 3			
H1032	032	0	1	02	01	H1032_032_0	6	4	Tier 4			
H1032	033	0	1	02	01	H1032_033_0	6	3	Tier 3			
H1032	033	0	1	02	01	H1032_033_0	6	2	Tier 2			
H1032	033	0	1	02	01	H1032_033_0	6	1	Tier 1			
H1032	033	0	1	02	01	H1032_033_0	6	4	Tier 4			
H1032	033	0	1	02	01	H1032_033_0	6	4	Tier 4	2		
H1032	033	0	1	02	01	H1032_033_0	6	3	Tier 3	2		
H1032	033	0	1	02	01	H1032_033_0	6	2	Tier 2	2		
H1032	033	0	1	02	01	H1032_033_0	6	1	Tier 1	1		1
H1032	035	0	1	02	01	H1032_035_0	6	1	Tier 1			
H1032	035	0	1	02	01	H1032_035_0	6	2	Tier 2			
H1032	035	0	1	02	01	H1032_035_0	6	3	Tier 3			
H1032	035	0	1	02	01	H1032_035_0	6	3	Tier 3	2		
H1032	035	0	1	02	01	H1032_035_0	6	2	Tier 2	2		
H1032	035	0	1	02	01	H1032_035_0	6	1	Tier 1	1		1
H1032	035	0	1	02	01	H1032_035_0	6	4	Tier 4			
H1032	035	0	1	02	01	H1032_035_0	6	4	Tier 4	2		
H1032	040	0	1	02	01	H1032_040_0	6	1	Tier 1			
H1032	040	0	1	02	01	H1032_040_0	6	2	Tier 2			
H1032	040	0	1	02	01	H1032_040_0	6	3	Tier 3			
H1032	040	0	1	02	01	H1032_040_0	6	4	Tier 4			
H1032	043	0	1	02	01	H1032_043_0	6	3	Tier 3			
H1032	043	0	1	02	01	H1032_043_0	6	2	Tier 2			
H1032	043	0	1	02	01	H1032_043_0	6	1	Tier 1			
H1032	043	0	1	02	01	H1032_043_0	6	4	Tier 4			
H1032	044	0	1	02	01	H1032_044_0	6	3	Tier 3			
H1032	044	0	1	02	01	H1032_044_0	6	4	Tier 4			
H1032	044	0	1	02	01	H1032_044_0	6	1	Tier 1			
H1032	044	0	1	02	01	H1032_044_0	6	2	Tier 2			
H1032	060	0	1	02	01	H1032_060_0	7	1	Tier 1			
H1032	060	0	1	02	01	H1032_060_0	7	2	Tier 2			
H1032	060	0	1	02	01	H1032_060_0	7	3	Tier 3			
H1032	060	0	1	02	01	H1032_060_0	7	4	Tier 4			
H1032	061	0	1	02	01	H1032_061_0	8	1	Tier 1			
H1032	061	0	1	02	01	H1032_061_0	8	2	Tier 2			
H1032	061	0	1	02	01	H1032_061_0	8	4	Tier 4			
H1032	061	0	1	02	01	H1032_061_0	8	3	Tier 3			
H1032	064	0	1	02	01	H1032_064_0	7	1	Tier 1			
H1032	064	0	1	02	01	H1032_064_0	7	3	Tier 3			
H1032	064	0	1	02	01	H1032_064_0	7	2	Tier 2			
H1032	064	0	1	02	01	H1032_064_0	7	4	Tier 4			
H1032	065	0	1	02	01	H1032_065_0	7	1	Tier 1			
H1032	065	0	1	02	01	H1032_065_0	7	2	Tier 2			
H1032	065	0	1	02	01	H1032_065_0	7	4	Tier 4			
H1032	065	0	1	02	01	H1032_065_0	7	3	Tier 3			
H1032	066	0	1	02	01	H1032_066_0	6	2	Tier 2			
H1032	066	0	1	02	01	H1032_066_0	6	3	Tier 3			
H1032	066	0	1	02	01	H1032_066_0	6	1	Tier 1			
H1032	066	0	1	02	01	H1032_066_0	6	4	Tier 4			
H1032	069	0	1	02	01	H1032_069_0	7	1	Tier 1	1		1
H1032	069	0	1	02	01	H1032_069_0	7	3	Tier 3	2		
H1032	069	0	1	02	01	H1032_069_0	7	4	Tier 4	2		
H1032	069	0	1	02	01	H1032_069_0	7	4	Tier 4			
H1032	069	0	1	02	01	H1032_069_0	7	3	Tier 3			
H1032	069	0	1	02	01	H1032_069_0	7	2	Tier 2			
H1032	069	0	1	02	01	H1032_069_0	7	1	Tier 1			
H1032	069	0	1	02	01	H1032_069_0	7	2	Tier 2	2		
H1032	073	0	1	02	01	H1032_073_0	11	1	Tier 1			
H1032	073	0	1	02	01	H1032_073_0	11	2	Tier 2			
H1032	073	0	1	02	01	H1032_073_0	11	3	Tier 3			
H1032	073	0	1	02	01	H1032_073_0	11	4	Tier 4			
H1032	073	0	1	02	01	H1032_073_0	11	1	Tier 1	1		1
H1032	073	0	1	02	01	H1032_073_0	11	2	Tier 2	2		
H1032	073	0	1	02	01	H1032_073_0	11	3	Tier 3	2		
H1032	073	0	1	02	01	H1032_073_0	11	4	Tier 4	2		
H1032	079	0	1	02	01	H1032_079_0	6	2	Tier 2	2		
H1032	079	0	1	02	01	H1032_079_0	6	3	Tier 3	2		
H1032	079	0	1	02	01	H1032_079_0	6	4	Tier 4	2		
H1032	079	0	1	02	01	H1032_079_0	6	1	Tier 1	2		
H1032	079	0	1	02	01	H1032_079_0	6	2	Tier 2			
H1032	079	0	1	02	01	H1032_079_0	6	3	Tier 3			
H1032	079	0	1	02	01	H1032_079_0	6	4	Tier 4			
H1032	079	0	1	02	01	H1032_079_0	6	1	Tier 1			
H1032	085	0	1	01	01	H1032_085_0	7	2	Tier 2			
H1032	085	0	1	01	01	H1032_085_0	7	3	Tier 3			
H1032	085	0	1	01	01	H1032_085_0	7	4	Tier 4			
H1032	085	0	1	01	01	H1032_085_0	7	1	Tier 1			
H1032	086	0	1	01	01	H1032_086_0	7	2	Tier 2			
H1032	086	0	1	01	01	H1032_086_0	7	3	Tier 3			
H1032	086	0	1	01	01	H1032_086_0	7	4	Tier 4			
H1032	086	0	1	01	01	H1032_086_0	7	1	Tier 1			
H1032	088	0	1	01	01	H1032_088_0	8	4	Tier 4			
H1032	088	0	1	01	01	H1032_088_0	8	1	Tier 1			
H1032	088	0	1	01	01	H1032_088_0	8	2	Tier 2			
H1032	088	0	1	01	01	H1032_088_0	8	3	Tier 3			
H1032	089	0	1	01	01	H1032_089_0	7	1	Tier 1			
H1032	089	0	1	01	01	H1032_089_0	7	2	Tier 2			
H1032	089	0	1	01	01	H1032_089_0	7	4	Tier 4			
H1032	089	0	1	01	01	H1032_089_0	7	3	Tier 3			
H1032	091	0	1	02	01	H1032_091_0	6	3	Tier 3	2		
H1032	091	0	1	02	01	H1032_091_0	6	1	Tier 1			
H1032	091	0	1	02	01	H1032_091_0	6	2	Tier 2			
H1032	091	0	1	02	01	H1032_091_0	6	3	Tier 3			
H1032	091	0	1	02	01	H1032_091_0	6	4	Tier 4			
H1032	091	0	1	02	01	H1032_091_0	6	1	Tier 1	1		1
H1032	091	0	1	02	01	H1032_091_0	6	2	Tier 2	2		
H1032	091	0	1	02	01	H1032_091_0	6	4	Tier 4	2		
H1032	097	0	1	02	01	H1032_097_0	9	1	Tier 1			
H1032	097	0	1	02	01	H1032_097_0	9	2	Tier 2			
H1032	097	0	1	02	01	H1032_097_0	9	3	Tier 3			
H1032	097	0	1	02	01	H1032_097_0	9	4	Tier 4			
H1032	098	0	1	02	01	H1032_098_0	6	2	Tier 2			
H1032	098	0	1	02	01	H1032_098_0	6	1	Tier 1			
H1032	098	0	1	02	01	H1032_098_0	6	3	Tier 3			
H1032	098	0	1	02	01	H1032_098_0	6	4	Tier 4			
H1032	101	0	1	02	01	H1032_101_0	7	1	Tier 1			
H1032	101	0	1	02	01	H1032_101_0	7	2	Tier 2			
H1032	101	0	1	02	01	H1032_101_0	7	3	Tier 3			
H1032	101	0	1	02	01	H1032_101_0	7	4	Tier 4			
H1032	102	0	1	02	01	H1032_102_0	7	3	Tier 3			
H1032	102	0	1	02	01	H1032_102_0	7	4	Tier 4			
H1032	102	0	1	02	01	H1032_102_0	7	2	Tier 2			
H1032	102	0	1	02	01	H1032_102_0	7	1	Tier 1			
H1032	104	0	1	02	01	H1032_104_0	8	4	Tier 4			
H1032	104	0	1	02	01	H1032_104_0	8	2	Tier 2			
H1032	104	0	1	02	01	H1032_104_0	8	3	Tier 3			
H1032	104	0	1	02	01	H1032_104_0	8	1	Tier 1			
H1032	106	0	1	02	01	H1032_106_0	7	3	Tier 3			
H1032	106	0	1	02	01	H1032_106_0	7	1	Tier 1			
H1032	106	0	1	02	01	H1032_106_0	7	2	Tier 2			
H1032	106	0	1	02	01	H1032_106_0	7	4	Tier 4			
H1032	107	0	1	02	01	H1032_107_0	7	1	Tier 1			
H1032	107	0	1	02	01	H1032_107_0	7	2	Tier 2			
H1032	107	0	1	02	01	H1032_107_0	7	3	Tier 3			
H1032	107	0	1	02	01	H1032_107_0	7	4	Tier 4			
H1032	113	0	1	02	01	H1032_113_0	6	4	Tier 4			
H1032	113	0	1	02	01	H1032_113_0	6	2	Tier 2			
H1032	113	0	1	02	01	H1032_113_0	6	3	Tier 3			
H1032	113	0	1	02	01	H1032_113_0	6	1	Tier 1			
H1032	122	0	1	01	01	H1032_122_0	7	3	Tier 3			
H1032	122	0	1	01	01	H1032_122_0	7	4	Tier 4			
H1032	122	0	1	01	01	H1032_122_0	7	1	Tier 1			
H1032	122	0	1	01	01	H1032_122_0	7	2	Tier 2			
H1032	123	0	1	01	01	H1032_123_0	7	2	Tier 2			
H1032	123	0	1	01	01	H1032_123_0	7	1	Tier 1			
H1032	123	0	1	01	01	H1032_123_0	7	3	Tier 3			
H1032	123	0	1	01	01	H1032_123_0	7	4	Tier 4			
H1032	124	0	1	01	01	H1032_124_0	7	3	Tier 3			
H1032	124	0	1	01	01	H1032_124_0	7	2	Tier 2			
H1032	124	0	1	01	01	H1032_124_0	7	1	Tier 1			
H1032	124	0	1	01	01	H1032_124_0	7	4	Tier 4			
H1032	125	0	1	01	01	H1032_125_0	7	3	Tier 3			
H1032	125	0	1	01	01	H1032_125_0	7	4	Tier 4			
H1032	125	0	1	01	01	H1032_125_0	7	1	Tier 1			
H1032	125	0	1	01	01	H1032_125_0	7	2	Tier 2			
H1032	126	0	1	02	01	H1032_126_0	7	4	Tier 4			
H1032	126	0	1	02	01	H1032_126_0	7	3	Tier 3			
H1032	126	0	1	02	01	H1032_126_0	7	2	Tier 2			
H1032	126	0	1	02	01	H1032_126_0	7	1	Tier 1			
H1032	127	0	1	01	01	H1032_127_0	7	2	Tier 2			
H1032	127	0	1	01	01	H1032_127_0	7	3	Tier 3			
H1032	127	0	1	01	01	H1032_127_0	7	4	Tier 4			
H1032	127	0	1	01	01	H1032_127_0	7	1	Tier 1			
H1032	128	0	1	01	01	H1032_128_0	8	4	Tier 4			
H1032	128	0	1	01	01	H1032_128_0	8	3	Tier 3			
H1032	128	0	1	01	01	H1032_128_0	8	2	Tier 2			
H1032	128	0	1	01	01	H1032_128_0	8	1	Tier 1			
H1032	130	0	1	01	01	H1032_130_0	7	1	Tier 1			
H1032	130	0	1	01	01	H1032_130_0	7	2	Tier 2			
H1032	130	0	1	01	01	H1032_130_0	7	4	Tier 4			
H1032	130	0	1	01	01	H1032_130_0	7	3	Tier 3			
H1032	131	0	1	02	01	H1032_131_0	6	1	Tier 1			
H1032	131	0	1	02	01	H1032_131_0	6	2	Tier 2			
H1032	131	0	1	02	01	H1032_131_0	6	3	Tier 3			
H1032	131	0	1	02	01	H1032_131_0	6	4	Tier 4			
H1032	132	0	1	02	01	H1032_132_0	6	1	Tier 1			
H1032	132	0	1	02	01	H1032_132_0	6	2	Tier 2			
H1032	132	0	1	02	01	H1032_132_0	6	3	Tier 3			
H1032	132	0	1	02	01	H1032_132_0	6	4	Tier 4			
H1032	132	0	1	02	01	H1032_132_0	6	1	Tier 1	1		1
H1032	132	0	1	02	01	H1032_132_0	6	2	Tier 2	2		
H1032	132	0	1	02	01	H1032_132_0	6	3	Tier 3	2		
H1032	132	0	1	02	01	H1032_132_0	6	4	Tier 4	2		
H1032	133	0	1	02	01	H1032_133_0	6	1	Tier 1	1		1
H1032	133	0	1	02	01	H1032_133_0	6	4	Tier 4			
H1032	133	0	1	02	01	H1032_133_0	6	4	Tier 4	2		
H1032	133	0	1	02	01	H1032_133_0	6	3	Tier 3	2		
H1032	133	0	1	02	01	H1032_133_0	6	2	Tier 2	2		
H1032	133	0	1	02	01	H1032_133_0	6	1	Tier 1			
H1032	133	0	1	02	01	H1032_133_0	6	2	Tier 2			
H1032	133	0	1	02	01	H1032_133_0	6	3	Tier 3			
H1032	136	0	1	02	01	H1032_136_0	7	1	Tier 1			
H1032	136	0	1	02	01	H1032_136_0	7	4	Tier 4			
H1032	136	0	1	02	01	H1032_136_0	7	3	Tier 3			
H1032	136	0	1	02	01	H1032_136_0	7	2	Tier 2			
H1032	138	0	1	01	01	H1032_138_0	7	3	Tier 3			
H1032	138	0	1	01	01	H1032_138_0	7	2	Tier 2			
H1032	138	0	1	01	01	H1032_138_0	7	1	Tier 1			
H1032	138	0	1	01	01	H1032_138_0	7	4	Tier 4			
H1032	144	0	1	02	01	H1032_144_0	6	1	Tier 1	1		1
H1032	144	0	1	02	01	H1032_144_0	6	4	Tier 4			
H1032	144	0	1	02	01	H1032_144_0	6	3	Tier 3			
H1032	144	0	1	02	01	H1032_144_0	6	2	Tier 2			
H1032	144	0	1	02	01	H1032_144_0	6	1	Tier 1			
H1032	144	0	1	02	01	H1032_144_0	6	2	Tier 2	2		
H1032	144	0	1	02	01	H1032_144_0	6	4	Tier 4	2		
H1032	144	0	1	02	01	H1032_144_0	6	3	Tier 3	2		
H1032	145	0	1	02	01	H1032_145_0	6	1	Tier 1			
H1032	145	0	1	02	01	H1032_145_0	6	4	Tier 4			
H1032	145	0	1	02	01	H1032_145_0	6	3	Tier 3			
H1032	145	0	1	02	01	H1032_145_0	6	2	Tier 2			
H1032	146	0	1	02	01	H1032_146_0	6	1	Tier 1	1		1
H1032	146	0	1	02	01	H1032_146_0	6	4	Tier 4			
H1032	146	0	1	02	01	H1032_146_0	6	3	Tier 3			
H1032	146	0	1	02	01	H1032_146_0	6	2	Tier 2			
H1032	146	0	1	02	01	H1032_146_0	6	1	Tier 1			
H1032	146	0	1	02	01	H1032_146_0	6	2	Tier 2	2		
H1032	146	0	1	02	01	H1032_146_0	6	4	Tier 4	2		
H1032	146	0	1	02	01	H1032_146_0	6	3	Tier 3	2		
H1032	148	0	1	01	01	H1032_148_0	7	1	Tier 1			
H1032	148	0	1	01	01	H1032_148_0	7	2	Tier 2			
H1032	148	0	1	01	01	H1032_148_0	7	3	Tier 3			
H1032	148	0	1	01	01	H1032_148_0	7	4	Tier 4			
H1032	152	0	1	02	01	H1032_152_0	8	1	Tier 1			
H1032	152	0	1	02	01	H1032_152_0	8	2	Tier 2			
H1032	152	0	1	02	01	H1032_152_0	8	3	Tier 3			
H1032	152	0	1	02	01	H1032_152_0	8	4	Tier 4			
H1032	153	0	1	02	01	H1032_153_0	7	1	Tier 1			
H1032	153	0	1	02	01	H1032_153_0	7	2	Tier 2			
H1032	153	0	1	02	01	H1032_153_0	7	3	Tier 3			
H1032	153	0	1	02	01	H1032_153_0	7	4	Tier 4			
H1032	162	0	1	02	01	H1032_162_0	6	1	Tier 1			
H1032	162	0	1	02	01	H1032_162_0	6	2	Tier 2			
H1032	162	0	1	02	01	H1032_162_0	6	3	Tier 3			
H1032	162	0	1	02	01	H1032_162_0	6	4	Tier 4			
H1032	163	0	1	01	01	H1032_163_0	8	1	Tier 1			
H1032	163	0	1	01	01	H1032_163_0	8	2	Tier 2			
H1032	163	0	1	01	01	H1032_163_0	8	4	Tier 4			
H1032	163	0	1	01	01	H1032_163_0	8	3	Tier 3			
H1032	164	0	1	02	01	H1032_164_0	6	1	Tier 1			
H1032	164	0	1	02	01	H1032_164_0	6	3	Tier 3			
H1032	164	0	1	02	01	H1032_164_0	6	2	Tier 2			
H1032	164	0	1	02	01	H1032_164_0	6	4	Tier 4			
H1032	166	0	1	02	01	H1032_166_0	8	1	Tier 1			
H1032	166	0	1	02	01	H1032_166_0	8	2	Tier 2			
H1032	166	0	1	02	01	H1032_166_0	8	4	Tier 4	2		
H1032	166	0	1	02	01	H1032_166_0	8	3	Tier 3	2		
H1032	166	0	1	02	01	H1032_166_0	8	2	Tier 2	2		
H1032	166	0	1	02	01	H1032_166_0	8	1	Tier 1	1		1
H1032	166	0	1	02	01	H1032_166_0	8	4	Tier 4			
H1032	166	0	1	02	01	H1032_166_0	8	3	Tier 3			
H1032	168	0	1	02	01	H1032_168_0	8	1	Tier 1			
H1032	168	0	1	02	01	H1032_168_0	8	3	Tier 3	2		
H1032	168	0	1	02	01	H1032_168_0	8	2	Tier 2	2		
H1032	168	0	1	02	01	H1032_168_0	8	1	Tier 1	1		1
H1032	168	0	1	02	01	H1032_168_0	8	4	Tier 4			
H1032	168	0	1	02	01	H1032_168_0	8	3	Tier 3			
H1032	168	0	1	02	01	H1032_168_0	8	2	Tier 2			
H1032	168	0	1	02	01	H1032_168_0	8	4	Tier 4	2		
H1035	002	0	1	02	01	H1035_002_0	6	1	Preferred Generic			
H1035	002	0	1	02	01	H1035_002_0	6	7	Enhanced Medicare	1		1
H1035	002	0	1	02	01	H1035_002_0	6	6	Specialty Drugs	2		
H1035	002	0	1	02	01	H1035_002_0	6	5	Injectables	2		
H1035	002	0	1	02	01	H1035_002_0	6	4	Non-Preferred Brand	2		
H1035	002	0	1	02	01	H1035_002_0	6	2	Non-Preferred Generic			
H1035	002	0	1	02	01	H1035_002_0	6	3	Preferred Brand	2		
H1035	002	0	1	02	01	H1035_002_0	6	4	Non-Preferred Brand			
H1035	002	0	1	02	01	H1035_002_0	6	5	Injectables			
H1035	002	0	1	02	01	H1035_002_0	6	6	Specialty Drugs			
H1035	002	0	1	02	01	H1035_002_0	6	7	Enhanced Medicare			
H1035	002	0	1	02	01	H1035_002_0	6	1	Preferred Generic	1		1
H1035	002	0	1	02	01	H1035_002_0	6	2	Non-Preferred Generic	1		1
H1035	002	0	1	02	01	H1035_002_0	6	3	Preferred Brand			
H1035	006	0	1	02	01	H1035_006_0	7	1	Preferred Generic			
H1035	006	0	1	02	01	H1035_006_0	7	6	Specialty Drugs			
H1035	006	0	1	02	01	H1035_006_0	7	5	Injectables			
H1035	006	0	1	02	01	H1035_006_0	7	2	Non-Preferred Generic			
H1035	006	0	1	02	01	H1035_006_0	7	3	Preferred Brand			
H1035	006	0	1	02	01	H1035_006_0	7	4	Non-Preferred Brand			
H1036	011	0	1	01	01	H1036_011_0	3	3	Non-Preferred Brand			
H1036	011	0	1	01	01	H1036_011_0	3	2	Preferred Brand			
H1036	011	0	1	01	01	H1036_011_0	3	4	Specialty	1	10001000	2
H1036	011	0	1	01	01	H1036_011_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	011	0	1	01	01	H1036_011_0	3	2	Preferred Brand	1	10000000	2
H1036	011	0	1	01	01	H1036_011_0	3	1	Other (Gen/Brand)	1	10001000	2
H1036	011	0	1	01	01	H1036_011_0	3	4	Specialty			
H1036	011	0	1	01	01	H1036_011_0	3	1	Other (Gen/Brand)			
H1036	025	0	1	01	01	H1036_025_0	6	1	Preferred Generic			
H1036	025	0	1	01	01	H1036_025_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	025	0	1	01	01	H1036_025_0	6	2	Preferred Brand	1	10000000	2
H1036	025	0	1	01	01	H1036_025_0	6	1	Preferred Generic	1		1
H1036	025	0	1	01	01	H1036_025_0	6	4	Specialty			
H1036	025	0	1	01	01	H1036_025_0	6	3	Non-Preferred Brand			
H1036	025	0	1	01	01	H1036_025_0	6	2	Preferred Brand			
H1036	025	0	1	01	01	H1036_025_0	6	4	Specialty	1	10001000	2
H1036	034	0	1	01	01	H1036_034_0	3	3	Non-Preferred Brand			
H1036	034	0	1	01	01	H1036_034_0	3	2	Preferred Brand			
H1036	034	0	1	01	01	H1036_034_0	3	1	Other (Gen/Brand)			
H1036	034	0	1	01	01	H1036_034_0	3	4	Specialty			
H1036	034	0	1	01	01	H1036_034_0	3	4	Specialty	1	10001000	2
H1036	034	0	1	01	01	H1036_034_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	034	0	1	01	01	H1036_034_0	3	2	Preferred Brand	1	10000000	2
H1036	034	0	1	01	01	H1036_034_0	3	1	Other (Gen/Brand)	1	10001000	2
H1036	035	0	1	01	01	H1036_035_0	3	1	Other (Gen/Brand)			
H1036	035	0	1	01	01	H1036_035_0	3	2	Preferred Brand			
H1036	035	0	1	01	01	H1036_035_0	3	4	Specialty	1	10001000	2
H1036	035	0	1	01	01	H1036_035_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	035	0	1	01	01	H1036_035_0	3	2	Preferred Brand	1	10000000	2
H1036	035	0	1	01	01	H1036_035_0	3	1	Other (Gen/Brand)	1	10001000	2
H1036	035	0	1	01	01	H1036_035_0	3	4	Specialty			
H1036	035	0	1	01	01	H1036_035_0	3	3	Non-Preferred Brand			
H1036	037	0	1	01	01	H1036_037_0	4	1	Other (Gen/Brand)			
H1036	037	0	1	01	01	H1036_037_0	4	4	Specialty			
H1036	037	0	1	01	01	H1036_037_0	4	1	Other (Gen/Brand)	1	10001000	2
H1036	037	0	1	01	01	H1036_037_0	4	2	Preferred Brand	1	10000000	2
H1036	037	0	1	01	01	H1036_037_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	037	0	1	01	01	H1036_037_0	4	3	Non-Preferred Brand			
H1036	037	0	1	01	01	H1036_037_0	4	2	Preferred Brand			
H1036	037	0	1	01	01	H1036_037_0	4	4	Specialty	1	10001000	2
H1036	040	0	1	01	01	H1036_040_0	7	1	Preferred Generic			
H1036	040	0	1	01	01	H1036_040_0	7	2	Preferred Brand			
H1036	040	0	1	01	01	H1036_040_0	7	3	Non-Preferred Brand			
H1036	040	0	1	01	01	H1036_040_0	7	4	Specialty			
H1036	040	0	1	01	01	H1036_040_0	7	1	Preferred Generic	1		1
H1036	040	0	1	01	01	H1036_040_0	7	2	Preferred Brand	1	10000000	2
H1036	040	0	1	01	01	H1036_040_0	7	3	Non-Preferred Brand	1	10000000	2
H1036	040	0	1	01	01	H1036_040_0	7	4	Specialty	1	10001000	2
H1036	044	0	1	01	01	H1036_044_0	3	3	Non-Preferred Brand			
H1036	044	0	1	01	01	H1036_044_0	3	2	Preferred Brand			
H1036	044	0	1	01	01	H1036_044_0	3	4	Specialty	1	10001000	2
H1036	044	0	1	01	01	H1036_044_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	044	0	1	01	01	H1036_044_0	3	2	Preferred Brand	1	10000000	2
H1036	044	0	1	01	01	H1036_044_0	3	1	Preferred Generic	1		1
H1036	044	0	1	01	01	H1036_044_0	3	4	Specialty			
H1036	044	0	1	01	01	H1036_044_0	3	1	Preferred Generic			
H1036	047	0	1	01	01	H1036_047_0	6	1	Preferred Generic			
H1036	047	0	1	01	01	H1036_047_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	047	0	1	01	01	H1036_047_0	6	2	Preferred Brand	1	10000000	2
H1036	047	0	1	01	01	H1036_047_0	6	1	Preferred Generic	1	00001000	2
H1036	047	0	1	01	01	H1036_047_0	6	4	Specialty			
H1036	047	0	1	01	01	H1036_047_0	6	3	Non-Preferred Brand			
H1036	047	0	1	01	01	H1036_047_0	6	2	Preferred Brand			
H1036	047	0	1	01	01	H1036_047_0	6	4	Specialty	1	10001000	2
H1036	052	0	1	01	01	H1036_052_0	4	3	Non-Preferred Brand			
H1036	052	0	1	01	01	H1036_052_0	4	2	Preferred Brand			
H1036	052	0	1	01	01	H1036_052_0	4	1	Preferred Generic			
H1036	052	0	1	01	01	H1036_052_0	4	4	Specialty			
H1036	052	0	1	01	01	H1036_052_0	4	4	Specialty	1	10001000	2
H1036	052	0	1	01	01	H1036_052_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	052	0	1	01	01	H1036_052_0	4	2	Preferred Brand	1	10000000	2
H1036	052	0	1	01	01	H1036_052_0	4	1	Preferred Generic	1		1
H1036	054	0	1	01	01	H1036_054_0	2	1	Other (Gen/Brand)			
H1036	054	0	1	01	01	H1036_054_0	2	2	Preferred Brand			
H1036	054	0	1	01	01	H1036_054_0	2	4	Specialty	1	10001000	2
H1036	054	0	1	01	01	H1036_054_0	2	3	Non-Preferred Brand	1	10000000	2
H1036	054	0	1	01	01	H1036_054_0	2	2	Preferred Brand	1	10000000	2
H1036	054	0	1	01	01	H1036_054_0	2	1	Other (Gen/Brand)	1		1
H1036	054	0	1	01	01	H1036_054_0	2	4	Specialty			
H1036	054	0	1	01	01	H1036_054_0	2	3	Non-Preferred Brand			
H1036	062	0	1	01	01	H1036_062_0	3	1	Other (Gen/Brand)			
H1036	062	0	1	01	01	H1036_062_0	3	4	Specialty			
H1036	062	0	1	01	01	H1036_062_0	3	1	Other (Gen/Brand)	1		1
H1036	062	0	1	01	01	H1036_062_0	3	2	Preferred Brand	1	10000000	2
H1036	062	0	1	01	01	H1036_062_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	062	0	1	01	01	H1036_062_0	3	3	Non-Preferred Brand			
H1036	062	0	1	01	01	H1036_062_0	3	2	Preferred Brand			
H1036	062	0	1	01	01	H1036_062_0	3	4	Specialty	1	10001000	2
H1036	065	0	1	01	01	H1036_065_0	2	1	Other (Gen/Brand)			
H1036	065	0	1	01	01	H1036_065_0	2	2	Preferred Brand			
H1036	065	0	1	01	01	H1036_065_0	2	3	Non-Preferred Brand			
H1036	065	0	1	01	01	H1036_065_0	2	4	Specialty			
H1036	065	0	1	01	01	H1036_065_0	2	1	Other (Gen/Brand)	1		1
H1036	065	0	1	01	01	H1036_065_0	2	2	Preferred Brand	1	10000000	2
H1036	065	0	1	01	01	H1036_065_0	2	3	Non-Preferred Brand	1	10000000	2
H1036	065	0	1	01	01	H1036_065_0	2	4	Specialty	1	10001000	2
H1036	067	0	1	01	01	H1036_067_0	4	3	Non-Preferred Brand			
H1036	067	0	1	01	01	H1036_067_0	4	2	Preferred Brand			
H1036	067	0	1	01	01	H1036_067_0	4	4	Specialty	1	10001000	2
H1036	067	0	1	01	01	H1036_067_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	067	0	1	01	01	H1036_067_0	4	2	Preferred Brand	1	10000000	2
H1036	067	0	1	01	01	H1036_067_0	4	1	Preferred Generic	1		1
H1036	067	0	1	01	01	H1036_067_0	4	4	Specialty			
H1036	067	0	1	01	01	H1036_067_0	4	1	Preferred Generic			
H1036	068	0	1	01	01	H1036_068_0	4	1	Other (Gen/Brand)			
H1036	068	0	1	01	01	H1036_068_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	068	0	1	01	01	H1036_068_0	4	2	Preferred Brand	1	10000000	2
H1036	068	0	1	01	01	H1036_068_0	4	1	Other (Gen/Brand)	1	10001000	2
H1036	068	0	1	01	01	H1036_068_0	4	4	Specialty			
H1036	068	0	1	01	01	H1036_068_0	4	3	Non-Preferred Brand			
H1036	068	0	1	01	01	H1036_068_0	4	2	Preferred Brand			
H1036	068	0	1	01	01	H1036_068_0	4	4	Specialty	1	10001000	2
H1036	074	0	1	01	01	H1036_074_0	4	3	Non-Preferred Brand			
H1036	074	0	1	01	01	H1036_074_0	4	2	Preferred Brand			
H1036	074	0	1	01	01	H1036_074_0	4	1	Preferred Generic			
H1036	074	0	1	01	01	H1036_074_0	4	4	Specialty			
H1036	074	0	1	01	01	H1036_074_0	4	4	Specialty	1	10001000	2
H1036	074	0	1	01	01	H1036_074_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	074	0	1	01	01	H1036_074_0	4	2	Preferred Brand	1	10000000	2
H1036	074	0	1	01	01	H1036_074_0	4	1	Preferred Generic	1		1
H1036	077	0	1	01	01	H1036_077_0	3	1	Other (Gen/Brand)			
H1036	077	0	1	01	01	H1036_077_0	3	2	Preferred Brand			
H1036	077	0	1	01	01	H1036_077_0	3	4	Specialty	1	10001000	2
H1036	077	0	1	01	01	H1036_077_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	077	0	1	01	01	H1036_077_0	3	2	Preferred Brand	1	10000000	2
H1036	077	0	1	01	01	H1036_077_0	3	1	Other (Gen/Brand)	1	10001000	2
H1036	077	0	1	01	01	H1036_077_0	3	4	Specialty			
H1036	077	0	1	01	01	H1036_077_0	3	3	Non-Preferred Brand			
H1036	081	0	1	01	01	H1036_081_0	4	1	Other (Gen/Brand)			
H1036	081	0	1	01	01	H1036_081_0	4	4	Specialty			
H1036	081	0	1	01	01	H1036_081_0	4	1	Other (Gen/Brand)	1	10001000	2
H1036	081	0	1	01	01	H1036_081_0	4	2	Preferred Brand	1	10000000	2
H1036	081	0	1	01	01	H1036_081_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	081	0	1	01	01	H1036_081_0	4	3	Non-Preferred Brand			
H1036	081	0	1	01	01	H1036_081_0	4	2	Preferred Brand			
H1036	081	0	1	01	01	H1036_081_0	4	4	Specialty	1	10001000	2
H1036	100	0	1	01	01	H1036_100_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	100	0	1	01	01	H1036_100_0	6	2	Preferred Brand	1	10000000	2
H1036	100	0	1	01	01	H1036_100_0	6	1	Preferred Generic	1	00001000	2
H1036	100	0	1	01	01	H1036_100_0	6	4	Specialty			
H1036	100	0	1	01	01	H1036_100_0	6	3	Non-Preferred Brand			
H1036	100	0	1	01	01	H1036_100_0	6	2	Preferred Brand			
H1036	100	0	1	01	01	H1036_100_0	6	1	Preferred Generic			
H1036	100	0	1	01	01	H1036_100_0	6	4	Specialty	1	10001000	2
H1036	102	0	1	01	01	H1036_102_0	6	1	Preferred Generic			
H1036	102	0	1	01	01	H1036_102_0	6	2	Preferred Brand			
H1036	102	0	1	01	01	H1036_102_0	6	3	Non-Preferred Brand			
H1036	102	0	1	01	01	H1036_102_0	6	4	Specialty			
H1036	102	0	1	01	01	H1036_102_0	6	1	Preferred Generic	1	00001000	2
H1036	102	0	1	01	01	H1036_102_0	6	2	Preferred Brand	1	10000000	2
H1036	102	0	1	01	01	H1036_102_0	6	4	Specialty	1	10001000	2
H1036	102	0	1	01	01	H1036_102_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	103	0	1	01	01	H1036_103_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	103	0	1	01	01	H1036_103_0	3	4	Specialty	1	10001000	2
H1036	103	0	1	01	01	H1036_103_0	3	2	Preferred Brand	1	10000000	2
H1036	103	0	1	01	01	H1036_103_0	3	1	Other (Gen/Brand)	1	10001000	2
H1036	103	0	1	01	01	H1036_103_0	3	4	Specialty			
H1036	103	0	1	01	01	H1036_103_0	3	3	Non-Preferred Brand			
H1036	103	0	1	01	01	H1036_103_0	3	2	Preferred Brand			
H1036	103	0	1	01	01	H1036_103_0	3	1	Other (Gen/Brand)			
H1036	104	0	1	01	01	H1036_104_0	4	4	Specialty	1	10001000	2
H1036	104	0	1	01	01	H1036_104_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	104	0	1	01	01	H1036_104_0	4	2	Preferred Brand	1	10000000	2
H1036	104	0	1	01	01	H1036_104_0	4	1	Other (Gen/Brand)	1	10001000	2
H1036	104	0	1	01	01	H1036_104_0	4	4	Specialty			
H1036	104	0	1	01	01	H1036_104_0	4	3	Non-Preferred Brand			
H1036	104	0	1	01	01	H1036_104_0	4	2	Preferred Brand			
H1036	104	0	1	01	01	H1036_104_0	4	1	Other (Gen/Brand)			
H1036	105	0	1	01	01	H1036_105_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	105	0	1	01	01	H1036_105_0	6	4	Specialty	1	10001000	2
H1036	105	0	1	01	01	H1036_105_0	6	2	Preferred Brand	1	10000000	2
H1036	105	0	1	01	01	H1036_105_0	6	1	Preferred Generic	1	00001000	2
H1036	105	0	1	01	01	H1036_105_0	6	4	Specialty			
H1036	105	0	1	01	01	H1036_105_0	6	3	Non-Preferred Brand			
H1036	105	0	1	01	01	H1036_105_0	6	2	Preferred Brand			
H1036	105	0	1	01	01	H1036_105_0	6	1	Preferred Generic			
H1036	106	0	1	01	01	H1036_106_0	3	4	Specialty	1	10001000	2
H1036	106	0	1	01	01	H1036_106_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	106	0	1	01	01	H1036_106_0	3	2	Preferred Brand	1	10000000	2
H1036	106	0	1	01	01	H1036_106_0	3	1	Preferred Generic	1		1
H1036	106	0	1	01	01	H1036_106_0	3	4	Specialty			
H1036	106	0	1	01	01	H1036_106_0	3	3	Non-Preferred Brand			
H1036	106	0	1	01	01	H1036_106_0	3	2	Preferred Brand			
H1036	106	0	1	01	01	H1036_106_0	3	1	Preferred Generic			
H1036	108	0	1	01	01	H1036_108_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	108	0	1	01	01	H1036_108_0	4	4	Specialty	1	10001000	2
H1036	108	0	1	01	01	H1036_108_0	4	2	Preferred Brand	1	10000000	2
H1036	108	0	1	01	01	H1036_108_0	4	1	Other (Gen/Brand)	1	10001000	2
H1036	108	0	1	01	01	H1036_108_0	4	4	Specialty			
H1036	108	0	1	01	01	H1036_108_0	4	3	Non-Preferred Brand			
H1036	108	0	1	01	01	H1036_108_0	4	2	Preferred Brand			
H1036	108	0	1	01	01	H1036_108_0	4	1	Other (Gen/Brand)			
H1036	109	0	1	01	01	H1036_109_0	6	1	Other (Gen/Brand)			
H1036	109	0	1	01	01	H1036_109_0	6	2	Preferred Brand			
H1036	109	0	1	01	01	H1036_109_0	6	3	Non-Preferred Brand			
H1036	109	0	1	01	01	H1036_109_0	6	4	Specialty			
H1036	109	0	1	01	01	H1036_109_0	6	1	Other (Gen/Brand)	1	10001000	2
H1036	109	0	1	01	01	H1036_109_0	6	2	Preferred Brand	1	10000000	2
H1036	109	0	1	01	01	H1036_109_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	109	0	1	01	01	H1036_109_0	6	4	Specialty	1	10001000	2
H1036	110	0	1	01	01	H1036_110_0	4	3	Non-Preferred Brand	1	10000000	2
H1036	110	0	1	01	01	H1036_110_0	4	2	Preferred Brand	1	10000000	2
H1036	110	0	1	01	01	H1036_110_0	4	4	Specialty	1	10001000	2
H1036	110	0	1	01	01	H1036_110_0	4	1	Other (Gen/Brand)			
H1036	110	0	1	01	01	H1036_110_0	4	2	Preferred Brand			
H1036	110	0	1	01	01	H1036_110_0	4	3	Non-Preferred Brand			
H1036	110	0	1	01	01	H1036_110_0	4	4	Specialty			
H1036	110	0	1	01	01	H1036_110_0	4	1	Other (Gen/Brand)	1	10001000	2
H1036	114	0	1	01	01	H1036_114_0	6	1	Preferred Generic			
H1036	114	0	1	01	01	H1036_114_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	114	0	1	01	01	H1036_114_0	6	2	Preferred Brand	1	10000000	2
H1036	114	0	1	01	01	H1036_114_0	6	1	Preferred Generic	1	00001000	2
H1036	114	0	1	01	01	H1036_114_0	6	4	Specialty			
H1036	114	0	1	01	01	H1036_114_0	6	3	Non-Preferred Brand			
H1036	114	0	1	01	01	H1036_114_0	6	2	Preferred Brand			
H1036	114	0	1	01	01	H1036_114_0	6	4	Specialty	1	10001000	2
H1036	115	0	1	01	01	H1036_115_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	115	0	1	01	01	H1036_115_0	6	2	Preferred Brand	1	10000000	2
H1036	115	0	1	01	01	H1036_115_0	6	1	Preferred Generic	1	00001000	2
H1036	115	0	1	01	01	H1036_115_0	6	4	Specialty			
H1036	115	0	1	01	01	H1036_115_0	6	3	Non-Preferred Brand			
H1036	115	0	1	01	01	H1036_115_0	6	2	Preferred Brand			
H1036	115	0	1	01	01	H1036_115_0	6	1	Preferred Generic			
H1036	115	0	1	01	01	H1036_115_0	6	4	Specialty	1	10001000	2
H1036	116	0	1	01	01	H1036_116_0	6	3	Non-Preferred Brand			
H1036	116	0	1	01	01	H1036_116_0	6	2	Preferred Brand			
H1036	116	0	1	01	01	H1036_116_0	6	1	Preferred Generic			
H1036	116	0	1	01	01	H1036_116_0	6	4	Specialty			
H1036	116	0	1	01	01	H1036_116_0	6	1	Preferred Generic	1	00001000	2
H1036	116	0	1	01	01	H1036_116_0	6	2	Preferred Brand	1	10000000	2
H1036	116	0	1	01	01	H1036_116_0	6	3	Non-Preferred Brand	1	10000000	2
H1036	116	0	1	01	01	H1036_116_0	6	4	Specialty	1	10001000	2
H1036	117	0	1	01	01	H1036_117_0	7	3	Non-Preferred Brand			
H1036	117	0	1	01	01	H1036_117_0	7	2	Preferred Brand			
H1036	117	0	1	01	01	H1036_117_0	7	1	Preferred Generic			
H1036	117	0	1	01	01	H1036_117_0	7	4	Specialty			
H1036	117	0	1	01	01	H1036_117_0	7	4	Specialty	1	10001000	2
H1036	117	0	1	01	01	H1036_117_0	7	3	Non-Preferred Brand	1	10000000	2
H1036	117	0	1	01	01	H1036_117_0	7	2	Preferred Brand	1	10000000	2
H1036	117	0	1	01	01	H1036_117_0	7	1	Preferred Generic	1		1
H1036	118	0	1	01	01	H1036_118_0	8	1	Preferred Generic			
H1036	118	0	1	01	01	H1036_118_0	8	2	Preferred Brand			
H1036	118	0	1	01	01	H1036_118_0	8	3	Non-Preferred Brand			
H1036	118	0	1	01	01	H1036_118_0	8	3	Non-Preferred Brand	1	10000000	2
H1036	118	0	1	01	01	H1036_118_0	8	2	Preferred Brand	1	10000000	2
H1036	118	0	1	01	01	H1036_118_0	8	1	Preferred Generic	1		1
H1036	118	0	1	01	01	H1036_118_0	8	4	Specialty			
H1036	118	0	1	01	01	H1036_118_0	8	4	Specialty	1	10001000	2
H1036	121	0	1	01	01	H1036_121_0	3	1	Other (Gen/Brand)			
H1036	121	0	1	01	01	H1036_121_0	3	2	Preferred Brand			
H1036	121	0	1	01	01	H1036_121_0	3	3	Non-Preferred Brand			
H1036	121	0	1	01	01	H1036_121_0	3	4	Specialty			
H1036	121	0	1	01	01	H1036_121_0	3	1	Other (Gen/Brand)	1		1
H1036	121	0	1	01	01	H1036_121_0	3	2	Preferred Brand	1	10000000	2
H1036	121	0	1	01	01	H1036_121_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	121	0	1	01	01	H1036_121_0	3	4	Specialty	1	10001000	2
H1036	122	0	1	01	01	H1036_122_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	122	0	1	01	01	H1036_122_0	3	2	Preferred Brand	1	10000000	2
H1036	122	0	1	01	01	H1036_122_0	3	4	Specialty	1	10001000	2
H1036	122	0	1	01	01	H1036_122_0	3	1	Other (Gen/Brand)			
H1036	122	0	1	01	01	H1036_122_0	3	2	Preferred Brand			
H1036	122	0	1	01	01	H1036_122_0	3	3	Non-Preferred Brand			
H1036	122	0	1	01	01	H1036_122_0	3	4	Specialty			
H1036	122	0	1	01	01	H1036_122_0	3	1	Other (Gen/Brand)	1		1
H1036	125	0	1	01	01	H1036_125_0	3	1	Other (Gen/Brand)			
H1036	125	0	1	01	01	H1036_125_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	125	0	1	01	01	H1036_125_0	3	2	Preferred Brand	1	10000000	2
H1036	125	0	1	01	01	H1036_125_0	3	1	Other (Gen/Brand)	1		1
H1036	125	0	1	01	01	H1036_125_0	3	4	Specialty			
H1036	125	0	1	01	01	H1036_125_0	3	3	Non-Preferred Brand			
H1036	125	0	1	01	01	H1036_125_0	3	2	Preferred Brand			
H1036	125	0	1	01	01	H1036_125_0	3	4	Specialty	1	10001000	2
H1036	126	0	1	01	01	H1036_126_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	126	0	1	01	01	H1036_126_0	3	2	Preferred Brand	1	10000000	2
H1036	126	0	1	01	01	H1036_126_0	3	1	Other (Gen/Brand)	1		1
H1036	126	0	1	01	01	H1036_126_0	3	4	Specialty			
H1036	126	0	1	01	01	H1036_126_0	3	3	Non-Preferred Brand			
H1036	126	0	1	01	01	H1036_126_0	3	2	Preferred Brand			
H1036	126	0	1	01	01	H1036_126_0	3	1	Other (Gen/Brand)			
H1036	126	0	1	01	01	H1036_126_0	3	4	Specialty	1	10001000	2
H1036	127	0	1	01	01	H1036_127_0	3	3	Non-Preferred Brand			
H1036	127	0	1	01	01	H1036_127_0	3	2	Preferred Brand			
H1036	127	0	1	01	01	H1036_127_0	3	1	Other (Gen/Brand)			
H1036	127	0	1	01	01	H1036_127_0	3	4	Specialty			
H1036	127	0	1	01	01	H1036_127_0	3	1	Other (Gen/Brand)	1	10001000	2
H1036	127	0	1	01	01	H1036_127_0	3	2	Preferred Brand	1	10000000	2
H1036	127	0	1	01	01	H1036_127_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	127	0	1	01	01	H1036_127_0	3	4	Specialty	1	10001000	2
H1036	130	0	1	01	01	H1036_130_0	3	3	Non-Preferred Brand			
H1036	130	0	1	01	01	H1036_130_0	3	2	Preferred Brand			
H1036	130	0	1	01	01	H1036_130_0	3	1	Other (Gen/Brand)			
H1036	130	0	1	01	01	H1036_130_0	3	4	Specialty			
H1036	130	0	1	01	01	H1036_130_0	3	4	Specialty	1	10001000	2
H1036	130	0	1	01	01	H1036_130_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	130	0	1	01	01	H1036_130_0	3	2	Preferred Brand	1	10000000	2
H1036	130	0	1	01	01	H1036_130_0	3	1	Other (Gen/Brand)	1		1
H1036	131	0	1	01	01	H1036_131_0	3	1	Other (Gen/Brand)			
H1036	131	0	1	01	01	H1036_131_0	3	2	Preferred Brand			
H1036	131	0	1	01	01	H1036_131_0	3	3	Non-Preferred Brand			
H1036	131	0	1	01	01	H1036_131_0	3	3	Non-Preferred Brand	1	10000000	2
H1036	131	0	1	01	01	H1036_131_0	3	2	Preferred Brand	1	10000000	2
H1036	131	0	1	01	01	H1036_131_0	3	1	Other (Gen/Brand)	1		1
H1036	131	0	1	01	01	H1036_131_0	3	4	Specialty			
H1036	131	0	1	01	01	H1036_131_0	3	4	Specialty	1	10001000	2
H1045	001	0	1	01	01	H1045_001_0	4	3	Tier 3			
H1045	001	0	1	01	01	H1045_001_0	4	2	Tier 2			
H1045	001	0	1	01	01	H1045_001_0	4	4	Tier 4	2		
H1045	001	0	1	01	01	H1045_001_0	4	3	Tier 3	2		
H1045	001	0	1	01	01	H1045_001_0	4	2	Tier 2	2		
H1045	001	0	1	01	01	H1045_001_0	4	1	Tier 1	1		1
H1045	001	0	1	01	01	H1045_001_0	4	4	Tier 4			
H1045	001	0	1	01	01	H1045_001_0	4	1	Tier 1			
H1045	005	0	1	01	01	H1045_005_0	3	1	Tier 1			
H1045	005	0	1	01	01	H1045_005_0	3	3	Tier 3	2		
H1045	005	0	1	01	01	H1045_005_0	3	2	Tier 2	2		
H1045	005	0	1	01	01	H1045_005_0	3	1	Tier 1	1		1
H1045	005	0	1	01	01	H1045_005_0	3	4	Tier 4			
H1045	005	0	1	01	01	H1045_005_0	3	3	Tier 3			
H1045	005	0	1	01	01	H1045_005_0	3	2	Tier 2			
H1045	005	0	1	01	01	H1045_005_0	3	4	Tier 4	2		
H1045	008	0	1	01	01	H1045_008_0	4	3	Tier 3			
H1045	008	0	1	01	01	H1045_008_0	4	2	Tier 2			
H1045	008	0	1	01	01	H1045_008_0	4	1	Tier 1			
H1045	008	0	1	01	01	H1045_008_0	4	4	Tier 4			
H1045	008	0	1	01	01	H1045_008_0	4	4	Tier 4	2		
H1045	008	0	1	01	01	H1045_008_0	4	3	Tier 3	2		
H1045	008	0	1	01	01	H1045_008_0	4	2	Tier 2	2		
H1045	008	0	1	01	01	H1045_008_0	4	1	Tier 1	1		1
H1045	010	0	1	01	01	H1045_010_0	4	3	Tier 3			
H1045	010	0	1	01	01	H1045_010_0	4	2	Tier 2			
H1045	010	0	1	01	01	H1045_010_0	4	1	Tier 1			
H1045	010	0	1	01	01	H1045_010_0	4	4	Tier 4			
H1045	011	0	1	01	01	H1045_011_0	5	3	Tier 3			
H1045	011	0	1	01	01	H1045_011_0	5	2	Tier 2			
H1045	011	0	1	01	01	H1045_011_0	5	1	Tier 1			
H1045	011	0	1	01	01	H1045_011_0	5	4	Tier 4			
H1045	014	0	1	02	01	H1045_014_0	9	1	Tier 1			
H1045	014	0	1	02	01	H1045_014_0	9	2	Tier 2			
H1045	014	0	1	02	01	H1045_014_0	9	3	Tier 3			
H1045	014	0	1	02	01	H1045_014_0	9	4	Tier 4			
H1045	015	0	1	02	01	H1045_015_0	7	3	Tier 3			
H1045	015	0	1	02	01	H1045_015_0	7	2	Tier 2			
H1045	015	0	1	02	01	H1045_015_0	7	1	Tier 1			
H1045	015	0	1	02	01	H1045_015_0	7	4	Tier 4			
H1076	003	0	1	01	01	H1076_003_0	6	1	Preferred Generic and Select Brand			
H1076	003	0	1	01	01	H1076_003_0	6	2	Preferred Brand			
H1076	003	0	1	01	01	H1076_003_0	6	3	Non-Preferred Brand			
H1076	003	0	1	01	01	H1076_003_0	6	4	Specialty Drugs			
H1076	003	0	1	01	01	H1076_003_0	6	1	Preferred Generic and Select Brand	1		1
H1076	003	0	1	01	01	H1076_003_0	6	2	Preferred Brand	2		
H1076	003	0	1	01	01	H1076_003_0	6	3	Non-Preferred Brand	2		
H1076	003	0	1	01	01	H1076_003_0	6	4	Specialty Drugs	2		
H1076	011	0	1	01	01	H1076_011_0	6	1	Preferred Generic and Select Brand			
H1076	011	0	1	01	01	H1076_011_0	6	2	Preferred Brand			
H1076	011	0	1	01	01	H1076_011_0	6	4	Specialty Drugs			
H1076	011	0	1	01	01	H1076_011_0	6	3	Non-Preferred Brand			
H1076	016	0	1	01	01	H1076_016_0	8	1	Preferred Generic and Select Brand			
H1076	016	0	1	01	01	H1076_016_0	8	2	Preferred Brand			
H1076	016	0	1	01	01	H1076_016_0	8	3	Non-Preferred Brand			
H1076	016	0	1	01	01	H1076_016_0	8	4	Specialty Drugs			
H1076	016	0	1	01	01	H1076_016_0	8	1	Preferred Generic and Select Brand	1		1
H1076	016	0	1	01	01	H1076_016_0	8	3	Non-Preferred Brand	2		
H1076	016	0	1	01	01	H1076_016_0	8	2	Preferred Brand	2		
H1076	016	0	1	01	01	H1076_016_0	8	4	Specialty Drugs	2		
H1080	004	0	1	01	01	H1080_004_0	7	1	Preferred Generic			
H1080	004	0	1	01	01	H1080_004_0	7	2	Preferred Brand			
H1080	004	0	1	01	01	H1080_004_0	7	3	Non Preferred			
H1080	004	0	1	01	01	H1080_004_0	7	4	Specialty			
H1080	011	0	1	02	01	H1080_011_0	5	1	Preferred Generic			
H1080	011	0	1	02	01	H1080_011_0	5	2	Preferred Brand			
H1080	011	0	1	02	01	H1080_011_0	5	4	Specialty			
H1080	011	0	1	02	01	H1080_011_0	5	3	Non Preferred			
H1080	042	0	1	01	01	H1080_042_0	4	1	Preferred Generic			
H1080	042	0	1	01	01	H1080_042_0	4	3	Non-Preferred			
H1080	042	0	1	01	01	H1080_042_0	4	2	Preferred Brand			
H1080	042	0	1	01	01	H1080_042_0	4	4	Specialty			
H1099	001	0	1	02	01	H1099_001_0	4	3	Tier 3 Brand	2		
H1099	001	0	1	02	01	H1099_001_0	4	2	Tier 2 Generic	1		1
H1099	001	0	1	02	01	H1099_001_0	4	1	Tier 1 Preferred Generic	1		1
H1099	001	0	1	02	01	H1099_001_0	4	4	Tier 4 Specialty			
H1099	001	0	1	02	01	H1099_001_0	4	3	Tier 3 Brand			
H1099	001	0	1	02	01	H1099_001_0	4	2	Tier 2 Generic			
H1099	001	0	1	02	01	H1099_001_0	4	1	Tier 1 Preferred Generic			
H1099	001	0	1	02	01	H1099_001_0	4	4	Tier 4 Specialty	2		
H1099	006	0	1	01	01	H1099_006_0	4	3	Tier 3 Brand	2		
H1099	006	0	1	01	01	H1099_006_0	4	2	Tier 2 Generic	2		
H1099	006	0	1	01	01	H1099_006_0	4	1	Tier 1 Preferred Generic	1		1
H1099	006	0	1	01	01	H1099_006_0	4	4	Tier 4 Specialty			
H1099	006	0	1	01	01	H1099_006_0	4	3	Tier 3 Brand			
H1099	006	0	1	01	01	H1099_006_0	4	2	Tier 2 Generic			
H1099	006	0	1	01	01	H1099_006_0	4	1	Tier 1 Preferred Generic			
H1099	006	0	1	01	01	H1099_006_0	4	4	Tier 4 Specialty	2		
H1099	010	0	1	01	01	H1099_010_0	4	1	Tier 1 Preferred Generic			
H1099	010	0	1	01	01	H1099_010_0	4	2	Tier 2 Generic			
H1099	010	0	1	01	01	H1099_010_0	4	4	Tier 4 Specialty	1		1
H1099	010	0	1	01	01	H1099_010_0	4	3	Tier 3 Brand	1		1
H1099	010	0	1	01	01	H1099_010_0	4	2	Tier 2 Generic	1		1
H1099	010	0	1	01	01	H1099_010_0	4	1	Tier 1 Preferred Generic	1		1
H1099	010	0	1	01	01	H1099_010_0	4	4	Tier 4 Specialty			
H1099	010	0	1	01	01	H1099_010_0	4	3	Tier 3 Brand			
H1099	011	0	1	02	01	H1099_011_0	4	1	Tier 1 Preferred Generic			
H1099	011	0	1	02	01	H1099_011_0	4	3	Tier 3 Brand	1		1
H1099	011	0	1	02	01	H1099_011_0	4	2	Tier 2 Generic	1		1
H1099	011	0	1	02	01	H1099_011_0	4	1	Tier 1 Preferred Generic	1		1
H1099	011	0	1	02	01	H1099_011_0	4	4	Tier 4 Specialty			
H1099	011	0	1	02	01	H1099_011_0	4	3	Tier 3 Brand			
H1099	011	0	1	02	01	H1099_011_0	4	2	Tier 2 Generic			
H1099	011	0	1	02	01	H1099_011_0	4	4	Tier 4 Specialty	1		1
H1108	001	0	1	04	01	H1108_001_0	4	3	Non Preferred			
H1108	001	0	1	04	01	H1108_001_0	4	4	Specialty			
H1108	001	0	1	04	01	H1108_001_0	4	2	Preferred Brand			
H1108	001	0	1	04	01	H1108_001_0	4	1	Preferred Generic			
H1108	006	0	1	04	01	H1108_006_0	4	2	Preferred Brand	2		
H1108	006	0	1	04	01	H1108_006_0	4	1	Preferred Generic	1		1
H1108	006	0	1	04	01	H1108_006_0	4	4	Specialty			
H1108	006	0	1	04	01	H1108_006_0	4	3	Non Preferred	2		
H1108	006	0	1	04	01	H1108_006_0	4	3	Non Preferred			
H1108	006	0	1	04	01	H1108_006_0	4	1	Preferred Generic			
H1108	006	0	1	04	01	H1108_006_0	4	2	Preferred Brand			
H1108	006	0	1	04	01	H1108_006_0	4	4	Specialty	2		
H1108	007	0	1	04	01	H1108_007_0	5	1	Preferred Generic			
H1108	007	0	1	04	01	H1108_007_0	5	2	Preferred Brand			
H1108	007	0	1	04	01	H1108_007_0	5	3	Non Preferred			
H1108	007	0	1	04	01	H1108_007_0	5	4	Specialty			
H1109	001	0	1	01	01	H1109_001_0	5	1	Tier 1 - Preferred Generic			
H1109	001	0	1	01	01	H1109_001_0	5	2	Tier 2 - Non-Preferred Generic			
H1109	001	0	1	01	01	H1109_001_0	5	3	Tier 3 - Preferred Brand			
H1109	001	0	1	01	01	H1109_001_0	5	5	Tier 5 - Specialty			
H1109	001	0	1	01	01	H1109_001_0	5	4	Tier 4 - Non-Preferred Brand			
H1109	002	0	1	01	01	H1109_002_0	4	5	Tier 5 - Specialty			
H1109	002	0	1	01	01	H1109_002_0	4	4	Tier 4 - Non-Preferred Brand			
H1109	002	0	1	01	01	H1109_002_0	4	2	Tier 2 - Non-Preferred Generic			
H1109	002	0	1	01	01	H1109_002_0	4	1	Tier 1 - Preferred Generic			
H1109	002	0	1	01	01	H1109_002_0	4	3	Tier 3 - Preferred Brand			
H1109	003	0	1	01	01	H1109_003_0	4	4	Tier 4 - Non-Preferred Brand	2		
H1109	003	0	1	01	01	H1109_003_0	4	3	Tier 3 - Preferred Brand	2		
H1109	003	0	1	01	01	H1109_003_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H1109	003	0	1	01	01	H1109_003_0	4	1	Tier 1 - Preferred Generic	1		1
H1109	003	0	1	01	01	H1109_003_0	4	5	Tier 5 - Specialty	2		
H1109	003	0	1	01	01	H1109_003_0	4	4	Tier 4 - Non-Preferred Brand			
H1109	003	0	1	01	01	H1109_003_0	4	3	Tier 3 - Preferred Brand			
H1109	003	0	1	01	01	H1109_003_0	4	2	Tier 2 - Non-Preferred Generic			
H1109	003	0	1	01	01	H1109_003_0	4	1	Tier 1 - Preferred Generic			
H1109	003	0	1	01	01	H1109_003_0	4	5	Tier 5 - Specialty			
H1110	001	0	1	04	01	H1110_001_0	6	4	Tier 4 - Non-Preferred Brand			
H1110	001	0	1	04	01	H1110_001_0	6	3	Tier 3 - Preferred Brand			
H1110	001	0	1	04	01	H1110_001_0	6	2	Tier 2 - Non-Preferred Generic			
H1110	001	0	1	04	01	H1110_001_0	6	1	Tier 1 - Preferred Generic			
H1110	001	0	1	04	01	H1110_001_0	6	5	Tier 5 - Specialty			
H1110	003	0	1	04	01	H1110_003_0	5	4	Tier 4 - Non-Preferred Brand			
H1110	003	0	1	04	01	H1110_003_0	5	3	Tier 3 - Preferred Brand			
H1110	003	0	1	04	01	H1110_003_0	5	2	Tier 2 - Non-Preferred Generic			
H1110	003	0	1	04	01	H1110_003_0	5	1	Tier 1 - Preferred Generic			
H1110	003	0	1	04	01	H1110_003_0	5	5	Tier 5 - Specialty			
H1110	003	0	1	04	01	H1110_003_0	5	5	Tier 5 - Specialty	2		
H1110	003	0	1	04	01	H1110_003_0	5	4	Tier 4 - Non-Preferred Brand	2		
H1110	003	0	1	04	01	H1110_003_0	5	3	Tier 3 - Preferred Brand	2		
H1110	003	0	1	04	01	H1110_003_0	5	1	Tier 1 - Preferred Generic	1		1
H1110	003	0	1	04	01	H1110_003_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H1111	002	0	1	02	01	H1111_002_0	5	4	Specialty			
H1111	002	0	1	02	01	H1111_002_0	5	2	Preferred Brand			
H1111	002	0	1	02	01	H1111_002_0	5	3	Non Preferred			
H1111	002	0	1	02	01	H1111_002_0	5	1	Preferred Generic			
H1111	005	0	1	02	01	H1111_005_0	3	3	Non Preferred	2		
H1111	005	0	1	02	01	H1111_005_0	3	4	Specialty	2		
H1111	005	0	1	02	01	H1111_005_0	3	2	Preferred Brand	2		
H1111	005	0	1	02	01	H1111_005_0	3	1	Preferred Generic	1		1
H1111	005	0	1	02	01	H1111_005_0	3	4	Specialty			
H1111	005	0	1	02	01	H1111_005_0	3	3	Non Preferred			
H1111	005	0	1	02	01	H1111_005_0	3	2	Preferred Brand			
H1111	005	0	1	02	01	H1111_005_0	3	1	Preferred Generic			
H1112	001	0	1	01	01	H1112_001_0	8	2	Tier 2			
H1112	001	0	1	01	01	H1112_001_0	8	3	Tier 3			
H1112	001	0	1	01	01	H1112_001_0	8	4	Tier 4			
H1112	001	0	1	01	01	H1112_001_0	8	1	Tier 1	1		1
H1112	001	0	1	01	01	H1112_001_0	8	2	Tier 2	2		
H1112	001	0	1	01	01	H1112_001_0	8	3	Tier 3	2		
H1112	001	0	1	01	01	H1112_001_0	8	4	Tier 4	2		
H1112	001	0	1	01	01	H1112_001_0	8	1	Tier 1			
H1112	005	0	1	01	01	H1112_005_0	9	3	Tier 3			
H1112	005	0	1	01	01	H1112_005_0	9	4	Tier 4			
H1112	005	0	1	01	01	H1112_005_0	9	1	Tier 1			
H1112	005	0	1	01	01	H1112_005_0	9	2	Tier 2			
H1112	006	0	1	01	01	H1112_006_0	9	2	Tier 2			
H1112	006	0	1	01	01	H1112_006_0	9	1	Tier 1			
H1112	006	0	1	01	01	H1112_006_0	9	4	Tier 4			
H1112	006	0	1	01	01	H1112_006_0	9	3	Tier 3			
H1112	027	0	1	01	01	H1112_027_0	8	2	Tier 2			
H1112	027	0	1	01	01	H1112_027_0	8	3	Tier 3			
H1112	027	0	1	01	01	H1112_027_0	8	4	Tier 4			
H1112	027	0	1	01	01	H1112_027_0	8	3	Tier 3	2		
H1112	027	0	1	01	01	H1112_027_0	8	4	Tier 4	2		
H1112	027	0	1	01	01	H1112_027_0	8	1	Tier 1	1		1
H1112	027	0	1	01	01	H1112_027_0	8	2	Tier 2	2		
H1112	027	0	1	01	01	H1112_027_0	8	1	Tier 1			
H1112	030	0	1	01	01	H1112_030_0	8	2	Tier 2			
H1112	030	0	1	01	01	H1112_030_0	8	1	Tier 1			
H1112	030	0	1	01	01	H1112_030_0	8	4	Tier 4			
H1112	030	0	1	01	01	H1112_030_0	8	3	Tier 3			
H1170	002	0	1	01	01	H1170_002_0	11	1	Generic			
H1170	002	0	1	01	01	H1170_002_0	11	2	Brand			
H1170	002	0	1	01	01	H1170_002_0	11	3	Specialty	2		
H1170	002	0	1	01	01	H1170_002_0	11	1	Generic	1		1
H1170	002	0	1	01	01	H1170_002_0	11	2	Brand	2		
H1170	002	0	1	01	01	H1170_002_0	11	3	Specialty			
H1170	008	0	1	01	01	H1170_008_0	12	3	Specialty			
H1170	008	0	1	01	01	H1170_008_0	12	1	Generic			
H1170	008	0	1	01	01	H1170_008_0	12	2	Brand			
H1170	009	0	1	01	01	H1170_009_0	9	1	Generic			
H1170	009	0	1	01	01	H1170_009_0	9	2	Brand			
H1170	009	0	1	01	01	H1170_009_0	9	3	Specialty	2		
H1170	009	0	1	01	01	H1170_009_0	9	1	Generic	1		1
H1170	009	0	1	01	01	H1170_009_0	9	2	Brand	2		
H1170	009	0	1	01	01	H1170_009_0	9	3	Specialty			
H1216	001	0	1	02	01	H1216_001_0	9	1	Tier 1			
H1216	001	0	1	02	01	H1216_001_0	9	2	Tier 2	2		
H1216	001	0	1	02	01	H1216_001_0	9	3	Tier 3			
H1216	001	0	1	02	01	H1216_001_0	9	4	Tier 4			
H1216	001	0	1	02	01	H1216_001_0	9	1	Tier 1	1		1
H1216	001	0	1	02	01	H1216_001_0	9	2	Tier 2			
H1216	001	0	1	02	01	H1216_001_0	9	3	Tier 3	2		
H1216	001	0	1	02	01	H1216_001_0	9	4	Tier 4	2		
H1216	003	0	1	01	01	H1216_003_0	8	4	Tier 4			
H1216	003	0	1	01	01	H1216_003_0	8	3	Tier 3			
H1216	003	0	1	01	01	H1216_003_0	8	2	Tier 2			
H1216	003	0	1	01	01	H1216_003_0	8	1	Tier 1			
H1216	004	0	1	02	01	H1216_004_0	8	1	Tier 1			
H1216	004	0	1	02	01	H1216_004_0	8	2	Tier 2			
H1216	004	0	1	02	01	H1216_004_0	8	3	Tier 3			
H1216	004	0	1	02	01	H1216_004_0	8	4	Tier 4			
H1230	001	0	1	01	01	H1230_001_0	11	3	Specialty	2		
H1230	001	0	1	01	01	H1230_001_0	11	2	Brand	2		
H1230	001	0	1	01	01	H1230_001_0	11	1	Generic	1		1
H1230	001	0	1	01	01	H1230_001_0	11	3	Specialty			
H1230	001	0	1	01	01	H1230_001_0	11	1	Generic			
H1230	001	0	1	01	01	H1230_001_0	11	2	Brand			
H1230	003	0	1	01	01	H1230_003_0	11	1	Generic			
H1230	003	0	1	01	01	H1230_003_0	11	2	Brand			
H1230	003	0	1	01	01	H1230_003_0	11	3	Specialty			
H1230	003	0	1	01	01	H1230_003_0	11	1	Generic	1		1
H1230	003	0	1	01	01	H1230_003_0	11	2	Brand	2		
H1230	003	0	1	01	01	H1230_003_0	11	3	Specialty	2		
H1251	003	0	1	18	06	H1251_003_0	5	3	Other Brand			
H1251	003	0	1	18	06	H1251_003_0	5	1	Generic			
H1251	003	0	1	18	06	H1251_003_0	5	2	Preferred Brand			
H1251	003	0	1	18	06	H1251_003_0	5	4	Injectables			
H1251	003	0	1	18	06	H1251_003_0	5	5	Specialty Drugs			
H1251	004	0	1	18	06	H1251_004_0	5	1	Generic			
H1251	004	0	1	18	06	H1251_004_0	5	3	Other Brand			
H1251	004	0	1	18	06	H1251_004_0	5	5	Specialty Drugs			
H1251	004	0	1	18	06	H1251_004_0	5	4	Injectables			
H1251	004	0	1	18	06	H1251_004_0	5	2	Preferred Brand			
H1251	011	0	1	18	06	H1251_011_0	5	3	Other Brand			
H1251	011	0	1	18	06	H1251_011_0	5	2	Preferred Brand			
H1251	011	0	1	18	06	H1251_011_0	5	5	Specialty Drugs			
H1251	011	0	1	18	06	H1251_011_0	5	1	Generic			
H1251	011	0	1	18	06	H1251_011_0	5	4	Injectables			
H1264	004	0	1	02	01	H1264_004_0	8	3	Tier 3			
H1264	004	0	1	02	01	H1264_004_0	8	4	Tier 4			
H1264	004	0	1	02	01	H1264_004_0	8	1	Tier 1	1		1
H1264	004	0	1	02	01	H1264_004_0	8	2	Tier 2	2		
H1264	004	0	1	02	01	H1264_004_0	8	3	Tier 3	2		
H1264	004	0	1	02	01	H1264_004_0	8	4	Tier 4	2		
H1264	004	0	1	02	01	H1264_004_0	8	1	Tier 1			
H1264	004	0	1	02	01	H1264_004_0	8	2	Tier 2			
H1264	005	0	1	02	01	H1264_005_0	8	1	Tier 1			
H1264	005	0	1	02	01	H1264_005_0	8	2	Tier 2			
H1264	005	0	1	02	01	H1264_005_0	8	3	Tier 3			
H1264	005	0	1	02	01	H1264_005_0	8	4	Tier 4			
H1264	005	0	1	02	01	H1264_005_0	8	1	Tier 1	1		1
H1264	005	0	1	02	01	H1264_005_0	8	2	Tier 2	2		
H1264	005	0	1	02	01	H1264_005_0	8	3	Tier 3	2		
H1264	005	0	1	02	01	H1264_005_0	8	4	Tier 4	2		
H1264	006	0	1	01	01	H1264_006_0	8	3	Tier 3			
H1264	006	0	1	01	01	H1264_006_0	8	2	Tier 2			
H1264	006	0	1	01	01	H1264_006_0	8	1	Tier 1			
H1264	006	0	1	01	01	H1264_006_0	8	4	Tier 4			
H1264	007	0	1	01	01	H1264_007_0	8	3	Tier 3			
H1264	007	0	1	01	01	H1264_007_0	8	2	Tier 2			
H1264	007	0	1	01	01	H1264_007_0	8	1	Tier 1			
H1264	007	0	1	01	01	H1264_007_0	8	4	Tier 4			
H1264	008	0	1	02	01	H1264_008_0	8	1	Tier 1	1		1
H1264	008	0	1	02	01	H1264_008_0	8	2	Tier 2	2		
H1264	008	0	1	02	01	H1264_008_0	8	3	Tier 3	2		
H1264	008	0	1	02	01	H1264_008_0	8	4	Tier 4			
H1264	008	0	1	02	01	H1264_008_0	8	3	Tier 3			
H1264	008	0	1	02	01	H1264_008_0	8	4	Tier 4	2		
H1264	008	0	1	02	01	H1264_008_0	8	1	Tier 1			
H1264	008	0	1	02	01	H1264_008_0	8	2	Tier 2			
H1264	009	0	1	02	01	H1264_009_0	8	3	Tier 3			
H1264	009	0	1	02	01	H1264_009_0	8	2	Tier 2			
H1264	009	0	1	02	01	H1264_009_0	8	1	Tier 1			
H1264	009	0	1	02	01	H1264_009_0	8	4	Tier 4			
H1264	010	0	1	02	01	H1264_010_0	8	4	Tier 4			
H1264	010	0	1	02	01	H1264_010_0	8	3	Tier 3			
H1264	010	0	1	02	01	H1264_010_0	8	2	Tier 2			
H1264	010	0	1	02	01	H1264_010_0	8	1	Tier 1			
H1264	011	0	1	02	01	H1264_011_0	8	1	Tier 1			
H1264	011	0	1	02	01	H1264_011_0	8	2	Tier 2			
H1264	011	0	1	02	01	H1264_011_0	8	3	Tier 3			
H1264	011	0	1	02	01	H1264_011_0	8	4	Tier 4			
H1264	013	0	1	02	01	H1264_013_0	8	1	Tier 1	1		1
H1264	013	0	1	02	01	H1264_013_0	8	4	Tier 4			
H1264	013	0	1	02	01	H1264_013_0	8	3	Tier 3			
H1264	013	0	1	02	01	H1264_013_0	8	2	Tier 2			
H1264	013	0	1	02	01	H1264_013_0	8	1	Tier 1			
H1264	013	0	1	02	01	H1264_013_0	8	2	Tier 2	2		
H1264	013	0	1	02	01	H1264_013_0	8	4	Tier 4	2		
H1264	013	0	1	02	01	H1264_013_0	8	3	Tier 3	2		
H1264	014	0	1	02	01	H1264_014_0	8	1	Tier 1			
H1264	014	0	1	02	01	H1264_014_0	8	2	Tier 2			
H1264	014	0	1	02	01	H1264_014_0	8	3	Tier 3			
H1264	014	0	1	02	01	H1264_014_0	8	4	Tier 4			
H1264	014	0	1	02	01	H1264_014_0	8	1	Tier 1	1		1
H1264	014	0	1	02	01	H1264_014_0	8	2	Tier 2	2		
H1264	014	0	1	02	01	H1264_014_0	8	4	Tier 4	2		
H1264	014	0	1	02	01	H1264_014_0	8	3	Tier 3	2		
H1264	016	0	1	01	01	H1264_016_0	9	1	Tier 1			
H1264	016	0	1	01	01	H1264_016_0	9	2	Tier 2			
H1264	016	0	1	01	01	H1264_016_0	9	3	Tier 3			
H1264	016	0	1	01	01	H1264_016_0	9	4	Tier 4			
H1286	001	0	1	02	01	H1286_001_0	4	1	Preferred Generic			
H1286	001	0	1	02	01	H1286_001_0	4	4	Specialty			
H1286	001	0	1	02	01	H1286_001_0	4	3	Non Preferred			
H1286	001	0	1	02	01	H1286_001_0	4	2	Preferred Brand			
H1286	002	0	1	02	01	H1286_002_0	6	3	Non-Preferred			
H1286	002	0	1	02	01	H1286_002_0	6	2	Preferred Brand			
H1286	002	0	1	02	01	H1286_002_0	6	1	Preferred Generic			
H1286	002	0	1	02	01	H1286_002_0	6	4	Specialty			
H1286	004	0	1	02	01	H1286_004_0	4	1	Preferred Generic			
H1286	004	0	1	02	01	H1286_004_0	4	2	Preferred Brand			
H1286	004	0	1	02	01	H1286_004_0	4	3	Non Preferred			
H1286	004	0	1	02	01	H1286_004_0	4	4	Specialty			
H1286	007	0	1	02	01	H1286_007_0	3	4	Specialty			
H1286	007	0	1	02	01	H1286_007_0	3	2	Preferred Brand			
H1286	007	0	1	02	01	H1286_007_0	3	3	Non Preferred			
H1286	007	0	1	02	01	H1286_007_0	3	1	Preferred Generic			
H1286	008	0	1	02	01	H1286_008_0	5	1	Preferred Generic			
H1286	008	0	1	02	01	H1286_008_0	5	2	Preferred Brand			
H1286	008	0	1	02	01	H1286_008_0	5	3	Non-Preferred			
H1286	008	0	1	02	01	H1286_008_0	5	4	Specialty			
H1302	001	0	1	04	01	H1302_001_0	13	2	Preferred Brand			
H1302	001	0	1	04	01	H1302_001_0	13	3	Non Preferred Brand			
H1302	001	0	1	04	01	H1302_001_0	13	4	Injectable Drugs			
H1302	001	0	1	04	01	H1302_001_0	13	1	Generic			
H1302	001	0	1	04	01	H1302_001_0	13	5	Specialty Drugs			
H1303	001	0	1	04	01	H1303_001_0	4	4	Specialty			
H1303	001	0	1	04	01	H1303_001_0	4	3	Non Preferred			
H1303	001	0	1	04	01	H1303_001_0	4	1	Preferred Generic			
H1303	001	0	1	04	01	H1303_001_0	4	2	Preferred Brand			
H1303	006	0	1	04	01	H1303_006_0	3	3	Non Preferred			
H1303	006	0	1	04	01	H1303_006_0	3	1	Preferred Generic			
H1303	006	0	1	04	01	H1303_006_0	3	2	Preferred Brand			
H1303	006	0	1	04	01	H1303_006_0	3	4	Specialty			
H1304	002	0	1	04	01	H1304_002_0	7	4	Miscellaneous Injectables			
H1304	002	0	1	04	01	H1304_002_0	7	3	Non-Preferred Brand			
H1304	002	0	1	04	01	H1304_002_0	7	2	Preferred Brand			
H1304	002	0	1	04	01	H1304_002_0	7	5	Specialty Medications			
H1304	002	0	1	04	01	H1304_002_0	7	1	Generic			
H1304	004	0	1	04	01	H1304_004_0	7	1	Generic			
H1304	004	0	1	04	01	H1304_004_0	7	2	Preferred Brand			
H1304	004	0	1	04	01	H1304_004_0	7	3	Non-Preferred Brand			
H1304	004	0	1	04	01	H1304_004_0	7	4	Miscellaneous Injectables			
H1304	004	0	1	04	01	H1304_004_0	7	5	Specialty Medications			
H1304	004	0	1	04	01	H1304_004_0	7	1	Generic	1		1
H1304	004	0	1	04	01	H1304_004_0	7	2	Preferred Brand	2		
H1304	004	0	1	04	01	H1304_004_0	7	3	Non-Preferred Brand	2		
H1304	004	0	1	04	01	H1304_004_0	7	4	Miscellaneous Injectables	2		
H1304	004	0	1	04	01	H1304_004_0	7	5	Specialty Medications	2		
H1304	006	0	1	04	01	H1304_006_0	6	1	Generic			
H1304	006	0	1	04	01	H1304_006_0	6	2	Preferred Brand			
H1304	006	0	1	04	01	H1304_006_0	6	5	Specialty Medications			
H1304	006	0	1	04	01	H1304_006_0	6	4	Miscellaneous Injectables			
H1304	006	0	1	04	01	H1304_006_0	6	3	Non-Preferred Brand			
H1317	002	0	1	04	01	H1317_002_0	3	1	Generic			
H1317	002	0	1	04	01	H1317_002_0	3	2	Preferred Brand			
H1317	002	0	1	04	01	H1317_002_0	3	3	Non-Preferred Brand			
H1317	002	0	1	04	01	H1317_002_0	3	4	Specialty	2		
H1317	002	0	1	04	01	H1317_002_0	3	1	Generic	1		1
H1317	002	0	1	04	01	H1317_002_0	3	2	Preferred Brand	2		
H1317	002	0	1	04	01	H1317_002_0	3	3	Non-Preferred Brand	2		
H1317	002	0	1	04	01	H1317_002_0	3	4	Specialty			
H1340	014	0	1	09	04	H1340_014_0	7	1	Tier 1			
H1340	014	0	1	09	04	H1340_014_0	7	2	Tier 2			
H1340	014	0	1	09	04	H1340_014_0	7	3	Tier 3			
H1340	014	0	1	09	04	H1340_014_0	7	4	Tier 4			
H1340	033	0	1	09	04	H1340_033_0	8	1	Tier 1			
H1340	033	0	1	09	04	H1340_033_0	8	2	Tier 2			
H1340	033	0	1	09	04	H1340_033_0	8	3	Tier 3			
H1340	033	0	1	09	04	H1340_033_0	8	4	Tier 4			
H1340	034	0	1	09	04	H1340_034_0	8	1	Tier 1			
H1340	034	0	1	09	04	H1340_034_0	8	2	Tier 2			
H1340	034	0	1	09	04	H1340_034_0	8	4	Tier 4			
H1340	034	0	1	09	04	H1340_034_0	8	3	Tier 3			
H1340	035	0	1	09	04	H1340_035_0	8	1	Tier 1			
H1340	035	0	1	09	04	H1340_035_0	8	2	Tier 2			
H1340	035	0	1	09	04	H1340_035_0	8	3	Tier 3			
H1340	035	0	1	09	04	H1340_035_0	8	4	Tier 4			
H1340	036	0	1	09	04	H1340_036_0	8	1	Tier 1			
H1340	036	0	1	09	04	H1340_036_0	8	3	Tier 3			
H1340	036	0	1	09	04	H1340_036_0	8	2	Tier 2			
H1340	036	0	1	09	04	H1340_036_0	8	4	Tier 4			
H1350	001	0	1	01	01	H1350_001_0	15	1	Tier 1 - Generic			
H1350	001	0	1	01	01	H1350_001_0	15	2	Tier 2 - Preferred Brand			
H1350	001	0	1	01	01	H1350_001_0	15	3	Tier 3 - Non Preferred Brand			
H1350	001	0	1	01	01	H1350_001_0	15	4	Tier 4 - Injectable Drugs			
H1350	001	0	1	01	01	H1350_001_0	15	5	Tier 5 - Specialty Drugs	2		
H1350	001	0	1	01	01	H1350_001_0	15	1	Tier 1 - Generic	1		1
H1350	001	0	1	01	01	H1350_001_0	15	2	Tier 2 - Preferred Brand	2		
H1350	001	0	1	01	01	H1350_001_0	15	3	Tier 3 - Non Preferred Brand	2		
H1350	001	0	1	01	01	H1350_001_0	15	4	Tier 4 - Injectable Drugs	2		
H1350	001	0	1	01	01	H1350_001_0	15	5	Tier 5 - Specialty Drugs			
H1355	001	0	1	04	01	H1355_001_0	2	3	Non-Preferred Brand			
H1355	001	0	1	04	01	H1355_001_0	2	4	Specialty			
H1355	001	0	1	04	01	H1355_001_0	2	2	Preferred Brand			
H1355	001	0	1	04	01	H1355_001_0	2	1	Generic			
H1356	002	0	1	04	01	H1356_002_0	3	1	Generic	1		1
H1356	002	0	1	04	01	H1356_002_0	3	2	Preferred Brand	2		
H1356	002	0	1	04	01	H1356_002_0	3	3	Non-Preferred Brand	2		
H1356	002	0	1	04	01	H1356_002_0	3	4	Specialty	2		
H1356	002	0	1	04	01	H1356_002_0	3	4	Specialty			
H1356	002	0	1	04	01	H1356_002_0	3	3	Non-Preferred Brand			
H1356	002	0	1	04	01	H1356_002_0	3	2	Preferred Brand			
H1356	002	0	1	04	01	H1356_002_0	3	1	Generic			
H1364	006	0	1	01	01	H1364_006_0	10	3	Specialty			
H1364	006	0	1	01	01	H1364_006_0	10	2	Preferred Brand			
H1364	006	0	1	01	01	H1364_006_0	10	1	Preferred Generic			
H1364	006	0	1	01	01	H1364_006_0	10	4	Non-Preferred			
H1364	007	0	1	01	01	H1364_007_0	7	1	Preferred Generic	1		1
H1364	007	0	1	01	01	H1364_007_0	7	2	Preferred Brand	2		
H1364	007	0	1	01	01	H1364_007_0	7	3	Specialty	2		
H1364	007	0	1	01	01	H1364_007_0	7	4	Non-Preferred			
H1364	007	0	1	01	01	H1364_007_0	7	3	Specialty			
H1364	007	0	1	01	01	H1364_007_0	7	4	Non-Preferred	2		
H1364	007	0	1	01	01	H1364_007_0	7	1	Preferred Generic			
H1364	007	0	1	01	01	H1364_007_0	7	2	Preferred Brand			
H1406	013	0	1	01	01	H1406_013_0	4	3	Non-Preferred Brand			
H1406	013	0	1	01	01	H1406_013_0	4	2	Preferred Brand			
H1406	013	0	1	01	01	H1406_013_0	4	1	Preferred Generic			
H1406	013	0	1	01	01	H1406_013_0	4	4	Specialty			
H1406	013	0	1	01	01	H1406_013_0	4	1	Preferred Generic	1	00001000	2
H1406	013	0	1	01	01	H1406_013_0	4	2	Preferred Brand	1	10000000	2
H1406	013	0	1	01	01	H1406_013_0	4	3	Non-Preferred Brand	1	10000000	2
H1406	013	0	1	01	01	H1406_013_0	4	4	Specialty	1	10001000	2
H1406	022	0	1	01	01	H1406_022_0	4	3	Non-Preferred Brand			
H1406	022	0	1	01	01	H1406_022_0	4	2	Preferred Brand			
H1406	022	0	1	01	01	H1406_022_0	4	1	Preferred Generic			
H1406	022	0	1	01	01	H1406_022_0	4	4	Specialty			
H1406	022	0	1	01	01	H1406_022_0	4	4	Specialty	1	10001000	2
H1406	022	0	1	01	01	H1406_022_0	4	3	Non-Preferred Brand	1	10000000	2
H1406	022	0	1	01	01	H1406_022_0	4	2	Preferred Brand	1	10000000	2
H1406	022	0	1	01	01	H1406_022_0	4	1	Preferred Generic	1	00001000	2
H1406	024	0	1	01	01	H1406_024_0	3	1	Preferred Generic			
H1406	024	0	1	01	01	H1406_024_0	3	2	Preferred Brand			
H1406	024	0	1	01	01	H1406_024_0	3	3	Non-Preferred Brand			
H1406	024	0	1	01	01	H1406_024_0	3	3	Non-Preferred Brand	1	10000000	2
H1406	024	0	1	01	01	H1406_024_0	3	2	Preferred Brand	1	10000000	2
H1406	024	0	1	01	01	H1406_024_0	3	1	Preferred Generic	1	00001000	2
H1406	024	0	1	01	01	H1406_024_0	3	4	Specialty			
H1406	024	0	1	01	01	H1406_024_0	3	4	Specialty	1	10001000	2
H1415	015	0	1	01	01	H1415_015_0	5	1	Preferred Generic			
H1415	015	0	1	01	01	H1415_015_0	5	2	Generic	1	00001000	2
H1415	015	0	1	01	01	H1415_015_0	5	3	Preferred Brand			
H1415	015	0	1	01	01	H1415_015_0	5	2	Generic			
H1415	015	0	1	01	01	H1415_015_0	5	4	Non-Preferred Brand			
H1415	015	0	1	01	01	H1415_015_0	5	1	Preferred Generic	1		1
H1415	015	0	1	01	01	H1415_015_0	5	5	Specialty			
H1415	015	0	1	01	01	H1415_015_0	5	3	Preferred Brand	2		
H1415	015	0	1	01	01	H1415_015_0	5	4	Non-Preferred Brand	2		
H1415	015	0	1	01	01	H1415_015_0	5	5	Specialty	2		
H1415	017	0	1	02	01	H1415_017_0	7	2	Generic	1		1
H1415	017	0	1	02	01	H1415_017_0	7	1	Preferred Generic	1		1
H1415	017	0	1	02	01	H1415_017_0	7	5	Specialty			
H1415	017	0	1	02	01	H1415_017_0	7	2	Generic			
H1415	017	0	1	02	01	H1415_017_0	7	1	Preferred Generic			
H1415	017	0	1	02	01	H1415_017_0	7	4	Non-Preferred Brand			
H1415	017	0	1	02	01	H1415_017_0	7	5	Specialty	2		
H1415	017	0	1	02	01	H1415_017_0	7	4	Non-Preferred Brand	2		
H1415	017	0	1	02	01	H1415_017_0	7	3	Preferred Brand	2		
H1415	017	0	1	02	01	H1415_017_0	7	3	Preferred Brand			
H1415	021	0	1	02	01	H1415_021_0	6	3	Preferred Brand	2		
H1415	021	0	1	02	01	H1415_021_0	6	4	Non-Preferred Brand	2		
H1415	021	0	1	02	01	H1415_021_0	6	5	Specialty	2		
H1415	021	0	1	02	01	H1415_021_0	6	2	Generic	1		1
H1415	021	0	1	02	01	H1415_021_0	6	1	Preferred Generic	1		1
H1415	021	0	1	02	01	H1415_021_0	6	5	Specialty			
H1415	021	0	1	02	01	H1415_021_0	6	3	Preferred Brand			
H1415	021	0	1	02	01	H1415_021_0	6	2	Generic			
H1415	021	0	1	02	01	H1415_021_0	6	1	Preferred Generic			
H1415	021	0	1	02	01	H1415_021_0	6	4	Non-Preferred Brand			
H1416	002	0	1	02	01	H1416_002_0	6	4	Tier 4	2		
H1416	002	0	1	02	01	H1416_002_0	6	3	Tier 3	2		
H1416	002	0	1	02	01	H1416_002_0	6	2	Tier 2	2		
H1416	002	0	1	02	01	H1416_002_0	6	1	Tier 1	1		1
H1416	002	0	1	02	01	H1416_002_0	6	4	Tier 4			
H1416	002	0	1	02	01	H1416_002_0	6	2	Tier 2			
H1416	002	0	1	02	01	H1416_002_0	6	1	Tier 1			
H1416	002	0	1	02	01	H1416_002_0	6	3	Tier 3			
H1416	003	0	1	02	01	H1416_003_0	6	3	Tier 3			
H1416	003	0	1	02	01	H1416_003_0	6	2	Tier 2			
H1416	003	0	1	02	01	H1416_003_0	6	1	Tier 1			
H1416	003	0	1	02	01	H1416_003_0	6	4	Tier 4			
H1416	007	0	1	01	01	H1416_007_0	6	1	Tier 1			
H1416	007	0	1	01	01	H1416_007_0	6	2	Tier 2			
H1416	007	0	1	01	01	H1416_007_0	6	3	Tier 3			
H1416	007	0	1	01	01	H1416_007_0	6	4	Tier 4			
H1416	009	0	1	02	01	H1416_009_0	6	1	Tier 1			
H1416	009	0	1	02	01	H1416_009_0	6	2	Tier 2			
H1416	009	0	1	02	01	H1416_009_0	6	4	Tier 4	2		
H1416	009	0	1	02	01	H1416_009_0	6	3	Tier 3	2		
H1416	009	0	1	02	01	H1416_009_0	6	2	Tier 2	2		
H1416	009	0	1	02	01	H1416_009_0	6	3	Tier 3			
H1416	009	0	1	02	01	H1416_009_0	6	4	Tier 4			
H1416	009	0	1	02	01	H1416_009_0	6	1	Tier 1	1		1
H1416	013	0	1	02	01	H1416_013_0	6	3	Tier 3			
H1416	013	0	1	02	01	H1416_013_0	6	2	Tier 2			
H1416	013	0	1	02	01	H1416_013_0	6	1	Tier 1			
H1416	013	0	1	02	01	H1416_013_0	6	4	Tier 4			
H1416	014	0	1	02	01	H1416_014_0	6	3	Tier 3	2		
H1416	014	0	1	02	01	H1416_014_0	6	4	Tier 4	2		
H1416	014	0	1	02	01	H1416_014_0	6	1	Tier 1			
H1416	014	0	1	02	01	H1416_014_0	6	2	Tier 2			
H1416	014	0	1	02	01	H1416_014_0	6	3	Tier 3			
H1416	014	0	1	02	01	H1416_014_0	6	4	Tier 4			
H1416	014	0	1	02	01	H1416_014_0	6	1	Tier 1	1		1
H1416	014	0	1	02	01	H1416_014_0	6	2	Tier 2	2		
H1416	017	0	1	02	01	H1416_017_0	7	1	Tier 1			
H1416	017	0	1	02	01	H1416_017_0	7	2	Tier 2			
H1416	017	0	1	02	01	H1416_017_0	7	3	Tier 3			
H1416	017	0	1	02	01	H1416_017_0	7	4	Tier 4			
H1416	018	0	1	02	01	H1416_018_0	6	1	Tier 1	1		1
H1416	018	0	1	02	01	H1416_018_0	6	2	Tier 2	2		
H1416	018	0	1	02	01	H1416_018_0	6	3	Tier 3	2		
H1416	018	0	1	02	01	H1416_018_0	6	4	Tier 4			
H1416	018	0	1	02	01	H1416_018_0	6	3	Tier 3			
H1416	018	0	1	02	01	H1416_018_0	6	4	Tier 4	2		
H1416	018	0	1	02	01	H1416_018_0	6	1	Tier 1			
H1416	018	0	1	02	01	H1416_018_0	6	2	Tier 2			
H1416	019	0	1	02	01	H1416_019_0	7	3	Tier 3			
H1416	019	0	1	02	01	H1416_019_0	7	2	Tier 2			
H1416	019	0	1	02	01	H1416_019_0	7	1	Tier 1			
H1416	019	0	1	02	01	H1416_019_0	7	4	Tier 4			
H1416	020	0	1	02	01	H1416_020_0	7	3	Tier 3			
H1416	020	0	1	02	01	H1416_020_0	7	2	Tier 2			
H1416	020	0	1	02	01	H1416_020_0	7	1	Tier 1			
H1416	020	0	1	02	01	H1416_020_0	7	4	Tier 4			
H1416	021	0	1	02	01	H1416_021_0	6	3	Tier 3			
H1416	021	0	1	02	01	H1416_021_0	6	2	Tier 2			
H1416	021	0	1	02	01	H1416_021_0	6	1	Tier 1			
H1416	021	0	1	02	01	H1416_021_0	6	4	Tier 4			
H1417	002	0	1	04	01	H1417_002_0	7	1	Tier 1			
H1417	002	0	1	04	01	H1417_002_0	7	2	Tier 2			
H1417	002	0	1	04	01	H1417_002_0	7	3	Tier 3			
H1417	002	0	1	04	01	H1417_002_0	7	4	Tier 4			
H1417	004	0	1	04	01	H1417_004_0	9	1	Tier 1			
H1417	004	0	1	04	01	H1417_004_0	9	2	Tier 2			
H1417	004	0	1	04	01	H1417_004_0	9	3	Tier 3			
H1417	004	0	1	04	01	H1417_004_0	9	4	Tier 4			
H1417	005	0	1	04	01	H1417_005_0	8	1	Tier 1			
H1417	005	0	1	04	01	H1417_005_0	8	2	Tier 2			
H1417	005	0	1	04	01	H1417_005_0	8	3	Tier 3			
H1417	005	0	1	04	01	H1417_005_0	8	4	Tier 4			
H1417	005	0	1	04	01	H1417_005_0	8	1	Tier 1	1		1
H1417	005	0	1	04	01	H1417_005_0	8	2	Tier 2	2		
H1417	005	0	1	04	01	H1417_005_0	8	3	Tier 3	2		
H1417	005	0	1	04	01	H1417_005_0	8	4	Tier 4	2		
H1417	006	0	1	04	01	H1417_006_0	9	3	Tier 3			
H1417	006	0	1	04	01	H1417_006_0	9	4	Tier 4	2		
H1417	006	0	1	04	01	H1417_006_0	9	2	Tier 2			
H1417	006	0	1	04	01	H1417_006_0	9	4	Tier 4			
H1417	006	0	1	04	01	H1417_006_0	9	1	Tier 1	1		1
H1417	006	0	1	04	01	H1417_006_0	9	2	Tier 2	2		
H1417	006	0	1	04	01	H1417_006_0	9	3	Tier 3	2		
H1417	006	0	1	04	01	H1417_006_0	9	1	Tier 1			
H1417	008	0	1	04	01	H1417_008_0	10	1	Tier 1			
H1417	008	0	1	04	01	H1417_008_0	10	3	Tier 3			
H1417	008	0	1	04	01	H1417_008_0	10	4	Tier 4			
H1417	008	0	1	04	01	H1417_008_0	10	2	Tier 2			
H1417	009	0	1	04	01	H1417_009_0	10	3	Tier 3	2		
H1417	009	0	1	04	01	H1417_009_0	10	2	Tier 2	2		
H1417	009	0	1	04	01	H1417_009_0	10	1	Tier 1	1		1
H1417	009	0	1	04	01	H1417_009_0	10	4	Tier 4			
H1417	009	0	1	04	01	H1417_009_0	10	3	Tier 3			
H1417	009	0	1	04	01	H1417_009_0	10	2	Tier 2			
H1417	009	0	1	04	01	H1417_009_0	10	1	Tier 1			
H1417	009	0	1	04	01	H1417_009_0	10	4	Tier 4	2		
H1418	002	0	1	04	01	H1418_002_0	3	3	Non-Preferred Brand	1	10000000	2
H1418	002	0	1	04	01	H1418_002_0	3	2	Preferred Brand	1	10000000	2
H1418	002	0	1	04	01	H1418_002_0	3	1	Preferred Generic	1	00001000	2
H1418	002	0	1	04	01	H1418_002_0	3	4	Specialty			
H1418	002	0	1	04	01	H1418_002_0	3	3	Non-Preferred Brand			
H1418	002	0	1	04	01	H1418_002_0	3	2	Preferred Brand			
H1418	002	0	1	04	01	H1418_002_0	3	1	Preferred Generic			
H1418	002	0	1	04	01	H1418_002_0	3	4	Specialty	1	10001000	2
H1418	007	0	1	04	01	H1418_007_0	3	1	Preferred Generic			
H1418	007	0	1	04	01	H1418_007_0	3	2	Preferred Brand			
H1418	007	0	1	04	01	H1418_007_0	3	3	Non-Preferred Brand			
H1418	007	0	1	04	01	H1418_007_0	3	4	Specialty			
H1418	007	0	1	04	01	H1418_007_0	3	1	Preferred Generic	1	00001000	2
H1418	007	0	1	04	01	H1418_007_0	3	2	Preferred Brand	1	10000000	2
H1418	007	0	1	04	01	H1418_007_0	3	3	Non-Preferred Brand	1	10000000	2
H1418	007	0	1	04	01	H1418_007_0	3	4	Specialty	1	10001000	2
H1419	001	0	1	01	01	H1419_001_0	5	1	Tier 1 - Preferred Generic			
H1419	001	0	1	01	01	H1419_001_0	5	2	Tier 2 - Non-Preferred Generic			
H1419	001	0	1	01	01	H1419_001_0	5	3	Tier 3 - Preferred Brand			
H1419	001	0	1	01	01	H1419_001_0	5	4	Tier 4 - Non-Preferred Brand			
H1419	001	0	1	01	01	H1419_001_0	5	5	Tier 5 - Specialty			
H1419	002	0	1	01	01	H1419_002_0	5	2	Tier 2 - Non-Preferred Generic			
H1419	002	0	1	01	01	H1419_002_0	5	3	Tier 3 - Preferred Brand			
H1419	002	0	1	01	01	H1419_002_0	5	4	Tier 4 - Non-Preferred Brand			
H1419	002	0	1	01	01	H1419_002_0	5	1	Tier 1 - Preferred Generic			
H1419	002	0	1	01	01	H1419_002_0	5	5	Tier 5 - Specialty			
H1419	003	0	1	01	01	H1419_003_0	5	1	Tier 1 - Preferred Generic			
H1419	003	0	1	01	01	H1419_003_0	5	2	Tier 2 - Non-Preferred Generic			
H1419	003	0	1	01	01	H1419_003_0	5	4	Tier 4 - Non-Preferred Brand			
H1419	003	0	1	01	01	H1419_003_0	5	3	Tier 3 - Preferred Brand			
H1419	003	0	1	01	01	H1419_003_0	5	5	Tier 5 - Specialty			
H1419	005	0	1	01	01	H1419_005_0	5	3	Tier 3 - Preferred Brand			
H1419	005	0	1	01	01	H1419_005_0	5	1	Tier 1 - Preferred Generic			
H1419	005	0	1	01	01	H1419_005_0	5	2	Tier 2 - Non-Preferred Generic			
H1419	005	0	1	01	01	H1419_005_0	5	5	Tier 5 - Specialty			
H1419	005	0	1	01	01	H1419_005_0	5	4	Tier 4 - Non-Preferred Brand			
H1420	001	0	1	04	01	H1420_001_0	5	1	Tier 1 - Preferred Generic			
H1420	001	0	1	04	01	H1420_001_0	5	3	Tier 3 - Preferred Brand			
H1420	001	0	1	04	01	H1420_001_0	5	5	Tier 5 - Specialty			
H1420	001	0	1	04	01	H1420_001_0	5	4	Tier 4 - Non-Preferred Brand			
H1420	001	0	1	04	01	H1420_001_0	5	2	Tier 2 - Non-Preferred Generic			
H1420	003	0	1	04	01	H1420_003_0	6	5	Tier 5 - Specialty			
H1420	003	0	1	04	01	H1420_003_0	6	4	Tier 4 - Non-Preferred Brand			
H1420	003	0	1	04	01	H1420_003_0	6	3	Tier 3 - Preferred Brand			
H1420	003	0	1	04	01	H1420_003_0	6	1	Tier 1 - Preferred Generic			
H1420	003	0	1	04	01	H1420_003_0	6	2	Tier 2 - Non-Preferred Generic			
H1463	003	0	1	01	01	H1463_003_0	7	3	Tier 3			
H1463	003	0	1	01	01	H1463_003_0	7	2	Tier 2			
H1463	003	0	1	01	01	H1463_003_0	7	1	Tier 1			
H1463	003	0	1	01	01	H1463_003_0	7	4	Tier 4			
H1463	005	0	1	01	01	H1463_005_0	7	1	Tier 1	1		1
H1463	005	0	1	01	01	H1463_005_0	7	2	Tier 2	2		
H1463	005	0	1	01	01	H1463_005_0	7	3	Tier 3	2		
H1463	005	0	1	01	01	H1463_005_0	7	4	Tier 4			
H1463	005	0	1	01	01	H1463_005_0	7	3	Tier 3			
H1463	005	0	1	01	01	H1463_005_0	7	4	Tier 4	2		
H1463	005	0	1	01	01	H1463_005_0	7	1	Tier 1			
H1463	005	0	1	01	01	H1463_005_0	7	2	Tier 2			
H1468	004	0	1	01	01	H1468_004_0	3	1	Preferred Generic			
H1468	004	0	1	01	01	H1468_004_0	3	2	Preferred Brand			
H1468	004	0	1	01	01	H1468_004_0	3	4	Specialty	1	10001000	2
H1468	004	0	1	01	01	H1468_004_0	3	3	Non-Preferred Brand	1	10000000	2
H1468	004	0	1	01	01	H1468_004_0	3	2	Preferred Brand	1	10000000	2
H1468	004	0	1	01	01	H1468_004_0	3	1	Preferred Generic	1		1
H1468	004	0	1	01	01	H1468_004_0	3	4	Specialty			
H1468	004	0	1	01	01	H1468_004_0	3	3	Non-Preferred Brand			
H1468	007	0	1	01	01	H1468_007_0	5	1	Preferred Generic			
H1468	007	0	1	01	01	H1468_007_0	5	3	Non-Preferred Brand	1	10000000	2
H1468	007	0	1	01	01	H1468_007_0	5	2	Preferred Brand	1	10000000	2
H1468	007	0	1	01	01	H1468_007_0	5	1	Preferred Generic	1	00001000	2
H1468	007	0	1	01	01	H1468_007_0	5	4	Specialty			
H1468	007	0	1	01	01	H1468_007_0	5	3	Non-Preferred Brand			
H1468	007	0	1	01	01	H1468_007_0	5	2	Preferred Brand			
H1468	007	0	1	01	01	H1468_007_0	5	4	Specialty	1	10001000	2
H1509	001	0	1	04	01	H1509_001_0	5	4	Specialty			
H1509	001	0	1	04	01	H1509_001_0	5	3	Non-Preferred			
H1509	001	0	1	04	01	H1509_001_0	5	2	Preferred Brand			
H1509	001	0	1	04	01	H1509_001_0	5	1	Preferred Generic			
H1509	005	0	1	04	01	H1509_005_0	3	2	Preferred Brand			
H1509	005	0	1	04	01	H1509_005_0	3	1	Preferred Generic			
H1509	005	0	1	04	01	H1509_005_0	3	3	Non Preferred			
H1509	005	0	1	04	01	H1509_005_0	3	4	Specialty			
H1509	006	0	1	04	01	H1509_006_0	7	1	Preferred Generic			
H1509	006	0	1	04	01	H1509_006_0	7	2	Preferred Brand			
H1509	006	0	1	04	01	H1509_006_0	7	4	Specialty			
H1509	006	0	1	04	01	H1509_006_0	7	3	Non Preferred			
H1509	007	0	1	04	01	H1509_007_0	7	1	Preferred Generic			
H1509	007	0	1	04	01	H1509_007_0	7	2	Preferred Brand			
H1509	007	0	1	04	01	H1509_007_0	7	3	Non-Preferred			
H1509	007	0	1	04	01	H1509_007_0	7	4	Specialty			
H1509	008	0	1	04	01	H1509_008_0	6	1	Preferred Generic			
H1509	008	0	1	04	01	H1509_008_0	6	3	Non-Preferred			
H1509	008	0	1	04	01	H1509_008_0	6	2	Preferred Brand			
H1509	008	0	1	04	01	H1509_008_0	6	4	Specialty			
H1510	001	0	1	04	01	H1510_001_0	5	2	Preferred Brand	1	10000000	2
H1510	001	0	1	04	01	H1510_001_0	5	1	Preferred Generic	1	00001000	2
H1510	001	0	1	04	01	H1510_001_0	5	4	Specialty			
H1510	001	0	1	04	01	H1510_001_0	5	3	Non-Preferred Brand			
H1510	001	0	1	04	01	H1510_001_0	5	2	Preferred Brand			
H1510	001	0	1	04	01	H1510_001_0	5	1	Preferred Generic			
H1510	001	0	1	04	01	H1510_001_0	5	3	Non-Preferred Brand	1	10000000	2
H1510	001	0	1	04	01	H1510_001_0	5	4	Specialty	1	10001000	2
H1510	004	0	1	04	01	H1510_004_0	6	4	Specialty			
H1510	004	0	1	04	01	H1510_004_0	6	3	Non-Preferred Brand			
H1510	004	0	1	04	01	H1510_004_0	6	2	Preferred Brand			
H1510	004	0	1	04	01	H1510_004_0	6	1	Preferred Generic			
H1510	004	0	1	04	01	H1510_004_0	6	1	Preferred Generic	1	00001000	2
H1510	004	0	1	04	01	H1510_004_0	6	2	Preferred Brand	1	10000000	2
H1510	004	0	1	04	01	H1510_004_0	6	3	Non-Preferred Brand	1	10000000	2
H1510	004	0	1	04	01	H1510_004_0	6	4	Specialty	1	10001000	2
H1510	005	0	1	04	01	H1510_005_0	3	4	Specialty			
H1510	005	0	1	04	01	H1510_005_0	3	3	Non-Preferred Brand			
H1510	005	0	1	04	01	H1510_005_0	3	2	Preferred Brand			
H1510	005	0	1	04	01	H1510_005_0	3	1	Preferred Generic			
H1510	005	0	1	04	01	H1510_005_0	3	1	Preferred Generic	1	00001000	2
H1510	005	0	1	04	01	H1510_005_0	3	4	Specialty	1	10001000	2
H1510	005	0	1	04	01	H1510_005_0	3	3	Non-Preferred Brand	1	10000000	2
H1510	005	0	1	04	01	H1510_005_0	3	2	Preferred Brand	1	10000000	2
H1511	001	0	1	01	01	H1511_001_0	7	1	Tier 1 Preferred Generic			
H1511	001	0	1	01	01	H1511_001_0	7	2	Tier 2 Preferred Brand			
H1511	001	0	1	01	01	H1511_001_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H1511	001	0	1	01	01	H1511_001_0	7	4	Tier 4 Non-Specialty Injectable			
H1511	001	0	1	01	01	H1511_001_0	7	5	Tier 5 Specialty	2		
H1511	001	0	1	01	01	H1511_001_0	7	1	Tier 1 Preferred Generic	1		1
H1511	001	0	1	01	01	H1511_001_0	7	4	Tier 4 Non-Specialty Injectable	2		
H1511	001	0	1	01	01	H1511_001_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H1511	001	0	1	01	01	H1511_001_0	7	2	Tier 2 Preferred Brand	2		
H1511	001	0	1	01	01	H1511_001_0	7	5	Tier 5 Specialty			
H1511	005	0	1	01	01	H1511_005_0	8	1	Tier 1 Preferred Generic			
H1511	005	0	1	01	01	H1511_005_0	8	2	Tier 2 Preferred Brand			
H1511	005	0	1	01	01	H1511_005_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H1511	005	0	1	01	01	H1511_005_0	8	4	Tier 4 Non-Specialty Injectable			
H1511	005	0	1	01	01	H1511_005_0	8	5	Tier 5 Specialty			
H1511	005	0	1	01	01	H1511_005_0	8	1	Tier 1 Preferred Generic	1		1
H1511	005	0	1	01	01	H1511_005_0	8	2	Tier 2 Preferred Brand	2		
H1511	005	0	1	01	01	H1511_005_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H1511	005	0	1	01	01	H1511_005_0	8	4	Tier 4 Non-Specialty Injectable	2		
H1511	005	0	1	01	01	H1511_005_0	8	5	Tier 5 Specialty	2		
H1517	001	0	1	04	01	H1517_001_0	9	1	Tier One Preferred Generics			
H1517	001	0	1	04	01	H1517_001_0	9	2	Tier 2 Preferred Brand			
H1517	001	0	1	04	01	H1517_001_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H1517	001	0	1	04	01	H1517_001_0	9	4	Tier 4 Non-Specialty Injectibles			
H1517	001	0	1	04	01	H1517_001_0	9	5	Tier 5 Speciality	2		
H1517	001	0	1	04	01	H1517_001_0	9	1	Tier One Preferred Generics	1		1
H1517	001	0	1	04	01	H1517_001_0	9	2	Tier 2 Preferred Brand	2		
H1517	001	0	1	04	01	H1517_001_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H1517	001	0	1	04	01	H1517_001_0	9	4	Tier 4 Non-Specialty Injectibles	2		
H1517	001	0	1	04	01	H1517_001_0	9	5	Tier 5 Speciality			
H1607	001	0	1	04	01	H1607_001_0	10	1	Tier 1 Preferred Generics			
H1607	001	0	1	04	01	H1607_001_0	10	2	Tier 2 Preferred Brand			
H1607	001	0	1	04	01	H1607_001_0	10	5	Tier 5 Specialty	2		
H1607	001	0	1	04	01	H1607_001_0	10	4	Tier 4 Non- Specialty Injectable	2		
H1607	001	0	1	04	01	H1607_001_0	10	3	Tier 3 Non-Preferred Brand or Generic	2		
H1607	001	0	1	04	01	H1607_001_0	10	2	Tier 2 Preferred Brand	2		
H1607	001	0	1	04	01	H1607_001_0	10	1	Tier 1 Preferred Generics	1		1
H1607	001	0	1	04	01	H1607_001_0	10	5	Tier 5 Specialty			
H1607	001	0	1	04	01	H1607_001_0	10	4	Tier 4 Non- Specialty Injectable			
H1607	001	0	1	04	01	H1607_001_0	10	3	Tier 3 Non-Preferred Brand or Generic			
H1608	001	0	1	04	01	H1608_001_0	12	2	Preferred Brand	2		
H1608	001	0	1	04	01	H1608_001_0	12	1	Preferred Generic	1		1
H1608	001	0	1	04	01	H1608_001_0	12	4	Specialty - Generic and Brand			
H1608	001	0	1	04	01	H1608_001_0	12	3	Non-Preferred Generic/Non-Preferred Brand			
H1608	001	0	1	04	01	H1608_001_0	12	2	Preferred Brand			
H1608	001	0	1	04	01	H1608_001_0	12	1	Preferred Generic			
H1608	001	0	1	04	01	H1608_001_0	12	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1608	001	0	1	04	01	H1608_001_0	12	4	Specialty - Generic and Brand	2		
H1608	002	0	1	04	01	H1608_002_0	10	1	Preferred Generic			
H1608	002	0	1	04	01	H1608_002_0	10	2	Preferred Brand			
H1608	002	0	1	04	01	H1608_002_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H1608	002	0	1	04	01	H1608_002_0	10	4	Specialty - Generic and Brand			
H1608	002	0	1	04	01	H1608_002_0	10	1	Preferred Generic	1		1
H1608	002	0	1	04	01	H1608_002_0	10	2	Preferred Brand	2		
H1608	002	0	1	04	01	H1608_002_0	10	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1608	002	0	1	04	01	H1608_002_0	10	4	Specialty - Generic and Brand	2		
H1608	003	0	1	04	01	H1608_003_0	10	2	Preferred Brand			
H1608	003	0	1	04	01	H1608_003_0	10	1	Preferred Generic			
H1608	003	0	1	04	01	H1608_003_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H1608	003	0	1	04	01	H1608_003_0	10	4	Specialty - Generic and Brand			
H1608	003	0	1	04	01	H1608_003_0	10	1	Preferred Generic	1		1
H1608	003	0	1	04	01	H1608_003_0	10	2	Preferred Brand	2		
H1608	003	0	1	04	01	H1608_003_0	10	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1608	003	0	1	04	01	H1608_003_0	10	4	Specialty - Generic and Brand	2		
H1609	001	0	1	01	01	H1609_001_0	11	4	Specialty - Generic and Brand	2		
H1609	001	0	1	01	01	H1609_001_0	11	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1609	001	0	1	01	01	H1609_001_0	11	1	Preferred Generic	1		1
H1609	001	0	1	01	01	H1609_001_0	11	2	Preferred Brand	2		
H1609	001	0	1	01	01	H1609_001_0	11	4	Specialty - Generic and Brand			
H1609	001	0	1	01	01	H1609_001_0	11	3	Non-Preferred Generic/Non-Preferred Brand			
H1609	001	0	1	01	01	H1609_001_0	11	2	Preferred Brand			
H1609	001	0	1	01	01	H1609_001_0	11	1	Preferred Generic			
H1609	003	0	1	01	01	H1609_003_0	13	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1609	003	0	1	01	01	H1609_003_0	13	1	Preferred Generic			
H1609	003	0	1	01	01	H1609_003_0	13	4	Specialty - Generic and Brand	2		
H1609	003	0	1	01	01	H1609_003_0	13	2	Preferred Brand			
H1609	003	0	1	01	01	H1609_003_0	13	3	Non-Preferred Generic/Non-Preferred Brand			
H1609	003	0	1	01	01	H1609_003_0	13	4	Specialty - Generic and Brand			
H1609	003	0	1	01	01	H1609_003_0	13	1	Preferred Generic	1		1
H1609	003	0	1	01	01	H1609_003_0	13	2	Preferred Brand	2		
H1609	004	0	1	01	01	H1609_004_0	11	2	Preferred Brand	2		
H1609	004	0	1	01	01	H1609_004_0	11	1	Preferred Generic			
H1609	004	0	1	01	01	H1609_004_0	11	4	Specialty - Generic and Brand	2		
H1609	004	0	1	01	01	H1609_004_0	11	5	Other - Special Needs	1		1
H1609	004	0	1	01	01	H1609_004_0	11	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1609	004	0	1	01	01	H1609_004_0	11	2	Preferred Brand			
H1609	004	0	1	01	01	H1609_004_0	11	3	Non-Preferred Generic/Non-Preferred Brand			
H1609	004	0	1	01	01	H1609_004_0	11	4	Specialty - Generic and Brand			
H1609	004	0	1	01	01	H1609_004_0	11	5	Other - Special Needs			
H1609	004	0	1	01	01	H1609_004_0	11	1	Preferred Generic	1		1
H1609	005	0	1	01	01	H1609_005_0	12	2	Preferred Brand	2		
H1609	005	0	1	01	01	H1609_005_0	12	1	Preferred Generic			
H1609	005	0	1	01	01	H1609_005_0	12	4	Specialty - Generic and Brand	2		
H1609	005	0	1	01	01	H1609_005_0	12	5	Other - Special Needs	1		1
H1609	005	0	1	01	01	H1609_005_0	12	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1609	005	0	1	01	01	H1609_005_0	12	2	Preferred Brand			
H1609	005	0	1	01	01	H1609_005_0	12	3	Non-Preferred Generic/Non-Preferred Brand			
H1609	005	0	1	01	01	H1609_005_0	12	4	Specialty - Generic and Brand			
H1609	005	0	1	01	01	H1609_005_0	12	5	Other - Special Needs			
H1609	005	0	1	01	01	H1609_005_0	12	1	Preferred Generic	1		1
H1609	006	0	1	01	01	H1609_006_0	12	4	Specialty - Generic and Brand			
H1609	006	0	1	01	01	H1609_006_0	12	3	Non-Preferred Generic/Non-Preferred Brand			
H1609	006	0	1	01	01	H1609_006_0	12	2	Preferred Brand			
H1609	006	0	1	01	01	H1609_006_0	12	1	Preferred Generic			
H1609	007	0	1	01	01	H1609_007_0	10	4	Specialty - Generic and Brand	2		
H1609	007	0	1	01	01	H1609_007_0	10	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1609	007	0	1	01	01	H1609_007_0	10	2	Preferred Brand	2		
H1609	007	0	1	01	01	H1609_007_0	10	1	Preferred Generic	1		1
H1609	007	0	1	01	01	H1609_007_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H1609	007	0	1	01	01	H1609_007_0	10	4	Specialty - Generic and Brand			
H1609	007	0	1	01	01	H1609_007_0	10	1	Preferred Generic			
H1609	007	0	1	01	01	H1609_007_0	10	2	Preferred Brand			
H1609	008	0	1	01	01	H1609_008_0	10	3	Non-Preferred Generic/Non-Preferred Brand	2		
H1609	008	0	1	01	01	H1609_008_0	10	4	Specialty - Generic and Brand	2		
H1609	008	0	1	01	01	H1609_008_0	10	2	Preferred Brand			
H1609	008	0	1	01	01	H1609_008_0	10	1	Preferred Generic			
H1609	008	0	1	01	01	H1609_008_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H1609	008	0	1	01	01	H1609_008_0	10	2	Preferred Brand	2		
H1609	008	0	1	01	01	H1609_008_0	10	1	Preferred Generic	1		1
H1609	008	0	1	01	01	H1609_008_0	10	4	Specialty - Generic and Brand			
H1643	001	0	1	09	04	H1643_001_0	8	1	Generic			
H1643	001	0	1	09	04	H1643_001_0	8	2	Preferred Brand			
H1643	001	0	1	09	04	H1643_001_0	8	3	Non-Preferred Brand			
H1643	001	0	1	09	04	H1643_001_0	8	4	Specialty			
H1643	003	0	1	09	04	H1643_003_0	8	1	Generic			
H1643	003	0	1	09	04	H1643_003_0	8	2	Preferred Brand			
H1643	003	0	1	09	04	H1643_003_0	8	3	Non-Preferred Brand			
H1643	003	0	1	09	04	H1643_003_0	8	4	Specialty			
H1643	003	0	1	09	04	H1643_003_0	8	1	Generic	1		1
H1643	003	0	1	09	04	H1643_003_0	8	2	Preferred Brand	2		
H1643	003	0	1	09	04	H1643_003_0	8	3	Non-Preferred Brand	2		
H1643	003	0	1	09	04	H1643_003_0	8	4	Specialty	2		
H1643	004	0	1	09	04	H1643_004_0	8	1	Generic			
H1643	004	0	1	09	04	H1643_004_0	8	2	Preferred Brand			
H1643	004	0	1	09	04	H1643_004_0	8	4	Specialty			
H1643	004	0	1	09	04	H1643_004_0	8	3	Non-Preferred Brand			
H1643	006	0	1	09	04	H1643_006_0	8	1	Generic			
H1643	006	0	1	09	04	H1643_006_0	8	2	Preferred Brand			
H1643	006	0	1	09	04	H1643_006_0	8	3	Non-Preferred Brand			
H1643	006	0	1	09	04	H1643_006_0	8	4	Specialty			
H1643	006	0	1	09	04	H1643_006_0	8	1	Generic	1		1
H1643	006	0	1	09	04	H1643_006_0	8	3	Non-Preferred Brand	2		
H1643	006	0	1	09	04	H1643_006_0	8	2	Preferred Brand	2		
H1643	006	0	1	09	04	H1643_006_0	8	4	Specialty	2		
H1657	002	0	1	02	01	H1657_002_0	7	4	Tier 4			
H1657	002	0	1	02	01	H1657_002_0	7	2	Tier 2			
H1657	002	0	1	02	01	H1657_002_0	7	3	Tier 3			
H1657	002	0	1	02	01	H1657_002_0	7	1	Tier 1			
H1657	003	0	1	02	01	H1657_003_0	7	3	Tier 3			
H1657	003	0	1	02	01	H1657_003_0	7	2	Tier 2			
H1657	003	0	1	02	01	H1657_003_0	7	1	Tier 1			
H1657	003	0	1	02	01	H1657_003_0	7	4	Tier 4			
H1657	003	0	1	02	01	H1657_003_0	7	2	Tier 2	2		
H1657	003	0	1	02	01	H1657_003_0	7	3	Tier 3	2		
H1657	003	0	1	02	01	H1657_003_0	7	4	Tier 4	2		
H1657	003	0	1	02	01	H1657_003_0	7	1	Tier 1	1		1
H1657	004	0	1	01	01	H1657_004_0	7	2	Tier 2			
H1657	004	0	1	01	01	H1657_004_0	7	3	Tier 3			
H1657	004	0	1	01	01	H1657_004_0	7	4	Tier 4			
H1657	004	0	1	01	01	H1657_004_0	7	1	Tier 1			
H1657	005	0	1	02	01	H1657_005_0	7	1	Tier 1			
H1657	005	0	1	02	01	H1657_005_0	7	2	Tier 2			
H1657	005	0	1	02	01	H1657_005_0	7	3	Tier 3			
H1657	005	0	1	02	01	H1657_005_0	7	4	Tier 4			
H1657	006	0	1	02	01	H1657_006_0	8	4	Tier 4			
H1657	006	0	1	02	01	H1657_006_0	8	3	Tier 3			
H1657	006	0	1	02	01	H1657_006_0	8	1	Tier 1			
H1657	006	0	1	02	01	H1657_006_0	8	2	Tier 2			
H1657	007	0	1	02	01	H1657_007_0	7	1	Tier 1	2		
H1657	007	0	1	02	01	H1657_007_0	7	3	Tier 3	2		
H1657	007	0	1	02	01	H1657_007_0	7	4	Tier 4	2		
H1657	007	0	1	02	01	H1657_007_0	7	2	Tier 2	2		
H1657	007	0	1	02	01	H1657_007_0	7	1	Tier 1			
H1657	007	0	1	02	01	H1657_007_0	7	2	Tier 2			
H1657	007	0	1	02	01	H1657_007_0	7	3	Tier 3			
H1657	007	0	1	02	01	H1657_007_0	7	4	Tier 4			
H1657	008	0	1	02	01	H1657_008_0	7	4	Tier 4	2		
H1657	008	0	1	02	01	H1657_008_0	7	1	Tier 1			
H1657	008	0	1	02	01	H1657_008_0	7	2	Tier 2			
H1657	008	0	1	02	01	H1657_008_0	7	3	Tier 3			
H1657	008	0	1	02	01	H1657_008_0	7	4	Tier 4			
H1657	008	0	1	02	01	H1657_008_0	7	1	Tier 1	1		1
H1657	008	0	1	02	01	H1657_008_0	7	2	Tier 2	2		
H1657	008	0	1	02	01	H1657_008_0	7	3	Tier 3	2		
H1657	009	0	1	02	01	H1657_009_0	7	2	Tier 2			
H1657	009	0	1	02	01	H1657_009_0	7	3	Tier 3			
H1657	009	0	1	02	01	H1657_009_0	7	4	Tier 4			
H1657	009	0	1	02	01	H1657_009_0	7	1	Tier 1	1		1
H1657	009	0	1	02	01	H1657_009_0	7	2	Tier 2	2		
H1657	009	0	1	02	01	H1657_009_0	7	1	Tier 1			
H1657	009	0	1	02	01	H1657_009_0	7	3	Tier 3	2		
H1657	009	0	1	02	01	H1657_009_0	7	4	Tier 4	2		
H1681	001	0	1	04	01	H1681_001_0	4	3	Non-Preferred Brand	1	10000000	2
H1681	001	0	1	04	01	H1681_001_0	4	4	Specialty	1	10001000	2
H1681	001	0	1	04	01	H1681_001_0	4	1	Preferred Generic			
H1681	001	0	1	04	01	H1681_001_0	4	2	Preferred Brand			
H1681	001	0	1	04	01	H1681_001_0	4	3	Non-Preferred Brand			
H1681	001	0	1	04	01	H1681_001_0	4	4	Specialty			
H1681	001	0	1	04	01	H1681_001_0	4	1	Preferred Generic	1	00001000	2
H1681	001	0	1	04	01	H1681_001_0	4	2	Preferred Brand	1	10000000	2
H1681	002	0	1	04	01	H1681_002_0	4	4	Specialty			
H1681	002	0	1	04	01	H1681_002_0	4	3	Non-Preferred Brand			
H1681	002	0	1	04	01	H1681_002_0	4	2	Preferred Brand			
H1681	002	0	1	04	01	H1681_002_0	4	1	Preferred Generic			
H1681	002	0	1	04	01	H1681_002_0	4	1	Preferred Generic	1	00001000	2
H1681	002	0	1	04	01	H1681_002_0	4	2	Preferred Brand	1	10000000	2
H1681	002	0	1	04	01	H1681_002_0	4	3	Non-Preferred Brand	1	10000000	2
H1681	002	0	1	04	01	H1681_002_0	4	4	Specialty	1	10001000	2
H1681	003	0	1	04	01	H1681_003_0	4	4	Specialty			
H1681	003	0	1	04	01	H1681_003_0	4	3	Non-Preferred Brand			
H1681	003	0	1	04	01	H1681_003_0	4	2	Preferred Brand			
H1681	003	0	1	04	01	H1681_003_0	4	1	Preferred Generic			
H1681	003	0	1	04	01	H1681_003_0	4	1	Preferred Generic	1	00001000	2
H1681	003	0	1	04	01	H1681_003_0	4	4	Specialty	1	10001000	2
H1681	003	0	1	04	01	H1681_003_0	4	3	Non-Preferred Brand	1	10000000	2
H1681	003	0	1	04	01	H1681_003_0	4	2	Preferred Brand	1	10000000	2
H1689	013	0	1	09	04	H1689_013_0	9	1	Tier 1 Preferred Generic			
H1689	013	0	1	09	04	H1689_013_0	9	2	Tier 2 Preferred Brand			
H1689	013	0	1	09	04	H1689_013_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H1689	013	0	1	09	04	H1689_013_0	9	4	Tier 4 Non-Specialty Injectable			
H1689	013	0	1	09	04	H1689_013_0	9	5	Tier 5 Specialty	2		
H1689	013	0	1	09	04	H1689_013_0	9	1	Tier 1 Preferred Generic	1		1
H1689	013	0	1	09	04	H1689_013_0	9	4	Tier 4 Non-Specialty Injectable	2		
H1689	013	0	1	09	04	H1689_013_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H1689	013	0	1	09	04	H1689_013_0	9	2	Tier 2 Preferred Brand	2		
H1689	013	0	1	09	04	H1689_013_0	9	5	Tier 5 Specialty			
H1716	001	0	1	04	01	H1716_001_0	3	4	Specialty	1	10001000	2
H1716	001	0	1	04	01	H1716_001_0	3	1	Preferred Generic	1	00001000	2
H1716	001	0	1	04	01	H1716_001_0	3	2	Preferred Brand	1	10000000	2
H1716	001	0	1	04	01	H1716_001_0	3	3	Non-Preferred Brand	1	10000000	2
H1716	001	0	1	04	01	H1716_001_0	3	4	Specialty			
H1716	001	0	1	04	01	H1716_001_0	3	3	Non-Preferred Brand			
H1716	001	0	1	04	01	H1716_001_0	3	2	Preferred Brand			
H1716	001	0	1	04	01	H1716_001_0	3	1	Preferred Generic			
H1716	002	0	1	04	01	H1716_002_0	4	1	Preferred Generic	1	00001000	2
H1716	002	0	1	04	01	H1716_002_0	4	2	Preferred Brand	1	10000000	2
H1716	002	0	1	04	01	H1716_002_0	4	3	Non-Preferred Brand	1	10000000	2
H1716	002	0	1	04	01	H1716_002_0	4	4	Specialty	1	10001000	2
H1716	002	0	1	04	01	H1716_002_0	4	4	Specialty			
H1716	002	0	1	04	01	H1716_002_0	4	3	Non-Preferred Brand			
H1716	002	0	1	04	01	H1716_002_0	4	2	Preferred Brand			
H1716	002	0	1	04	01	H1716_002_0	4	1	Preferred Generic			
H1716	004	0	1	04	01	H1716_004_0	4	1	Preferred Generic			
H1716	004	0	1	04	01	H1716_004_0	4	2	Preferred Brand			
H1716	004	0	1	04	01	H1716_004_0	4	3	Non-Preferred Brand			
H1716	004	0	1	04	01	H1716_004_0	4	4	Specialty			
H1716	004	0	1	04	01	H1716_004_0	4	1	Preferred Generic	1	00001000	2
H1716	004	0	1	04	01	H1716_004_0	4	2	Preferred Brand	1	10000000	2
H1716	004	0	1	04	01	H1716_004_0	4	4	Specialty	1	10001000	2
H1716	004	0	1	04	01	H1716_004_0	4	3	Non-Preferred Brand	1	10000000	2
H1716	006	0	1	04	01	H1716_006_0	3	3	Non-Preferred Brand	1	10000000	2
H1716	006	0	1	04	01	H1716_006_0	3	4	Specialty	1	10001000	2
H1716	006	0	1	04	01	H1716_006_0	3	1	Preferred Generic	1	00001000	2
H1716	006	0	1	04	01	H1716_006_0	3	1	Preferred Generic			
H1716	006	0	1	04	01	H1716_006_0	3	2	Preferred Brand			
H1716	006	0	1	04	01	H1716_006_0	3	3	Non-Preferred Brand			
H1716	006	0	1	04	01	H1716_006_0	3	4	Specialty			
H1716	006	0	1	04	01	H1716_006_0	3	2	Preferred Brand	1	10000000	2
H1716	009	0	1	04	01	H1716_009_0	5	4	Specialty	1	10001000	2
H1716	009	0	1	04	01	H1716_009_0	5	3	Non-Preferred Brand	1	10000000	2
H1716	009	0	1	04	01	H1716_009_0	5	2	Preferred Brand	1	10000000	2
H1716	009	0	1	04	01	H1716_009_0	5	4	Specialty			
H1716	009	0	1	04	01	H1716_009_0	5	1	Preferred Generic	1	00001000	2
H1716	009	0	1	04	01	H1716_009_0	5	3	Non-Preferred Brand			
H1716	009	0	1	04	01	H1716_009_0	5	2	Preferred Brand			
H1716	009	0	1	04	01	H1716_009_0	5	1	Preferred Generic			
H1716	010	0	1	04	01	H1716_010_0	3	3	Non-Preferred Brand			
H1716	010	0	1	04	01	H1716_010_0	3	4	Specialty	1	10001000	2
H1716	010	0	1	04	01	H1716_010_0	3	1	Preferred Generic			
H1716	010	0	1	04	01	H1716_010_0	3	2	Preferred Brand			
H1716	010	0	1	04	01	H1716_010_0	3	3	Non-Preferred Brand	1	10000000	2
H1716	010	0	1	04	01	H1716_010_0	3	2	Preferred Brand	1	10000000	2
H1716	010	0	1	04	01	H1716_010_0	3	1	Preferred Generic	1	00001000	2
H1716	010	0	1	04	01	H1716_010_0	3	4	Specialty			
H1717	001	0	1	04	01	H1717_001_0	5	2	Preferred Brand			
H1717	001	0	1	04	01	H1717_001_0	5	3	Non-Preferred			
H1717	001	0	1	04	01	H1717_001_0	5	1	Preferred Generic			
H1717	001	0	1	04	01	H1717_001_0	5	4	Specialty			
H1717	008	0	1	04	01	H1717_008_0	3	4	Specialty			
H1717	008	0	1	04	01	H1717_008_0	3	3	Non Preferred			
H1717	008	0	1	04	01	H1717_008_0	3	2	Preferred Brand			
H1717	008	0	1	04	01	H1717_008_0	3	1	Preferred Generic			
H1717	009	0	1	04	01	H1717_009_0	5	1	Preferred Generic			
H1717	009	0	1	04	01	H1717_009_0	5	3	Non Preferred			
H1717	009	0	1	04	01	H1717_009_0	5	2	Preferred Brand			
H1717	009	0	1	04	01	H1717_009_0	5	4	Specialty			
H1717	010	0	1	04	01	H1717_010_0	3	1	Preferred Generic			
H1717	010	0	1	04	01	H1717_010_0	3	2	Preferred Brand			
H1717	010	0	1	04	01	H1717_010_0	3	3	Non Preferred			
H1717	010	0	1	04	01	H1717_010_0	3	4	Specialty			
H1804	001	0	1	09	04	H1804_001_0	4	4	Specialty	1	10001000	2
H1804	001	0	1	09	04	H1804_001_0	4	2	Preferred Brand			
H1804	001	0	1	09	04	H1804_001_0	4	2	Preferred Brand	1	10000000	2
H1804	001	0	1	09	04	H1804_001_0	4	1	Preferred Generic	1	00001000	2
H1804	001	0	1	09	04	H1804_001_0	4	4	Specialty			
H1804	001	0	1	09	04	H1804_001_0	4	3	Non-Preferred Brand			
H1804	001	0	1	09	04	H1804_001_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	001	0	1	09	04	H1804_001_0	4	1	Preferred Generic			
H1804	005	0	1	09	04	H1804_005_0	3	2	Preferred Brand	1	10000000	2
H1804	005	0	1	09	04	H1804_005_0	3	1	Preferred Generic	1	00001000	2
H1804	005	0	1	09	04	H1804_005_0	3	4	Specialty			
H1804	005	0	1	09	04	H1804_005_0	3	3	Non-Preferred Brand			
H1804	005	0	1	09	04	H1804_005_0	3	2	Preferred Brand			
H1804	005	0	1	09	04	H1804_005_0	3	1	Preferred Generic			
H1804	005	0	1	09	04	H1804_005_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	005	0	1	09	04	H1804_005_0	3	4	Specialty	1	10001000	2
H1804	006	0	1	09	04	H1804_006_0	3	3	Non-Preferred Brand			
H1804	006	0	1	09	04	H1804_006_0	3	4	Specialty			
H1804	006	0	1	09	04	H1804_006_0	3	1	Preferred Generic	1	00001000	2
H1804	006	0	1	09	04	H1804_006_0	3	2	Preferred Brand	1	10000000	2
H1804	006	0	1	09	04	H1804_006_0	3	2	Preferred Brand			
H1804	006	0	1	09	04	H1804_006_0	3	4	Specialty	1	10001000	2
H1804	006	0	1	09	04	H1804_006_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	006	0	1	09	04	H1804_006_0	3	1	Preferred Generic			
H1804	007	0	1	09	04	H1804_007_0	3	3	Non-Preferred Brand			
H1804	007	0	1	09	04	H1804_007_0	3	4	Specialty			
H1804	007	0	1	09	04	H1804_007_0	3	1	Preferred Generic	1	00001000	2
H1804	007	0	1	09	04	H1804_007_0	3	2	Preferred Brand	1	10000000	2
H1804	007	0	1	09	04	H1804_007_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	007	0	1	09	04	H1804_007_0	3	4	Specialty	1	10001000	2
H1804	007	0	1	09	04	H1804_007_0	3	2	Preferred Brand			
H1804	007	0	1	09	04	H1804_007_0	3	1	Preferred Generic			
H1804	008	0	1	09	04	H1804_008_0	3	4	Specialty	1	10001000	2
H1804	008	0	1	09	04	H1804_008_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	008	0	1	09	04	H1804_008_0	3	2	Preferred Brand	1	10000000	2
H1804	008	0	1	09	04	H1804_008_0	3	1	Preferred Generic	1	00001000	2
H1804	008	0	1	09	04	H1804_008_0	3	2	Preferred Brand			
H1804	008	0	1	09	04	H1804_008_0	3	3	Non-Preferred Brand			
H1804	008	0	1	09	04	H1804_008_0	3	4	Specialty			
H1804	008	0	1	09	04	H1804_008_0	3	1	Preferred Generic			
H1804	009	0	1	09	04	H1804_009_0	3	2	Preferred Brand	1	10000000	2
H1804	009	0	1	09	04	H1804_009_0	3	1	Preferred Generic	1	00001000	2
H1804	009	0	1	09	04	H1804_009_0	3	4	Specialty			
H1804	009	0	1	09	04	H1804_009_0	3	3	Non-Preferred Brand			
H1804	009	0	1	09	04	H1804_009_0	3	2	Preferred Brand			
H1804	009	0	1	09	04	H1804_009_0	3	1	Preferred Generic			
H1804	009	0	1	09	04	H1804_009_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	009	0	1	09	04	H1804_009_0	3	4	Specialty	1	10001000	2
H1804	011	0	1	09	04	H1804_011_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	011	0	1	09	04	H1804_011_0	3	2	Preferred Brand	1	10000000	2
H1804	011	0	1	09	04	H1804_011_0	3	4	Specialty	1	10001000	2
H1804	011	0	1	09	04	H1804_011_0	3	1	Preferred Generic			
H1804	011	0	1	09	04	H1804_011_0	3	2	Preferred Brand			
H1804	011	0	1	09	04	H1804_011_0	3	3	Non-Preferred Brand			
H1804	011	0	1	09	04	H1804_011_0	3	4	Specialty			
H1804	011	0	1	09	04	H1804_011_0	3	1	Preferred Generic	1	00001000	2
H1804	013	0	1	09	04	H1804_013_0	3	1	Preferred Generic			
H1804	013	0	1	09	04	H1804_013_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	013	0	1	09	04	H1804_013_0	3	2	Preferred Brand	1	10000000	2
H1804	013	0	1	09	04	H1804_013_0	3	1	Preferred Generic	1	00001000	2
H1804	013	0	1	09	04	H1804_013_0	3	4	Specialty			
H1804	013	0	1	09	04	H1804_013_0	3	3	Non-Preferred Brand			
H1804	013	0	1	09	04	H1804_013_0	3	2	Preferred Brand			
H1804	013	0	1	09	04	H1804_013_0	3	4	Specialty	1	10001000	2
H1804	014	0	1	09	04	H1804_014_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	014	0	1	09	04	H1804_014_0	3	2	Preferred Brand	1	10000000	2
H1804	014	0	1	09	04	H1804_014_0	3	1	Preferred Generic	1	00001000	2
H1804	014	0	1	09	04	H1804_014_0	3	4	Specialty			
H1804	014	0	1	09	04	H1804_014_0	3	3	Non-Preferred Brand			
H1804	014	0	1	09	04	H1804_014_0	3	2	Preferred Brand			
H1804	014	0	1	09	04	H1804_014_0	3	1	Preferred Generic			
H1804	014	0	1	09	04	H1804_014_0	3	4	Specialty	1	10001000	2
H1804	016	0	1	09	04	H1804_016_0	3	3	Non-Preferred Brand			
H1804	016	0	1	09	04	H1804_016_0	3	2	Preferred Brand			
H1804	016	0	1	09	04	H1804_016_0	3	1	Preferred Generic			
H1804	016	0	1	09	04	H1804_016_0	3	4	Specialty			
H1804	016	0	1	09	04	H1804_016_0	3	1	Preferred Generic	1	00001000	2
H1804	016	0	1	09	04	H1804_016_0	3	2	Preferred Brand	1	10000000	2
H1804	016	0	1	09	04	H1804_016_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	016	0	1	09	04	H1804_016_0	3	4	Specialty	1	10001000	2
H1804	018	0	1	09	04	H1804_018_0	5	3	Non-Preferred Brand			
H1804	018	0	1	09	04	H1804_018_0	5	2	Preferred Brand			
H1804	018	0	1	09	04	H1804_018_0	5	1	Preferred Generic			
H1804	018	0	1	09	04	H1804_018_0	5	4	Specialty			
H1804	018	0	1	09	04	H1804_018_0	5	4	Specialty	1	10001000	2
H1804	018	0	1	09	04	H1804_018_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	018	0	1	09	04	H1804_018_0	5	2	Preferred Brand	1	10000000	2
H1804	018	0	1	09	04	H1804_018_0	5	1	Preferred Generic	1	00001000	2
H1804	019	0	1	09	04	H1804_019_0	3	1	Preferred Generic			
H1804	019	0	1	09	04	H1804_019_0	3	2	Preferred Brand			
H1804	019	0	1	09	04	H1804_019_0	3	3	Non-Preferred Brand			
H1804	019	0	1	09	04	H1804_019_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	019	0	1	09	04	H1804_019_0	3	2	Preferred Brand	1	10000000	2
H1804	019	0	1	09	04	H1804_019_0	3	1	Preferred Generic	1	00001000	2
H1804	019	0	1	09	04	H1804_019_0	3	4	Specialty			
H1804	019	0	1	09	04	H1804_019_0	3	4	Specialty	1	10001000	2
H1804	020	0	1	09	04	H1804_020_0	3	3	Non-Preferred Brand			
H1804	020	0	1	09	04	H1804_020_0	3	2	Preferred Brand			
H1804	020	0	1	09	04	H1804_020_0	3	1	Preferred Generic	1	00001000	2
H1804	020	0	1	09	04	H1804_020_0	3	2	Preferred Brand	1	10000000	2
H1804	020	0	1	09	04	H1804_020_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	020	0	1	09	04	H1804_020_0	3	4	Specialty	1	10001000	2
H1804	020	0	1	09	04	H1804_020_0	3	4	Specialty			
H1804	020	0	1	09	04	H1804_020_0	3	1	Preferred Generic			
H1804	022	0	1	09	04	H1804_022_0	3	3	Non-Preferred Brand			
H1804	022	0	1	09	04	H1804_022_0	3	1	Preferred Generic			
H1804	022	0	1	09	04	H1804_022_0	3	1	Preferred Generic	1	00001000	2
H1804	022	0	1	09	04	H1804_022_0	3	2	Preferred Brand	1	10000000	2
H1804	022	0	1	09	04	H1804_022_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	022	0	1	09	04	H1804_022_0	3	4	Specialty	1	10001000	2
H1804	022	0	1	09	04	H1804_022_0	3	4	Specialty			
H1804	022	0	1	09	04	H1804_022_0	3	2	Preferred Brand			
H1804	023	0	1	09	04	H1804_023_0	3	3	Non-Preferred Brand			
H1804	023	0	1	09	04	H1804_023_0	3	1	Preferred Generic			
H1804	023	0	1	09	04	H1804_023_0	3	1	Preferred Generic	1	00001000	2
H1804	023	0	1	09	04	H1804_023_0	3	2	Preferred Brand	1	10000000	2
H1804	023	0	1	09	04	H1804_023_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	023	0	1	09	04	H1804_023_0	3	4	Specialty	1	10001000	2
H1804	023	0	1	09	04	H1804_023_0	3	4	Specialty			
H1804	023	0	1	09	04	H1804_023_0	3	2	Preferred Brand			
H1804	025	0	1	09	04	H1804_025_0	3	3	Non-Preferred Brand			
H1804	025	0	1	09	04	H1804_025_0	3	4	Specialty			
H1804	025	0	1	09	04	H1804_025_0	3	1	Preferred Generic	1	00001000	2
H1804	025	0	1	09	04	H1804_025_0	3	2	Preferred Brand	1	10000000	2
H1804	025	0	1	09	04	H1804_025_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	025	0	1	09	04	H1804_025_0	3	4	Specialty	1	10001000	2
H1804	025	0	1	09	04	H1804_025_0	3	2	Preferred Brand			
H1804	025	0	1	09	04	H1804_025_0	3	1	Preferred Generic			
H1804	061	0	1	09	04	H1804_061_0	3	3	Non-Preferred Brand			
H1804	061	0	1	09	04	H1804_061_0	3	2	Preferred Brand			
H1804	061	0	1	09	04	H1804_061_0	3	1	Preferred Generic			
H1804	061	0	1	09	04	H1804_061_0	3	4	Specialty			
H1804	061	0	1	09	04	H1804_061_0	3	1	Preferred Generic	1	00001000	2
H1804	061	0	1	09	04	H1804_061_0	3	2	Preferred Brand	1	10000000	2
H1804	061	0	1	09	04	H1804_061_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	061	0	1	09	04	H1804_061_0	3	4	Specialty	1	10001000	2
H1804	063	0	1	09	04	H1804_063_0	3	3	Non-Preferred Brand			
H1804	063	0	1	09	04	H1804_063_0	3	2	Preferred Brand			
H1804	063	0	1	09	04	H1804_063_0	3	1	Preferred Generic			
H1804	063	0	1	09	04	H1804_063_0	3	4	Specialty			
H1804	063	0	1	09	04	H1804_063_0	3	4	Specialty	1	10001000	2
H1804	063	0	1	09	04	H1804_063_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	063	0	1	09	04	H1804_063_0	3	2	Preferred Brand	1	10000000	2
H1804	063	0	1	09	04	H1804_063_0	3	1	Preferred Generic	1	00001000	2
H1804	066	0	1	09	04	H1804_066_0	3	1	Preferred Generic			
H1804	066	0	1	09	04	H1804_066_0	3	2	Preferred Brand			
H1804	066	0	1	09	04	H1804_066_0	3	3	Non-Preferred Brand			
H1804	066	0	1	09	04	H1804_066_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	066	0	1	09	04	H1804_066_0	3	2	Preferred Brand	1	10000000	2
H1804	066	0	1	09	04	H1804_066_0	3	1	Preferred Generic	1	00001000	2
H1804	066	0	1	09	04	H1804_066_0	3	4	Specialty			
H1804	066	0	1	09	04	H1804_066_0	3	4	Specialty	1	10001000	2
H1804	067	0	1	09	04	H1804_067_0	3	1	Preferred Generic	1	00001000	2
H1804	067	0	1	09	04	H1804_067_0	3	2	Preferred Brand	1	10000000	2
H1804	067	0	1	09	04	H1804_067_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	067	0	1	09	04	H1804_067_0	3	4	Specialty	1	10001000	2
H1804	067	0	1	09	04	H1804_067_0	3	1	Preferred Generic			
H1804	067	0	1	09	04	H1804_067_0	3	2	Preferred Brand			
H1804	067	0	1	09	04	H1804_067_0	3	3	Non-Preferred Brand			
H1804	067	0	1	09	04	H1804_067_0	3	4	Specialty			
H1804	068	0	1	09	04	H1804_068_0	3	3	Non-Preferred Brand			
H1804	068	0	1	09	04	H1804_068_0	3	4	Specialty			
H1804	068	0	1	09	04	H1804_068_0	3	1	Preferred Generic	1	00001000	2
H1804	068	0	1	09	04	H1804_068_0	3	2	Preferred Brand			
H1804	068	0	1	09	04	H1804_068_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	068	0	1	09	04	H1804_068_0	3	4	Specialty	1	10001000	2
H1804	068	0	1	09	04	H1804_068_0	3	1	Preferred Generic			
H1804	068	0	1	09	04	H1804_068_0	3	2	Preferred Brand	1	10000000	2
H1804	075	0	1	09	04	H1804_075_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	075	0	1	09	04	H1804_075_0	3	2	Preferred Brand	1	10000000	2
H1804	075	0	1	09	04	H1804_075_0	3	4	Specialty	1	10001000	2
H1804	075	0	1	09	04	H1804_075_0	3	1	Preferred Generic	1	00001000	2
H1804	075	0	1	09	04	H1804_075_0	3	4	Specialty			
H1804	075	0	1	09	04	H1804_075_0	3	3	Non-Preferred Brand			
H1804	075	0	1	09	04	H1804_075_0	3	2	Preferred Brand			
H1804	075	0	1	09	04	H1804_075_0	3	1	Preferred Generic			
H1804	077	0	1	09	04	H1804_077_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	077	0	1	09	04	H1804_077_0	3	4	Specialty	1	10001000	2
H1804	077	0	1	09	04	H1804_077_0	3	2	Preferred Brand	1	10000000	2
H1804	077	0	1	09	04	H1804_077_0	3	1	Preferred Generic	1	00001000	2
H1804	077	0	1	09	04	H1804_077_0	3	4	Specialty			
H1804	077	0	1	09	04	H1804_077_0	3	3	Non-Preferred Brand			
H1804	077	0	1	09	04	H1804_077_0	3	2	Preferred Brand			
H1804	077	0	1	09	04	H1804_077_0	3	1	Preferred Generic			
H1804	081	0	1	09	04	H1804_081_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	081	0	1	09	04	H1804_081_0	3	2	Preferred Brand	1	10000000	2
H1804	081	0	1	09	04	H1804_081_0	3	1	Preferred Generic	1	00001000	2
H1804	081	0	1	09	04	H1804_081_0	3	4	Specialty			
H1804	081	0	1	09	04	H1804_081_0	3	3	Non-Preferred Brand			
H1804	081	0	1	09	04	H1804_081_0	3	2	Preferred Brand			
H1804	081	0	1	09	04	H1804_081_0	3	1	Preferred Generic			
H1804	081	0	1	09	04	H1804_081_0	3	4	Specialty	1	10001000	2
H1804	086	0	1	09	04	H1804_086_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	086	0	1	09	04	H1804_086_0	3	2	Preferred Brand	1	10000000	2
H1804	086	0	1	09	04	H1804_086_0	3	1	Preferred Generic	1	00001000	2
H1804	086	0	1	09	04	H1804_086_0	3	4	Specialty			
H1804	086	0	1	09	04	H1804_086_0	3	3	Non-Preferred Brand			
H1804	086	0	1	09	04	H1804_086_0	3	2	Preferred Brand			
H1804	086	0	1	09	04	H1804_086_0	3	1	Preferred Generic			
H1804	086	0	1	09	04	H1804_086_0	3	4	Specialty	1	10001000	2
H1804	087	0	1	09	04	H1804_087_0	3	1	Preferred Generic			
H1804	087	0	1	09	04	H1804_087_0	3	2	Preferred Brand			
H1804	087	0	1	09	04	H1804_087_0	3	4	Specialty	1	10001000	2
H1804	087	0	1	09	04	H1804_087_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	087	0	1	09	04	H1804_087_0	3	2	Preferred Brand	1	10000000	2
H1804	087	0	1	09	04	H1804_087_0	3	1	Preferred Generic	1	00001000	2
H1804	087	0	1	09	04	H1804_087_0	3	4	Specialty			
H1804	087	0	1	09	04	H1804_087_0	3	3	Non-Preferred Brand			
H1804	089	0	1	09	04	H1804_089_0	3	1	Preferred Generic			
H1804	089	0	1	09	04	H1804_089_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	089	0	1	09	04	H1804_089_0	3	2	Preferred Brand	1	10000000	2
H1804	089	0	1	09	04	H1804_089_0	3	1	Preferred Generic	1	00001000	2
H1804	089	0	1	09	04	H1804_089_0	3	4	Specialty			
H1804	089	0	1	09	04	H1804_089_0	3	3	Non-Preferred Brand			
H1804	089	0	1	09	04	H1804_089_0	3	2	Preferred Brand			
H1804	089	0	1	09	04	H1804_089_0	3	4	Specialty	1	10001000	2
H1804	090	0	1	09	04	H1804_090_0	3	3	Non-Preferred Brand			
H1804	090	0	1	09	04	H1804_090_0	3	2	Preferred Brand			
H1804	090	0	1	09	04	H1804_090_0	3	4	Specialty			
H1804	090	0	1	09	04	H1804_090_0	3	1	Preferred Generic	1	00001000	2
H1804	090	0	1	09	04	H1804_090_0	3	2	Preferred Brand	1	10000000	2
H1804	090	0	1	09	04	H1804_090_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	090	0	1	09	04	H1804_090_0	3	4	Specialty	1	10001000	2
H1804	090	0	1	09	04	H1804_090_0	3	1	Preferred Generic			
H1804	091	0	1	09	04	H1804_091_0	3	1	Preferred Generic	1	00001000	2
H1804	091	0	1	09	04	H1804_091_0	3	2	Preferred Brand	1	10000000	2
H1804	091	0	1	09	04	H1804_091_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	091	0	1	09	04	H1804_091_0	3	4	Specialty	1	10001000	2
H1804	091	0	1	09	04	H1804_091_0	3	1	Preferred Generic			
H1804	091	0	1	09	04	H1804_091_0	3	2	Preferred Brand			
H1804	091	0	1	09	04	H1804_091_0	3	4	Specialty			
H1804	091	0	1	09	04	H1804_091_0	3	3	Non-Preferred Brand			
H1804	093	0	1	09	04	H1804_093_0	3	2	Preferred Brand	1	10000000	2
H1804	093	0	1	09	04	H1804_093_0	3	4	Specialty	1	10001000	2
H1804	093	0	1	09	04	H1804_093_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	093	0	1	09	04	H1804_093_0	3	1	Preferred Generic	1	00001000	2
H1804	093	0	1	09	04	H1804_093_0	3	4	Specialty			
H1804	093	0	1	09	04	H1804_093_0	3	3	Non-Preferred Brand			
H1804	093	0	1	09	04	H1804_093_0	3	2	Preferred Brand			
H1804	093	0	1	09	04	H1804_093_0	3	1	Preferred Generic			
H1804	094	0	1	09	04	H1804_094_0	3	1	Preferred Generic			
H1804	094	0	1	09	04	H1804_094_0	3	4	Specialty	1	10001000	2
H1804	094	0	1	09	04	H1804_094_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	094	0	1	09	04	H1804_094_0	3	2	Preferred Brand	1	10000000	2
H1804	094	0	1	09	04	H1804_094_0	3	1	Preferred Generic	1	00001000	2
H1804	094	0	1	09	04	H1804_094_0	3	4	Specialty			
H1804	094	0	1	09	04	H1804_094_0	3	3	Non-Preferred Brand			
H1804	094	0	1	09	04	H1804_094_0	3	2	Preferred Brand			
H1804	095	0	1	09	04	H1804_095_0	3	1	Preferred Generic			
H1804	095	0	1	09	04	H1804_095_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	095	0	1	09	04	H1804_095_0	3	4	Specialty	1	10001000	2
H1804	095	0	1	09	04	H1804_095_0	3	3	Non-Preferred Brand			
H1804	095	0	1	09	04	H1804_095_0	3	4	Specialty			
H1804	095	0	1	09	04	H1804_095_0	3	2	Preferred Brand			
H1804	095	0	1	09	04	H1804_095_0	3	2	Preferred Brand	1	10000000	2
H1804	095	0	1	09	04	H1804_095_0	3	1	Preferred Generic	1	00001000	2
H1804	097	0	1	09	04	H1804_097_0	3	1	Preferred Generic			
H1804	097	0	1	09	04	H1804_097_0	3	2	Preferred Brand			
H1804	097	0	1	09	04	H1804_097_0	3	3	Non-Preferred Brand			
H1804	097	0	1	09	04	H1804_097_0	3	1	Preferred Generic	1	00001000	2
H1804	097	0	1	09	04	H1804_097_0	3	4	Specialty			
H1804	097	0	1	09	04	H1804_097_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	097	0	1	09	04	H1804_097_0	3	2	Preferred Brand	1	10000000	2
H1804	097	0	1	09	04	H1804_097_0	3	4	Specialty	1	10001000	2
H1804	098	0	1	09	04	H1804_098_0	3	2	Preferred Brand	1	10000000	2
H1804	098	0	1	09	04	H1804_098_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	098	0	1	09	04	H1804_098_0	3	3	Non-Preferred Brand			
H1804	098	0	1	09	04	H1804_098_0	3	4	Specialty			
H1804	098	0	1	09	04	H1804_098_0	3	1	Preferred Generic	1	00001000	2
H1804	098	0	1	09	04	H1804_098_0	3	1	Preferred Generic			
H1804	098	0	1	09	04	H1804_098_0	3	4	Specialty	1	10001000	2
H1804	098	0	1	09	04	H1804_098_0	3	2	Preferred Brand			
H1804	103	0	1	09	04	H1804_103_0	3	1	Preferred Generic			
H1804	103	0	1	09	04	H1804_103_0	3	2	Preferred Brand			
H1804	103	0	1	09	04	H1804_103_0	3	3	Non-Preferred Brand			
H1804	103	0	1	09	04	H1804_103_0	3	4	Specialty	1	10001000	2
H1804	103	0	1	09	04	H1804_103_0	3	1	Preferred Generic	1	00001000	2
H1804	103	0	1	09	04	H1804_103_0	3	2	Preferred Brand	1	10000000	2
H1804	103	0	1	09	04	H1804_103_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	103	0	1	09	04	H1804_103_0	3	4	Specialty			
H1804	122	0	1	09	04	H1804_122_0	3	1	Preferred Generic			
H1804	122	0	1	09	04	H1804_122_0	3	1	Preferred Generic	1	00001000	2
H1804	122	0	1	09	04	H1804_122_0	3	3	Non-Preferred Brand			
H1804	122	0	1	09	04	H1804_122_0	3	4	Specialty			
H1804	122	0	1	09	04	H1804_122_0	3	2	Preferred Brand			
H1804	122	0	1	09	04	H1804_122_0	3	2	Preferred Brand	1	10000000	2
H1804	122	0	1	09	04	H1804_122_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	122	0	1	09	04	H1804_122_0	3	4	Specialty	1	10001000	2
H1804	125	0	1	09	04	H1804_125_0	3	4	Specialty			
H1804	125	0	1	09	04	H1804_125_0	3	3	Non-Preferred Brand			
H1804	125	0	1	09	04	H1804_125_0	3	2	Preferred Brand			
H1804	125	0	1	09	04	H1804_125_0	3	1	Preferred Generic			
H1804	125	0	1	09	04	H1804_125_0	3	1	Preferred Generic	1	00001000	2
H1804	125	0	1	09	04	H1804_125_0	3	2	Preferred Brand	1	10000000	2
H1804	125	0	1	09	04	H1804_125_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	125	0	1	09	04	H1804_125_0	3	4	Specialty	1	10001000	2
H1804	126	0	1	09	04	H1804_126_0	3	4	Specialty	1	10001000	2
H1804	126	0	1	09	04	H1804_126_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	126	0	1	09	04	H1804_126_0	3	4	Specialty			
H1804	126	0	1	09	04	H1804_126_0	3	1	Preferred Generic	1	00001000	2
H1804	126	0	1	09	04	H1804_126_0	3	2	Preferred Brand	1	10000000	2
H1804	126	0	1	09	04	H1804_126_0	3	3	Non-Preferred Brand			
H1804	126	0	1	09	04	H1804_126_0	3	2	Preferred Brand			
H1804	126	0	1	09	04	H1804_126_0	3	1	Preferred Generic			
H1804	127	0	1	09	04	H1804_127_0	3	2	Preferred Brand	1	10000000	2
H1804	127	0	1	09	04	H1804_127_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	127	0	1	09	04	H1804_127_0	3	4	Specialty	1	10001000	2
H1804	127	0	1	09	04	H1804_127_0	3	4	Specialty			
H1804	127	0	1	09	04	H1804_127_0	3	3	Non-Preferred Brand			
H1804	127	0	1	09	04	H1804_127_0	3	2	Preferred Brand			
H1804	127	0	1	09	04	H1804_127_0	3	1	Preferred Generic			
H1804	127	0	1	09	04	H1804_127_0	3	1	Preferred Generic	1	00001000	2
H1804	128	0	1	09	04	H1804_128_0	3	1	Preferred Generic			
H1804	128	0	1	09	04	H1804_128_0	3	2	Preferred Brand			
H1804	128	0	1	09	04	H1804_128_0	3	3	Non-Preferred Brand			
H1804	128	0	1	09	04	H1804_128_0	3	4	Specialty			
H1804	128	0	1	09	04	H1804_128_0	3	1	Preferred Generic	1	00001000	2
H1804	128	0	1	09	04	H1804_128_0	3	4	Specialty	1	10001000	2
H1804	128	0	1	09	04	H1804_128_0	3	2	Preferred Brand	1	10000000	2
H1804	128	0	1	09	04	H1804_128_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	129	0	1	09	04	H1804_129_0	3	2	Preferred Brand			
H1804	129	0	1	09	04	H1804_129_0	3	3	Non-Preferred Brand			
H1804	129	0	1	09	04	H1804_129_0	3	4	Specialty			
H1804	129	0	1	09	04	H1804_129_0	3	4	Specialty	1	10001000	2
H1804	129	0	1	09	04	H1804_129_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	129	0	1	09	04	H1804_129_0	3	1	Preferred Generic			
H1804	129	0	1	09	04	H1804_129_0	3	1	Preferred Generic	1	00001000	2
H1804	129	0	1	09	04	H1804_129_0	3	2	Preferred Brand	1	10000000	2
H1804	130	0	1	09	04	H1804_130_0	3	3	Non-Preferred Brand			
H1804	130	0	1	09	04	H1804_130_0	3	2	Preferred Brand			
H1804	130	0	1	09	04	H1804_130_0	3	1	Preferred Generic			
H1804	130	0	1	09	04	H1804_130_0	3	1	Preferred Generic	1	00001000	2
H1804	130	0	1	09	04	H1804_130_0	3	2	Preferred Brand	1	10000000	2
H1804	130	0	1	09	04	H1804_130_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	130	0	1	09	04	H1804_130_0	3	4	Specialty	1	10001000	2
H1804	130	0	1	09	04	H1804_130_0	3	4	Specialty			
H1804	131	0	1	09	04	H1804_131_0	3	1	Preferred Generic	1	00001000	2
H1804	131	0	1	09	04	H1804_131_0	3	2	Preferred Brand	1	10000000	2
H1804	131	0	1	09	04	H1804_131_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	131	0	1	09	04	H1804_131_0	3	4	Specialty	1	10001000	2
H1804	131	0	1	09	04	H1804_131_0	3	4	Specialty			
H1804	131	0	1	09	04	H1804_131_0	3	3	Non-Preferred Brand			
H1804	131	0	1	09	04	H1804_131_0	3	1	Preferred Generic			
H1804	131	0	1	09	04	H1804_131_0	3	2	Preferred Brand			
H1804	132	0	1	09	04	H1804_132_0	3	2	Preferred Brand			
H1804	132	0	1	09	04	H1804_132_0	3	4	Specialty			
H1804	132	0	1	09	04	H1804_132_0	3	3	Non-Preferred Brand			
H1804	132	0	1	09	04	H1804_132_0	3	1	Preferred Generic	1	00001000	2
H1804	132	0	1	09	04	H1804_132_0	3	4	Specialty	1	10001000	2
H1804	132	0	1	09	04	H1804_132_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	132	0	1	09	04	H1804_132_0	3	2	Preferred Brand	1	10000000	2
H1804	132	0	1	09	04	H1804_132_0	3	1	Preferred Generic			
H1804	133	0	1	09	04	H1804_133_0	3	4	Specialty	1	10001000	2
H1804	133	0	1	09	04	H1804_133_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	133	0	1	09	04	H1804_133_0	3	2	Preferred Brand			
H1804	133	0	1	09	04	H1804_133_0	3	1	Preferred Generic	1	00001000	2
H1804	133	0	1	09	04	H1804_133_0	3	4	Specialty			
H1804	133	0	1	09	04	H1804_133_0	3	3	Non-Preferred Brand			
H1804	133	0	1	09	04	H1804_133_0	3	2	Preferred Brand	1	10000000	2
H1804	133	0	1	09	04	H1804_133_0	3	1	Preferred Generic			
H1804	137	0	1	09	04	H1804_137_0	3	2	Preferred Brand			
H1804	137	0	1	09	04	H1804_137_0	3	4	Specialty			
H1804	137	0	1	09	04	H1804_137_0	3	1	Preferred Generic			
H1804	137	0	1	09	04	H1804_137_0	3	3	Non-Preferred Brand			
H1804	137	0	1	09	04	H1804_137_0	3	1	Preferred Generic	1	00001000	2
H1804	137	0	1	09	04	H1804_137_0	3	2	Preferred Brand	1	10000000	2
H1804	137	0	1	09	04	H1804_137_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	137	0	1	09	04	H1804_137_0	3	4	Specialty	1	10001000	2
H1804	138	0	1	09	04	H1804_138_0	3	2	Preferred Brand			
H1804	138	0	1	09	04	H1804_138_0	3	1	Preferred Generic			
H1804	138	0	1	09	04	H1804_138_0	3	3	Non-Preferred Brand			
H1804	138	0	1	09	04	H1804_138_0	3	4	Specialty			
H1804	138	0	1	09	04	H1804_138_0	3	1	Preferred Generic	1	00001000	2
H1804	138	0	1	09	04	H1804_138_0	3	2	Preferred Brand	1	10000000	2
H1804	138	0	1	09	04	H1804_138_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	138	0	1	09	04	H1804_138_0	3	4	Specialty	1	10001000	2
H1804	145	0	1	09	04	H1804_145_0	3	3	Non-Preferred Brand			
H1804	145	0	1	09	04	H1804_145_0	3	2	Preferred Brand			
H1804	145	0	1	09	04	H1804_145_0	3	1	Preferred Generic			
H1804	145	0	1	09	04	H1804_145_0	3	4	Specialty			
H1804	145	0	1	09	04	H1804_145_0	3	1	Preferred Generic	1	00001000	2
H1804	145	0	1	09	04	H1804_145_0	3	2	Preferred Brand	1	10000000	2
H1804	145	0	1	09	04	H1804_145_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	145	0	1	09	04	H1804_145_0	3	4	Specialty	1	10001000	2
H1804	146	0	1	09	04	H1804_146_0	3	3	Non-Preferred Brand			
H1804	146	0	1	09	04	H1804_146_0	3	2	Preferred Brand			
H1804	146	0	1	09	04	H1804_146_0	3	1	Preferred Generic			
H1804	146	0	1	09	04	H1804_146_0	3	4	Specialty			
H1804	146	0	1	09	04	H1804_146_0	3	4	Specialty	1	10001000	2
H1804	146	0	1	09	04	H1804_146_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	146	0	1	09	04	H1804_146_0	3	2	Preferred Brand	1	10000000	2
H1804	146	0	1	09	04	H1804_146_0	3	1	Preferred Generic	1	00001000	2
H1804	147	0	1	09	04	H1804_147_0	6	1	Preferred Generic			
H1804	147	0	1	09	04	H1804_147_0	6	2	Preferred Brand			
H1804	147	0	1	09	04	H1804_147_0	6	3	Non-Preferred Brand			
H1804	147	0	1	09	04	H1804_147_0	6	3	Non-Preferred Brand	1	10000000	2
H1804	147	0	1	09	04	H1804_147_0	6	2	Preferred Brand	1	10000000	2
H1804	147	0	1	09	04	H1804_147_0	6	1	Preferred Generic	1	00001000	2
H1804	147	0	1	09	04	H1804_147_0	6	4	Specialty			
H1804	147	0	1	09	04	H1804_147_0	6	4	Specialty	1	10001000	2
H1804	153	0	1	09	04	H1804_153_0	4	4	Specialty	1	10001000	2
H1804	153	0	1	09	04	H1804_153_0	4	1	Preferred Generic			
H1804	153	0	1	09	04	H1804_153_0	4	3	Non-Preferred Brand			
H1804	153	0	1	09	04	H1804_153_0	4	4	Specialty			
H1804	153	0	1	09	04	H1804_153_0	4	1	Preferred Generic	1	00001000	2
H1804	153	0	1	09	04	H1804_153_0	4	2	Preferred Brand	1	10000000	2
H1804	153	0	1	09	04	H1804_153_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	153	0	1	09	04	H1804_153_0	4	2	Preferred Brand			
H1804	154	0	1	09	04	H1804_154_0	4	3	Non-Preferred Brand			
H1804	154	0	1	09	04	H1804_154_0	4	4	Specialty			
H1804	154	0	1	09	04	H1804_154_0	4	1	Preferred Generic	1	00001000	2
H1804	154	0	1	09	04	H1804_154_0	4	2	Preferred Brand			
H1804	154	0	1	09	04	H1804_154_0	4	4	Specialty	1	10001000	2
H1804	154	0	1	09	04	H1804_154_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	154	0	1	09	04	H1804_154_0	4	2	Preferred Brand	1	10000000	2
H1804	154	0	1	09	04	H1804_154_0	4	1	Preferred Generic			
H1804	155	0	1	09	04	H1804_155_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	155	0	1	09	04	H1804_155_0	4	4	Specialty	1	10001000	2
H1804	155	0	1	09	04	H1804_155_0	4	2	Preferred Brand			
H1804	155	0	1	09	04	H1804_155_0	4	1	Preferred Generic			
H1804	155	0	1	09	04	H1804_155_0	4	1	Preferred Generic	1	00001000	2
H1804	155	0	1	09	04	H1804_155_0	4	4	Specialty			
H1804	155	0	1	09	04	H1804_155_0	4	3	Non-Preferred Brand			
H1804	155	0	1	09	04	H1804_155_0	4	2	Preferred Brand	1	10000000	2
H1804	156	0	1	09	04	H1804_156_0	4	4	Specialty			
H1804	156	0	1	09	04	H1804_156_0	4	3	Non-Preferred Brand			
H1804	156	0	1	09	04	H1804_156_0	4	2	Preferred Brand			
H1804	156	0	1	09	04	H1804_156_0	4	1	Preferred Generic			
H1804	156	0	1	09	04	H1804_156_0	4	4	Specialty	1	10001000	2
H1804	156	0	1	09	04	H1804_156_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	156	0	1	09	04	H1804_156_0	4	1	Preferred Generic	1	00001000	2
H1804	156	0	1	09	04	H1804_156_0	4	2	Preferred Brand	1	10000000	2
H1804	157	0	1	09	04	H1804_157_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	157	0	1	09	04	H1804_157_0	4	2	Preferred Brand	1	10000000	2
H1804	157	0	1	09	04	H1804_157_0	4	1	Preferred Generic	1	00001000	2
H1804	157	0	1	09	04	H1804_157_0	4	4	Specialty			
H1804	157	0	1	09	04	H1804_157_0	4	3	Non-Preferred Brand			
H1804	157	0	1	09	04	H1804_157_0	4	2	Preferred Brand			
H1804	157	0	1	09	04	H1804_157_0	4	1	Preferred Generic			
H1804	157	0	1	09	04	H1804_157_0	4	4	Specialty	1	10001000	2
H1804	161	0	1	09	04	H1804_161_0	5	3	Non-Preferred Brand			
H1804	161	0	1	09	04	H1804_161_0	5	2	Preferred Brand			
H1804	161	0	1	09	04	H1804_161_0	5	4	Specialty	1	10001000	2
H1804	161	0	1	09	04	H1804_161_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	161	0	1	09	04	H1804_161_0	5	2	Preferred Brand	1	10000000	2
H1804	161	0	1	09	04	H1804_161_0	5	1	Preferred Generic	1	00001000	2
H1804	161	0	1	09	04	H1804_161_0	5	4	Specialty			
H1804	161	0	1	09	04	H1804_161_0	5	1	Preferred Generic			
H1804	162	0	1	09	04	H1804_162_0	7	1	Preferred Generic			
H1804	162	0	1	09	04	H1804_162_0	7	3	Non-Preferred Brand	1	10000000	2
H1804	162	0	1	09	04	H1804_162_0	7	2	Preferred Brand	1	10000000	2
H1804	162	0	1	09	04	H1804_162_0	7	1	Preferred Generic	1	00001000	2
H1804	162	0	1	09	04	H1804_162_0	7	4	Specialty			
H1804	162	0	1	09	04	H1804_162_0	7	3	Non-Preferred Brand			
H1804	162	0	1	09	04	H1804_162_0	7	2	Preferred Brand			
H1804	162	0	1	09	04	H1804_162_0	7	4	Specialty	1	10001000	2
H1804	163	0	1	09	04	H1804_163_0	4	3	Non-Preferred Brand			
H1804	163	0	1	09	04	H1804_163_0	4	2	Preferred Brand			
H1804	163	0	1	09	04	H1804_163_0	4	1	Preferred Generic			
H1804	163	0	1	09	04	H1804_163_0	4	4	Specialty			
H1804	163	0	1	09	04	H1804_163_0	4	4	Specialty	1	10001000	2
H1804	163	0	1	09	04	H1804_163_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	163	0	1	09	04	H1804_163_0	4	2	Preferred Brand	1	10000000	2
H1804	163	0	1	09	04	H1804_163_0	4	1	Preferred Generic	1	00001000	2
H1804	165	0	1	09	04	H1804_165_0	4	1	Preferred Generic			
H1804	165	0	1	09	04	H1804_165_0	4	2	Preferred Brand			
H1804	165	0	1	09	04	H1804_165_0	4	4	Specialty	1	10001000	2
H1804	165	0	1	09	04	H1804_165_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	165	0	1	09	04	H1804_165_0	4	2	Preferred Brand	1	10000000	2
H1804	165	0	1	09	04	H1804_165_0	4	1	Preferred Generic	1	00001000	2
H1804	165	0	1	09	04	H1804_165_0	4	4	Specialty			
H1804	165	0	1	09	04	H1804_165_0	4	3	Non-Preferred Brand			
H1804	166	0	1	09	04	H1804_166_0	5	1	Preferred Generic			
H1804	166	0	1	09	04	H1804_166_0	5	4	Specialty			
H1804	166	0	1	09	04	H1804_166_0	5	1	Preferred Generic	1	00001000	2
H1804	166	0	1	09	04	H1804_166_0	5	2	Preferred Brand	1	10000000	2
H1804	166	0	1	09	04	H1804_166_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	166	0	1	09	04	H1804_166_0	5	3	Non-Preferred Brand			
H1804	166	0	1	09	04	H1804_166_0	5	2	Preferred Brand			
H1804	166	0	1	09	04	H1804_166_0	5	4	Specialty	1	10001000	2
H1804	167	0	1	09	04	H1804_167_0	5	3	Non-Preferred Brand			
H1804	167	0	1	09	04	H1804_167_0	5	4	Specialty			
H1804	167	0	1	09	04	H1804_167_0	5	1	Preferred Generic	1	00001000	2
H1804	167	0	1	09	04	H1804_167_0	5	2	Preferred Brand	1	10000000	2
H1804	167	0	1	09	04	H1804_167_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	167	0	1	09	04	H1804_167_0	5	4	Specialty	1	10001000	2
H1804	167	0	1	09	04	H1804_167_0	5	1	Preferred Generic			
H1804	167	0	1	09	04	H1804_167_0	5	2	Preferred Brand			
H1804	168	0	1	09	04	H1804_168_0	4	1	Preferred Generic	1	00001000	2
H1804	168	0	1	09	04	H1804_168_0	4	4	Specialty			
H1804	168	0	1	09	04	H1804_168_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	168	0	1	09	04	H1804_168_0	4	4	Specialty	1	10001000	2
H1804	168	0	1	09	04	H1804_168_0	4	2	Preferred Brand	1	10000000	2
H1804	168	0	1	09	04	H1804_168_0	4	3	Non-Preferred Brand			
H1804	168	0	1	09	04	H1804_168_0	4	2	Preferred Brand			
H1804	168	0	1	09	04	H1804_168_0	4	1	Preferred Generic			
H1804	169	0	1	09	04	H1804_169_0	3	1	Preferred Generic	1	00001000	2
H1804	169	0	1	09	04	H1804_169_0	3	2	Preferred Brand	1	10000000	2
H1804	169	0	1	09	04	H1804_169_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	169	0	1	09	04	H1804_169_0	3	4	Specialty	1	10001000	2
H1804	169	0	1	09	04	H1804_169_0	3	4	Specialty			
H1804	169	0	1	09	04	H1804_169_0	3	3	Non-Preferred Brand			
H1804	169	0	1	09	04	H1804_169_0	3	2	Preferred Brand			
H1804	169	0	1	09	04	H1804_169_0	3	1	Preferred Generic			
H1804	170	0	1	09	04	H1804_170_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	170	0	1	09	04	H1804_170_0	5	2	Preferred Brand	1	10000000	2
H1804	170	0	1	09	04	H1804_170_0	5	1	Preferred Generic	1	00001000	2
H1804	170	0	1	09	04	H1804_170_0	5	4	Specialty			
H1804	170	0	1	09	04	H1804_170_0	5	3	Non-Preferred Brand			
H1804	170	0	1	09	04	H1804_170_0	5	2	Preferred Brand			
H1804	170	0	1	09	04	H1804_170_0	5	1	Preferred Generic			
H1804	170	0	1	09	04	H1804_170_0	5	4	Specialty	1	10001000	2
H1804	171	0	1	09	04	H1804_171_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	171	0	1	09	04	H1804_171_0	3	2	Preferred Brand	1	10000000	2
H1804	171	0	1	09	04	H1804_171_0	3	1	Preferred Generic	1	00001000	2
H1804	171	0	1	09	04	H1804_171_0	3	4	Specialty			
H1804	171	0	1	09	04	H1804_171_0	3	3	Non-Preferred Brand			
H1804	171	0	1	09	04	H1804_171_0	3	2	Preferred Brand			
H1804	171	0	1	09	04	H1804_171_0	3	1	Preferred Generic			
H1804	171	0	1	09	04	H1804_171_0	3	4	Specialty	1	10001000	2
H1804	172	0	1	09	04	H1804_172_0	4	1	Preferred Generic			
H1804	172	0	1	09	04	H1804_172_0	4	2	Preferred Brand			
H1804	172	0	1	09	04	H1804_172_0	4	4	Specialty	1	10001000	2
H1804	172	0	1	09	04	H1804_172_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	172	0	1	09	04	H1804_172_0	4	2	Preferred Brand	1	10000000	2
H1804	172	0	1	09	04	H1804_172_0	4	1	Preferred Generic	1	00001000	2
H1804	172	0	1	09	04	H1804_172_0	4	4	Specialty			
H1804	172	0	1	09	04	H1804_172_0	4	3	Non-Preferred Brand			
H1804	173	0	1	09	04	H1804_173_0	3	1	Preferred Generic			
H1804	173	0	1	09	04	H1804_173_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	173	0	1	09	04	H1804_173_0	3	2	Preferred Brand	1	10000000	2
H1804	173	0	1	09	04	H1804_173_0	3	1	Preferred Generic	1	00001000	2
H1804	173	0	1	09	04	H1804_173_0	3	4	Specialty			
H1804	173	0	1	09	04	H1804_173_0	3	3	Non-Preferred Brand			
H1804	173	0	1	09	04	H1804_173_0	3	2	Preferred Brand			
H1804	173	0	1	09	04	H1804_173_0	3	4	Specialty	1	10001000	2
H1804	174	0	1	09	04	H1804_174_0	6	3	Non-Preferred Brand			
H1804	174	0	1	09	04	H1804_174_0	6	4	Specialty			
H1804	174	0	1	09	04	H1804_174_0	6	1	Preferred Generic	1	00001000	2
H1804	174	0	1	09	04	H1804_174_0	6	2	Preferred Brand	1	10000000	2
H1804	174	0	1	09	04	H1804_174_0	6	3	Non-Preferred Brand	1	10000000	2
H1804	174	0	1	09	04	H1804_174_0	6	4	Specialty	1	10001000	2
H1804	174	0	1	09	04	H1804_174_0	6	1	Preferred Generic			
H1804	174	0	1	09	04	H1804_174_0	6	2	Preferred Brand			
H1804	175	0	1	09	04	H1804_175_0	3	3	Non-Preferred Brand			
H1804	175	0	1	09	04	H1804_175_0	3	4	Specialty			
H1804	175	0	1	09	04	H1804_175_0	3	1	Preferred Generic			
H1804	175	0	1	09	04	H1804_175_0	3	2	Preferred Brand			
H1804	175	0	1	09	04	H1804_175_0	3	4	Specialty	1	10001000	2
H1804	175	0	1	09	04	H1804_175_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	175	0	1	09	04	H1804_175_0	3	2	Preferred Brand	1	10000000	2
H1804	175	0	1	09	04	H1804_175_0	3	1	Preferred Generic	1	00001000	2
H1804	176	0	1	09	04	H1804_176_0	6	4	Specialty	1	10001000	2
H1804	176	0	1	09	04	H1804_176_0	6	3	Non-Preferred Brand	1	10000000	2
H1804	176	0	1	09	04	H1804_176_0	6	1	Preferred Generic	1	00001000	2
H1804	176	0	1	09	04	H1804_176_0	6	2	Preferred Brand	1	10000000	2
H1804	176	0	1	09	04	H1804_176_0	6	4	Specialty			
H1804	176	0	1	09	04	H1804_176_0	6	3	Non-Preferred Brand			
H1804	176	0	1	09	04	H1804_176_0	6	2	Preferred Brand			
H1804	176	0	1	09	04	H1804_176_0	6	1	Preferred Generic			
H1804	177	0	1	09	04	H1804_177_0	3	3	Non-Preferred Brand			
H1804	177	0	1	09	04	H1804_177_0	3	4	Specialty	1	10001000	2
H1804	177	0	1	09	04	H1804_177_0	3	1	Preferred Generic			
H1804	177	0	1	09	04	H1804_177_0	3	2	Preferred Brand			
H1804	177	0	1	09	04	H1804_177_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	177	0	1	09	04	H1804_177_0	3	4	Specialty			
H1804	177	0	1	09	04	H1804_177_0	3	1	Preferred Generic	1	00001000	2
H1804	177	0	1	09	04	H1804_177_0	3	2	Preferred Brand	1	10000000	2
H1804	178	0	1	09	04	H1804_178_0	7	3	Non-Preferred Brand			
H1804	178	0	1	09	04	H1804_178_0	7	4	Specialty			
H1804	178	0	1	09	04	H1804_178_0	7	1	Preferred Generic			
H1804	178	0	1	09	04	H1804_178_0	7	2	Preferred Brand			
H1804	178	0	1	09	04	H1804_178_0	7	4	Specialty	1	10001000	2
H1804	178	0	1	09	04	H1804_178_0	7	3	Non-Preferred Brand	1	10000000	2
H1804	178	0	1	09	04	H1804_178_0	7	2	Preferred Brand	1	10000000	2
H1804	178	0	1	09	04	H1804_178_0	7	1	Preferred Generic	1	00001000	2
H1804	180	0	1	09	04	H1804_180_0	6	2	Preferred Brand	1	10000000	2
H1804	180	0	1	09	04	H1804_180_0	6	1	Preferred Generic	1	00001000	2
H1804	180	0	1	09	04	H1804_180_0	6	4	Specialty	1	10001000	2
H1804	180	0	1	09	04	H1804_180_0	6	3	Non-Preferred Brand	1	10000000	2
H1804	180	0	1	09	04	H1804_180_0	6	1	Preferred Generic			
H1804	180	0	1	09	04	H1804_180_0	6	2	Preferred Brand			
H1804	180	0	1	09	04	H1804_180_0	6	3	Non-Preferred Brand			
H1804	180	0	1	09	04	H1804_180_0	6	4	Specialty			
H1804	181	0	1	09	04	H1804_181_0	6	1	Preferred Generic			
H1804	181	0	1	09	04	H1804_181_0	6	3	Non-Preferred Brand	1	10000000	2
H1804	181	0	1	09	04	H1804_181_0	6	2	Preferred Brand	1	10000000	2
H1804	181	0	1	09	04	H1804_181_0	6	1	Preferred Generic	1	00001000	2
H1804	181	0	1	09	04	H1804_181_0	6	4	Specialty			
H1804	181	0	1	09	04	H1804_181_0	6	3	Non-Preferred Brand			
H1804	181	0	1	09	04	H1804_181_0	6	2	Preferred Brand			
H1804	181	0	1	09	04	H1804_181_0	6	4	Specialty	1	10001000	2
H1804	184	0	1	09	04	H1804_184_0	4	3	Non-Preferred Brand			
H1804	184	0	1	09	04	H1804_184_0	4	4	Specialty			
H1804	184	0	1	09	04	H1804_184_0	4	1	Preferred Generic	1	00001000	2
H1804	184	0	1	09	04	H1804_184_0	4	2	Preferred Brand	1	10000000	2
H1804	184	0	1	09	04	H1804_184_0	4	2	Preferred Brand			
H1804	184	0	1	09	04	H1804_184_0	4	4	Specialty	1	10001000	2
H1804	184	0	1	09	04	H1804_184_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	184	0	1	09	04	H1804_184_0	4	1	Preferred Generic			
H1804	185	0	1	09	04	H1804_185_0	4	2	Preferred Brand	1	10000000	2
H1804	185	0	1	09	04	H1804_185_0	4	1	Preferred Generic	1	00001000	2
H1804	185	0	1	09	04	H1804_185_0	4	4	Specialty			
H1804	185	0	1	09	04	H1804_185_0	4	3	Non-Preferred Brand			
H1804	185	0	1	09	04	H1804_185_0	4	2	Preferred Brand			
H1804	185	0	1	09	04	H1804_185_0	4	1	Preferred Generic			
H1804	185	0	1	09	04	H1804_185_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	185	0	1	09	04	H1804_185_0	4	4	Specialty	1	10001000	2
H1804	187	0	1	09	04	H1804_187_0	5	4	Specialty	1	10001000	2
H1804	187	0	1	09	04	H1804_187_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	187	0	1	09	04	H1804_187_0	5	2	Preferred Brand	1	10000000	2
H1804	187	0	1	09	04	H1804_187_0	5	1	Preferred Generic	1	00001000	2
H1804	187	0	1	09	04	H1804_187_0	5	4	Specialty			
H1804	187	0	1	09	04	H1804_187_0	5	3	Non-Preferred Brand			
H1804	187	0	1	09	04	H1804_187_0	5	1	Preferred Generic			
H1804	187	0	1	09	04	H1804_187_0	5	2	Preferred Brand			
H1804	188	0	1	09	04	H1804_188_0	4	2	Preferred Brand	1	10000000	2
H1804	188	0	1	09	04	H1804_188_0	4	1	Preferred Generic	1	00001000	2
H1804	188	0	1	09	04	H1804_188_0	4	4	Specialty			
H1804	188	0	1	09	04	H1804_188_0	4	3	Non-Preferred Brand			
H1804	188	0	1	09	04	H1804_188_0	4	2	Preferred Brand			
H1804	188	0	1	09	04	H1804_188_0	4	1	Preferred Generic			
H1804	188	0	1	09	04	H1804_188_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	188	0	1	09	04	H1804_188_0	4	4	Specialty	1	10001000	2
H1804	190	0	1	09	04	H1804_190_0	3	1	Preferred Generic			
H1804	190	0	1	09	04	H1804_190_0	3	2	Preferred Brand			
H1804	190	0	1	09	04	H1804_190_0	3	3	Non-Preferred Brand			
H1804	190	0	1	09	04	H1804_190_0	3	4	Specialty			
H1804	190	0	1	09	04	H1804_190_0	3	1	Preferred Generic	1	00001000	2
H1804	190	0	1	09	04	H1804_190_0	3	2	Preferred Brand	1	10000000	2
H1804	190	0	1	09	04	H1804_190_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	190	0	1	09	04	H1804_190_0	3	4	Specialty	1	10001000	2
H1804	192	0	1	09	04	H1804_192_0	3	1	Preferred Generic			
H1804	192	0	1	09	04	H1804_192_0	3	2	Preferred Brand			
H1804	192	0	1	09	04	H1804_192_0	3	3	Non-Preferred Brand			
H1804	192	0	1	09	04	H1804_192_0	3	4	Specialty			
H1804	192	0	1	09	04	H1804_192_0	3	1	Preferred Generic	1	00001000	2
H1804	192	0	1	09	04	H1804_192_0	3	2	Preferred Brand	1	10000000	2
H1804	192	0	1	09	04	H1804_192_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	192	0	1	09	04	H1804_192_0	3	4	Specialty	1	10001000	2
H1804	193	0	1	09	04	H1804_193_0	5	4	Specialty	1	10001000	2
H1804	193	0	1	09	04	H1804_193_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	193	0	1	09	04	H1804_193_0	5	2	Preferred Brand	1	10000000	2
H1804	193	0	1	09	04	H1804_193_0	5	1	Preferred Generic	1	00001000	2
H1804	193	0	1	09	04	H1804_193_0	5	4	Specialty			
H1804	193	0	1	09	04	H1804_193_0	5	3	Non-Preferred Brand			
H1804	193	0	1	09	04	H1804_193_0	5	1	Preferred Generic			
H1804	193	0	1	09	04	H1804_193_0	5	2	Preferred Brand			
H1804	195	0	1	09	04	H1804_195_0	4	1	Preferred Generic	1	00001000	2
H1804	195	0	1	09	04	H1804_195_0	4	2	Preferred Brand	1	10000000	2
H1804	195	0	1	09	04	H1804_195_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	195	0	1	09	04	H1804_195_0	4	4	Specialty			
H1804	195	0	1	09	04	H1804_195_0	4	3	Non-Preferred Brand			
H1804	195	0	1	09	04	H1804_195_0	4	2	Preferred Brand			
H1804	195	0	1	09	04	H1804_195_0	4	1	Preferred Generic			
H1804	195	0	1	09	04	H1804_195_0	4	4	Specialty	1	10001000	2
H1804	196	0	1	09	04	H1804_196_0	5	3	Non-Preferred Brand			
H1804	196	0	1	09	04	H1804_196_0	5	2	Preferred Brand			
H1804	196	0	1	09	04	H1804_196_0	5	1	Preferred Generic			
H1804	196	0	1	09	04	H1804_196_0	5	4	Specialty			
H1804	196	0	1	09	04	H1804_196_0	5	4	Specialty	1	10001000	2
H1804	196	0	1	09	04	H1804_196_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	196	0	1	09	04	H1804_196_0	5	2	Preferred Brand	1	10000000	2
H1804	196	0	1	09	04	H1804_196_0	5	1	Preferred Generic	1	00001000	2
H1804	197	0	1	09	04	H1804_197_0	5	1	Preferred Generic			
H1804	197	0	1	09	04	H1804_197_0	5	2	Preferred Brand			
H1804	197	0	1	09	04	H1804_197_0	5	3	Non-Preferred Brand			
H1804	197	0	1	09	04	H1804_197_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	197	0	1	09	04	H1804_197_0	5	2	Preferred Brand	1	10000000	2
H1804	197	0	1	09	04	H1804_197_0	5	1	Preferred Generic	1	00001000	2
H1804	197	0	1	09	04	H1804_197_0	5	4	Specialty			
H1804	197	0	1	09	04	H1804_197_0	5	4	Specialty	1	10001000	2
H1804	198	0	1	09	04	H1804_198_0	4	1	Preferred Generic			
H1804	198	0	1	09	04	H1804_198_0	4	2	Preferred Brand			
H1804	198	0	1	09	04	H1804_198_0	4	3	Non-Preferred Brand			
H1804	198	0	1	09	04	H1804_198_0	4	4	Specialty			
H1804	198	0	1	09	04	H1804_198_0	4	1	Preferred Generic	1	00001000	2
H1804	198	0	1	09	04	H1804_198_0	4	2	Preferred Brand	1	10000000	2
H1804	198	0	1	09	04	H1804_198_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	198	0	1	09	04	H1804_198_0	4	4	Specialty	1	10001000	2
H1804	199	0	1	09	04	H1804_199_0	5	1	Preferred Generic			
H1804	199	0	1	09	04	H1804_199_0	5	2	Preferred Brand			
H1804	199	0	1	09	04	H1804_199_0	5	3	Non-Preferred Brand			
H1804	199	0	1	09	04	H1804_199_0	5	4	Specialty	1	10001000	2
H1804	199	0	1	09	04	H1804_199_0	5	1	Preferred Generic	1	00001000	2
H1804	199	0	1	09	04	H1804_199_0	5	2	Preferred Brand	1	10000000	2
H1804	199	0	1	09	04	H1804_199_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	199	0	1	09	04	H1804_199_0	5	4	Specialty			
H1804	200	0	1	09	04	H1804_200_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	200	0	1	09	04	H1804_200_0	4	2	Preferred Brand	1	10000000	2
H1804	200	0	1	09	04	H1804_200_0	4	1	Preferred Generic	1	00001000	2
H1804	200	0	1	09	04	H1804_200_0	4	4	Specialty			
H1804	200	0	1	09	04	H1804_200_0	4	3	Non-Preferred Brand			
H1804	200	0	1	09	04	H1804_200_0	4	2	Preferred Brand			
H1804	200	0	1	09	04	H1804_200_0	4	1	Preferred Generic			
H1804	200	0	1	09	04	H1804_200_0	4	4	Specialty	1	10001000	2
H1804	201	0	1	09	04	H1804_201_0	5	1	Preferred Generic			
H1804	201	0	1	09	04	H1804_201_0	5	4	Specialty	1	10001000	2
H1804	201	0	1	09	04	H1804_201_0	5	2	Preferred Brand			
H1804	201	0	1	09	04	H1804_201_0	5	3	Non-Preferred Brand			
H1804	201	0	1	09	04	H1804_201_0	5	4	Specialty			
H1804	201	0	1	09	04	H1804_201_0	5	1	Preferred Generic	1	00001000	2
H1804	201	0	1	09	04	H1804_201_0	5	2	Preferred Brand	1	10000000	2
H1804	201	0	1	09	04	H1804_201_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	202	0	1	09	04	H1804_202_0	4	4	Specialty	1	10001000	2
H1804	202	0	1	09	04	H1804_202_0	4	1	Preferred Generic			
H1804	202	0	1	09	04	H1804_202_0	4	2	Preferred Brand			
H1804	202	0	1	09	04	H1804_202_0	4	3	Non-Preferred Brand			
H1804	202	0	1	09	04	H1804_202_0	4	4	Specialty			
H1804	202	0	1	09	04	H1804_202_0	4	1	Preferred Generic	1	00001000	2
H1804	202	0	1	09	04	H1804_202_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	202	0	1	09	04	H1804_202_0	4	2	Preferred Brand	1	10000000	2
H1804	203	0	1	09	04	H1804_203_0	4	2	Preferred Brand	1	10000000	2
H1804	203	0	1	09	04	H1804_203_0	4	1	Preferred Generic	1	00001000	2
H1804	203	0	1	09	04	H1804_203_0	4	4	Specialty			
H1804	203	0	1	09	04	H1804_203_0	4	3	Non-Preferred Brand			
H1804	203	0	1	09	04	H1804_203_0	4	2	Preferred Brand			
H1804	203	0	1	09	04	H1804_203_0	4	1	Preferred Generic			
H1804	203	0	1	09	04	H1804_203_0	4	4	Specialty	1	10001000	2
H1804	203	0	1	09	04	H1804_203_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	204	0	1	09	04	H1804_204_0	5	2	Preferred Brand	1	10000000	2
H1804	204	0	1	09	04	H1804_204_0	5	1	Preferred Generic			
H1804	204	0	1	09	04	H1804_204_0	5	2	Preferred Brand			
H1804	204	0	1	09	04	H1804_204_0	5	3	Non-Preferred Brand			
H1804	204	0	1	09	04	H1804_204_0	5	4	Specialty			
H1804	204	0	1	09	04	H1804_204_0	5	1	Preferred Generic	1	00001000	2
H1804	204	0	1	09	04	H1804_204_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	204	0	1	09	04	H1804_204_0	5	4	Specialty	1	10001000	2
H1804	205	0	1	09	04	H1804_205_0	4	4	Specialty			
H1804	205	0	1	09	04	H1804_205_0	4	1	Preferred Generic	1	00001000	2
H1804	205	0	1	09	04	H1804_205_0	4	2	Preferred Brand	1	10000000	2
H1804	205	0	1	09	04	H1804_205_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	205	0	1	09	04	H1804_205_0	4	2	Preferred Brand			
H1804	205	0	1	09	04	H1804_205_0	4	4	Specialty	1	10001000	2
H1804	205	0	1	09	04	H1804_205_0	4	3	Non-Preferred Brand			
H1804	205	0	1	09	04	H1804_205_0	4	1	Preferred Generic			
H1804	207	0	1	09	04	H1804_207_0	5	2	Preferred Brand			
H1804	207	0	1	09	04	H1804_207_0	5	1	Preferred Generic			
H1804	207	0	1	09	04	H1804_207_0	5	4	Specialty	1	10001000	2
H1804	207	0	1	09	04	H1804_207_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	207	0	1	09	04	H1804_207_0	5	2	Preferred Brand	1	10000000	2
H1804	207	0	1	09	04	H1804_207_0	5	1	Preferred Generic	1	00001000	2
H1804	207	0	1	09	04	H1804_207_0	5	3	Non-Preferred Brand			
H1804	207	0	1	09	04	H1804_207_0	5	4	Specialty			
H1804	209	0	1	09	04	H1804_209_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	209	0	1	09	04	H1804_209_0	4	2	Preferred Brand	1	10000000	2
H1804	209	0	1	09	04	H1804_209_0	4	1	Preferred Generic	1	00001000	2
H1804	209	0	1	09	04	H1804_209_0	4	4	Specialty			
H1804	209	0	1	09	04	H1804_209_0	4	3	Non-Preferred Brand			
H1804	209	0	1	09	04	H1804_209_0	4	2	Preferred Brand			
H1804	209	0	1	09	04	H1804_209_0	4	1	Preferred Generic			
H1804	209	0	1	09	04	H1804_209_0	4	4	Specialty	1	10001000	2
H1804	210	0	1	09	04	H1804_210_0	4	1	Preferred Generic			
H1804	210	0	1	09	04	H1804_210_0	4	2	Preferred Brand			
H1804	210	0	1	09	04	H1804_210_0	4	3	Non-Preferred Brand			
H1804	210	0	1	09	04	H1804_210_0	4	4	Specialty			
H1804	210	0	1	09	04	H1804_210_0	4	4	Specialty	1	10001000	2
H1804	210	0	1	09	04	H1804_210_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	210	0	1	09	04	H1804_210_0	4	2	Preferred Brand	1	10000000	2
H1804	210	0	1	09	04	H1804_210_0	4	1	Preferred Generic	1	00001000	2
H1804	211	0	1	09	04	H1804_211_0	3	2	Preferred Brand			
H1804	211	0	1	09	04	H1804_211_0	3	4	Specialty	1	10001000	2
H1804	211	0	1	09	04	H1804_211_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	211	0	1	09	04	H1804_211_0	3	2	Preferred Brand	1	10000000	2
H1804	211	0	1	09	04	H1804_211_0	3	1	Preferred Generic	1	00001000	2
H1804	211	0	1	09	04	H1804_211_0	3	4	Specialty			
H1804	211	0	1	09	04	H1804_211_0	3	3	Non-Preferred Brand			
H1804	211	0	1	09	04	H1804_211_0	3	1	Preferred Generic			
H1804	212	0	1	09	04	H1804_212_0	4	4	Specialty			
H1804	212	0	1	09	04	H1804_212_0	4	1	Preferred Generic	1	00001000	2
H1804	212	0	1	09	04	H1804_212_0	4	3	Non-Preferred Brand			
H1804	212	0	1	09	04	H1804_212_0	4	2	Preferred Brand			
H1804	212	0	1	09	04	H1804_212_0	4	1	Preferred Generic			
H1804	212	0	1	09	04	H1804_212_0	4	4	Specialty	1	10001000	2
H1804	212	0	1	09	04	H1804_212_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	212	0	1	09	04	H1804_212_0	4	2	Preferred Brand	1	10000000	2
H1804	213	0	1	09	04	H1804_213_0	4	2	Preferred Brand			
H1804	213	0	1	09	04	H1804_213_0	4	2	Preferred Brand	1	10000000	2
H1804	213	0	1	09	04	H1804_213_0	4	1	Preferred Generic	1	00001000	2
H1804	213	0	1	09	04	H1804_213_0	4	1	Preferred Generic			
H1804	213	0	1	09	04	H1804_213_0	4	4	Specialty			
H1804	213	0	1	09	04	H1804_213_0	4	3	Non-Preferred Brand			
H1804	213	0	1	09	04	H1804_213_0	4	4	Specialty	1	10001000	2
H1804	213	0	1	09	04	H1804_213_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	214	0	1	09	04	H1804_214_0	5	1	Preferred Generic			
H1804	214	0	1	09	04	H1804_214_0	5	2	Preferred Brand			
H1804	214	0	1	09	04	H1804_214_0	5	3	Non-Preferred Brand			
H1804	214	0	1	09	04	H1804_214_0	5	4	Specialty			
H1804	214	0	1	09	04	H1804_214_0	5	1	Preferred Generic	1	00001000	2
H1804	214	0	1	09	04	H1804_214_0	5	2	Preferred Brand	1	10000000	2
H1804	214	0	1	09	04	H1804_214_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	214	0	1	09	04	H1804_214_0	5	4	Specialty	1	10001000	2
H1804	216	0	1	09	04	H1804_216_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	216	0	1	09	04	H1804_216_0	4	2	Preferred Brand	1	10000000	2
H1804	216	0	1	09	04	H1804_216_0	4	1	Preferred Generic	1	00001000	2
H1804	216	0	1	09	04	H1804_216_0	4	4	Specialty			
H1804	216	0	1	09	04	H1804_216_0	4	3	Non-Preferred Brand			
H1804	216	0	1	09	04	H1804_216_0	4	2	Preferred Brand			
H1804	216	0	1	09	04	H1804_216_0	4	1	Preferred Generic			
H1804	216	0	1	09	04	H1804_216_0	4	4	Specialty	1	10001000	2
H1804	217	0	1	09	04	H1804_217_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	217	0	1	09	04	H1804_217_0	4	2	Preferred Brand	1	10000000	2
H1804	217	0	1	09	04	H1804_217_0	4	1	Preferred Generic	1	00001000	2
H1804	217	0	1	09	04	H1804_217_0	4	4	Specialty			
H1804	217	0	1	09	04	H1804_217_0	4	3	Non-Preferred Brand			
H1804	217	0	1	09	04	H1804_217_0	4	2	Preferred Brand			
H1804	217	0	1	09	04	H1804_217_0	4	1	Preferred Generic			
H1804	217	0	1	09	04	H1804_217_0	4	4	Specialty	1	10001000	2
H1804	218	0	1	09	04	H1804_218_0	4	1	Preferred Generic			
H1804	218	0	1	09	04	H1804_218_0	4	2	Preferred Brand			
H1804	218	0	1	09	04	H1804_218_0	4	4	Specialty	1	10001000	2
H1804	218	0	1	09	04	H1804_218_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	218	0	1	09	04	H1804_218_0	4	2	Preferred Brand	1	10000000	2
H1804	218	0	1	09	04	H1804_218_0	4	1	Preferred Generic	1	00001000	2
H1804	218	0	1	09	04	H1804_218_0	4	4	Specialty			
H1804	218	0	1	09	04	H1804_218_0	4	3	Non-Preferred Brand			
H1804	219	0	1	09	04	H1804_219_0	5	1	Preferred Generic			
H1804	219	0	1	09	04	H1804_219_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	219	0	1	09	04	H1804_219_0	5	2	Preferred Brand	1	10000000	2
H1804	219	0	1	09	04	H1804_219_0	5	1	Preferred Generic	1	00001000	2
H1804	219	0	1	09	04	H1804_219_0	5	4	Specialty			
H1804	219	0	1	09	04	H1804_219_0	5	3	Non-Preferred Brand			
H1804	219	0	1	09	04	H1804_219_0	5	2	Preferred Brand			
H1804	219	0	1	09	04	H1804_219_0	5	4	Specialty	1	10001000	2
H1804	223	0	1	09	04	H1804_223_0	5	1	Preferred Generic	1	00001000	2
H1804	223	0	1	09	04	H1804_223_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	223	0	1	09	04	H1804_223_0	5	4	Specialty	1	10001000	2
H1804	223	0	1	09	04	H1804_223_0	5	2	Preferred Brand	1	10000000	2
H1804	223	0	1	09	04	H1804_223_0	5	1	Preferred Generic			
H1804	223	0	1	09	04	H1804_223_0	5	2	Preferred Brand			
H1804	223	0	1	09	04	H1804_223_0	5	3	Non-Preferred Brand			
H1804	223	0	1	09	04	H1804_223_0	5	4	Specialty			
H1804	224	0	1	09	04	H1804_224_0	4	2	Preferred Brand	1	10000000	2
H1804	224	0	1	09	04	H1804_224_0	4	1	Preferred Generic			
H1804	224	0	1	09	04	H1804_224_0	4	2	Preferred Brand			
H1804	224	0	1	09	04	H1804_224_0	4	3	Non-Preferred Brand			
H1804	224	0	1	09	04	H1804_224_0	4	4	Specialty			
H1804	224	0	1	09	04	H1804_224_0	4	4	Specialty	1	10001000	2
H1804	224	0	1	09	04	H1804_224_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	224	0	1	09	04	H1804_224_0	4	1	Preferred Generic	1	00001000	2
H1804	225	0	1	09	04	H1804_225_0	5	2	Preferred Brand	1	10000000	2
H1804	225	0	1	09	04	H1804_225_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	225	0	1	09	04	H1804_225_0	5	4	Specialty	1	10001000	2
H1804	225	0	1	09	04	H1804_225_0	5	1	Preferred Generic			
H1804	225	0	1	09	04	H1804_225_0	5	2	Preferred Brand			
H1804	225	0	1	09	04	H1804_225_0	5	3	Non-Preferred Brand			
H1804	225	0	1	09	04	H1804_225_0	5	1	Preferred Generic	1	00001000	2
H1804	225	0	1	09	04	H1804_225_0	5	4	Specialty			
H1804	226	0	1	09	04	H1804_226_0	4	4	Specialty	1	10001000	2
H1804	226	0	1	09	04	H1804_226_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	226	0	1	09	04	H1804_226_0	4	2	Preferred Brand	1	10000000	2
H1804	226	0	1	09	04	H1804_226_0	4	1	Preferred Generic	1	00001000	2
H1804	226	0	1	09	04	H1804_226_0	4	4	Specialty			
H1804	226	0	1	09	04	H1804_226_0	4	3	Non-Preferred Brand			
H1804	226	0	1	09	04	H1804_226_0	4	2	Preferred Brand			
H1804	226	0	1	09	04	H1804_226_0	4	1	Preferred Generic			
H1804	227	0	1	09	04	H1804_227_0	3	4	Specialty			
H1804	227	0	1	09	04	H1804_227_0	3	3	Non-Preferred Brand			
H1804	227	0	1	09	04	H1804_227_0	3	2	Preferred Brand			
H1804	227	0	1	09	04	H1804_227_0	3	1	Preferred Generic			
H1804	227	0	1	09	04	H1804_227_0	3	4	Specialty	1	10001000	2
H1804	227	0	1	09	04	H1804_227_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	227	0	1	09	04	H1804_227_0	3	1	Preferred Generic	1	00001000	2
H1804	227	0	1	09	04	H1804_227_0	3	2	Preferred Brand	1	10000000	2
H1804	228	0	1	09	04	H1804_228_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	228	0	1	09	04	H1804_228_0	3	2	Preferred Brand	1	10000000	2
H1804	228	0	1	09	04	H1804_228_0	3	1	Preferred Generic	1	00001000	2
H1804	228	0	1	09	04	H1804_228_0	3	4	Specialty			
H1804	228	0	1	09	04	H1804_228_0	3	3	Non-Preferred Brand			
H1804	228	0	1	09	04	H1804_228_0	3	2	Preferred Brand			
H1804	228	0	1	09	04	H1804_228_0	3	1	Preferred Generic			
H1804	228	0	1	09	04	H1804_228_0	3	4	Specialty	1	10001000	2
H1804	229	0	1	09	04	H1804_229_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	229	0	1	09	04	H1804_229_0	3	2	Preferred Brand	1	10000000	2
H1804	229	0	1	09	04	H1804_229_0	3	1	Preferred Generic	1	00001000	2
H1804	229	0	1	09	04	H1804_229_0	3	4	Specialty			
H1804	229	0	1	09	04	H1804_229_0	3	3	Non-Preferred Brand			
H1804	229	0	1	09	04	H1804_229_0	3	2	Preferred Brand			
H1804	229	0	1	09	04	H1804_229_0	3	1	Preferred Generic			
H1804	229	0	1	09	04	H1804_229_0	3	4	Specialty	1	10001000	2
H1804	230	0	1	09	04	H1804_230_0	4	1	Preferred Generic	1	00001000	2
H1804	230	0	1	09	04	H1804_230_0	4	2	Preferred Brand	1	10000000	2
H1804	230	0	1	09	04	H1804_230_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	230	0	1	09	04	H1804_230_0	4	4	Specialty	1	10001000	2
H1804	230	0	1	09	04	H1804_230_0	4	1	Preferred Generic			
H1804	230	0	1	09	04	H1804_230_0	4	2	Preferred Brand			
H1804	230	0	1	09	04	H1804_230_0	4	3	Non-Preferred Brand			
H1804	230	0	1	09	04	H1804_230_0	4	4	Specialty			
H1804	231	0	1	09	04	H1804_231_0	5	1	Preferred Generic			
H1804	231	0	1	09	04	H1804_231_0	5	2	Preferred Brand			
H1804	231	0	1	09	04	H1804_231_0	5	3	Non-Preferred Brand			
H1804	231	0	1	09	04	H1804_231_0	5	4	Specialty			
H1804	231	0	1	09	04	H1804_231_0	5	2	Preferred Brand	1	10000000	2
H1804	231	0	1	09	04	H1804_231_0	5	4	Specialty	1	10001000	2
H1804	231	0	1	09	04	H1804_231_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	231	0	1	09	04	H1804_231_0	5	1	Preferred Generic	1	00001000	2
H1804	232	0	1	09	04	H1804_232_0	4	1	Preferred Generic			
H1804	232	0	1	09	04	H1804_232_0	4	2	Preferred Brand			
H1804	232	0	1	09	04	H1804_232_0	4	3	Non-Preferred Brand			
H1804	232	0	1	09	04	H1804_232_0	4	1	Preferred Generic	1	00001000	2
H1804	232	0	1	09	04	H1804_232_0	4	4	Specialty			
H1804	232	0	1	09	04	H1804_232_0	4	2	Preferred Brand	1	10000000	2
H1804	232	0	1	09	04	H1804_232_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	232	0	1	09	04	H1804_232_0	4	4	Specialty	1	10001000	2
H1804	233	0	1	09	04	H1804_233_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	233	0	1	09	04	H1804_233_0	4	4	Specialty	1	10001000	2
H1804	233	0	1	09	04	H1804_233_0	4	4	Specialty			
H1804	233	0	1	09	04	H1804_233_0	4	1	Preferred Generic	1	00001000	2
H1804	233	0	1	09	04	H1804_233_0	4	2	Preferred Brand	1	10000000	2
H1804	233	0	1	09	04	H1804_233_0	4	1	Preferred Generic			
H1804	233	0	1	09	04	H1804_233_0	4	2	Preferred Brand			
H1804	233	0	1	09	04	H1804_233_0	4	3	Non-Preferred Brand			
H1804	234	0	1	09	04	H1804_234_0	4	4	Specialty	1	10001000	2
H1804	234	0	1	09	04	H1804_234_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	234	0	1	09	04	H1804_234_0	4	2	Preferred Brand	1	10000000	2
H1804	234	0	1	09	04	H1804_234_0	4	1	Preferred Generic	1	00001000	2
H1804	234	0	1	09	04	H1804_234_0	4	4	Specialty			
H1804	234	0	1	09	04	H1804_234_0	4	3	Non-Preferred Brand			
H1804	234	0	1	09	04	H1804_234_0	4	1	Preferred Generic			
H1804	234	0	1	09	04	H1804_234_0	4	2	Preferred Brand			
H1804	235	0	1	09	04	H1804_235_0	4	1	Preferred Generic			
H1804	235	0	1	09	04	H1804_235_0	4	4	Specialty	1	10001000	2
H1804	235	0	1	09	04	H1804_235_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	235	0	1	09	04	H1804_235_0	4	2	Preferred Brand	1	10000000	2
H1804	235	0	1	09	04	H1804_235_0	4	1	Preferred Generic	1	00001000	2
H1804	235	0	1	09	04	H1804_235_0	4	4	Specialty			
H1804	235	0	1	09	04	H1804_235_0	4	3	Non-Preferred Brand			
H1804	235	0	1	09	04	H1804_235_0	4	2	Preferred Brand			
H1804	236	0	1	09	04	H1804_236_0	4	1	Preferred Generic			
H1804	236	0	1	09	04	H1804_236_0	4	4	Specialty			
H1804	236	0	1	09	04	H1804_236_0	4	4	Specialty	1	10001000	2
H1804	236	0	1	09	04	H1804_236_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	236	0	1	09	04	H1804_236_0	4	2	Preferred Brand	1	10000000	2
H1804	236	0	1	09	04	H1804_236_0	4	1	Preferred Generic	1	00001000	2
H1804	236	0	1	09	04	H1804_236_0	4	2	Preferred Brand			
H1804	236	0	1	09	04	H1804_236_0	4	3	Non-Preferred Brand			
H1804	237	0	1	09	04	H1804_237_0	5	1	Preferred Generic			
H1804	237	0	1	09	04	H1804_237_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	237	0	1	09	04	H1804_237_0	5	2	Preferred Brand	1	10000000	2
H1804	237	0	1	09	04	H1804_237_0	5	1	Preferred Generic	1	00001000	2
H1804	237	0	1	09	04	H1804_237_0	5	4	Specialty			
H1804	237	0	1	09	04	H1804_237_0	5	3	Non-Preferred Brand			
H1804	237	0	1	09	04	H1804_237_0	5	2	Preferred Brand			
H1804	237	0	1	09	04	H1804_237_0	5	4	Specialty	1	10001000	2
H1804	238	0	1	09	04	H1804_238_0	5	1	Preferred Generic			
H1804	238	0	1	09	04	H1804_238_0	5	2	Preferred Brand			
H1804	238	0	1	09	04	H1804_238_0	5	3	Non-Preferred Brand			
H1804	238	0	1	09	04	H1804_238_0	5	4	Specialty			
H1804	238	0	1	09	04	H1804_238_0	5	1	Preferred Generic	1	00001000	2
H1804	238	0	1	09	04	H1804_238_0	5	2	Preferred Brand	1	10000000	2
H1804	238	0	1	09	04	H1804_238_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	238	0	1	09	04	H1804_238_0	5	4	Specialty	1	10001000	2
H1804	239	0	1	09	04	H1804_239_0	4	1	Preferred Generic			
H1804	239	0	1	09	04	H1804_239_0	4	2	Preferred Brand			
H1804	239	0	1	09	04	H1804_239_0	4	3	Non-Preferred Brand			
H1804	239	0	1	09	04	H1804_239_0	4	4	Specialty	1	10001000	2
H1804	239	0	1	09	04	H1804_239_0	4	1	Preferred Generic	1	00001000	2
H1804	239	0	1	09	04	H1804_239_0	4	2	Preferred Brand	1	10000000	2
H1804	239	0	1	09	04	H1804_239_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	239	0	1	09	04	H1804_239_0	4	4	Specialty			
H1804	240	0	1	09	04	H1804_240_0	5	1	Preferred Generic			
H1804	240	0	1	09	04	H1804_240_0	5	2	Preferred Brand			
H1804	240	0	1	09	04	H1804_240_0	5	3	Non-Preferred Brand			
H1804	240	0	1	09	04	H1804_240_0	5	4	Specialty	1	10001000	2
H1804	240	0	1	09	04	H1804_240_0	5	4	Specialty			
H1804	240	0	1	09	04	H1804_240_0	5	1	Preferred Generic	1	00001000	2
H1804	240	0	1	09	04	H1804_240_0	5	2	Preferred Brand	1	10000000	2
H1804	240	0	1	09	04	H1804_240_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	241	0	1	09	04	H1804_241_0	5	2	Preferred Brand	1	10000000	2
H1804	241	0	1	09	04	H1804_241_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	241	0	1	09	04	H1804_241_0	5	4	Specialty	1	10001000	2
H1804	241	0	1	09	04	H1804_241_0	5	1	Preferred Generic			
H1804	241	0	1	09	04	H1804_241_0	5	2	Preferred Brand			
H1804	241	0	1	09	04	H1804_241_0	5	3	Non-Preferred Brand			
H1804	241	0	1	09	04	H1804_241_0	5	1	Preferred Generic	1	00001000	2
H1804	241	0	1	09	04	H1804_241_0	5	4	Specialty			
H1804	245	0	1	09	04	H1804_245_0	3	4	Specialty			
H1804	245	0	1	09	04	H1804_245_0	3	3	Non-Preferred Brand			
H1804	245	0	1	09	04	H1804_245_0	3	2	Preferred Brand			
H1804	245	0	1	09	04	H1804_245_0	3	1	Preferred Generic			
H1804	245	0	1	09	04	H1804_245_0	3	4	Specialty	1	10001000	2
H1804	245	0	1	09	04	H1804_245_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	245	0	1	09	04	H1804_245_0	3	1	Preferred Generic	1	00001000	2
H1804	245	0	1	09	04	H1804_245_0	3	2	Preferred Brand	1	10000000	2
H1804	246	0	1	09	04	H1804_246_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	246	0	1	09	04	H1804_246_0	4	2	Preferred Brand	1	10000000	2
H1804	246	0	1	09	04	H1804_246_0	4	1	Preferred Generic	1	00001000	2
H1804	246	0	1	09	04	H1804_246_0	4	4	Specialty			
H1804	246	0	1	09	04	H1804_246_0	4	3	Non-Preferred Brand			
H1804	246	0	1	09	04	H1804_246_0	4	2	Preferred Brand			
H1804	246	0	1	09	04	H1804_246_0	4	1	Preferred Generic			
H1804	246	0	1	09	04	H1804_246_0	4	4	Specialty	1	10001000	2
H1804	251	0	1	09	04	H1804_251_0	3	1	Preferred Generic			
H1804	251	0	1	09	04	H1804_251_0	3	2	Preferred Brand			
H1804	251	0	1	09	04	H1804_251_0	3	3	Non-Preferred Brand			
H1804	251	0	1	09	04	H1804_251_0	3	4	Specialty			
H1804	251	0	1	09	04	H1804_251_0	3	1	Preferred Generic	1	00001000	2
H1804	251	0	1	09	04	H1804_251_0	3	2	Preferred Brand	1	10000000	2
H1804	251	0	1	09	04	H1804_251_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	251	0	1	09	04	H1804_251_0	3	4	Specialty	1	10001000	2
H1804	252	0	1	09	04	H1804_252_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	252	0	1	09	04	H1804_252_0	5	2	Preferred Brand	1	10000000	2
H1804	252	0	1	09	04	H1804_252_0	5	1	Preferred Generic	1	00001000	2
H1804	252	0	1	09	04	H1804_252_0	5	4	Specialty			
H1804	252	0	1	09	04	H1804_252_0	5	3	Non-Preferred Brand			
H1804	252	0	1	09	04	H1804_252_0	5	2	Preferred Brand			
H1804	252	0	1	09	04	H1804_252_0	5	1	Preferred Generic			
H1804	252	0	1	09	04	H1804_252_0	5	4	Specialty	1	10001000	2
H1804	254	0	1	09	04	H1804_254_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	254	0	1	09	04	H1804_254_0	3	2	Preferred Brand	1	10000000	2
H1804	254	0	1	09	04	H1804_254_0	3	1	Preferred Generic	1	00001000	2
H1804	254	0	1	09	04	H1804_254_0	3	4	Specialty			
H1804	254	0	1	09	04	H1804_254_0	3	3	Non-Preferred Brand			
H1804	254	0	1	09	04	H1804_254_0	3	2	Preferred Brand			
H1804	254	0	1	09	04	H1804_254_0	3	1	Preferred Generic			
H1804	254	0	1	09	04	H1804_254_0	3	4	Specialty	1	10001000	2
H1804	257	0	1	09	04	H1804_257_0	3	1	Preferred Generic			
H1804	257	0	1	09	04	H1804_257_0	3	2	Preferred Brand			
H1804	257	0	1	09	04	H1804_257_0	3	4	Specialty	1	10001000	2
H1804	257	0	1	09	04	H1804_257_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	257	0	1	09	04	H1804_257_0	3	2	Preferred Brand	1	10000000	2
H1804	257	0	1	09	04	H1804_257_0	3	1	Preferred Generic	1	00001000	2
H1804	257	0	1	09	04	H1804_257_0	3	4	Specialty			
H1804	257	0	1	09	04	H1804_257_0	3	3	Non-Preferred Brand			
H1804	258	0	1	09	04	H1804_258_0	4	1	Preferred Generic			
H1804	258	0	1	09	04	H1804_258_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	258	0	1	09	04	H1804_258_0	4	2	Preferred Brand	1	10000000	2
H1804	258	0	1	09	04	H1804_258_0	4	1	Preferred Generic	1	00001000	2
H1804	258	0	1	09	04	H1804_258_0	4	4	Specialty			
H1804	258	0	1	09	04	H1804_258_0	4	3	Non-Preferred Brand			
H1804	258	0	1	09	04	H1804_258_0	4	2	Preferred Brand			
H1804	258	0	1	09	04	H1804_258_0	4	4	Specialty	1	10001000	2
H1804	261	0	1	09	04	H1804_261_0	4	1	Preferred Generic			
H1804	261	0	1	09	04	H1804_261_0	4	2	Preferred Brand			
H1804	261	0	1	09	04	H1804_261_0	4	3	Non-Preferred Brand			
H1804	261	0	1	09	04	H1804_261_0	4	4	Specialty			
H1804	261	0	1	09	04	H1804_261_0	4	1	Preferred Generic	1	00001000	2
H1804	261	0	1	09	04	H1804_261_0	4	2	Preferred Brand	1	10000000	2
H1804	261	0	1	09	04	H1804_261_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	261	0	1	09	04	H1804_261_0	4	4	Specialty	1	10001000	2
H1804	263	0	1	09	04	H1804_263_0	3	4	Specialty	1	10001000	2
H1804	263	0	1	09	04	H1804_263_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	263	0	1	09	04	H1804_263_0	3	2	Preferred Brand	1	10000000	2
H1804	263	0	1	09	04	H1804_263_0	3	1	Preferred Generic	1	00001000	2
H1804	263	0	1	09	04	H1804_263_0	3	4	Specialty			
H1804	263	0	1	09	04	H1804_263_0	3	3	Non-Preferred Brand			
H1804	263	0	1	09	04	H1804_263_0	3	1	Preferred Generic			
H1804	263	0	1	09	04	H1804_263_0	3	2	Preferred Brand			
H1804	269	0	1	09	04	H1804_269_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	269	0	1	09	04	H1804_269_0	3	2	Preferred Brand	1	10000000	2
H1804	269	0	1	09	04	H1804_269_0	3	1	Preferred Generic	1	00001000	2
H1804	269	0	1	09	04	H1804_269_0	3	4	Specialty			
H1804	269	0	1	09	04	H1804_269_0	3	3	Non-Preferred Brand			
H1804	269	0	1	09	04	H1804_269_0	3	2	Preferred Brand			
H1804	269	0	1	09	04	H1804_269_0	3	1	Preferred Generic			
H1804	269	0	1	09	04	H1804_269_0	3	4	Specialty	1	10001000	2
H1804	270	0	1	09	04	H1804_270_0	4	1	Preferred Generic			
H1804	270	0	1	09	04	H1804_270_0	4	4	Specialty	1	10001000	2
H1804	270	0	1	09	04	H1804_270_0	4	2	Preferred Brand			
H1804	270	0	1	09	04	H1804_270_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	270	0	1	09	04	H1804_270_0	4	2	Preferred Brand	1	10000000	2
H1804	270	0	1	09	04	H1804_270_0	4	1	Preferred Generic	1	00001000	2
H1804	270	0	1	09	04	H1804_270_0	4	4	Specialty			
H1804	270	0	1	09	04	H1804_270_0	4	3	Non-Preferred Brand			
H1804	272	0	1	09	04	H1804_272_0	4	2	Preferred Brand			
H1804	272	0	1	09	04	H1804_272_0	4	1	Preferred Generic			
H1804	272	0	1	09	04	H1804_272_0	4	3	Non-Preferred Brand			
H1804	272	0	1	09	04	H1804_272_0	4	4	Specialty			
H1804	272	0	1	09	04	H1804_272_0	4	1	Preferred Generic	1	00001000	2
H1804	272	0	1	09	04	H1804_272_0	4	2	Preferred Brand	1	10000000	2
H1804	272	0	1	09	04	H1804_272_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	272	0	1	09	04	H1804_272_0	4	4	Specialty	1	10001000	2
H1804	273	0	1	09	04	H1804_273_0	3	4	Specialty			
H1804	273	0	1	09	04	H1804_273_0	3	4	Specialty	1	10001000	2
H1804	273	0	1	09	04	H1804_273_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	273	0	1	09	04	H1804_273_0	3	2	Preferred Brand	1	10000000	2
H1804	273	0	1	09	04	H1804_273_0	3	1	Preferred Generic	1	00001000	2
H1804	273	0	1	09	04	H1804_273_0	3	3	Non-Preferred Brand			
H1804	273	0	1	09	04	H1804_273_0	3	2	Preferred Brand			
H1804	273	0	1	09	04	H1804_273_0	3	1	Preferred Generic			
H1804	274	0	1	09	04	H1804_274_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	274	0	1	09	04	H1804_274_0	4	2	Preferred Brand	1	10000000	2
H1804	274	0	1	09	04	H1804_274_0	4	1	Preferred Generic	1	00001000	2
H1804	274	0	1	09	04	H1804_274_0	4	4	Specialty			
H1804	274	0	1	09	04	H1804_274_0	4	3	Non-Preferred Brand			
H1804	274	0	1	09	04	H1804_274_0	4	2	Preferred Brand			
H1804	274	0	1	09	04	H1804_274_0	4	1	Preferred Generic			
H1804	274	0	1	09	04	H1804_274_0	4	4	Specialty	1	10001000	2
H1804	275	0	1	09	04	H1804_275_0	5	4	Specialty	1	10001000	2
H1804	275	0	1	09	04	H1804_275_0	5	1	Preferred Generic			
H1804	275	0	1	09	04	H1804_275_0	5	2	Preferred Brand			
H1804	275	0	1	09	04	H1804_275_0	5	3	Non-Preferred Brand			
H1804	275	0	1	09	04	H1804_275_0	5	4	Specialty			
H1804	275	0	1	09	04	H1804_275_0	5	1	Preferred Generic	1	00001000	2
H1804	275	0	1	09	04	H1804_275_0	5	3	Non-Preferred Brand	1	10000000	2
H1804	275	0	1	09	04	H1804_275_0	5	2	Preferred Brand	1	10000000	2
H1804	278	0	1	09	04	H1804_278_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	278	0	1	09	04	H1804_278_0	3	2	Preferred Brand	1	10000000	2
H1804	278	0	1	09	04	H1804_278_0	3	1	Preferred Generic	1	00001000	2
H1804	278	0	1	09	04	H1804_278_0	3	4	Specialty			
H1804	278	0	1	09	04	H1804_278_0	3	4	Specialty	1	10001000	2
H1804	278	0	1	09	04	H1804_278_0	3	3	Non-Preferred Brand			
H1804	278	0	1	09	04	H1804_278_0	3	1	Preferred Generic			
H1804	278	0	1	09	04	H1804_278_0	3	2	Preferred Brand			
H1804	279	0	1	09	04	H1804_279_0	4	1	Preferred Generic			
H1804	279	0	1	09	04	H1804_279_0	4	2	Preferred Brand			
H1804	279	0	1	09	04	H1804_279_0	4	3	Non-Preferred Brand			
H1804	279	0	1	09	04	H1804_279_0	4	4	Specialty			
H1804	279	0	1	09	04	H1804_279_0	4	1	Preferred Generic	1	00001000	2
H1804	279	0	1	09	04	H1804_279_0	4	2	Preferred Brand	1	10000000	2
H1804	279	0	1	09	04	H1804_279_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	279	0	1	09	04	H1804_279_0	4	4	Specialty	1	10001000	2
H1804	280	0	1	09	04	H1804_280_0	3	2	Preferred Brand			
H1804	280	0	1	09	04	H1804_280_0	3	1	Preferred Generic			
H1804	280	0	1	09	04	H1804_280_0	3	3	Non-Preferred Brand			
H1804	280	0	1	09	04	H1804_280_0	3	4	Specialty			
H1804	280	0	1	09	04	H1804_280_0	3	1	Preferred Generic	1	00001000	2
H1804	280	0	1	09	04	H1804_280_0	3	2	Preferred Brand	1	10000000	2
H1804	280	0	1	09	04	H1804_280_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	280	0	1	09	04	H1804_280_0	3	4	Specialty	1	10001000	2
H1804	281	0	1	09	04	H1804_281_0	4	2	Preferred Brand			
H1804	281	0	1	09	04	H1804_281_0	4	1	Preferred Generic			
H1804	281	0	1	09	04	H1804_281_0	4	2	Preferred Brand	1	10000000	2
H1804	281	0	1	09	04	H1804_281_0	4	4	Specialty	1	10001000	2
H1804	281	0	1	09	04	H1804_281_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	281	0	1	09	04	H1804_281_0	4	1	Preferred Generic	1	00001000	2
H1804	281	0	1	09	04	H1804_281_0	4	4	Specialty			
H1804	281	0	1	09	04	H1804_281_0	4	3	Non-Preferred Brand			
H1804	284	0	1	09	04	H1804_284_0	4	1	Preferred Generic			
H1804	284	0	1	09	04	H1804_284_0	4	2	Preferred Brand			
H1804	284	0	1	09	04	H1804_284_0	4	3	Non-Preferred Brand			
H1804	284	0	1	09	04	H1804_284_0	4	1	Preferred Generic	1	00001000	2
H1804	284	0	1	09	04	H1804_284_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	284	0	1	09	04	H1804_284_0	4	4	Specialty	1	10001000	2
H1804	284	0	1	09	04	H1804_284_0	4	2	Preferred Brand	1	10000000	2
H1804	284	0	1	09	04	H1804_284_0	4	4	Specialty			
H1804	285	0	1	09	04	H1804_285_0	3	1	Preferred Generic	1	00001000	2
H1804	285	0	1	09	04	H1804_285_0	3	2	Preferred Brand	1	10000000	2
H1804	285	0	1	09	04	H1804_285_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	285	0	1	09	04	H1804_285_0	3	4	Specialty	1	10001000	2
H1804	285	0	1	09	04	H1804_285_0	3	1	Preferred Generic			
H1804	285	0	1	09	04	H1804_285_0	3	2	Preferred Brand			
H1804	285	0	1	09	04	H1804_285_0	3	4	Specialty			
H1804	285	0	1	09	04	H1804_285_0	3	3	Non-Preferred Brand			
H1804	286	0	1	09	04	H1804_286_0	3	4	Specialty			
H1804	286	0	1	09	04	H1804_286_0	3	3	Non-Preferred Brand			
H1804	286	0	1	09	04	H1804_286_0	3	2	Preferred Brand	1	10000000	2
H1804	286	0	1	09	04	H1804_286_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	286	0	1	09	04	H1804_286_0	3	4	Specialty	1	10001000	2
H1804	286	0	1	09	04	H1804_286_0	3	1	Preferred Generic			
H1804	286	0	1	09	04	H1804_286_0	3	2	Preferred Brand			
H1804	286	0	1	09	04	H1804_286_0	3	1	Preferred Generic	1	00001000	2
H1804	287	0	1	09	04	H1804_287_0	4	1	Preferred Generic	1	00001000	2
H1804	287	0	1	09	04	H1804_287_0	4	4	Specialty			
H1804	287	0	1	09	04	H1804_287_0	4	2	Preferred Brand	1	10000000	2
H1804	287	0	1	09	04	H1804_287_0	4	3	Non-Preferred Brand			
H1804	287	0	1	09	04	H1804_287_0	4	2	Preferred Brand			
H1804	287	0	1	09	04	H1804_287_0	4	1	Preferred Generic			
H1804	287	0	1	09	04	H1804_287_0	4	4	Specialty	1	10001000	2
H1804	287	0	1	09	04	H1804_287_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	288	0	1	09	04	H1804_288_0	3	4	Specialty	1	10001000	2
H1804	288	0	1	09	04	H1804_288_0	3	1	Preferred Generic			
H1804	288	0	1	09	04	H1804_288_0	3	2	Preferred Brand			
H1804	288	0	1	09	04	H1804_288_0	3	3	Non-Preferred Brand			
H1804	288	0	1	09	04	H1804_288_0	3	4	Specialty			
H1804	288	0	1	09	04	H1804_288_0	3	1	Preferred Generic	1	00001000	2
H1804	288	0	1	09	04	H1804_288_0	3	2	Preferred Brand	1	10000000	2
H1804	288	0	1	09	04	H1804_288_0	3	3	Non-Preferred Brand	1	10000000	2
H1804	289	0	1	09	04	H1804_289_0	4	3	Non-Preferred Brand	1	10000000	2
H1804	289	0	1	09	04	H1804_289_0	4	1	Preferred Generic			
H1804	289	0	1	09	04	H1804_289_0	4	2	Preferred Brand			
H1804	289	0	1	09	04	H1804_289_0	4	3	Non-Preferred Brand			
H1804	289	0	1	09	04	H1804_289_0	4	4	Specialty			
H1804	289	0	1	09	04	H1804_289_0	4	4	Specialty	1	10001000	2
H1804	289	0	1	09	04	H1804_289_0	4	2	Preferred Brand	1	10000000	2
H1804	289	0	1	09	04	H1804_289_0	4	1	Preferred Generic	1	00001000	2
H1806	001	0	1	04	01	H1806_001_0	7	3	Non-Preferred Brand			
H1806	001	0	1	04	01	H1806_001_0	7	2	Preferred Brand			
H1806	001	0	1	04	01	H1806_001_0	7	1	Preferred Generic			
H1806	001	0	1	04	01	H1806_001_0	7	4	Specialty	1	10001000	2
H1806	001	0	1	04	01	H1806_001_0	7	3	Non-Preferred Brand	1	10000000	2
H1806	001	0	1	04	01	H1806_001_0	7	2	Preferred Brand	1	10000000	2
H1806	001	0	1	04	01	H1806_001_0	7	1	Preferred Generic	1	00001000	2
H1806	001	0	1	04	01	H1806_001_0	7	4	Specialty			
H1806	002	0	1	04	01	H1806_002_0	7	3	Non-Preferred Brand			
H1806	002	0	1	04	01	H1806_002_0	7	2	Preferred Brand			
H1806	002	0	1	04	01	H1806_002_0	7	1	Preferred Generic			
H1806	002	0	1	04	01	H1806_002_0	7	4	Specialty	1	10001000	2
H1806	002	0	1	04	01	H1806_002_0	7	3	Non-Preferred Brand	1	10000000	2
H1806	002	0	1	04	01	H1806_002_0	7	4	Specialty			
H1806	002	0	1	04	01	H1806_002_0	7	1	Preferred Generic	1		1
H1806	002	0	1	04	01	H1806_002_0	7	2	Preferred Brand	1	10000000	2
H1837	001	0	1	01	01	H1837_001_0	10	4	Tier 4 specialty			
H1837	001	0	1	01	01	H1837_001_0	10	3	Tier 3 non-preferred brand			
H1837	001	0	1	01	01	H1837_001_0	10	2	Tier 2 Preferred Brand			
H1837	001	0	1	01	01	H1837_001_0	10	1	Tier 1 Generic			
H1837	002	0	1	01	01	H1837_002_0	8	1	Tier 1 Generic			
H1837	002	0	1	01	01	H1837_002_0	8	4	Tier 4 specialty			
H1837	002	0	1	01	01	H1837_002_0	8	3	Tier 3 non-preferred brand			
H1837	002	0	1	01	01	H1837_002_0	8	2	Tier 2 Preferred Brand			
H1837	003	0	1	01	01	H1837_003_0	5	1	Tier 1 Generic	1		1
H1837	003	0	1	01	01	H1837_003_0	5	4	Tier 4 Specialty			
H1837	003	0	1	01	01	H1837_003_0	5	3	Tier 3 Non-Preferred Brand			
H1837	003	0	1	01	01	H1837_003_0	5	2	Tier 2 Preferred Brand			
H1837	003	0	1	01	01	H1837_003_0	5	1	Tier 1 Generic			
H1837	003	0	1	01	01	H1837_003_0	5	3	Tier 3 Non-Preferred Brand	2		
H1837	003	0	1	01	01	H1837_003_0	5	2	Tier 2 Preferred Brand	2		
H1837	003	0	1	01	01	H1837_003_0	5	4	Tier 4 Specialty	2		
H1837	004	0	1	01	01	H1837_004_0	7	1	Tier 1 Generic			
H1837	004	0	1	01	01	H1837_004_0	7	2	Tier 2 Preferred Brand			
H1837	004	0	1	01	01	H1837_004_0	7	3	Tier 3 non-preferred brand			
H1837	004	0	1	01	01	H1837_004_0	7	4	Tier 4 specialty			
H1846	001	0	1	04	01	H1846_001_0	6	1	Generic			
H1846	001	0	1	04	01	H1846_001_0	6	2	Preferred Brand			
H1846	001	0	1	04	01	H1846_001_0	6	3	Non-Preferred Brand			
H1846	001	0	1	04	01	H1846_001_0	6	4	Specialty Drugs			
H1846	001	0	1	04	01	H1846_001_0	6	1	Generic	1		1
H1846	001	0	1	04	01	H1846_001_0	6	2	Preferred Brand	2		
H1846	001	0	1	04	01	H1846_001_0	6	3	Non-Preferred Brand	2		
H1846	001	0	1	04	01	H1846_001_0	6	4	Specialty Drugs	2		
H1849	005	0	1	01	01	H1849_005_0	7	5	Tier 5 Specialty	2		
H1849	005	0	1	01	01	H1849_005_0	7	4	Tier 4 Non-Specialty Injectable	2		
H1849	005	0	1	01	01	H1849_005_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H1849	005	0	1	01	01	H1849_005_0	7	2	Tier 2 Preferred Brand	2		
H1849	005	0	1	01	01	H1849_005_0	7	1	Tier 1 Preferred Generic	1		1
H1849	005	0	1	01	01	H1849_005_0	7	5	Tier 5 Specialty			
H1849	005	0	1	01	01	H1849_005_0	7	4	Tier 4 Non-Specialty Injectable			
H1849	005	0	1	01	01	H1849_005_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H1849	005	0	1	01	01	H1849_005_0	7	1	Tier 1 Preferred Generic			
H1849	005	0	1	01	01	H1849_005_0	7	2	Tier 2 Preferred Brand			
H1849	014	0	1	01	01	H1849_014_0	8	4	Tier 4 Non-Specialty Injectable	2		
H1849	014	0	1	01	01	H1849_014_0	8	5	Tier 5 Specialty	2		
H1849	014	0	1	01	01	H1849_014_0	8	2	Tier 2 Preferred Brand	2		
H1849	014	0	1	01	01	H1849_014_0	8	1	Tier 1 Preferred Generic	1		1
H1849	014	0	1	01	01	H1849_014_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H1849	014	0	1	01	01	H1849_014_0	8	4	Tier 4 Non-Specialty Injectable			
H1849	014	0	1	01	01	H1849_014_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H1849	014	0	1	01	01	H1849_014_0	8	2	Tier 2 Preferred Brand			
H1849	014	0	1	01	01	H1849_014_0	8	1	Tier 1 Preferred Generic			
H1849	014	0	1	01	01	H1849_014_0	8	5	Tier 5 Specialty			
H1903	011	0	1	01	01	H1903_011_0	8	4	Tier 4			
H1903	011	0	1	01	01	H1903_011_0	8	3	Tier 3			
H1903	011	0	1	01	01	H1903_011_0	8	2	Tier 2			
H1903	011	0	1	01	01	H1903_011_0	8	1	Tier 1			
H1903	014	0	1	02	01	H1903_014_0	9	1	Tier 1			
H1903	014	0	1	02	01	H1903_014_0	9	2	Tier 2			
H1903	014	0	1	02	01	H1903_014_0	9	3	Tier 3			
H1903	014	0	1	02	01	H1903_014_0	9	4	Tier 4			
H1903	018	0	1	02	01	H1903_018_0	8	1	Tier 1	1		1
H1903	018	0	1	02	01	H1903_018_0	8	4	Tier 4			
H1903	018	0	1	02	01	H1903_018_0	8	3	Tier 3			
H1903	018	0	1	02	01	H1903_018_0	8	2	Tier 2			
H1903	018	0	1	02	01	H1903_018_0	8	1	Tier 1			
H1903	018	0	1	02	01	H1903_018_0	8	2	Tier 2	2		
H1903	018	0	1	02	01	H1903_018_0	8	4	Tier 4	2		
H1903	018	0	1	02	01	H1903_018_0	8	3	Tier 3	2		
H1903	022	0	1	02	01	H1903_022_0	8	1	Tier 1			
H1903	022	0	1	02	01	H1903_022_0	8	2	Tier 2			
H1903	022	0	1	02	01	H1903_022_0	8	3	Tier 3			
H1903	022	0	1	02	01	H1903_022_0	8	4	Tier 4			
H1903	022	0	1	02	01	H1903_022_0	8	1	Tier 1	1		1
H1903	022	0	1	02	01	H1903_022_0	8	2	Tier 2	2		
H1903	022	0	1	02	01	H1903_022_0	8	4	Tier 4	2		
H1903	022	0	1	02	01	H1903_022_0	8	3	Tier 3	2		
H1903	023	0	1	01	01	H1903_023_0	8	1	Tier 1			
H1903	023	0	1	01	01	H1903_023_0	8	2	Tier 2			
H1903	023	0	1	01	01	H1903_023_0	8	3	Tier 3			
H1903	023	0	1	01	01	H1903_023_0	8	4	Tier 4			
H1906	001	0	1	09	04	H1906_001_0	5	3	Non-Preferred Brand	1	10000000	2
H1906	001	0	1	09	04	H1906_001_0	5	4	Specialty	1	10001000	2
H1906	001	0	1	09	04	H1906_001_0	5	1	Preferred Generic			
H1906	001	0	1	09	04	H1906_001_0	5	2	Preferred Brand			
H1906	001	0	1	09	04	H1906_001_0	5	3	Non-Preferred Brand			
H1906	001	0	1	09	04	H1906_001_0	5	4	Specialty			
H1906	001	0	1	09	04	H1906_001_0	5	1	Preferred Generic	1	00001000	2
H1906	001	0	1	09	04	H1906_001_0	5	2	Preferred Brand	1	10000000	2
H1906	002	0	1	09	04	H1906_002_0	3	3	Non-Preferred Brand	1	10000000	2
H1906	002	0	1	09	04	H1906_002_0	3	2	Preferred Brand	1	10000000	2
H1906	002	0	1	09	04	H1906_002_0	3	1	Preferred Generic	1	00001000	2
H1906	002	0	1	09	04	H1906_002_0	3	4	Specialty			
H1906	002	0	1	09	04	H1906_002_0	3	3	Non-Preferred Brand			
H1906	002	0	1	09	04	H1906_002_0	3	2	Preferred Brand			
H1906	002	0	1	09	04	H1906_002_0	3	1	Preferred Generic			
H1906	002	0	1	09	04	H1906_002_0	3	4	Specialty	1	10001000	2
H1906	003	0	1	09	04	H1906_003_0	6	3	Non-Preferred Brand	1	10000000	2
H1906	003	0	1	09	04	H1906_003_0	6	2	Preferred Brand	1	10000000	2
H1906	003	0	1	09	04	H1906_003_0	6	1	Preferred Generic	1	00001000	2
H1906	003	0	1	09	04	H1906_003_0	6	4	Specialty			
H1906	003	0	1	09	04	H1906_003_0	6	3	Non-Preferred Brand			
H1906	003	0	1	09	04	H1906_003_0	6	2	Preferred Brand			
H1906	003	0	1	09	04	H1906_003_0	6	1	Preferred Generic			
H1906	003	0	1	09	04	H1906_003_0	6	4	Specialty	1	10001000	2
H1906	006	0	1	09	04	H1906_006_0	5	1	Preferred Generic			
H1906	006	0	1	09	04	H1906_006_0	5	2	Preferred Brand			
H1906	006	0	1	09	04	H1906_006_0	5	4	Specialty	1	10001000	2
H1906	006	0	1	09	04	H1906_006_0	5	3	Non-Preferred Brand	1	10000000	2
H1906	006	0	1	09	04	H1906_006_0	5	2	Preferred Brand	1	10000000	2
H1906	006	0	1	09	04	H1906_006_0	5	1	Preferred Generic	1	00001000	2
H1906	006	0	1	09	04	H1906_006_0	5	4	Specialty			
H1906	006	0	1	09	04	H1906_006_0	5	3	Non-Preferred Brand			
H1906	007	0	1	09	04	H1906_007_0	5	1	Preferred Generic			
H1906	007	0	1	09	04	H1906_007_0	5	3	Non-Preferred Brand	1	10000000	2
H1906	007	0	1	09	04	H1906_007_0	5	2	Preferred Brand	1	10000000	2
H1906	007	0	1	09	04	H1906_007_0	5	1	Preferred Generic	1	00001000	2
H1906	007	0	1	09	04	H1906_007_0	5	4	Specialty			
H1906	007	0	1	09	04	H1906_007_0	5	3	Non-Preferred Brand			
H1906	007	0	1	09	04	H1906_007_0	5	2	Preferred Brand			
H1906	007	0	1	09	04	H1906_007_0	5	4	Specialty	1	10001000	2
H1944	001	0	1	02	01	H1944_001_0	5	1	Preferred Generic			
H1944	001	0	1	02	01	H1944_001_0	5	4	Specialty			
H1944	001	0	1	02	01	H1944_001_0	5	3	Non-Preferred			
H1944	001	0	1	02	01	H1944_001_0	5	2	Preferred Brand			
H1951	001	0	1	01	01	H1951_001_0	6	1	Preferred Generic			
H1951	001	0	1	01	01	H1951_001_0	6	2	Preferred Brand			
H1951	001	0	1	01	01	H1951_001_0	6	4	Specialty	1	10001000	2
H1951	001	0	1	01	01	H1951_001_0	6	3	Non-Preferred Brand	1	10000000	2
H1951	001	0	1	01	01	H1951_001_0	6	2	Preferred Brand	1	10000000	2
H1951	001	0	1	01	01	H1951_001_0	6	1	Preferred Generic	1		1
H1951	001	0	1	01	01	H1951_001_0	6	4	Specialty			
H1951	001	0	1	01	01	H1951_001_0	6	3	Non-Preferred Brand			
H1951	005	0	1	01	01	H1951_005_0	6	2	Preferred Brand	1	10000000	2
H1951	005	0	1	01	01	H1951_005_0	6	4	Specialty	1	10001000	2
H1951	005	0	1	01	01	H1951_005_0	6	3	Non-Preferred Brand	1	10000000	2
H1951	005	0	1	01	01	H1951_005_0	6	1	Preferred Generic	1		1
H1951	005	0	1	01	01	H1951_005_0	6	4	Specialty			
H1951	005	0	1	01	01	H1951_005_0	6	3	Non-Preferred Brand			
H1951	005	0	1	01	01	H1951_005_0	6	2	Preferred Brand			
H1951	005	0	1	01	01	H1951_005_0	6	1	Preferred Generic			
H1951	013	0	1	01	01	H1951_013_0	6	3	Non-Preferred Brand			
H1951	013	0	1	01	01	H1951_013_0	6	2	Preferred Brand			
H1951	013	0	1	01	01	H1951_013_0	6	1	Preferred Generic			
H1951	013	0	1	01	01	H1951_013_0	6	4	Specialty	1	10001000	2
H1951	013	0	1	01	01	H1951_013_0	6	3	Non-Preferred Brand	1	10000000	2
H1951	013	0	1	01	01	H1951_013_0	6	4	Specialty			
H1951	013	0	1	01	01	H1951_013_0	6	2	Preferred Brand	1	10000000	2
H1951	013	0	1	01	01	H1951_013_0	6	1	Preferred Generic	1		1
H1951	017	0	1	01	01	H1951_017_0	8	3	Non-Preferred Brand			
H1951	017	0	1	01	01	H1951_017_0	8	2	Preferred Brand			
H1951	017	0	1	01	01	H1951_017_0	8	1	Preferred Generic			
H1951	017	0	1	01	01	H1951_017_0	8	4	Specialty			
H1951	019	0	1	01	01	H1951_019_0	9	2	Preferred Brand			
H1951	019	0	1	01	01	H1951_019_0	9	3	Non-Preferred Brand			
H1951	019	0	1	01	01	H1951_019_0	9	4	Specialty			
H1951	019	0	1	01	01	H1951_019_0	9	1	Preferred Generic			
H1951	021	0	1	01	01	H1951_021_0	8	4	Specialty			
H1951	021	0	1	01	01	H1951_021_0	8	1	Preferred Generic			
H1951	021	0	1	01	01	H1951_021_0	8	2	Preferred Brand			
H1951	021	0	1	01	01	H1951_021_0	8	3	Non-Preferred Brand			
H1951	023	0	1	01	01	H1951_023_0	6	2	Preferred Brand			
H1951	023	0	1	01	01	H1951_023_0	6	4	Specialty	1	10001000	2
H1951	023	0	1	01	01	H1951_023_0	6	3	Non-Preferred Brand	1	10000000	2
H1951	023	0	1	01	01	H1951_023_0	6	3	Non-Preferred Brand			
H1951	023	0	1	01	01	H1951_023_0	6	4	Specialty			
H1951	023	0	1	01	01	H1951_023_0	6	1	Preferred Generic	1	00001000	2
H1951	023	0	1	01	01	H1951_023_0	6	2	Preferred Brand	1	10000000	2
H1951	023	0	1	01	01	H1951_023_0	6	1	Preferred Generic			
H1961	001	0	1	01	01	H1961_001_0	9	3	Non-Preferred Brand			
H1961	001	0	1	01	01	H1961_001_0	9	2	Preferred Brand			
H1961	001	0	1	01	01	H1961_001_0	9	1	Generic	1		1
H1961	001	0	1	01	01	H1961_001_0	9	2	Preferred Brand	1		1
H1961	001	0	1	01	01	H1961_001_0	9	3	Non-Preferred Brand	2		
H1961	001	0	1	01	01	H1961_001_0	9	4	Specialty	2		
H1961	001	0	1	01	01	H1961_001_0	9	4	Specialty			
H1961	001	0	1	01	01	H1961_001_0	9	1	Generic			
H1961	002	0	1	02	01	H1961_002_0	12	3	Non-Preferred Brand			
H1961	002	0	1	02	01	H1961_002_0	12	4	Specialty			
H1961	002	0	1	02	01	H1961_002_0	12	1	Generic	1		1
H1961	002	0	1	02	01	H1961_002_0	12	2	Preferred Brand	1		1
H1961	002	0	1	02	01	H1961_002_0	12	3	Non-Preferred Brand	2		
H1961	002	0	1	02	01	H1961_002_0	12	4	Specialty	2		
H1961	002	0	1	02	01	H1961_002_0	12	2	Preferred Brand			
H1961	002	0	1	02	01	H1961_002_0	12	1	Generic			
H2001	001	0	1	04	01	H2001_001_0	5	3	Non Preferred			
H2001	001	0	1	04	01	H2001_001_0	5	2	Preferred Brand			
H2001	001	0	1	04	01	H2001_001_0	5	1	Preferred Generic			
H2001	001	0	1	04	01	H2001_001_0	5	4	Specialty			
H2001	003	0	1	04	01	H2001_003_0	4	3	Non Preferred			
H2001	003	0	1	04	01	H2001_003_0	4	2	Preferred Brand			
H2001	003	0	1	04	01	H2001_003_0	4	1	Preferred Generic			
H2001	003	0	1	04	01	H2001_003_0	4	4	Specialty			
H2003	001	0	1	04	01	H2003_001_0	4	1	Preferred Generic			
H2003	001	0	1	04	01	H2003_001_0	4	2	Preferred Brand			
H2003	001	0	1	04	01	H2003_001_0	4	3	Non Preferred			
H2003	001	0	1	04	01	H2003_001_0	4	4	Specialty			
H2003	002	0	1	04	01	H2003_002_0	4	1	Preferred Generic			
H2003	002	0	1	04	01	H2003_002_0	4	2	Preferred Brand			
H2003	002	0	1	04	01	H2003_002_0	4	3	Non Preferred			
H2003	002	0	1	04	01	H2003_002_0	4	4	Specialty			
H2029	001	0	1	04	01	H2029_001_0	4	3	Non-Preferred Brand	1	10000000	2
H2029	001	0	1	04	01	H2029_001_0	4	4	Specialty	1	10001000	2
H2029	001	0	1	04	01	H2029_001_0	4	2	Preferred Brand	1	10000000	2
H2029	001	0	1	04	01	H2029_001_0	4	1	Preferred Generic	1		1
H2029	001	0	1	04	01	H2029_001_0	4	4	Specialty			
H2029	001	0	1	04	01	H2029_001_0	4	3	Non-Preferred Brand			
H2029	001	0	1	04	01	H2029_001_0	4	2	Preferred Brand			
H2029	001	0	1	04	01	H2029_001_0	4	1	Preferred Generic			
H2047	001	0	1	04	01	H2047_001_0	6	1	Tier 1 - Preferred Generic			
H2047	001	0	1	04	01	H2047_001_0	6	2	Tier 2 - Non-Preferred Generic			
H2047	001	0	1	04	01	H2047_001_0	6	3	Tier 3 - Preferred Brand			
H2047	001	0	1	04	01	H2047_001_0	6	4	Tier 4 - Non-Preferred Brand			
H2047	001	0	1	04	01	H2047_001_0	6	5	Tier 5 - Specialty			
H2047	002	0	1	04	01	H2047_002_0	5	3	Tier 3 - Preferred Brand	2		
H2047	002	0	1	04	01	H2047_002_0	5	4	Tier 4 - Non-Preferred Brand	2		
H2047	002	0	1	04	01	H2047_002_0	5	2	Tier 2 - Non-Preferred Generic			
H2047	002	0	1	04	01	H2047_002_0	5	1	Tier 1 - Preferred Generic			
H2047	002	0	1	04	01	H2047_002_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H2047	002	0	1	04	01	H2047_002_0	5	1	Tier 1 - Preferred Generic	1		1
H2047	002	0	1	04	01	H2047_002_0	5	5	Tier 5 - Specialty			
H2047	002	0	1	04	01	H2047_002_0	5	5	Tier 5 - Specialty	2		
H2047	002	0	1	04	01	H2047_002_0	5	3	Tier 3 - Preferred Brand			
H2047	002	0	1	04	01	H2047_002_0	5	4	Tier 4 - Non-Preferred Brand			
H2108	022	0	1	01	01	H2108_022_0	2	1	Generic			
H2108	022	0	1	01	01	H2108_022_0	2	2	Preferred Brand			
H2108	022	0	1	01	01	H2108_022_0	2	3	Non-Preferred Brand			
H2108	022	0	1	01	01	H2108_022_0	2	4	Specialty			
H2108	023	0	1	02	01	H2108_023_0	2	1	Generic			
H2108	023	0	1	02	01	H2108_023_0	2	2	Preferred Brand			
H2108	023	0	1	02	01	H2108_023_0	2	3	Non-Preferred Brand			
H2108	023	0	1	02	01	H2108_023_0	2	4	Specialty			
H2108	026	0	1	02	01	H2108_026_0	2	3	Non-Preferred Brand			
H2108	026	0	1	02	01	H2108_026_0	2	2	Preferred Brand			
H2108	026	0	1	02	01	H2108_026_0	2	1	Generic			
H2108	026	0	1	02	01	H2108_026_0	2	4	Specialty			
H2108	028	0	1	01	01	H2108_028_0	2	1	Generic			
H2108	028	0	1	01	01	H2108_028_0	2	2	Preferred Brand			
H2108	028	0	1	01	01	H2108_028_0	2	3	Non-Preferred Brand			
H2108	028	0	1	01	01	H2108_028_0	2	4	Specialty			
H2111	001	0	1	04	01	H2111_001_0	4	4	Specialty			
H2111	001	0	1	04	01	H2111_001_0	4	1	Preferred Generic			
H2111	001	0	1	04	01	H2111_001_0	4	2	Preferred Brand			
H2111	001	0	1	04	01	H2111_001_0	4	3	Non Preferred			
H2111	011	0	1	04	01	H2111_011_0	3	4	Specialty			
H2111	011	0	1	04	01	H2111_011_0	3	3	Non Preferred			
H2111	011	0	1	04	01	H2111_011_0	3	1	Preferred Generic			
H2111	011	0	1	04	01	H2111_011_0	3	2	Preferred Brand			
H2111	012	0	1	04	01	H2111_012_0	3	3	Non Preferred			
H2111	012	0	1	04	01	H2111_012_0	3	2	Preferred Brand			
H2111	012	0	1	04	01	H2111_012_0	3	1	Preferred Generic			
H2111	012	0	1	04	01	H2111_012_0	3	4	Specialty			
H2111	013	0	1	04	01	H2111_013_0	3	3	Non Preferred			
H2111	013	0	1	04	01	H2111_013_0	3	4	Specialty			
H2111	013	0	1	04	01	H2111_013_0	3	1	Preferred Generic			
H2111	013	0	1	04	01	H2111_013_0	3	2	Preferred Brand			
H2112	002	0	1	01	01	H2112_002_0	6	5	Tier 5 - Specialty			
H2112	002	0	1	01	01	H2112_002_0	6	4	Tier 4 - Non-Preferred Brand			
H2112	002	0	1	01	01	H2112_002_0	6	3	Tier 3 - Preferred Brand			
H2112	002	0	1	01	01	H2112_002_0	6	2	Tier 2 - Non-Preferred Generic			
H2112	002	0	1	01	01	H2112_002_0	6	1	Tier 1 - Preferred Generic			
H2112	002	0	1	01	01	H2112_002_0	6	1	Tier 1 - Preferred Generic	1		1
H2112	002	0	1	01	01	H2112_002_0	6	5	Tier 5 - Specialty	2		
H2112	002	0	1	01	01	H2112_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H2112	002	0	1	01	01	H2112_002_0	6	3	Tier 3 - Preferred Brand	2		
H2112	002	0	1	01	01	H2112_002_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H2112	007	0	1	01	01	H2112_007_0	6	4	Tier 4 - Non-Preferred Brand			
H2112	007	0	1	01	01	H2112_007_0	6	3	Tier 3 - Preferred Brand			
H2112	007	0	1	01	01	H2112_007_0	6	2	Tier 2 - Non-Preferred Generic			
H2112	007	0	1	01	01	H2112_007_0	6	1	Tier 1 - Preferred Generic			
H2112	007	0	1	01	01	H2112_007_0	6	5	Tier 5 - Specialty			
H2112	009	0	1	01	01	H2112_009_0	5	4	Tier 4 - Non-Preferred Brand			
H2112	009	0	1	01	01	H2112_009_0	5	5	Tier 5 - Specialty			
H2112	009	0	1	01	01	H2112_009_0	5	1	Tier 1 - Preferred Generic	1		1
H2112	009	0	1	01	01	H2112_009_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H2112	009	0	1	01	01	H2112_009_0	5	3	Tier 3 - Preferred Brand	2		
H2112	009	0	1	01	01	H2112_009_0	5	4	Tier 4 - Non-Preferred Brand	2		
H2112	009	0	1	01	01	H2112_009_0	5	5	Tier 5 - Specialty	2		
H2112	009	0	1	01	01	H2112_009_0	5	1	Tier 1 - Preferred Generic			
H2112	009	0	1	01	01	H2112_009_0	5	2	Tier 2 - Non-Preferred Generic			
H2112	009	0	1	01	01	H2112_009_0	5	3	Tier 3 - Preferred Brand			
H2112	011	0	1	01	01	H2112_011_0	6	4	Tier 4 - Non-Preferred Brand			
H2112	011	0	1	01	01	H2112_011_0	6	3	Tier 3 - Preferred Brand			
H2112	011	0	1	01	01	H2112_011_0	6	1	Tier 1 - Preferred Generic			
H2112	011	0	1	01	01	H2112_011_0	6	2	Tier 2 - Non-Preferred Generic			
H2112	011	0	1	01	01	H2112_011_0	6	5	Tier 5 - Specialty			
H2112	013	0	1	01	01	H2112_013_0	7	1	Tier 1 - Preferred Generic			
H2112	013	0	1	01	01	H2112_013_0	7	2	Tier 2 - Non-Preferred Generic			
H2112	013	0	1	01	01	H2112_013_0	7	3	Tier 3 - Preferred Brand			
H2112	013	0	1	01	01	H2112_013_0	7	4	Tier 4 - Non-Preferred Brand			
H2112	013	0	1	01	01	H2112_013_0	7	5	Tier 5 - Specialty			
H2112	014	0	1	01	01	H2112_014_0	7	4	Tier 4 - Non-Preferred Brand			
H2112	014	0	1	01	01	H2112_014_0	7	3	Tier 3 - Preferred Brand			
H2112	014	0	1	01	01	H2112_014_0	7	2	Tier 2 - Non-Preferred Generic			
H2112	014	0	1	01	01	H2112_014_0	7	1	Tier 1 - Preferred Generic			
H2112	014	0	1	01	01	H2112_014_0	7	5	Tier 5 - Specialty			
H2112	015	0	1	01	01	H2112_015_0	6	1	Tier 1 - Preferred Generic			
H2112	015	0	1	01	01	H2112_015_0	6	2	Tier 2 - Non-Preferred Generic			
H2112	015	0	1	01	01	H2112_015_0	6	3	Tier 3 - Preferred Brand			
H2112	015	0	1	01	01	H2112_015_0	6	4	Tier 4 - Non-Preferred Brand			
H2112	015	0	1	01	01	H2112_015_0	6	5	Tier 5 - Specialty			
H2150	002	0	1	18	06	H2150_002_0	7	1	Generic			
H2150	002	0	1	18	06	H2150_002_0	7	2	Brand			
H2150	002	0	1	18	06	H2150_002_0	7	3	Specialty	2		
H2150	002	0	1	18	06	H2150_002_0	7	2	Brand	2		
H2150	002	0	1	18	06	H2150_002_0	7	3	Specialty			
H2150	002	0	1	18	06	H2150_002_0	7	1	Generic	1		1
H2150	009	0	1	18	06	H2150_009_0	8	2	Brand			
H2150	009	0	1	18	06	H2150_009_0	8	1	Generic			
H2150	009	0	1	18	06	H2150_009_0	8	3	Specialty			
H2150	028	0	2	18	06	H2150_028_0	11	2	Brand			
H2150	028	0	2	18	06	H2150_028_0	11	1	Generic			
H2150	028	0	2	18	06	H2150_028_0	11	3	Specialty			
H2150	028	0	2	18	06	H2150_028_0	11	3	Specialty	2		
H2150	028	0	2	18	06	H2150_028_0	11	2	Brand	2		
H2150	028	0	2	18	06	H2150_028_0	11	1	Generic	1		1
H2150	029	0	2	18	06	H2150_029_0	11	1	Generic			
H2150	029	0	2	18	06	H2150_029_0	11	2	Brand			
H2150	029	0	2	18	06	H2150_029_0	11	3	Specialty			
H2169	002	0	1	01	01	H2169_002_0	4	2	Preferred Brand			
H2169	002	0	1	01	01	H2169_002_0	4	4	Specialty			
H2169	002	0	1	01	01	H2169_002_0	4	3	Non-Preferred Brand			
H2169	002	0	1	01	01	H2169_002_0	4	1	Generic			
H2169	003	0	1	01	01	H2169_003_0	3	1	Generic			
H2169	003	0	1	01	01	H2169_003_0	3	2	Preferred Brand			
H2169	003	0	1	01	01	H2169_003_0	3	3	Non-Preferred Brand			
H2169	003	0	1	01	01	H2169_003_0	3	4	Specialty			
H2169	005	0	1	01	01	H2169_005_0	4	1	Generic			
H2169	005	0	1	01	01	H2169_005_0	4	2	Preferred Brand			
H2169	005	0	1	01	01	H2169_005_0	4	3	Non-Preferred Brand			
H2169	005	0	1	01	01	H2169_005_0	4	4	Specialty			
H2169	006	0	1	01	01	H2169_006_0	3	2	Preferred Brand			
H2169	006	0	1	01	01	H2169_006_0	3	1	Generic			
H2169	006	0	1	01	01	H2169_006_0	3	3	Non-Preferred Brand			
H2169	006	0	1	01	01	H2169_006_0	3	4	Specialty			
H2174	002	0	1	01	01	H2174_002_0	6	3	Non-Preferred Medication	2		
H2174	002	0	1	01	01	H2174_002_0	6	2	Preferred Brand	2		
H2174	002	0	1	01	01	H2174_002_0	6	1	Preferred Generic	1		1
H2174	002	0	1	01	01	H2174_002_0	6	3	Non-Preferred Medication			
H2174	002	0	1	01	01	H2174_002_0	6	1	Preferred Generic			
H2174	002	0	1	01	01	H2174_002_0	6	2	Preferred Brand			
H2182	001	0	1	02	01	H2182_001_0	6	4	Specialty			
H2182	001	0	1	02	01	H2182_001_0	6	3	Non Preferred			
H2182	001	0	1	02	01	H2182_001_0	6	2	Preferred Brand			
H2182	001	0	1	02	01	H2182_001_0	6	1	Preferred Generic			
H2228	001	0	1	04	01	H2228_001_0	5	4	Specialty			
H2228	001	0	1	04	01	H2228_001_0	5	3	Non Preferred			
H2228	001	0	1	04	01	H2228_001_0	5	2	Preferred Brand			
H2228	001	0	1	04	01	H2228_001_0	5	1	Preferred Generic			
H2228	002	0	1	04	01	H2228_002_0	6	4	Specialty			
H2228	002	0	1	04	01	H2228_002_0	6	3	Non Preferred			
H2228	002	0	1	04	01	H2228_002_0	6	2	Preferred Brand			
H2228	002	0	1	04	01	H2228_002_0	6	1	Preferred Generic			
H2228	009	0	1	04	01	H2228_009_0	4	3	Non Preferred			
H2228	009	0	1	04	01	H2228_009_0	4	4	Specialty			
H2228	009	0	1	04	01	H2228_009_0	4	2	Preferred Brand			
H2228	009	0	1	04	01	H2228_009_0	4	1	Preferred Generic			
H2229	028	0	1	04	01	H2229_028_0	6	2	Tier 2	2		
H2229	028	0	1	04	01	H2229_028_0	6	1	Tier 1	1		1
H2229	028	0	1	04	01	H2229_028_0	6	3	Tier 3			
H2229	028	0	1	04	01	H2229_028_0	6	2	Tier 2			
H2229	028	0	1	04	01	H2229_028_0	6	1	Tier 1			
H2229	028	0	1	04	01	H2229_028_0	6	3	Tier 3	2		
H2229	029	0	1	04	01	H2229_029_0	6	1	Tier 1			
H2229	029	0	1	04	01	H2229_029_0	6	2	Tier 2			
H2229	029	0	1	04	01	H2229_029_0	6	3	Tier 3			
H2230	002	0	1	04	01	H2230_002_0	8	3	Non-Preferred Brand			
H2230	002	0	1	04	01	H2230_002_0	8	4	Speciality Medications			
H2230	002	0	1	04	01	H2230_002_0	8	1	Generic			
H2230	002	0	1	04	01	H2230_002_0	8	2	Preferred Brand			
H2230	006	0	1	04	01	H2230_006_0	7	1	Generic			
H2230	006	0	1	04	01	H2230_006_0	7	2	Preferred Brand			
H2230	006	0	1	04	01	H2230_006_0	7	3	Non-Preferred Brand			
H2230	006	0	1	04	01	H2230_006_0	7	4	Specialty Medication			
H2230	006	0	1	04	01	H2230_006_0	7	1	Generic	1		1
H2230	006	0	1	04	01	H2230_006_0	7	2	Preferred Brand	2		
H2230	006	0	1	04	01	H2230_006_0	7	3	Non-Preferred Brand	2		
H2230	006	0	1	04	01	H2230_006_0	7	4	Specialty Medication	2		
H2237	001	0	1	01	01	H2237_001_0	5	2	Other			
H2237	001	0	1	01	01	H2237_001_0	5	1	Generic			
H2237	002	0	1	01	01	H2237_002_0	5	2	Other			
H2237	002	0	1	01	01	H2237_002_0	5	1	Generic			
H2237	006	0	1	01	01	H2237_006_0	5	1	Generic			
H2237	006	0	1	01	01	H2237_006_0	5	2	Brand			
H2237	006	0	1	01	01	H2237_006_0	5	3	Specialty			
H2256	001	1	1	01	01	H2256_001_1	8	3	Tier 3			
H2256	001	1	1	01	01	H2256_001_1	8	1	Tier 1	1		1
H2256	001	1	1	01	01	H2256_001_1	8	2	Tier 2			
H2256	001	1	1	01	01	H2256_001_1	8	1	Tier 1			
H2256	001	1	1	01	01	H2256_001_1	8	2	Tier 2	2		
H2256	001	1	1	01	01	H2256_001_1	8	3	Tier 3	2		
H2256	001	2	1	01	01	H2256_001_2	9	2	Tier 2			
H2256	001	2	1	01	01	H2256_001_2	9	1	Tier 1			
H2256	001	2	1	01	01	H2256_001_2	9	3	Tier 3			
H2256	001	2	1	01	01	H2256_001_2	9	3	Tier 3	2		
H2256	001	2	1	01	01	H2256_001_2	9	2	Tier 2	2		
H2256	001	2	1	01	01	H2256_001_2	9	1	Tier 1	1		1
H2256	015	1	1	01	01	H2256_015_1	8	1	Tier 1			
H2256	015	1	1	01	01	H2256_015_1	8	2	Tier 2			
H2256	015	1	1	01	01	H2256_015_1	8	3	Tier 3			
H2256	015	2	1	01	01	H2256_015_2	8	2	Tier 2			
H2256	015	2	1	01	01	H2256_015_2	8	1	Tier 1			
H2256	015	2	1	01	01	H2256_015_2	8	3	Tier 3			
H2256	017	1	1	01	01	H2256_017_1	8	1	Tier 1	1		1
H2256	017	1	1	01	01	H2256_017_1	8	3	Tier 3			
H2256	017	1	1	01	01	H2256_017_1	8	2	Tier 2			
H2256	017	1	1	01	01	H2256_017_1	8	1	Tier 1			
H2256	017	1	1	01	01	H2256_017_1	8	2	Tier 2	2		
H2256	017	1	1	01	01	H2256_017_1	8	3	Tier 3	2		
H2256	017	7	1	01	01	H2256_017_7	8	1	Tier 1			
H2256	017	7	1	01	01	H2256_017_7	8	2	Tier 2			
H2256	017	7	1	01	01	H2256_017_7	8	3	Tier 3			
H2256	017	7	1	01	01	H2256_017_7	8	1	Tier 1	1		1
H2256	017	7	1	01	01	H2256_017_7	8	2	Tier 2	2		
H2256	017	7	1	01	01	H2256_017_7	8	3	Tier 3	2		
H2256	018	1	1	01	01	H2256_018_1	8	1	Tier 1			
H2256	018	1	1	01	01	H2256_018_1	8	2	Tier 2			
H2256	018	1	1	01	01	H2256_018_1	8	3	Tier 3			
H2256	018	7	1	01	01	H2256_018_7	7	1	Tier 1			
H2256	018	7	1	01	01	H2256_018_7	7	2	Tier 2			
H2256	018	7	1	01	01	H2256_018_7	7	3	Tier 3			
H2256	023	0	1	01	01	H2256_023_0	5	1	Tier 1			
H2256	023	0	1	01	01	H2256_023_0	5	2	Tier 2			
H2256	023	0	1	01	01	H2256_023_0	5	3	Tier 3			
H2256	023	0	1	01	01	H2256_023_0	5	1	Tier 1	1		1
H2256	023	0	1	01	01	H2256_023_0	5	2	Tier 2	2		
H2256	023	0	1	01	01	H2256_023_0	5	3	Tier 3	2		
H2256	024	0	1	01	01	H2256_024_0	5	1	Tier 1			
H2256	024	0	1	01	01	H2256_024_0	5	2	Tier 2			
H2256	024	0	1	01	01	H2256_024_0	5	3	Tier 3			
H2261	005	0	1	01	01	H2261_005_0	4	3	Non-Preferred Brand			
H2261	005	0	1	01	01	H2261_005_0	4	2	Preferred Brand			
H2261	005	0	1	01	01	H2261_005_0	4	1	Generic			
H2261	005	0	1	01	01	H2261_005_0	4	4	Specialty Medication			
H2261	011	0	1	01	01	H2261_011_0	4	1	Generic	1		1
H2261	011	0	1	01	01	H2261_011_0	4	2	Preferred Brand	2		
H2261	011	0	1	01	01	H2261_011_0	4	3	Non-Preferred Brand	2		
H2261	011	0	1	01	01	H2261_011_0	4	4	Specialty Medication			
H2261	011	0	1	01	01	H2261_011_0	4	3	Non-Preferred Brand			
H2261	011	0	1	01	01	H2261_011_0	4	4	Specialty Medication	2		
H2261	011	0	1	01	01	H2261_011_0	4	1	Generic			
H2261	011	0	1	01	01	H2261_011_0	4	2	Preferred Brand			
H2291	002	0	1	01	01	H2291_002_0	6	1	Generic			
H2291	002	0	1	01	01	H2291_002_0	6	4	Specialty			
H2291	002	0	1	01	01	H2291_002_0	6	3	Non-Preferred Brand			
H2291	002	0	1	01	01	H2291_002_0	6	2	Preferred Brand			
H2312	004	0	1	01	01	H2312_004_0	10	3	Tier 3			
H2312	004	0	1	01	01	H2312_004_0	10	2	Tier 2			
H2312	004	0	1	01	01	H2312_004_0	10	1	Tier 1			
H2312	004	0	1	01	01	H2312_004_0	10	4	Tier 4			
H2312	007	0	1	01	01	H2312_007_0	8	1	Tier 1			
H2312	007	0	1	01	01	H2312_007_0	8	2	Tier 2			
H2312	007	0	1	01	01	H2312_007_0	8	3	Tier 3			
H2312	007	0	1	01	01	H2312_007_0	8	4	Tier 4			
H2312	009	0	1	01	01	H2312_009_0	8	3	Tier 3			
H2312	009	0	1	01	01	H2312_009_0	8	2	Tier 2			
H2312	009	0	1	01	01	H2312_009_0	8	1	Tier 1			
H2312	009	0	1	01	01	H2312_009_0	8	4	Tier 4			
H2312	009	0	1	01	01	H2312_009_0	8	4	Tier 4	2		
H2312	009	0	1	01	01	H2312_009_0	8	3	Tier 3	2		
H2312	009	0	1	01	01	H2312_009_0	8	2	Tier 2	2		
H2312	009	0	1	01	01	H2312_009_0	8	1	Tier 1	1		1
H2312	010	0	1	01	01	H2312_010_0	8	1	Tier 1			
H2312	010	0	1	01	01	H2312_010_0	8	2	Tier 2			
H2312	010	0	1	01	01	H2312_010_0	8	3	Tier 3			
H2312	010	0	1	01	01	H2312_010_0	8	3	Tier 3	2		
H2312	010	0	1	01	01	H2312_010_0	8	2	Tier 2	2		
H2312	010	0	1	01	01	H2312_010_0	8	1	Tier 1	1		1
H2312	010	0	1	01	01	H2312_010_0	8	4	Tier 4			
H2312	010	0	1	01	01	H2312_010_0	8	4	Tier 4	2		
H2319	008	3	1	09	04	H2319_008_3	9	2	Preferred Brand			
H2319	008	3	1	09	04	H2319_008_3	9	1	Generic			
H2319	008	3	1	09	04	H2319_008_3	9	3	Non Preferred			
H2319	008	3	1	09	04	H2319_008_3	9	4	Specialty			
H2319	008	3	1	09	04	H2319_008_3	9	5	Non Self Administered Injectable			
H2319	008	4	1	09	04	H2319_008_4	8	2	Preferred Brand			
H2319	008	4	1	09	04	H2319_008_4	8	1	Generic			
H2319	008	4	1	09	04	H2319_008_4	8	3	Non Preferred			
H2319	008	4	1	09	04	H2319_008_4	8	5	Non Self Administered Injectable			
H2319	008	4	1	09	04	H2319_008_4	8	4	Specialty			
H2319	008	5	1	09	04	H2319_008_5	8	1	Generic			
H2319	008	5	1	09	04	H2319_008_5	8	2	Preferred Brand			
H2319	008	5	1	09	04	H2319_008_5	8	4	Specialty			
H2319	008	5	1	09	04	H2319_008_5	8	3	Non Preferred			
H2319	008	5	1	09	04	H2319_008_5	8	5	Non Self Administered Injectable			
H2319	008	7	1	09	04	H2319_008_7	9	4	Specialty			
H2319	008	7	1	09	04	H2319_008_7	9	5	Non Self Administered Injectable			
H2319	008	7	1	09	04	H2319_008_7	9	3	Non Preferred			
H2319	008	7	1	09	04	H2319_008_7	9	2	Preferred Brand			
H2319	008	7	1	09	04	H2319_008_7	9	1	Generic			
H2319	008	8	1	09	04	H2319_008_8	8	2	Preferred Brand			
H2319	008	8	1	09	04	H2319_008_8	8	3	Non Preferred			
H2319	008	8	1	09	04	H2319_008_8	8	4	Specialty			
H2319	008	8	1	09	04	H2319_008_8	8	5	Non Self Administered Injectable			
H2319	008	8	1	09	04	H2319_008_8	8	1	Generic			
H2319	009	1	1	09	04	H2319_009_1	8	2	Preferred Brand			
H2319	009	1	1	09	04	H2319_009_1	8	3	Non Preferred			
H2319	009	1	1	09	04	H2319_009_1	8	4	Specialty			
H2319	009	1	1	09	04	H2319_009_1	8	5	Non Self Administered Injectable			
H2319	009	1	1	09	04	H2319_009_1	8	1	Generic			
H2319	009	2	1	09	04	H2319_009_2	8	5	Non Self Administered Injectable			
H2319	009	2	1	09	04	H2319_009_2	8	4	Specialty			
H2319	009	2	1	09	04	H2319_009_2	8	3	Non Preferred			
H2319	009	2	1	09	04	H2319_009_2	8	2	Preferred Brand			
H2319	009	2	1	09	04	H2319_009_2	8	1	Generic			
H2319	009	3	1	09	04	H2319_009_3	8	3	Non Preferred			
H2319	009	3	1	09	04	H2319_009_3	8	4	Specialty			
H2319	009	3	1	09	04	H2319_009_3	8	5	Non Self Administered Injectable			
H2319	009	3	1	09	04	H2319_009_3	8	2	Preferred Brand			
H2319	009	3	1	09	04	H2319_009_3	8	1	Generic			
H2319	009	4	1	09	04	H2319_009_4	8	2	Preferred Brand			
H2319	009	4	1	09	04	H2319_009_4	8	3	Non Preferred			
H2319	009	4	1	09	04	H2319_009_4	8	4	Specialty			
H2319	009	4	1	09	04	H2319_009_4	8	1	Generic			
H2319	009	4	1	09	04	H2319_009_4	8	5	Non Self Administered Injectable			
H2319	009	5	1	09	04	H2319_009_5	8	1	Generic			
H2319	009	5	1	09	04	H2319_009_5	8	3	Non Preferred			
H2319	009	5	1	09	04	H2319_009_5	8	2	Preferred Brand			
H2319	009	5	1	09	04	H2319_009_5	8	4	Specialty			
H2319	009	5	1	09	04	H2319_009_5	8	5	Non Self Administered Injectable			
H2319	009	6	1	09	04	H2319_009_6	8	1	Generic			
H2319	009	6	1	09	04	H2319_009_6	8	2	Preferred Brand			
H2319	009	6	1	09	04	H2319_009_6	8	3	Non Preferred			
H2319	009	6	1	09	04	H2319_009_6	8	4	Specialty			
H2319	009	6	1	09	04	H2319_009_6	8	5	Non Self Administered Injectable			
H2319	010	1	1	09	04	H2319_010_1	8	4	Specialty			
H2319	010	1	1	09	04	H2319_010_1	8	3	Non Preferred			
H2319	010	1	1	09	04	H2319_010_1	8	2	Preferred Brand			
H2319	010	1	1	09	04	H2319_010_1	8	1	Generic			
H2319	010	1	1	09	04	H2319_010_1	8	5	Non Self Administered Injectable	2		
H2319	010	1	1	09	04	H2319_010_1	8	1	Generic	1		1
H2319	010	1	1	09	04	H2319_010_1	8	2	Preferred Brand	2		
H2319	010	1	1	09	04	H2319_010_1	8	3	Non Preferred	2		
H2319	010	1	1	09	04	H2319_010_1	8	4	Specialty	2		
H2319	010	1	1	09	04	H2319_010_1	8	5	Non Self Administered Injectable			
H2319	010	2	1	09	04	H2319_010_2	8	4	Specialty			
H2319	010	2	1	09	04	H2319_010_2	8	3	Non Preferred			
H2319	010	2	1	09	04	H2319_010_2	8	2	Preferred Brand			
H2319	010	2	1	09	04	H2319_010_2	8	1	Generic			
H2319	010	2	1	09	04	H2319_010_2	8	5	Non Self Administered Injectable			
H2319	010	2	1	09	04	H2319_010_2	8	5	Non Self Administered Injectable	2		
H2319	010	2	1	09	04	H2319_010_2	8	4	Specialty	2		
H2319	010	2	1	09	04	H2319_010_2	8	3	Non Preferred	2		
H2319	010	2	1	09	04	H2319_010_2	8	2	Preferred Brand	2		
H2319	010	2	1	09	04	H2319_010_2	8	1	Generic	1		1
H2319	010	3	1	09	04	H2319_010_3	8	1	Generic			
H2319	010	3	1	09	04	H2319_010_3	8	2	Preferred Brand			
H2319	010	3	1	09	04	H2319_010_3	8	3	Non Preferred			
H2319	010	3	1	09	04	H2319_010_3	8	4	Specialty			
H2319	010	3	1	09	04	H2319_010_3	8	5	Non Self Administered Injectable	2		
H2319	010	3	1	09	04	H2319_010_3	8	3	Non Preferred	2		
H2319	010	3	1	09	04	H2319_010_3	8	2	Preferred Brand	2		
H2319	010	3	1	09	04	H2319_010_3	8	1	Generic	1		1
H2319	010	3	1	09	04	H2319_010_3	8	5	Non Self Administered Injectable			
H2319	010	3	1	09	04	H2319_010_3	8	4	Specialty	2		
H2319	010	4	1	09	04	H2319_010_4	8	5	Non Self Administered Injectable	2		
H2319	010	4	1	09	04	H2319_010_4	8	1	Generic			
H2319	010	4	1	09	04	H2319_010_4	8	2	Preferred Brand			
H2319	010	4	1	09	04	H2319_010_4	8	3	Non Preferred			
H2319	010	4	1	09	04	H2319_010_4	8	4	Specialty			
H2319	010	4	1	09	04	H2319_010_4	8	5	Non Self Administered Injectable			
H2319	010	4	1	09	04	H2319_010_4	8	1	Generic	1		1
H2319	010	4	1	09	04	H2319_010_4	8	2	Preferred Brand	2		
H2319	010	4	1	09	04	H2319_010_4	8	3	Non Preferred	2		
H2319	010	4	1	09	04	H2319_010_4	8	4	Specialty	2		
H2319	010	5	1	09	04	H2319_010_5	8	1	Generic			
H2319	010	5	1	09	04	H2319_010_5	8	2	Preferred Brand			
H2319	010	5	1	09	04	H2319_010_5	8	5	Non Self Administered Injectable	2		
H2319	010	5	1	09	04	H2319_010_5	8	4	Specialty	2		
H2319	010	5	1	09	04	H2319_010_5	8	3	Non Preferred	2		
H2319	010	5	1	09	04	H2319_010_5	8	2	Preferred Brand	2		
H2319	010	5	1	09	04	H2319_010_5	8	1	Generic	1		1
H2319	010	5	1	09	04	H2319_010_5	8	5	Non Self Administered Injectable			
H2319	010	5	1	09	04	H2319_010_5	8	4	Specialty			
H2319	010	5	1	09	04	H2319_010_5	8	3	Non Preferred			
H2319	010	6	1	09	04	H2319_010_6	8	1	Generic			
H2319	010	6	1	09	04	H2319_010_6	8	4	Specialty	2		
H2319	010	6	1	09	04	H2319_010_6	8	3	Non Preferred	2		
H2319	010	6	1	09	04	H2319_010_6	8	2	Preferred Brand	2		
H2319	010	6	1	09	04	H2319_010_6	8	5	Non Self Administered Injectable	2		
H2319	010	6	1	09	04	H2319_010_6	8	5	Non Self Administered Injectable			
H2319	010	6	1	09	04	H2319_010_6	8	4	Specialty			
H2319	010	6	1	09	04	H2319_010_6	8	3	Non Preferred			
H2319	010	6	1	09	04	H2319_010_6	8	2	Preferred Brand			
H2319	010	6	1	09	04	H2319_010_6	8	1	Generic	1		1
H2319	011	1	1	09	04	H2319_011_1	8	1	Generic			
H2319	011	1	1	09	04	H2319_011_1	8	2	Preferred Brand			
H2319	011	1	1	09	04	H2319_011_1	8	3	Non Preferred			
H2319	011	1	1	09	04	H2319_011_1	8	4	Specialty			
H2319	011	1	1	09	04	H2319_011_1	8	5	Non Self Administered Injectable			
H2319	011	1	1	09	04	H2319_011_1	8	1	Generic	1		1
H2319	011	1	1	09	04	H2319_011_1	8	2	Preferred Brand	2		
H2319	011	1	1	09	04	H2319_011_1	8	3	Non Preferred	2		
H2319	011	1	1	09	04	H2319_011_1	8	4	Specialty	2		
H2319	011	1	1	09	04	H2319_011_1	8	5	Non Self Administered Injectable	2		
H2319	011	2	1	09	04	H2319_011_2	8	4	Specialty			
H2319	011	2	1	09	04	H2319_011_2	8	3	Non Preferred			
H2319	011	2	1	09	04	H2319_011_2	8	5	Non Self Administered Injectable	2		
H2319	011	2	1	09	04	H2319_011_2	8	4	Specialty	2		
H2319	011	2	1	09	04	H2319_011_2	8	3	Non Preferred	2		
H2319	011	2	1	09	04	H2319_011_2	8	2	Preferred Brand	2		
H2319	011	2	1	09	04	H2319_011_2	8	1	Generic	1		1
H2319	011	2	1	09	04	H2319_011_2	8	5	Non Self Administered Injectable			
H2319	011	2	1	09	04	H2319_011_2	8	1	Generic			
H2319	011	2	1	09	04	H2319_011_2	8	2	Preferred Brand			
H2319	011	3	1	09	04	H2319_011_3	8	1	Generic			
H2319	011	3	1	09	04	H2319_011_3	8	4	Specialty	2		
H2319	011	3	1	09	04	H2319_011_3	8	3	Non Preferred	2		
H2319	011	3	1	09	04	H2319_011_3	8	2	Preferred Brand	2		
H2319	011	3	1	09	04	H2319_011_3	8	5	Non Self Administered Injectable	2		
H2319	011	3	1	09	04	H2319_011_3	8	5	Non Self Administered Injectable			
H2319	011	3	1	09	04	H2319_011_3	8	4	Specialty			
H2319	011	3	1	09	04	H2319_011_3	8	3	Non Preferred			
H2319	011	3	1	09	04	H2319_011_3	8	2	Preferred Brand			
H2319	011	3	1	09	04	H2319_011_3	8	1	Generic	1		1
H2319	011	4	1	09	04	H2319_011_4	8	4	Specialty			
H2319	011	4	1	09	04	H2319_011_4	8	3	Non Preferred			
H2319	011	4	1	09	04	H2319_011_4	8	2	Preferred Brand			
H2319	011	4	1	09	04	H2319_011_4	8	1	Generic			
H2319	011	4	1	09	04	H2319_011_4	8	5	Non Self Administered Injectable			
H2319	011	4	1	09	04	H2319_011_4	8	5	Non Self Administered Injectable	2		
H2319	011	4	1	09	04	H2319_011_4	8	4	Specialty	2		
H2319	011	4	1	09	04	H2319_011_4	8	3	Non Preferred	2		
H2319	011	4	1	09	04	H2319_011_4	8	2	Preferred Brand	2		
H2319	011	4	1	09	04	H2319_011_4	8	1	Generic	1		1
H2319	011	5	1	09	04	H2319_011_5	8	1	Generic			
H2319	011	5	1	09	04	H2319_011_5	8	2	Preferred Brand			
H2319	011	5	1	09	04	H2319_011_5	8	5	Non Self Administered Injectable	2		
H2319	011	5	1	09	04	H2319_011_5	8	4	Specialty	2		
H2319	011	5	1	09	04	H2319_011_5	8	3	Non Preferred	2		
H2319	011	5	1	09	04	H2319_011_5	8	2	Preferred Brand	2		
H2319	011	5	1	09	04	H2319_011_5	8	1	Generic	1		1
H2319	011	5	1	09	04	H2319_011_5	8	5	Non Self Administered Injectable			
H2319	011	5	1	09	04	H2319_011_5	8	4	Specialty			
H2319	011	5	1	09	04	H2319_011_5	8	3	Non Preferred			
H2319	011	6	1	09	04	H2319_011_6	8	1	Generic			
H2319	011	6	1	09	04	H2319_011_6	8	5	Non Self Administered Injectable			
H2319	011	6	1	09	04	H2319_011_6	8	1	Generic	1		1
H2319	011	6	1	09	04	H2319_011_6	8	2	Preferred Brand	2		
H2319	011	6	1	09	04	H2319_011_6	8	5	Non Self Administered Injectable	2		
H2319	011	6	1	09	04	H2319_011_6	8	4	Specialty	2		
H2319	011	6	1	09	04	H2319_011_6	8	4	Specialty			
H2319	011	6	1	09	04	H2319_011_6	8	3	Non Preferred			
H2319	011	6	1	09	04	H2319_011_6	8	2	Preferred Brand			
H2319	011	6	1	09	04	H2319_011_6	8	3	Non Preferred	2		
H2320	007	0	1	02	01	H2320_007_0	4	3	Non-Preferred Brand			
H2320	007	0	1	02	01	H2320_007_0	4	2	Preferred Brand on Formulary			
H2320	007	0	1	02	01	H2320_007_0	4	1	Generic Drugs			
H2320	007	0	1	02	01	H2320_007_0	4	4	Specialty Tier			
H2320	008	0	1	02	01	H2320_008_0	4	1	Generic Drugs			
H2320	008	0	1	02	01	H2320_008_0	4	2	Preferred Brand on Formulary			
H2320	008	0	1	02	01	H2320_008_0	4	3	Non-Preferred Brand			
H2320	008	0	1	02	01	H2320_008_0	4	4	Specialty Tier			
H2320	009	0	1	02	01	H2320_009_0	5	3	Non-Preferred Brand			
H2320	009	0	1	02	01	H2320_009_0	5	2	Preferred Brand on Formulary			
H2320	009	0	1	02	01	H2320_009_0	5	1	Generic Drugs			
H2320	009	0	1	02	01	H2320_009_0	5	4	Specialty Tier			
H2320	009	0	1	02	01	H2320_009_0	5	4	Specialty Tier	2		
H2320	009	0	1	02	01	H2320_009_0	5	3	Non-Preferred Brand	2		
H2320	009	0	1	02	01	H2320_009_0	5	2	Preferred Brand on Formulary	2		
H2320	009	0	1	02	01	H2320_009_0	5	1	Generic Drugs	1		1
H2320	010	0	1	02	01	H2320_010_0	5	1	Generic Drugs			
H2320	010	0	1	02	01	H2320_010_0	5	2	Preferred Brand on Formulary			
H2320	010	0	1	02	01	H2320_010_0	5	3	Non-Preferred Brand			
H2320	010	0	1	02	01	H2320_010_0	5	3	Non-Preferred Brand	2		
H2320	010	0	1	02	01	H2320_010_0	5	2	Preferred Brand on Formulary	2		
H2320	010	0	1	02	01	H2320_010_0	5	1	Generic Drugs	1		1
H2320	010	0	1	02	01	H2320_010_0	5	4	Specialty Tier			
H2320	010	0	1	02	01	H2320_010_0	5	4	Specialty Tier	2		
H2320	011	0	1	02	01	H2320_011_0	4	1	Generic Drugs			
H2320	011	0	1	02	01	H2320_011_0	4	2	Preferred Brand on Formulary			
H2320	011	0	1	02	01	H2320_011_0	4	4	Specialty Tier			
H2320	011	0	1	02	01	H2320_011_0	4	3	Non-Preferred Brand			
H2320	012	0	1	02	01	H2320_012_0	4	3	Non-Preferred Brand			
H2320	012	0	1	02	01	H2320_012_0	4	2	Preferred Brand on Formulary			
H2320	012	0	1	02	01	H2320_012_0	4	1	Generic Drugs			
H2320	012	0	1	02	01	H2320_012_0	4	4	Specialty Tier			
H2320	013	0	1	02	01	H2320_013_0	4	1	Generic Drugs			
H2320	013	0	1	02	01	H2320_013_0	4	2	Preferred Brand on Formulary			
H2320	013	0	1	02	01	H2320_013_0	4	3	Non-Preferred Brand			
H2320	013	0	1	02	01	H2320_013_0	4	4	Specialty Tier			
H2320	014	0	1	02	01	H2320_014_0	5	3	Non-Preferred Brand			
H2320	014	0	1	02	01	H2320_014_0	5	2	Preferred Brand on Formulary			
H2320	014	0	1	02	01	H2320_014_0	5	1	Generic Drugs			
H2320	014	0	1	02	01	H2320_014_0	5	4	Specialty Tier			
H2320	014	0	1	02	01	H2320_014_0	5	4	Specialty Tier	2		
H2320	014	0	1	02	01	H2320_014_0	5	3	Non-Preferred Brand	2		
H2320	014	0	1	02	01	H2320_014_0	5	2	Preferred Brand on Formulary	2		
H2320	014	0	1	02	01	H2320_014_0	5	1	Generic Drugs	1		1
H2320	015	0	1	02	01	H2320_015_0	4	1	Generic Drugs			
H2320	015	0	1	02	01	H2320_015_0	4	2	Preferred Brand on Formulary			
H2320	015	0	1	02	01	H2320_015_0	4	3	Non-Preferred Brand			
H2320	015	0	1	02	01	H2320_015_0	4	4	Specialty Tier			
H2320	016	0	1	02	01	H2320_016_0	4	2	Preferred Brand on Formulary			
H2320	016	0	1	02	01	H2320_016_0	4	3	Non-Preferred Brand			
H2320	016	0	1	02	01	H2320_016_0	4	1	Generic Drugs			
H2320	016	0	1	02	01	H2320_016_0	4	4	Specialty Tier			
H2320	017	0	1	02	01	H2320_017_0	5	3	Non-Preferred Brand			
H2320	017	0	1	02	01	H2320_017_0	5	4	Specialty Tier			
H2320	017	0	1	02	01	H2320_017_0	5	1	Generic Drugs	1		1
H2320	017	0	1	02	01	H2320_017_0	5	2	Preferred Brand on Formulary	2		
H2320	017	0	1	02	01	H2320_017_0	5	3	Non-Preferred Brand	2		
H2320	017	0	1	02	01	H2320_017_0	5	4	Specialty Tier	2		
H2320	017	0	1	02	01	H2320_017_0	5	1	Generic Drugs			
H2320	017	0	1	02	01	H2320_017_0	5	2	Preferred Brand on Formulary			
H2320	018	0	1	02	01	H2320_018_0	4	3	Non-Preferred Brand			
H2320	018	0	1	02	01	H2320_018_0	4	2	Preferred Brand on Formulary			
H2320	018	0	1	02	01	H2320_018_0	4	1	Generic Drugs			
H2320	018	0	1	02	01	H2320_018_0	4	4	Specialty Tier			
H2322	001	0	1	04	01	H2322_001_0	8	2	Tier 2			
H2322	001	0	1	04	01	H2322_001_0	8	3	Tier 3			
H2322	001	0	1	04	01	H2322_001_0	8	1	Tier 1			
H2322	001	0	1	04	01	H2322_001_0	8	4	Tier 4			
H2322	004	0	1	04	01	H2322_004_0	8	1	Tier 1			
H2322	004	0	1	04	01	H2322_004_0	8	3	Tier 3			
H2322	004	0	1	04	01	H2322_004_0	8	4	Tier 4			
H2322	004	0	1	04	01	H2322_004_0	8	4	Tier 4	2		
H2322	004	0	1	04	01	H2322_004_0	8	1	Tier 1	1		1
H2322	004	0	1	04	01	H2322_004_0	8	2	Tier 2			
H2322	004	0	1	04	01	H2322_004_0	8	2	Tier 2	2		
H2322	004	0	1	04	01	H2322_004_0	8	3	Tier 3	2		
H2322	006	0	1	04	01	H2322_006_0	9	4	Tier 4			
H2322	006	0	1	04	01	H2322_006_0	9	3	Tier 3			
H2322	006	0	1	04	01	H2322_006_0	9	1	Tier 1			
H2322	006	0	1	04	01	H2322_006_0	9	2	Tier 2			
H2322	007	0	1	04	01	H2322_007_0	8	4	Tier 4	2		
H2322	007	0	1	04	01	H2322_007_0	8	3	Tier 3	2		
H2322	007	0	1	04	01	H2322_007_0	8	2	Tier 2	2		
H2322	007	0	1	04	01	H2322_007_0	8	1	Tier 1	1		1
H2322	007	0	1	04	01	H2322_007_0	8	4	Tier 4			
H2322	007	0	1	04	01	H2322_007_0	8	3	Tier 3			
H2322	007	0	1	04	01	H2322_007_0	8	2	Tier 2			
H2322	007	0	1	04	01	H2322_007_0	8	1	Tier 1			
H2323	006	0	1	01	01	H2323_006_0	6	1	Generic			
H2323	006	0	1	01	01	H2323_006_0	6	2	Preferred Brand			
H2323	006	0	1	01	01	H2323_006_0	6	3	Non-Preferred Brand			
H2323	007	0	1	01	01	H2323_007_0	6	1	Generic			
H2323	007	0	1	01	01	H2323_007_0	6	2	Preferred Brand			
H2323	007	0	1	01	01	H2323_007_0	6	3	Non-Preferred Brand			
H2354	001	0	1	01	01	H2354_001_0	5	1	Generic			
H2354	001	0	1	01	01	H2354_001_0	5	2	Preferred Brand			
H2354	001	0	1	01	01	H2354_001_0	5	3	Non-Preferred Brand			
H2354	001	0	1	01	01	H2354_001_0	5	4	Injectable and Miscellaneous Drugs			
H2354	013	0	1	01	01	H2354_013_0	5	1	Generic			
H2354	013	0	1	01	01	H2354_013_0	5	2	Preferred Brand			
H2354	013	0	1	01	01	H2354_013_0	5	3	Non-Preferred Brand			
H2354	013	0	1	01	01	H2354_013_0	5	4	Injectable and Miscellaneous Drugs			
H2406	001	0	1	04	01	H2406_001_0	4	3	Non Preferred			
H2406	001	0	1	04	01	H2406_001_0	4	2	Preferred Brand			
H2406	001	0	1	04	01	H2406_001_0	4	1	Preferred Generic			
H2406	001	0	1	04	01	H2406_001_0	4	4	Specialty			
H2409	006	0	1	09	04	H2409_006_0	10	3	Non-Preferred Brand			
H2409	006	0	1	09	04	H2409_006_0	10	2	Preferred Brand			
H2409	006	0	1	09	04	H2409_006_0	10	1	Generic			
H2409	006	0	1	09	04	H2409_006_0	10	4	Specialty			
H2410	015	0	1	09	04	H2410_015_0	9	1	Generic			
H2410	015	0	1	09	04	H2410_015_0	9	2	Preferred Brand			
H2410	015	0	1	09	04	H2410_015_0	9	3	Non-Preferred Brand			
H2410	015	0	1	09	04	H2410_015_0	9	4	Specialty			
H2411	002	0	1	04	01	H2411_002_0	7	1	Tier 1			
H2411	002	0	1	04	01	H2411_002_0	7	2	Tier 2			
H2411	002	0	1	04	01	H2411_002_0	7	3	Tier 3			
H2425	001	0	1	01	01	H2425_001_0	6	1	Level 1: Generic			
H2425	001	0	1	01	01	H2425_001_0	6	2	Level 2: Preferred Brand			
H2425	001	0	1	01	01	H2425_001_0	6	3	Level 3: Brand			
H2425	001	0	1	01	01	H2425_001_0	6	4	Specialty	2		
H2425	001	0	1	01	01	H2425_001_0	6	1	Level 1: Generic	1		1
H2425	001	0	1	01	01	H2425_001_0	6	2	Level 2: Preferred Brand	2		
H2425	001	0	1	01	01	H2425_001_0	6	3	Level 3: Brand	2		
H2425	001	0	1	01	01	H2425_001_0	6	4	Specialty			
H2450	001	0	1	18	06	H2450_001_0	12	2	Preferred Brand			
H2450	001	0	1	18	06	H2450_001_0	12	3	Non-Preferred Brand			
H2450	001	0	1	18	06	H2450_001_0	12	1	Generic			
H2450	001	0	1	18	06	H2450_001_0	12	4	Specialty			
H2450	002	0	1	18	06	H2450_002_0	11	1	Generic			
H2450	002	0	1	18	06	H2450_002_0	11	3	Non-Preferred Brand			
H2450	002	0	1	18	06	H2450_002_0	11	2	Preferred Brand			
H2450	002	0	1	18	06	H2450_002_0	11	4	Specialty			
H2450	005	0	1	18	06	H2450_005_0	12	1	Generic			
H2450	005	0	1	18	06	H2450_005_0	12	2	Preferred Brand			
H2450	005	0	1	18	06	H2450_005_0	12	3	Non-Preferred Brand			
H2450	005	0	1	18	06	H2450_005_0	12	4	Specialty			
H2450	005	0	1	18	06	H2450_005_0	12	1	Generic	1		1
H2450	005	0	1	18	06	H2450_005_0	12	2	Preferred Brand	2		
H2450	005	0	1	18	06	H2450_005_0	12	3	Non-Preferred Brand	2		
H2450	005	0	1	18	06	H2450_005_0	12	4	Specialty	2		
H2450	006	0	1	18	06	H2450_006_0	11	3	Non-Preferred Brand	2		
H2450	006	0	1	18	06	H2450_006_0	11	2	Preferred Brand	2		
H2450	006	0	1	18	06	H2450_006_0	11	1	Generic	1		1
H2450	006	0	1	18	06	H2450_006_0	11	4	Specialty			
H2450	006	0	1	18	06	H2450_006_0	11	3	Non-Preferred Brand			
H2450	006	0	1	18	06	H2450_006_0	11	2	Preferred Brand			
H2450	006	0	1	18	06	H2450_006_0	11	1	Generic			
H2450	006	0	1	18	06	H2450_006_0	11	4	Specialty	2		
H2450	007	0	1	18	06	H2450_007_0	9	3	Non-Preferred Brand			
H2450	007	0	1	18	06	H2450_007_0	9	2	Preferred Brand			
H2450	007	0	1	18	06	H2450_007_0	9	1	Generic			
H2450	007	0	1	18	06	H2450_007_0	9	4	Specialty			
H2450	008	0	1	18	06	H2450_008_0	8	1	Generic			
H2450	008	0	1	18	06	H2450_008_0	8	2	Preferred Brand			
H2450	008	0	1	18	06	H2450_008_0	8	3	Non-Preferred Brand			
H2450	008	0	1	18	06	H2450_008_0	8	4	Specialty			
H2450	009	0	1	18	06	H2450_009_0	7	3	Non-Preferred Brand			
H2450	009	0	1	18	06	H2450_009_0	7	2	Preferred Brand			
H2450	009	0	1	18	06	H2450_009_0	7	1	Generic			
H2450	009	0	1	18	06	H2450_009_0	7	4	Specialty			
H2450	009	0	1	18	06	H2450_009_0	7	4	Specialty	2		
H2450	009	0	1	18	06	H2450_009_0	7	3	Non-Preferred Brand	2		
H2450	009	0	1	18	06	H2450_009_0	7	2	Preferred Brand	2		
H2450	009	0	1	18	06	H2450_009_0	7	1	Generic	1		1
H2450	010	0	1	18	06	H2450_010_0	7	1	Generic			
H2450	010	0	1	18	06	H2450_010_0	7	2	Preferred Brand			
H2450	010	0	1	18	06	H2450_010_0	7	3	Non-Preferred Brand			
H2450	010	0	1	18	06	H2450_010_0	7	3	Non-Preferred Brand	2		
H2450	010	0	1	18	06	H2450_010_0	7	2	Preferred Brand	2		
H2450	010	0	1	18	06	H2450_010_0	7	1	Generic	1		1
H2450	010	0	1	18	06	H2450_010_0	7	4	Specialty			
H2450	010	0	1	18	06	H2450_010_0	7	4	Specialty	2		
H2450	011	0	1	18	06	H2450_011_0	7	2	Preferred Brand			
H2450	011	0	1	18	06	H2450_011_0	7	3	Non-Preferred Brand			
H2450	011	0	1	18	06	H2450_011_0	7	4	Specialty			
H2450	011	0	1	18	06	H2450_011_0	7	1	Generic			
H2450	012	0	1	18	06	H2450_012_0	6	1	Generic			
H2450	012	0	1	18	06	H2450_012_0	6	4	Specialty			
H2450	012	0	1	18	06	H2450_012_0	6	3	Non-Preferred Brand			
H2450	012	0	1	18	06	H2450_012_0	6	2	Preferred Brand			
H2450	013	0	1	18	06	H2450_013_0	7	4	Specialty	2		
H2450	013	0	1	18	06	H2450_013_0	7	1	Generic			
H2450	013	0	1	18	06	H2450_013_0	7	2	Preferred Brand			
H2450	013	0	1	18	06	H2450_013_0	7	3	Non-Preferred Brand			
H2450	013	0	1	18	06	H2450_013_0	7	4	Specialty			
H2450	013	0	1	18	06	H2450_013_0	7	1	Generic	1		1
H2450	013	0	1	18	06	H2450_013_0	7	2	Preferred Brand	2		
H2450	013	0	1	18	06	H2450_013_0	7	3	Non-Preferred Brand	2		
H2450	014	0	1	18	06	H2450_014_0	7	3	Non-Preferred Brand			
H2450	014	0	1	18	06	H2450_014_0	7	2	Preferred Brand			
H2450	014	0	1	18	06	H2450_014_0	7	1	Generic			
H2450	014	0	1	18	06	H2450_014_0	7	4	Specialty			
H2450	015	0	1	18	06	H2450_015_0	6	1	Generic	1		1
H2450	015	0	1	18	06	H2450_015_0	6	2	Preferred Brand	2		
H2450	015	0	1	18	06	H2450_015_0	6	3	Non-Preferred Brand	2		
H2450	015	0	1	18	06	H2450_015_0	6	4	Specialty			
H2450	015	0	1	18	06	H2450_015_0	6	3	Non-Preferred Brand			
H2450	015	0	1	18	06	H2450_015_0	6	4	Specialty	2		
H2450	015	0	1	18	06	H2450_015_0	6	1	Generic			
H2450	015	0	1	18	06	H2450_015_0	6	2	Preferred Brand			
H2459	002	0	1	02	01	H2459_002_0	5	1	Tier 1			
H2459	002	0	1	02	01	H2459_002_0	5	2	Tier 2			
H2459	002	0	1	02	01	H2459_002_0	5	3	Tier 3			
H2459	002	0	1	02	01	H2459_002_0	5	4	Tier 4			
H2459	002	0	1	02	01	H2459_002_0	5	1	Tier 1	1		1
H2459	002	0	1	02	01	H2459_002_0	5	2	Tier 2	2		
H2459	002	0	1	02	01	H2459_002_0	5	3	Tier 3	2		
H2459	002	0	1	02	01	H2459_002_0	5	4	Tier 4	2		
H2459	006	0	1	02	01	H2459_006_0	5	3	Tier 3			
H2459	006	0	1	02	01	H2459_006_0	5	2	Tier 2			
H2459	006	0	1	02	01	H2459_006_0	5	1	Tier 1			
H2459	006	0	1	02	01	H2459_006_0	5	4	Tier 4			
H2459	006	0	1	02	01	H2459_006_0	5	1	Tier 1	1		1
H2459	006	0	1	02	01	H2459_006_0	5	2	Tier 2	2		
H2459	006	0	1	02	01	H2459_006_0	5	3	Tier 3	2		
H2459	006	0	1	02	01	H2459_006_0	5	4	Tier 4	2		
H2459	013	0	1	02	01	H2459_013_0	5	3	Tier 3			
H2459	013	0	1	02	01	H2459_013_0	5	2	Tier 2			
H2459	013	0	1	02	01	H2459_013_0	5	1	Tier 1			
H2459	013	0	1	02	01	H2459_013_0	5	4	Tier 4			
H2459	014	0	1	02	01	H2459_014_0	4	3	Tier 3			
H2459	014	0	1	02	01	H2459_014_0	4	2	Tier 2			
H2459	014	0	1	02	01	H2459_014_0	4	1	Tier 1			
H2459	014	0	1	02	01	H2459_014_0	4	4	Tier 4			
H2459	017	0	1	01	01	H2459_017_0	4	1	Tier 1	1		1
H2459	017	0	1	01	01	H2459_017_0	4	2	Tier 2	2		
H2459	017	0	1	01	01	H2459_017_0	4	3	Tier 3	2		
H2459	017	0	1	01	01	H2459_017_0	4	4	Tier 4			
H2459	017	0	1	01	01	H2459_017_0	4	3	Tier 3			
H2459	017	0	1	01	01	H2459_017_0	4	4	Tier 4	2		
H2459	017	0	1	01	01	H2459_017_0	4	1	Tier 1			
H2459	017	0	1	01	01	H2459_017_0	4	2	Tier 2			
H2462	008	0	1	18	06	H2462_008_0	5	2	Formulary Brand			
H2462	008	0	1	18	06	H2462_008_0	5	1	Formulary Generic			
H2462	008	0	1	18	06	H2462_008_0	5	3	Formulary Specialty			
H2462	009	0	1	18	06	H2462_009_0	4	1	Formulary Generic			
H2462	009	0	1	18	06	H2462_009_0	4	2	Formulary Brand			
H2462	009	0	1	18	06	H2462_009_0	4	3	Formulary Specialty			
H2462	011	0	1	18	06	H2462_011_0	4	1	Formulary Generic			
H2462	011	0	1	18	06	H2462_011_0	4	2	Formulary Brand			
H2462	011	0	1	18	06	H2462_011_0	4	3	Formulary Specialty			
H2462	012	0	1	18	06	H2462_012_0	3	2	Formulary Brand			
H2462	012	0	1	18	06	H2462_012_0	3	1	Formulary Generic			
H2462	012	0	1	18	06	H2462_012_0	3	3	Formulary Specialty			
H2462	013	0	1	18	06	H2462_013_0	3	1	Formulary Generic			
H2462	013	0	1	18	06	H2462_013_0	3	2	Formulary Brand			
H2462	013	0	1	18	06	H2462_013_0	3	3	Formulary Specialty			
H2462	013	0	1	18	06	H2462_013_0	3	1	Formulary Generic	1		1
H2462	013	0	1	18	06	H2462_013_0	3	2	Formulary Brand	2		
H2462	013	0	1	18	06	H2462_013_0	3	3	Formulary Specialty	2		
H2462	014	0	1	18	06	H2462_014_0	2	1	Formulary Generic			
H2462	014	0	1	18	06	H2462_014_0	2	2	Formulary Brand			
H2462	014	0	1	18	06	H2462_014_0	2	3	Formulary Specialty			
H2462	014	0	1	18	06	H2462_014_0	2	1	Formulary Generic	1		1
H2462	014	0	1	18	06	H2462_014_0	2	2	Formulary Brand	2		
H2462	014	0	1	18	06	H2462_014_0	2	3	Formulary Specialty	2		
H2481	004	0	1	04	01	H2481_004_0	7	3	Non-Preferred Brand			
H2481	004	0	1	04	01	H2481_004_0	7	2	Preferred Brand			
H2481	004	0	1	04	01	H2481_004_0	7	1	Generic			
H2481	004	0	1	04	01	H2481_004_0	7	4	Specialty			
H2481	006	0	1	04	01	H2481_006_0	7	3	Non-Preferred Brand			
H2481	006	0	1	04	01	H2481_006_0	7	2	Preferred Brand			
H2481	006	0	1	04	01	H2481_006_0	7	1	Generic			
H2481	006	0	1	04	01	H2481_006_0	7	4	Specialty			
H2486	002	0	1	01	01	H2486_002_0	6	1	Preferred Generic			
H2486	002	0	1	01	01	H2486_002_0	6	2	Preferred Brand			
H2486	002	0	1	01	01	H2486_002_0	6	3	Non-Preferred Brand			
H2486	002	0	1	01	01	H2486_002_0	6	4	Specialty			
H2486	002	0	1	01	01	H2486_002_0	6	1	Preferred Generic	1		1
H2486	002	0	1	01	01	H2486_002_0	6	2	Preferred Brand	1	10000000	2
H2486	002	0	1	01	01	H2486_002_0	6	3	Non-Preferred Brand	1	10000000	2
H2486	002	0	1	01	01	H2486_002_0	6	4	Specialty	1	10001000	2
H2491	001	0	1	01	01	H2491_001_0	9	3	Tier 3			
H2491	001	0	1	01	01	H2491_001_0	9	2	Tier 2			
H2491	001	0	1	01	01	H2491_001_0	9	1	Tier 1			
H2491	001	0	1	01	01	H2491_001_0	9	4	Tier 4			
H2491	002	0	1	01	01	H2491_002_0	9	1	Tier 1	1		1
H2491	002	0	1	01	01	H2491_002_0	9	2	Tier 2	2		
H2491	002	0	1	01	01	H2491_002_0	9	3	Tier 3	2		
H2491	002	0	1	01	01	H2491_002_0	9	4	Tier 4			
H2491	002	0	1	01	01	H2491_002_0	9	3	Tier 3			
H2491	002	0	1	01	01	H2491_002_0	9	4	Tier 4	2		
H2491	002	0	1	01	01	H2491_002_0	9	1	Tier 1			
H2491	002	0	1	01	01	H2491_002_0	9	2	Tier 2			
H2542	001	0	1	04	01	H2542_001_0	7	1	Preferred Generic			
H2542	001	0	1	04	01	H2542_001_0	7	4	Specialty	1	10001000	2
H2542	001	0	1	04	01	H2542_001_0	7	3	Non-Preferred Brand	1	10000000	2
H2542	001	0	1	04	01	H2542_001_0	7	2	Preferred Brand	1	10000000	2
H2542	001	0	1	04	01	H2542_001_0	7	1	Preferred Generic	1	00001000	2
H2542	001	0	1	04	01	H2542_001_0	7	4	Specialty			
H2542	001	0	1	04	01	H2542_001_0	7	3	Non-Preferred Brand			
H2542	001	0	1	04	01	H2542_001_0	7	2	Preferred Brand			
H2542	002	0	1	04	01	H2542_002_0	6	1	Preferred Generic	1	00001000	2
H2542	002	0	1	04	01	H2542_002_0	6	4	Specialty			
H2542	002	0	1	04	01	H2542_002_0	6	3	Non-Preferred Brand			
H2542	002	0	1	04	01	H2542_002_0	6	2	Preferred Brand			
H2542	002	0	1	04	01	H2542_002_0	6	1	Preferred Generic			
H2542	002	0	1	04	01	H2542_002_0	6	2	Preferred Brand	1	10000000	2
H2542	002	0	1	04	01	H2542_002_0	6	3	Non-Preferred Brand	1	10000000	2
H2542	002	0	1	04	01	H2542_002_0	6	4	Specialty	1	10001000	2
H2610	005	0	1	01	01	H2610_005_0	8	3	Tier 3 non-preferred brand			
H2610	005	0	1	01	01	H2610_005_0	8	2	Tier 2 Preferred Brand			
H2610	005	0	1	01	01	H2610_005_0	8	1	Tier 1 Generic			
H2610	005	0	1	01	01	H2610_005_0	8	4	Tier 4 specialty			
H2610	006	0	1	01	01	H2610_006_0	8	1	Tier 1 Generic			
H2610	006	0	1	01	01	H2610_006_0	8	2	Tier 2 Preferred Brand			
H2610	006	0	1	01	01	H2610_006_0	8	3	Tier 3 Non-Preferred Brand			
H2610	006	0	1	01	01	H2610_006_0	8	4	Tier 4 Specialty			
H2610	010	0	1	01	01	H2610_010_0	8	3	Tier 3 non-preferred brand			
H2610	010	0	1	01	01	H2610_010_0	8	2	Tier 2 Preferred Brand			
H2610	010	0	1	01	01	H2610_010_0	8	1	Tier 1 Generic			
H2610	010	0	1	01	01	H2610_010_0	8	4	Tier 4 specialty			
H2611	001	0	1	04	01	H2611_001_0	9	2	Tier 2			
H2611	001	0	1	04	01	H2611_001_0	9	4	Tier 4			
H2611	001	0	1	04	01	H2611_001_0	9	3	Tier 3			
H2611	001	0	1	04	01	H2611_001_0	9	1	Tier 1			
H2611	002	0	1	04	01	H2611_002_0	9	1	Tier 1			
H2611	002	0	1	04	01	H2611_002_0	9	4	Tier 4			
H2611	002	0	1	04	01	H2611_002_0	9	2	Tier 2			
H2611	002	0	1	04	01	H2611_002_0	9	3	Tier 3			
H2611	002	0	1	04	01	H2611_002_0	9	1	Tier 1	1		1
H2611	002	0	1	04	01	H2611_002_0	9	2	Tier 2	2		
H2611	002	0	1	04	01	H2611_002_0	9	3	Tier 3	2		
H2611	002	0	1	04	01	H2611_002_0	9	4	Tier 4	2		
H2611	003	0	1	04	01	H2611_003_0	8	3	Tier 3			
H2611	003	0	1	04	01	H2611_003_0	8	4	Tier 4	2		
H2611	003	0	1	04	01	H2611_003_0	8	3	Tier 3	2		
H2611	003	0	1	04	01	H2611_003_0	8	2	Tier 2	2		
H2611	003	0	1	04	01	H2611_003_0	8	1	Tier 1	1		1
H2611	003	0	1	04	01	H2611_003_0	8	4	Tier 4			
H2611	003	0	1	04	01	H2611_003_0	8	2	Tier 2			
H2611	003	0	1	04	01	H2611_003_0	8	1	Tier 1			
H2611	008	0	1	04	01	H2611_008_0	8	2	Tier 2			
H2611	008	0	1	04	01	H2611_008_0	8	4	Tier 4			
H2611	008	0	1	04	01	H2611_008_0	8	3	Tier 3			
H2611	008	0	1	04	01	H2611_008_0	8	1	Tier 1			
H2611	012	0	1	04	01	H2611_012_0	6	1	Tier 1			
H2611	012	0	1	04	01	H2611_012_0	6	4	Tier 4			
H2611	012	0	1	04	01	H2611_012_0	6	2	Tier 2			
H2611	012	0	1	04	01	H2611_012_0	6	3	Tier 3			
H2611	012	0	1	04	01	H2611_012_0	6	1	Tier 1	1		1
H2611	012	0	1	04	01	H2611_012_0	6	2	Tier 2	2		
H2611	012	0	1	04	01	H2611_012_0	6	3	Tier 3	2		
H2611	012	0	1	04	01	H2611_012_0	6	4	Tier 4	2		
H2611	016	0	1	04	01	H2611_016_0	7	3	Tier 3	2		
H2611	016	0	1	04	01	H2611_016_0	7	4	Tier 4	2		
H2611	016	0	1	04	01	H2611_016_0	7	2	Tier 2	2		
H2611	016	0	1	04	01	H2611_016_0	7	1	Tier 1	1		1
H2611	016	0	1	04	01	H2611_016_0	7	4	Tier 4			
H2611	016	0	1	04	01	H2611_016_0	7	3	Tier 3			
H2611	016	0	1	04	01	H2611_016_0	7	2	Tier 2			
H2611	016	0	1	04	01	H2611_016_0	7	1	Tier 1			
H2613	004	0	1	09	04	H2613_004_0	8	5	Tier 5 Specialty	2		
H2613	004	0	1	09	04	H2613_004_0	8	1	Tier 1 Preferred Generic			
H2613	004	0	1	09	04	H2613_004_0	8	2	Tier 2 Preferred Brand			
H2613	004	0	1	09	04	H2613_004_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H2613	004	0	1	09	04	H2613_004_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H2613	004	0	1	09	04	H2613_004_0	8	4	Tier 4 Non-Specialty Injectable			
H2613	004	0	1	09	04	H2613_004_0	8	5	Tier 5 Specialty			
H2613	004	0	1	09	04	H2613_004_0	8	1	Tier 1 Preferred Generic	1		1
H2613	004	0	1	09	04	H2613_004_0	8	2	Tier 2 Preferred Brand	2		
H2613	004	0	1	09	04	H2613_004_0	8	4	Tier 4 Non-Specialty Injectable	2		
H2643	001	0	1	01	01	H2643_001_0	7	1	Tier 1 - Preferred Generic	1		1
H2643	001	0	1	01	01	H2643_001_0	7	1	Tier 1 - Preferred Generic			
H2643	001	0	1	01	01	H2643_001_0	7	2	Tier 2 - Other			
H2643	001	0	1	01	01	H2643_001_0	7	2	Tier 2 - Other	2		
H2648	003	0	1	09	04	H2648_003_0	5	4	Specialty Injectables			
H2648	003	0	1	09	04	H2648_003_0	5	3	Non-Preferred Brand/Generic			
H2648	003	0	1	09	04	H2648_003_0	5	2	Preferred Brand			
H2648	003	0	1	09	04	H2648_003_0	5	1	Formulary Generic			
H2648	004	0	1	09	04	H2648_004_0	5	4	Specialty Injectables			
H2648	004	0	1	09	04	H2648_004_0	5	1	Formulary Generic			
H2648	004	0	1	09	04	H2648_004_0	5	3	Non-Preferred Brand/Generic			
H2648	004	0	1	09	04	H2648_004_0	5	2	Preferred Brand			
H2649	004	0	1	01	01	H2649_004_0	3	4	Specialty	1	10001000	2
H2649	004	0	1	01	01	H2649_004_0	3	3	Non-Preferred Brand	1	10000000	2
H2649	004	0	1	01	01	H2649_004_0	3	2	Preferred Brand	1	10000000	2
H2649	004	0	1	01	01	H2649_004_0	3	4	Specialty			
H2649	004	0	1	01	01	H2649_004_0	3	1	Preferred Generic	1	00001000	2
H2649	004	0	1	01	01	H2649_004_0	3	3	Non-Preferred Brand			
H2649	004	0	1	01	01	H2649_004_0	3	2	Preferred Brand			
H2649	004	0	1	01	01	H2649_004_0	3	1	Preferred Generic			
H2649	011	0	1	01	01	H2649_011_0	3	2	Preferred Brand	1	10000000	2
H2649	011	0	1	01	01	H2649_011_0	3	3	Non-Preferred Brand	1	10000000	2
H2649	011	0	1	01	01	H2649_011_0	3	4	Specialty	1	10001000	2
H2649	011	0	1	01	01	H2649_011_0	3	3	Non-Preferred Brand			
H2649	011	0	1	01	01	H2649_011_0	3	4	Specialty			
H2649	011	0	1	01	01	H2649_011_0	3	1	Preferred Generic	1	00001000	2
H2649	011	0	1	01	01	H2649_011_0	3	1	Preferred Generic			
H2649	011	0	1	01	01	H2649_011_0	3	2	Preferred Brand			
H2649	015	0	1	01	01	H2649_015_0	5	1	Preferred Generic			
H2649	015	0	1	01	01	H2649_015_0	5	2	Preferred Brand			
H2649	015	0	1	01	01	H2649_015_0	5	3	Non-Preferred Brand			
H2649	015	0	1	01	01	H2649_015_0	5	4	Specialty	1	10001000	2
H2649	015	0	1	01	01	H2649_015_0	5	1	Preferred Generic	1	00001000	2
H2649	015	0	1	01	01	H2649_015_0	5	4	Specialty			
H2649	015	0	1	01	01	H2649_015_0	5	2	Preferred Brand	1	10000000	2
H2649	015	0	1	01	01	H2649_015_0	5	3	Non-Preferred Brand	1	10000000	2
H2649	016	0	1	01	01	H2649_016_0	4	1	Preferred Generic			
H2649	016	0	1	01	01	H2649_016_0	4	2	Preferred Brand	1	10000000	2
H2649	016	0	1	01	01	H2649_016_0	4	3	Non-Preferred Brand	1	10000000	2
H2649	016	0	1	01	01	H2649_016_0	4	4	Specialty	1	10001000	2
H2649	016	0	1	01	01	H2649_016_0	4	2	Preferred Brand			
H2649	016	0	1	01	01	H2649_016_0	4	3	Non-Preferred Brand			
H2649	016	0	1	01	01	H2649_016_0	4	4	Specialty			
H2649	016	0	1	01	01	H2649_016_0	4	1	Preferred Generic	1	00001000	2
H2654	004	0	1	01	01	H2654_004_0	5	1	Preferred Generic			
H2654	004	0	1	01	01	H2654_004_0	5	2	Preferred Brand			
H2654	004	0	1	01	01	H2654_004_0	5	3	Non Preferred			
H2654	004	0	1	01	01	H2654_004_0	5	4	Specialty			
H2654	010	0	1	02	01	H2654_010_0	6	1	Preferred Generic			
H2654	010	0	1	02	01	H2654_010_0	6	2	Preferred Brand			
H2654	010	0	1	02	01	H2654_010_0	6	3	Non Preferred			
H2654	010	0	1	02	01	H2654_010_0	6	4	Specialty			
H2654	013	0	1	02	01	H2654_013_0	5	1	Preferred Generic			
H2654	013	0	1	02	01	H2654_013_0	5	2	Preferred Brand			
H2654	013	0	1	02	01	H2654_013_0	5	3	Non Preferred			
H2654	013	0	1	02	01	H2654_013_0	5	4	Specialty			
H2654	026	0	1	01	01	H2654_026_0	4	1	Preferred Generic			
H2654	026	0	1	01	01	H2654_026_0	4	2	Preferred Brand			
H2654	026	0	1	01	01	H2654_026_0	4	3	Non Preferred			
H2654	026	0	1	01	01	H2654_026_0	4	4	Specialty			
H2654	027	0	1	01	01	H2654_027_0	4	1	Preferred Generic			
H2654	027	0	1	01	01	H2654_027_0	4	2	Preferred Brand			
H2654	027	0	1	01	01	H2654_027_0	4	3	Non Preferred			
H2654	027	0	1	01	01	H2654_027_0	4	4	Specialty			
H2663	002	0	1	01	01	H2663_002_0	12	1	Preferred Generic	1		1
H2663	002	0	1	01	01	H2663_002_0	12	2	Preferred Brand	2		
H2663	002	0	1	01	01	H2663_002_0	12	3	Non-Preferred Generic/Non-Preferred Brand	2		
H2663	002	0	1	01	01	H2663_002_0	12	4	Specialty	2		
H2663	002	0	1	01	01	H2663_002_0	12	1	Preferred Generic			
H2663	002	0	1	01	01	H2663_002_0	12	2	Preferred Brand			
H2663	002	0	1	01	01	H2663_002_0	12	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	002	0	1	01	01	H2663_002_0	12	4	Specialty			
H2663	005	0	1	01	01	H2663_005_0	11	4	Specialty			
H2663	005	0	1	01	01	H2663_005_0	11	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	005	0	1	01	01	H2663_005_0	11	2	Preferred Brand			
H2663	005	0	1	01	01	H2663_005_0	11	1	Preferred Generic			
H2663	006	0	1	01	01	H2663_006_0	7	2	Preferred Brand			
H2663	006	0	1	01	01	H2663_006_0	7	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	006	0	1	01	01	H2663_006_0	7	1	Preferred Generic			
H2663	006	0	1	01	01	H2663_006_0	7	4	Specialty			
H2663	007	0	1	01	01	H2663_007_0	10	2	Preferred Brand			
H2663	007	0	1	01	01	H2663_007_0	10	1	Preferred Generic			
H2663	007	0	1	01	01	H2663_007_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	007	0	1	01	01	H2663_007_0	10	4	Specialty			
H2663	008	0	1	01	01	H2663_008_0	8	1	Preferred Generic			
H2663	008	0	1	01	01	H2663_008_0	8	2	Preferred Brand			
H2663	008	0	1	01	01	H2663_008_0	8	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	008	0	1	01	01	H2663_008_0	8	4	Specialty			
H2663	008	0	1	01	01	H2663_008_0	8	5	Diabetic Needs	1		1
H2663	008	0	1	01	01	H2663_008_0	8	1	Preferred Generic	2		
H2663	008	0	1	01	01	H2663_008_0	8	2	Preferred Brand	2		
H2663	008	0	1	01	01	H2663_008_0	8	3	Non-Preferred Generic/Non-Preferred Brand	2		
H2663	008	0	1	01	01	H2663_008_0	8	4	Specialty	2		
H2663	008	0	1	01	01	H2663_008_0	8	5	Diabetic Needs			
H2663	009	0	1	01	01	H2663_009_0	8	2	Preferred Brand	2		
H2663	009	0	1	01	01	H2663_009_0	8	1	Preferred Generic	2		
H2663	009	0	1	01	01	H2663_009_0	8	5	Diabetic Needs			
H2663	009	0	1	01	01	H2663_009_0	8	4	Specialty			
H2663	009	0	1	01	01	H2663_009_0	8	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	009	0	1	01	01	H2663_009_0	8	2	Preferred Brand			
H2663	009	0	1	01	01	H2663_009_0	8	1	Preferred Generic			
H2663	009	0	1	01	01	H2663_009_0	8	3	Non-Preferred Generic/Non-Preferred Brand	2		
H2663	009	0	1	01	01	H2663_009_0	8	5	Diabetic Needs	1		1
H2663	009	0	1	01	01	H2663_009_0	8	4	Specialty	2		
H2663	010	0	1	01	01	H2663_010_0	7	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	010	0	1	01	01	H2663_010_0	7	2	Preferred Brand			
H2663	010	0	1	01	01	H2663_010_0	7	1	Preferred Generic			
H2663	010	0	1	01	01	H2663_010_0	7	4	Specialty			
H2663	010	0	1	01	01	H2663_010_0	7	5	High Cholesterol Needs	1		1
H2663	010	0	1	01	01	H2663_010_0	7	1	Preferred Generic	2		
H2663	010	0	1	01	01	H2663_010_0	7	2	Preferred Brand	2		
H2663	010	0	1	01	01	H2663_010_0	7	3	Non-Preferred Generic/Non-Preferred Brand	2		
H2663	010	0	1	01	01	H2663_010_0	7	4	Specialty	2		
H2663	010	0	1	01	01	H2663_010_0	7	5	High Cholesterol Needs			
H2663	011	0	1	01	01	H2663_011_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	011	0	1	01	01	H2663_011_0	6	2	Preferred Brand			
H2663	011	0	1	01	01	H2663_011_0	6	1	Preferred Generic			
H2663	011	0	1	01	01	H2663_011_0	6	4	Specialty			
H2663	011	0	1	01	01	H2663_011_0	6	5	High Cholesterol Needs	1		1
H2663	011	0	1	01	01	H2663_011_0	6	4	Specialty	2		
H2663	011	0	1	01	01	H2663_011_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
H2663	011	0	1	01	01	H2663_011_0	6	2	Preferred Brand	2		
H2663	011	0	1	01	01	H2663_011_0	6	1	Preferred Generic	2		
H2663	011	0	1	01	01	H2663_011_0	6	5	High Cholesterol Needs			
H2663	012	0	1	01	01	H2663_012_0	8	1	Preferred Generic			
H2663	012	0	1	01	01	H2663_012_0	8	2	Preferred Brand			
H2663	012	0	1	01	01	H2663_012_0	8	3	Non-Preferred Generic/Non-Preferred Brand			
H2663	012	0	1	01	01	H2663_012_0	8	4	Specialty			
H2667	003	0	1	01	01	H2667_003_0	15	4	Tier 4			
H2667	003	0	1	01	01	H2667_003_0	15	3	Tier 3			
H2667	003	0	1	01	01	H2667_003_0	15	2	Tier 2			
H2667	003	0	1	01	01	H2667_003_0	15	1	Tier 1			
H2672	001	0	1	01	01	H2672_001_0	7	4	SPECIALTY	2		
H2672	001	0	1	01	01	H2672_001_0	7	3	NON-PREFERRED BRAND	2		
H2672	001	0	1	01	01	H2672_001_0	7	2	PREFERRED BRAND	2		
H2672	001	0	1	01	01	H2672_001_0	7	1	PREFERRED GENERIC	1		1
H2672	001	0	1	01	01	H2672_001_0	7	4	SPECIALTY			
H2672	001	0	1	01	01	H2672_001_0	7	3	NON-PREFERRED BRAND			
H2672	001	0	1	01	01	H2672_001_0	7	2	PREFERRED BRAND			
H2672	001	0	1	01	01	H2672_001_0	7	1	PREFERRED GENERIC			
H2672	003	0	1	01	01	H2672_003_0	7	3	NON-PREFERRED BRAND	2		
H2672	003	0	1	01	01	H2672_003_0	7	4	SPECIALTY	2		
H2672	003	0	1	01	01	H2672_003_0	7	2	PREFERRED BRAND	2		
H2672	003	0	1	01	01	H2672_003_0	7	1	PREFERRED GENERIC	1		1
H2672	003	0	1	01	01	H2672_003_0	7	4	SPECIALTY			
H2672	003	0	1	01	01	H2672_003_0	7	3	NON-PREFERRED BRAND			
H2672	003	0	1	01	01	H2672_003_0	7	2	PREFERRED BRAND			
H2672	003	0	1	01	01	H2672_003_0	7	1	PREFERRED GENERIC			
H2672	008	0	1	01	01	H2672_008_0	7	1	PREFERRED GENERIC			
H2672	008	0	1	01	01	H2672_008_0	7	2	PREFERRED BRAND			
H2672	008	0	1	01	01	H2672_008_0	7	3	NON-PREFERRED BRAND			
H2672	008	0	1	01	01	H2672_008_0	7	4	SPECIALTY			
H2672	008	0	1	01	01	H2672_008_0	7	1	PREFERRED GENERIC	1		1
H2672	008	0	1	01	01	H2672_008_0	7	2	PREFERRED BRAND	2		
H2672	008	0	1	01	01	H2672_008_0	7	3	NON-PREFERRED BRAND	2		
H2672	008	0	1	01	01	H2672_008_0	7	4	SPECIALTY	2		
H2701	001	0	1	04	01	H2701_001_0	5	1	Formulary Generic			
H2701	001	0	1	04	01	H2701_001_0	5	2	Formulary Preferred Brand			
H2701	001	0	1	04	01	H2701_001_0	5	3	Formulary Non-Preferred Brand			
H2701	001	0	1	04	01	H2701_001_0	5	4	Specialty			
H2701	001	0	1	04	01	H2701_001_0	5	1	Formulary Generic	1		1
H2701	001	0	1	04	01	H2701_001_0	5	2	Formulary Preferred Brand	2		
H2701	001	0	1	04	01	H2701_001_0	5	4	Specialty	2		
H2701	001	0	1	04	01	H2701_001_0	5	3	Formulary Non-Preferred Brand	2		
H2701	003	0	1	04	01	H2701_003_0	6	1	Formulary Generic			
H2701	003	0	1	04	01	H2701_003_0	6	3	Formulary Brand			
H2701	003	0	1	04	01	H2701_003_0	6	2	Formulary Preferred Brand			
H2701	003	0	1	04	01	H2701_003_0	6	4	Specialty			
H2762	028	0	1	09	04	H2762_028_0	3	3	Tier 3			
H2762	028	0	1	09	04	H2762_028_0	3	2	Tier 2			
H2762	028	0	1	09	04	H2762_028_0	3	1	Tier 1			
H2762	028	0	1	09	04	H2762_028_0	3	4	Tier 4			
H2762	029	0	1	09	04	H2762_029_0	3	3	Tier 3			
H2762	029	0	1	09	04	H2762_029_0	3	2	Tier 2			
H2762	029	0	1	09	04	H2762_029_0	3	1	Tier 1			
H2762	029	0	1	09	04	H2762_029_0	3	4	Tier 4			
H2762	030	0	1	09	04	H2762_030_0	3	1	Tier 1			
H2762	030	0	1	09	04	H2762_030_0	3	2	Tier 2			
H2762	030	0	1	09	04	H2762_030_0	3	3	Tier 3			
H2762	030	0	1	09	04	H2762_030_0	3	4	Tier 4			
H2762	031	0	1	09	04	H2762_031_0	3	3	Tier 3			
H2762	031	0	1	09	04	H2762_031_0	3	2	Tier 2			
H2762	031	0	1	09	04	H2762_031_0	3	1	Tier 1			
H2762	031	0	1	09	04	H2762_031_0	3	4	Tier 4			
H2762	032	0	1	09	04	H2762_032_0	3	1	Tier 1			
H2762	032	0	1	09	04	H2762_032_0	3	2	Tier 2			
H2762	032	0	1	09	04	H2762_032_0	3	3	Tier 3			
H2762	032	0	1	09	04	H2762_032_0	3	4	Tier 4			
H2762	033	0	1	09	04	H2762_033_0	3	1	Tier 1			
H2762	033	0	1	09	04	H2762_033_0	3	2	Tier 2			
H2762	033	0	1	09	04	H2762_033_0	3	3	Tier 3			
H2762	033	0	1	09	04	H2762_033_0	3	4	Tier 4			
H2762	034	0	1	09	04	H2762_034_0	3	3	Tier 3			
H2762	034	0	1	09	04	H2762_034_0	3	2	Tier 2			
H2762	034	0	1	09	04	H2762_034_0	3	1	Tier 1			
H2762	034	0	1	09	04	H2762_034_0	3	4	Tier 4			
H2762	035	0	1	09	04	H2762_035_0	3	1	Tier 1			
H2762	035	0	1	09	04	H2762_035_0	3	2	Tier 2			
H2762	035	0	1	09	04	H2762_035_0	3	3	Tier 3			
H2762	035	0	1	09	04	H2762_035_0	3	4	Tier 4			
H2762	036	0	1	09	04	H2762_036_0	3	1	Tier 1			
H2762	036	0	1	09	04	H2762_036_0	3	2	Tier 2			
H2762	036	0	1	09	04	H2762_036_0	3	3	Tier 3			
H2762	036	0	1	09	04	H2762_036_0	3	4	Tier 4			
H2762	037	0	1	09	04	H2762_037_0	3	1	Tier 1			
H2762	037	0	1	09	04	H2762_037_0	3	2	Tier 2			
H2762	037	0	1	09	04	H2762_037_0	3	4	Tier 4			
H2762	037	0	1	09	04	H2762_037_0	3	3	Tier 3			
H2762	038	0	1	09	04	H2762_038_0	3	1	Tier 1			
H2762	038	0	1	09	04	H2762_038_0	3	2	Tier 2			
H2762	038	0	1	09	04	H2762_038_0	3	3	Tier 3			
H2762	038	0	1	09	04	H2762_038_0	3	4	Tier 4			
H2762	039	0	1	09	04	H2762_039_0	3	1	Tier 1			
H2762	039	0	1	09	04	H2762_039_0	3	3	Tier 3			
H2762	039	0	1	09	04	H2762_039_0	3	2	Tier 2			
H2762	039	0	1	09	04	H2762_039_0	3	4	Tier 4			
H2762	040	0	1	09	04	H2762_040_0	3	3	Tier 3			
H2762	040	0	1	09	04	H2762_040_0	3	2	Tier 2			
H2762	040	0	1	09	04	H2762_040_0	3	1	Tier 1			
H2762	040	0	1	09	04	H2762_040_0	3	4	Tier 4			
H2762	041	0	1	09	04	H2762_041_0	3	1	Tier 1			
H2762	041	0	1	09	04	H2762_041_0	3	2	Tier 2			
H2762	041	0	1	09	04	H2762_041_0	3	4	Tier 4			
H2762	041	0	1	09	04	H2762_041_0	3	3	Tier 3			
H2762	042	0	1	09	04	H2762_042_0	3	1	Tier 1			
H2762	042	0	1	09	04	H2762_042_0	3	3	Tier 3			
H2762	042	0	1	09	04	H2762_042_0	3	2	Tier 2			
H2762	042	0	1	09	04	H2762_042_0	3	4	Tier 4			
H2762	043	0	1	09	04	H2762_043_0	3	3	Tier 3			
H2762	043	0	1	09	04	H2762_043_0	3	2	Tier 2			
H2762	043	0	1	09	04	H2762_043_0	3	1	Tier 1			
H2762	043	0	1	09	04	H2762_043_0	3	4	Tier 4			
H2762	044	0	1	09	04	H2762_044_0	3	3	Tier 3			
H2762	044	0	1	09	04	H2762_044_0	3	2	Tier 2			
H2762	044	0	1	09	04	H2762_044_0	3	1	Tier 1			
H2762	044	0	1	09	04	H2762_044_0	3	4	Tier 4			
H2762	045	0	1	09	04	H2762_045_0	3	3	Tier 3			
H2762	045	0	1	09	04	H2762_045_0	3	2	Tier 2			
H2762	045	0	1	09	04	H2762_045_0	3	1	Tier 1			
H2762	045	0	1	09	04	H2762_045_0	3	4	Tier 4			
H2762	046	0	1	09	04	H2762_046_0	3	1	Tier 1			
H2762	046	0	1	09	04	H2762_046_0	3	2	Tier 2			
H2762	046	0	1	09	04	H2762_046_0	3	3	Tier 3			
H2762	046	0	1	09	04	H2762_046_0	3	4	Tier 4			
H2762	047	0	1	09	04	H2762_047_0	3	1	Tier 1			
H2762	047	0	1	09	04	H2762_047_0	3	2	Tier 2			
H2762	047	0	1	09	04	H2762_047_0	3	3	Tier 3			
H2762	047	0	1	09	04	H2762_047_0	3	4	Tier 4			
H2762	048	0	1	09	04	H2762_048_0	3	1	Tier 1			
H2762	048	0	1	09	04	H2762_048_0	3	2	Tier 2			
H2762	048	0	1	09	04	H2762_048_0	3	3	Tier 3			
H2762	048	0	1	09	04	H2762_048_0	3	4	Tier 4			
H2762	049	0	1	09	04	H2762_049_0	3	1	Tier 1			
H2762	049	0	1	09	04	H2762_049_0	3	2	Tier 2			
H2762	049	0	1	09	04	H2762_049_0	3	3	Tier 3			
H2762	049	0	1	09	04	H2762_049_0	3	4	Tier 4			
H2762	050	0	1	09	04	H2762_050_0	3	1	Tier 1			
H2762	050	0	1	09	04	H2762_050_0	3	2	Tier 2			
H2762	050	0	1	09	04	H2762_050_0	3	3	Tier 3			
H2762	050	0	1	09	04	H2762_050_0	3	4	Tier 4			
H2762	051	0	1	09	04	H2762_051_0	4	1	Tier 1			
H2762	051	0	1	09	04	H2762_051_0	4	2	Tier 2			
H2762	051	0	1	09	04	H2762_051_0	4	3	Tier 3			
H2762	051	0	1	09	04	H2762_051_0	4	4	Tier 4			
H2762	052	0	1	09	04	H2762_052_0	3	4	Tier 4			
H2762	052	0	1	09	04	H2762_052_0	3	3	Tier 3			
H2762	052	0	1	09	04	H2762_052_0	3	2	Tier 2			
H2762	052	0	1	09	04	H2762_052_0	3	1	Tier 1			
H2762	053	0	1	09	04	H2762_053_0	3	3	Tier 3			
H2762	053	0	1	09	04	H2762_053_0	3	2	Tier 2			
H2762	053	0	1	09	04	H2762_053_0	3	1	Tier 1			
H2762	053	0	1	09	04	H2762_053_0	3	4	Tier 4			
H2762	054	0	1	09	04	H2762_054_0	3	2	Tier 2			
H2762	054	0	1	09	04	H2762_054_0	3	1	Tier 1			
H2762	054	0	1	09	04	H2762_054_0	3	3	Tier 3			
H2762	054	0	1	09	04	H2762_054_0	3	4	Tier 4			
H2762	055	0	1	09	04	H2762_055_0	3	2	Tier 2			
H2762	055	0	1	09	04	H2762_055_0	3	4	Tier 4			
H2762	055	0	1	09	04	H2762_055_0	3	1	Tier 1			
H2762	055	0	1	09	04	H2762_055_0	3	3	Tier 3			
H2775	004	0	1	04	01	H2775_004_0	3	4	Specialty			
H2775	004	0	1	04	01	H2775_004_0	3	1	Generic			
H2775	004	0	1	04	01	H2775_004_0	3	3	Non-Preferred Brand			
H2775	004	0	1	04	01	H2775_004_0	3	2	Preferred Brand			
H2775	004	0	1	04	01	H2775_004_0	3	4	Specialty	2		
H2775	004	0	1	04	01	H2775_004_0	3	3	Non-Preferred Brand	2		
H2775	004	0	1	04	01	H2775_004_0	3	2	Preferred Brand	2		
H2775	004	0	1	04	01	H2775_004_0	3	1	Generic	1		1
H2775	005	0	1	04	01	H2775_005_0	3	4	Specialty	2		
H2775	005	0	1	04	01	H2775_005_0	3	3	Non-Preferred Brand	2		
H2775	005	0	1	04	01	H2775_005_0	3	2	Preferred Brand	2		
H2775	005	0	1	04	01	H2775_005_0	3	1	Generic	1		1
H2775	005	0	1	04	01	H2775_005_0	3	3	Non-Preferred Brand			
H2775	005	0	1	04	01	H2775_005_0	3	2	Preferred Brand			
H2775	005	0	1	04	01	H2775_005_0	3	1	Generic			
H2775	005	0	1	04	01	H2775_005_0	3	4	Specialty			
H2775	006	0	1	04	01	H2775_006_0	3	3	Non-Preferred Brand	2		
H2775	006	0	1	04	01	H2775_006_0	3	2	Preferred Brand	2		
H2775	006	0	1	04	01	H2775_006_0	3	1	Generic	1		1
H2775	006	0	1	04	01	H2775_006_0	3	4	Specialty			
H2775	006	0	1	04	01	H2775_006_0	3	3	Non-Preferred Brand			
H2775	006	0	1	04	01	H2775_006_0	3	2	Preferred Brand			
H2775	006	0	1	04	01	H2775_006_0	3	1	Generic			
H2775	006	0	1	04	01	H2775_006_0	3	4	Specialty	2		
H2802	001	0	1	01	01	H2802_001_0	6	1	Preferred Generic			
H2802	001	0	1	01	01	H2802_001_0	6	2	Preferred Brand			
H2802	001	0	1	01	01	H2802_001_0	6	3	Non Preferred			
H2802	001	0	1	01	01	H2802_001_0	6	4	Specialty			
H2802	005	0	1	01	01	H2802_005_0	5	4	Specialty			
H2802	005	0	1	01	01	H2802_005_0	5	3	Non Preferred			
H2802	005	0	1	01	01	H2802_005_0	5	2	Preferred Brand			
H2802	005	0	1	01	01	H2802_005_0	5	1	Preferred Generic			
H2803	001	0	1	02	01	H2803_001_0	4	3	Non-Preferred			
H2803	001	0	1	02	01	H2803_001_0	4	4	Specialty			
H2803	001	0	1	02	01	H2803_001_0	4	2	Preferred Brand			
H2803	001	0	1	02	01	H2803_001_0	4	1	Preferred Generic			
H2803	002	0	1	02	01	H2803_002_0	4	4	Specialty			
H2803	002	0	1	02	01	H2803_002_0	4	3	Non-Preferred			
H2803	002	0	1	02	01	H2803_002_0	4	2	Preferred Brand			
H2803	002	0	1	02	01	H2803_002_0	4	1	Preferred Generic			
H2803	011	0	1	02	01	H2803_011_0	4	4	Specialty			
H2803	011	0	1	02	01	H2803_011_0	4	3	Non Preferred			
H2803	011	0	1	02	01	H2803_011_0	4	1	Preferred Generic			
H2803	011	0	1	02	01	H2803_011_0	4	2	Preferred Brand			
H2803	014	0	1	02	01	H2803_014_0	3	4	Specialty			
H2803	014	0	1	02	01	H2803_014_0	3	3	Non Preferred			
H2803	014	0	1	02	01	H2803_014_0	3	2	Preferred Brand			
H2803	014	0	1	02	01	H2803_014_0	3	1	Preferred Generic			
H2803	015	0	1	02	01	H2803_015_0	3	4	Specialty			
H2803	015	0	1	02	01	H2803_015_0	3	2	Preferred Brand			
H2803	015	0	1	02	01	H2803_015_0	3	1	Preferred Generic			
H2803	015	0	1	02	01	H2803_015_0	3	3	Non Preferred			
H2869	002	0	1	04	01	H2869_002_0	3	4	Specialty	2		
H2869	002	0	1	04	01	H2869_002_0	3	3	Non-Preferred Brand	2		
H2869	002	0	1	04	01	H2869_002_0	3	2	Preferred Brand	2		
H2869	002	0	1	04	01	H2869_002_0	3	1	Generic	1		1
H2869	002	0	1	04	01	H2869_002_0	3	4	Specialty			
H2869	002	0	1	04	01	H2869_002_0	3	3	Non-Preferred Brand			
H2869	002	0	1	04	01	H2869_002_0	3	2	Preferred Brand			
H2869	002	0	1	04	01	H2869_002_0	3	1	Generic			
H2899	001	0	1	01	01	H2899_001_0	18	1	Tier 1 - Generic			
H2899	001	0	1	01	01	H2899_001_0	18	4	Tier 4 - Specialty	2		
H2899	001	0	1	01	01	H2899_001_0	18	3	Tier 3 - Non-Preferred Brand	2		
H2899	001	0	1	01	01	H2899_001_0	18	2	Tier 2 - Prefered Brand	2		
H2899	001	0	1	01	01	H2899_001_0	18	1	Tier 1 - Generic	1		1
H2899	001	0	1	01	01	H2899_001_0	18	4	Tier 4 - Specialty			
H2899	001	0	1	01	01	H2899_001_0	18	3	Tier 3 - Non-Preferred Brand			
H2899	001	0	1	01	01	H2899_001_0	18	2	Tier 2 - Prefered Brand			
H2905	001	0	1	04	01	H2905_001_0	9	1	Generic			
H2905	001	0	1	04	01	H2905_001_0	9	3	Specialty			
H2905	001	0	1	04	01	H2905_001_0	9	2	Brand			
H2906	003	0	1	04	01	H2906_003_0	7	4	Non- Preferred Brand Name			
H2906	003	0	1	04	01	H2906_003_0	7	3	Preferred Brand			
H2906	003	0	1	04	01	H2906_003_0	7	2	Non-Preferred Generic			
H2906	003	0	1	04	01	H2906_003_0	7	5	Special Pharmaceutical			
H2906	003	0	1	04	01	H2906_003_0	7	1	Preferred Generic			
H2914	003	0	1	04	01	H2914_003_0	3	1	Generic			
H2914	003	0	1	04	01	H2914_003_0	3	2	Preferred Brand			
H2914	003	0	1	04	01	H2914_003_0	3	4	Specialty	2		
H2914	003	0	1	04	01	H2914_003_0	3	3	Non-Preferred Brand	2		
H2914	003	0	1	04	01	H2914_003_0	3	2	Preferred Brand	2		
H2914	003	0	1	04	01	H2914_003_0	3	1	Generic	1		1
H2914	003	0	1	04	01	H2914_003_0	3	4	Specialty			
H2914	003	0	1	04	01	H2914_003_0	3	3	Non-Preferred Brand			
H2914	004	0	1	04	01	H2914_004_0	3	1	Generic			
H2914	004	0	1	04	01	H2914_004_0	3	3	Non-Preferred Brand	2		
H2914	004	0	1	04	01	H2914_004_0	3	2	Preferred Brand	2		
H2914	004	0	1	04	01	H2914_004_0	3	1	Generic	1		1
H2914	004	0	1	04	01	H2914_004_0	3	4	Specialty			
H2914	004	0	1	04	01	H2914_004_0	3	3	Non-Preferred Brand			
H2914	004	0	1	04	01	H2914_004_0	3	2	Preferred Brand			
H2914	004	0	1	04	01	H2914_004_0	3	4	Specialty	2		
H2931	002	0	1	02	01	H2931_002_0	8	4	Specialty			
H2931	002	0	1	02	01	H2931_002_0	8	3	Non-preferred			
H2931	002	0	1	02	01	H2931_002_0	8	6	Special Coverage - Brand	1		1
H2931	002	0	1	02	01	H2931_002_0	8	5	Special Coverage - Generic	1		1
H2931	002	0	1	02	01	H2931_002_0	8	4	Specialty	1	01000000	2
H2931	002	0	1	02	01	H2931_002_0	8	2	Preferred Brand			
H2931	002	0	1	02	01	H2931_002_0	8	1	Preferred Generic/Some Brand Maintenance			
H2931	002	0	1	02	01	H2931_002_0	8	5	Special Coverage - Generic			
H2931	002	0	1	02	01	H2931_002_0	8	6	Special Coverage - Brand			
H2931	002	0	1	02	01	H2931_002_0	8	1	Preferred Generic/Some Brand Maintenance	1		1
H2931	002	0	1	02	01	H2931_002_0	8	2	Preferred Brand	1		1
H2931	002	0	1	02	01	H2931_002_0	8	3	Non-preferred	1		1
H2931	004	0	1	01	01	H2931_004_0	8	2	Preferred Brand			
H2931	004	0	1	01	01	H2931_004_0	8	1	Preferred Generic/Some Brand Maintenance			
H2931	004	0	1	01	01	H2931_004_0	8	3	Non-preferred			
H2931	004	0	1	01	01	H2931_004_0	8	4	Specialty			
H2931	006	0	1	02	01	H2931_006_0	9	4	Specialty			
H2931	006	0	1	02	01	H2931_006_0	9	3	Non-preferred			
H2931	006	0	1	02	01	H2931_006_0	9	2	Preferred Brand			
H2931	006	0	1	02	01	H2931_006_0	9	1	Preferred Generic/Some Brand Maintenance			
H2931	006	0	1	02	01	H2931_006_0	9	5	Special Coverage - Generic			
H2931	006	0	1	02	01	H2931_006_0	9	6	Special Coverage - Brand	1		1
H2931	006	0	1	02	01	H2931_006_0	9	5	Special Coverage - Generic	1		1
H2931	006	0	1	02	01	H2931_006_0	9	4	Specialty	1	01000000	2
H2931	006	0	1	02	01	H2931_006_0	9	3	Non-preferred	1		1
H2931	006	0	1	02	01	H2931_006_0	9	2	Preferred Brand	1		1
H2931	006	0	1	02	01	H2931_006_0	9	1	Preferred Generic/Some Brand Maintenance	1		1
H2931	006	0	1	02	01	H2931_006_0	9	6	Special Coverage - Brand			
H2931	015	0	1	01	01	H2931_015_0	6	1	Preferred Generic/Some Brand Maintenance			
H2931	015	0	1	01	01	H2931_015_0	6	2	Preferred Brand			
H2931	015	0	1	01	01	H2931_015_0	6	3	Non-preferred			
H2931	015	0	1	01	01	H2931_015_0	6	4	Specialty			
H2931	015	0	1	01	01	H2931_015_0	6	5	Special Coverage - Vitamins			
H2931	015	0	1	01	01	H2931_015_0	6	6	Special Coverage - Generic			
H2931	015	0	1	01	01	H2931_015_0	6	7	Special Coverage - Brand	2		
H2931	015	0	1	01	01	H2931_015_0	6	5	Special Coverage - Vitamins	2		
H2931	015	0	1	01	01	H2931_015_0	6	4	Specialty	2		
H2931	015	0	1	01	01	H2931_015_0	6	3	Non-preferred	2		
H2931	015	0	1	01	01	H2931_015_0	6	2	Preferred Brand	1	10000000	2
H2931	015	0	1	01	01	H2931_015_0	6	1	Preferred Generic/Some Brand Maintenance	1		1
H2931	015	0	1	01	01	H2931_015_0	6	7	Special Coverage - Brand			
H2931	015	0	1	01	01	H2931_015_0	6	6	Special Coverage - Generic	2		
H2947	001	0	1	04	01	H2947_001_0	10	1	Preferred Generic			
H2947	001	0	1	04	01	H2947_001_0	10	2	Preferred Brand			
H2947	001	0	1	04	01	H2947_001_0	10	4	Specialty-Generic and Brand	2		
H2947	001	0	1	04	01	H2947_001_0	10	3	Non-preferred Generic/Non-Preferred Brand	2		
H2947	001	0	1	04	01	H2947_001_0	10	2	Preferred Brand	2		
H2947	001	0	1	04	01	H2947_001_0	10	1	Preferred Generic	1		1
H2947	001	0	1	04	01	H2947_001_0	10	4	Specialty-Generic and Brand			
H2947	001	0	1	04	01	H2947_001_0	10	3	Non-preferred Generic/Non-Preferred Brand			
H2947	002	0	1	04	01	H2947_002_0	7	1	Preferred Generic			
H2947	002	0	1	04	01	H2947_002_0	7	3	Non-preferred Generic/Non-Preferred Brand	2		
H2947	002	0	1	04	01	H2947_002_0	7	2	Preferred Brand	2		
H2947	002	0	1	04	01	H2947_002_0	7	1	Preferred Generic	1		1
H2947	002	0	1	04	01	H2947_002_0	7	4	Specialty-Generic and Brand			
H2947	002	0	1	04	01	H2947_002_0	7	3	Non-preferred Generic/Non-Preferred Brand			
H2947	002	0	1	04	01	H2947_002_0	7	2	Preferred Brand			
H2947	002	0	1	04	01	H2947_002_0	7	4	Specialty-Generic and Brand	2		
H2949	002	0	1	01	01	H2949_002_0	8	1	Preferred Generic	1		1
H2949	002	0	1	01	01	H2949_002_0	8	2	Preferred Brand	1	10000000	2
H2949	002	0	1	01	01	H2949_002_0	8	3	Non-Preferred Brand	1	10000000	2
H2949	002	0	1	01	01	H2949_002_0	8	4	Speciality	1	10001000	2
H2949	002	0	1	01	01	H2949_002_0	8	1	Preferred Generic			
H2949	002	0	1	01	01	H2949_002_0	8	2	Preferred Brand			
H2949	002	0	1	01	01	H2949_002_0	8	3	Non-Preferred Brand			
H2949	002	0	1	01	01	H2949_002_0	8	4	Speciality			
H2949	007	0	1	01	01	H2949_007_0	6	1	Preferred Generic			
H2949	007	0	1	01	01	H2949_007_0	6	2	Preferred Brand			
H2949	007	0	1	01	01	H2949_007_0	6	4	Speciality	1	10001000	2
H2949	007	0	1	01	01	H2949_007_0	6	3	Non-Preferred Brand	1	10000000	2
H2949	007	0	1	01	01	H2949_007_0	6	2	Preferred Brand	1	10000000	2
H2949	007	0	1	01	01	H2949_007_0	6	1	Preferred Generic	1		1
H2949	007	0	1	01	01	H2949_007_0	6	4	Speciality			
H2949	007	0	1	01	01	H2949_007_0	6	3	Non-Preferred Brand			
H2949	012	0	1	01	01	H2949_012_0	6	1	Preferred Generic			
H2949	012	0	1	01	01	H2949_012_0	6	3	Non-Preferred Brand	1	10000000	2
H2949	012	0	1	01	01	H2949_012_0	6	2	Preferred Brand	1	10000000	2
H2949	012	0	1	01	01	H2949_012_0	6	1	Preferred Generic	1		1
H2949	012	0	1	01	01	H2949_012_0	6	4	Speciality			
H2949	012	0	1	01	01	H2949_012_0	6	3	Non-Preferred Brand			
H2949	012	0	1	01	01	H2949_012_0	6	2	Preferred Brand			
H2949	012	0	1	01	01	H2949_012_0	6	4	Speciality	1	10001000	2
H2960	004	0	1	01	01	H2960_004_0	7	3	Preferred Brand	2		
H2960	004	0	1	01	01	H2960_004_0	7	2	Non-Preferred Generic			
H2960	004	0	1	01	01	H2960_004_0	7	3	Preferred Brand			
H2960	004	0	1	01	01	H2960_004_0	7	4	Non-Preferred Brand			
H2960	004	0	1	01	01	H2960_004_0	7	5	Special Pharmaceutical			
H2960	004	0	1	01	01	H2960_004_0	7	5	Special Pharmaceutical	2		
H2960	004	0	1	01	01	H2960_004_0	7	4	Non-Preferred Brand	2		
H2960	004	0	1	01	01	H2960_004_0	7	1	Preferred Generic			
H2960	004	0	1	01	01	H2960_004_0	7	2	Non-Preferred Generic	1		1
H2960	004	0	1	01	01	H2960_004_0	7	1	Preferred Generic	1		1
H2960	010	0	1	01	01	H2960_010_0	7	1	Preferred Generic			
H2960	010	0	1	01	01	H2960_010_0	7	2	Non-Preferred Generic			
H2960	010	0	1	01	01	H2960_010_0	7	3	Preferred Brand			
H2960	010	0	1	01	01	H2960_010_0	7	4	Non-Preferred Brand			
H2960	010	0	1	01	01	H2960_010_0	7	5	Special Pharmaceutical			
H2960	012	0	1	01	01	H2960_012_0	7	4	Non-Preferred Brand	2		
H2960	012	0	1	01	01	H2960_012_0	7	5	Special Pharmaceutical	2		
H2960	012	0	1	01	01	H2960_012_0	7	3	Preferred Brand	2		
H2960	012	0	1	01	01	H2960_012_0	7	2	Non-Preferred Generic	1		1
H2960	012	0	1	01	01	H2960_012_0	7	1	Preferred Generic	1		1
H2960	012	0	1	01	01	H2960_012_0	7	5	Special Pharmaceutical			
H2960	012	0	1	01	01	H2960_012_0	7	4	Non-Preferred Brand			
H2960	012	0	1	01	01	H2960_012_0	7	3	Preferred Brand			
H2960	012	0	1	01	01	H2960_012_0	7	2	Non-Preferred Generic			
H2960	012	0	1	01	01	H2960_012_0	7	1	Preferred Generic			
H2961	002	0	1	02	01	H2961_002_0	12	4	Specialty			
H2961	002	0	1	02	01	H2961_002_0	12	5	Special Coverage - Generic			
H2961	002	0	1	02	01	H2961_002_0	12	6	Special Coverage - Brand			
H2961	002	0	1	02	01	H2961_002_0	12	1	Preferred Generic/Some Brand Maintenance	1		1
H2961	002	0	1	02	01	H2961_002_0	12	2	Preferred Brand	1		1
H2961	002	0	1	02	01	H2961_002_0	12	3	Non-preferred			
H2961	002	0	1	02	01	H2961_002_0	12	4	Specialty	1	01000000	2
H2961	002	0	1	02	01	H2961_002_0	12	5	Special Coverage - Generic	1		1
H2961	002	0	1	02	01	H2961_002_0	12	6	Special Coverage - Brand	1		1
H2961	002	0	1	02	01	H2961_002_0	12	1	Preferred Generic/Some Brand Maintenance			
H2961	002	0	1	02	01	H2961_002_0	12	2	Preferred Brand			
H2961	002	0	1	02	01	H2961_002_0	12	3	Non-preferred	1		1
H2961	011	0	1	02	01	H2961_011_0	9	5	Special Coverage - Generic			
H2961	011	0	1	02	01	H2961_011_0	9	6	Special Coverage - Brand			
H2961	011	0	1	02	01	H2961_011_0	9	1	Preferred Generic/Some Brand Maintenance	1		1
H2961	011	0	1	02	01	H2961_011_0	9	2	Preferred Brand	1		1
H2961	011	0	1	02	01	H2961_011_0	9	3	Non-preferred	1		1
H2961	011	0	1	02	01	H2961_011_0	9	4	Specialty	1	01000000	2
H2961	011	0	1	02	01	H2961_011_0	9	5	Special Coverage - Generic	1		1
H2961	011	0	1	02	01	H2961_011_0	9	6	Special Coverage - Brand	1		1
H2961	011	0	1	02	01	H2961_011_0	9	3	Non-preferred			
H2961	011	0	1	02	01	H2961_011_0	9	4	Specialty			
H2961	011	0	1	02	01	H2961_011_0	9	2	Preferred Brand			
H2961	011	0	1	02	01	H2961_011_0	9	1	Preferred Generic/Some Brand Maintenance			
H2997	001	0	1	04	01	H2997_001_0	8	1	Tier 1 Preferred Generic			
H2997	001	0	1	04	01	H2997_001_0	8	2	Tier 2 Preferred Brand			
H2997	001	0	1	04	01	H2997_001_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H2997	001	0	1	04	01	H2997_001_0	8	4	Tier 4 Non-Specialty Injectable			
H2997	001	0	1	04	01	H2997_001_0	8	5	Tier 5 Specialty	2		
H2997	001	0	1	04	01	H2997_001_0	8	1	Tier 1 Preferred Generic	1		1
H2997	001	0	1	04	01	H2997_001_0	8	2	Tier 2 Preferred Brand	2		
H2997	001	0	1	04	01	H2997_001_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H2997	001	0	1	04	01	H2997_001_0	8	4	Tier 4 Non-Specialty Injectable	2		
H2997	001	0	1	04	01	H2997_001_0	8	5	Tier 5 Specialty			
H3011	001	0	1	09	04	H3011_001_0	5	4	Specialty Medication			
H3011	001	0	1	09	04	H3011_001_0	5	3	Non-Preferred Brand			
H3011	001	0	1	09	04	H3011_001_0	5	2	Preferred Brands			
H3011	001	0	1	09	04	H3011_001_0	5	1	Generic			
H3028	001	0	1	01	01	H3028_001_0	6	1	Preferred Generic	1		1
H3028	001	0	1	01	01	H3028_001_0	6	2	Preferred Brand	1	10000000	2
H3028	001	0	1	01	01	H3028_001_0	6	3	Non-Preferred Brand	1	10000000	2
H3028	001	0	1	01	01	H3028_001_0	6	4	Specialty			
H3028	001	0	1	01	01	H3028_001_0	6	4	Specialty	1	10001000	2
H3028	001	0	1	01	01	H3028_001_0	6	3	Non-Preferred Brand			
H3028	001	0	1	01	01	H3028_001_0	6	2	Preferred Brand			
H3028	001	0	1	01	01	H3028_001_0	6	1	Preferred Generic			
H3044	001	0	1	01	01	H3044_001_0	9	2	Brand			
H3044	001	0	1	01	01	H3044_001_0	9	3	Non-Preferred Brand			
H3044	001	0	1	01	01	H3044_001_0	9	4	Specialty			
H3044	001	0	1	01	01	H3044_001_0	9	1	Generics			
H3044	003	0	1	01	01	H3044_003_0	9	1	Generics	1		1
H3044	003	0	1	01	01	H3044_003_0	9	3	Non-Preferred Brand	2		
H3044	003	0	1	01	01	H3044_003_0	9	4	Specialty	2		
H3044	003	0	1	01	01	H3044_003_0	9	4	Specialty			
H3044	003	0	1	01	01	H3044_003_0	9	3	Non-Preferred Brand			
H3044	003	0	1	01	01	H3044_003_0	9	2	Brand			
H3044	003	0	1	01	01	H3044_003_0	9	1	Generics			
H3044	003	0	1	01	01	H3044_003_0	9	2	Brand	2		
H3057	001	1	1	09	04	H3057_001_1	4	1	Tier 1			
H3057	001	1	1	09	04	H3057_001_1	4	3	Tier 3			
H3057	001	1	1	09	04	H3057_001_1	4	1	Tier 1	1		1
H3057	001	1	1	09	04	H3057_001_1	4	2	Tier 2	2		
H3057	001	1	1	09	04	H3057_001_1	4	2	Tier 2			
H3057	001	1	1	09	04	H3057_001_1	4	3	Tier 3	2		
H3057	001	2	1	09	04	H3057_001_2	4	1	Tier 1			
H3057	001	2	1	09	04	H3057_001_2	4	1	Tier 1	1		1
H3057	001	2	1	09	04	H3057_001_2	4	2	Tier 2	2		
H3057	001	2	1	09	04	H3057_001_2	4	2	Tier 2			
H3057	001	2	1	09	04	H3057_001_2	4	3	Tier 3			
H3057	001	2	1	09	04	H3057_001_2	4	3	Tier 3	2		
H3057	002	1	1	09	04	H3057_002_1	4	3	Tier 3			
H3057	002	1	1	09	04	H3057_002_1	4	1	Tier 1			
H3057	002	1	1	09	04	H3057_002_1	4	2	Tier 2			
H3057	002	2	1	09	04	H3057_002_2	4	3	Tier 3			
H3057	002	2	1	09	04	H3057_002_2	4	2	Tier 2			
H3057	002	2	1	09	04	H3057_002_2	4	1	Tier 1			
H3057	007	0	1	09	04	H3057_007_0	4	1	Tier 1			
H3057	007	0	1	09	04	H3057_007_0	4	3	Tier 3			
H3057	007	0	1	09	04	H3057_007_0	4	1	Tier 1	1		1
H3057	007	0	1	09	04	H3057_007_0	4	2	Tier 2			
H3057	007	0	1	09	04	H3057_007_0	4	3	Tier 3	2		
H3057	007	0	1	09	04	H3057_007_0	4	2	Tier 2	2		
H3057	008	0	1	09	04	H3057_008_0	4	2	Tier 2			
H3057	008	0	1	09	04	H3057_008_0	4	3	Tier 3			
H3057	008	0	1	09	04	H3057_008_0	4	1	Tier 1			
H3059	002	0	1	01	01	H3059_002_0	6	1	Generic			
H3059	002	0	1	01	01	H3059_002_0	6	2	Preferred Brand			
H3059	002	0	1	01	01	H3059_002_0	6	3	Non Preferred Brand			
H3059	002	0	1	01	01	H3059_002_0	6	4	Specialty Drugs			
H3107	004	0	1	02	01	H3107_004_0	4	1	Preferred Generic			
H3107	004	0	1	02	01	H3107_004_0	4	2	Preferred Brand			
H3107	004	0	1	02	01	H3107_004_0	4	3	Non Preferred			
H3107	004	0	1	02	01	H3107_004_0	4	4	Specialty			
H3107	005	0	1	02	01	H3107_005_0	6	1	Preferred Generic			
H3107	005	0	1	02	01	H3107_005_0	6	2	Preferred Brand			
H3107	005	0	1	02	01	H3107_005_0	6	3	Non Preferred			
H3107	005	0	1	02	01	H3107_005_0	6	4	Specialty			
H3113	001	0	1	01	01	H3113_001_0	9	4	Specialty			
H3113	001	0	1	01	01	H3113_001_0	9	3	Non Preferred			
H3113	001	0	1	01	01	H3113_001_0	9	2	Preferred Brand			
H3113	001	0	1	01	01	H3113_001_0	9	1	Preferred Generic			
H3113	002	0	1	01	01	H3113_002_0	4	4	Specialty			
H3113	002	0	1	01	01	H3113_002_0	4	3	Non Preferred			
H3113	002	0	1	01	01	H3113_002_0	4	2	Preferred Brand			
H3113	002	0	1	01	01	H3113_002_0	4	1	Preferred Generic			
H3152	022	0	1	01	01	H3152_022_0	6	2	Tier 2 - Non-Preferred Generic			
H3152	022	0	1	01	01	H3152_022_0	6	1	Tier 1 - Preferred Generic			
H3152	022	0	1	01	01	H3152_022_0	6	5	Tier 5 - Specialty			
H3152	022	0	1	01	01	H3152_022_0	6	4	Tier 4 - Non-Preferred Brand			
H3152	022	0	1	01	01	H3152_022_0	6	3	Tier 3 - Preferred Brand			
H3152	046	0	1	01	01	H3152_046_0	4	5	Tier 5 - Specialty			
H3152	046	0	1	01	01	H3152_046_0	4	2	Tier 2 - Non-Preferred Generic			
H3152	046	0	1	01	01	H3152_046_0	4	1	Tier 1 - Preferred Generic			
H3152	046	0	1	01	01	H3152_046_0	4	4	Tier 4 - Non-Preferred Brand			
H3152	046	0	1	01	01	H3152_046_0	4	3	Tier 3 - Preferred Brand			
H3152	047	0	1	01	01	H3152_047_0	4	3	Tier 3 - Preferred Brand			
H3152	047	0	1	01	01	H3152_047_0	4	5	Tier 5 - Specialty			
H3152	047	0	1	01	01	H3152_047_0	4	4	Tier 4 - Non-Preferred Brand			
H3152	047	0	1	01	01	H3152_047_0	4	1	Tier 1 - Preferred Generic			
H3152	047	0	1	01	01	H3152_047_0	4	2	Tier 2 - Non-Preferred Generic			
H3152	048	0	1	01	01	H3152_048_0	4	2	Tier 2 - Non-Preferred Generic			
H3152	048	0	1	01	01	H3152_048_0	4	1	Tier 1 - Preferred Generic			
H3152	048	0	1	01	01	H3152_048_0	4	1	Tier 1 - Preferred Generic	1		1
H3152	048	0	1	01	01	H3152_048_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H3152	048	0	1	01	01	H3152_048_0	4	3	Tier 3 - Preferred Brand	2		
H3152	048	0	1	01	01	H3152_048_0	4	4	Tier 4 - Non-Preferred Brand	2		
H3152	048	0	1	01	01	H3152_048_0	4	5	Tier 5 - Specialty	2		
H3152	048	0	1	01	01	H3152_048_0	4	3	Tier 3 - Preferred Brand			
H3152	048	0	1	01	01	H3152_048_0	4	5	Tier 5 - Specialty			
H3152	048	0	1	01	01	H3152_048_0	4	4	Tier 4 - Non-Preferred Brand			
H3152	053	0	1	01	01	H3152_053_0	6	3	Tier 3 - Preferred Brand			
H3152	053	0	1	01	01	H3152_053_0	6	5	Tier 5 - Specialty			
H3152	053	0	1	01	01	H3152_053_0	6	4	Tier 4 - Non-Preferred Brand			
H3152	053	0	1	01	01	H3152_053_0	6	2	Tier 2 - Non-Preferred Generic			
H3152	053	0	1	01	01	H3152_053_0	6	1	Tier 1 - Preferred Generic			
H3152	073	0	1	01	01	H3152_073_0	7	4	Tier 4 - Non-Preferred Brand			
H3152	073	0	1	01	01	H3152_073_0	7	5	Tier 5 - Specialty			
H3152	073	0	1	01	01	H3152_073_0	7	3	Tier 3 - Preferred Brand			
H3152	073	0	1	01	01	H3152_073_0	7	2	Tier 2 - Non-Preferred Generic			
H3152	073	0	1	01	01	H3152_073_0	7	1	Tier 1 - Preferred Generic			
H3152	074	0	1	01	01	H3152_074_0	6	5	Tier 5 - Specialty			
H3152	074	0	1	01	01	H3152_074_0	6	3	Tier 3 - Preferred Brand			
H3152	074	0	1	01	01	H3152_074_0	6	4	Tier 4 - Non-Preferred Brand			
H3152	074	0	1	01	01	H3152_074_0	6	2	Tier 2 - Non-Preferred Generic			
H3152	074	0	1	01	01	H3152_074_0	6	1	Tier1 - Preferred Generic			
H3154	004	0	1	01	01	H3154_004_0	6	2	Preferred Brand			
H3154	004	0	1	01	01	H3154_004_0	6	3	Non-Preferred Brand			
H3154	004	0	1	01	01	H3154_004_0	6	1	Generic			
H3154	004	0	1	01	01	H3154_004_0	6	4	Specialty			
H3154	006	0	1	02	01	H3154_006_0	7	3	Non-Preferred Brand			
H3154	006	0	1	02	01	H3154_006_0	7	2	Preferred Brand			
H3154	006	0	1	02	01	H3154_006_0	7	1	Generic			
H3154	006	0	1	02	01	H3154_006_0	7	4	Specialty			
H3154	006	0	1	02	01	H3154_006_0	7	4	Specialty	2		
H3154	006	0	1	02	01	H3154_006_0	7	3	Non-Preferred Brand	2		
H3154	006	0	1	02	01	H3154_006_0	7	2	Preferred Brand	2		
H3154	006	0	1	02	01	H3154_006_0	7	1	Generic	1		1
H3154	012	0	1	02	01	H3154_012_0	3	2	Preferred Brand			
H3154	012	0	1	02	01	H3154_012_0	3	1	Generic			
H3154	012	0	1	02	01	H3154_012_0	3	4	Specialty			
H3154	012	0	1	02	01	H3154_012_0	3	3	Non-Preferred Brand			
H3154	015	0	1	02	01	H3154_015_0	7	1	Generic			
H3154	015	0	1	02	01	H3154_015_0	7	2	Preferred Brand			
H3154	015	0	1	02	01	H3154_015_0	7	3	Non-Preferred Brand			
H3154	015	0	1	02	01	H3154_015_0	7	4	Specialty			
H3154	015	0	1	02	01	H3154_015_0	7	1	Generic	1		1
H3154	015	0	1	02	01	H3154_015_0	7	2	Preferred Brand	2		
H3154	015	0	1	02	01	H3154_015_0	7	3	Non-Preferred Brand	2		
H3154	015	0	1	02	01	H3154_015_0	7	4	Specialty	2		
H3154	016	0	1	01	01	H3154_016_0	4	1	Generic			
H3154	016	0	1	01	01	H3154_016_0	4	2	Preferred Brand			
H3154	016	0	1	01	01	H3154_016_0	4	3	Non-Preferred Brand			
H3154	016	0	1	01	01	H3154_016_0	4	4	Specialty	2		
H3154	016	0	1	01	01	H3154_016_0	4	1	Generic	1		1
H3154	016	0	1	01	01	H3154_016_0	4	2	Preferred Brand	2		
H3154	016	0	1	01	01	H3154_016_0	4	3	Non-Preferred Brand	2		
H3154	016	0	1	01	01	H3154_016_0	4	4	Specialty			
H3154	017	0	1	01	01	H3154_017_0	8	1	Generic			
H3154	017	0	1	01	01	H3154_017_0	8	2	Preferred Brand			
H3154	017	0	1	01	01	H3154_017_0	8	3	Non-Preferred Brand			
H3154	017	0	1	01	01	H3154_017_0	8	4	Specialty			
H3154	017	0	1	01	01	H3154_017_0	8	1	Generic	1		1
H3154	017	0	1	01	01	H3154_017_0	8	2	Preferred Brand	2		
H3154	017	0	1	01	01	H3154_017_0	8	3	Non-Preferred Brand	2		
H3154	017	0	1	01	01	H3154_017_0	8	4	Specialty	2		
H3156	021	0	1	02	01	H3156_021_0	3	4	Specialty			
H3156	021	0	1	02	01	H3156_021_0	3	3	Non-Preferred Brand			
H3156	021	0	1	02	01	H3156_021_0	3	2	Preferred Brand			
H3156	021	0	1	02	01	H3156_021_0	3	1	Generic			
H3156	026	0	1	01	01	H3156_026_0	3	4	Specialty			
H3156	026	0	1	01	01	H3156_026_0	3	3	Non-Preferred Brand			
H3156	026	0	1	01	01	H3156_026_0	3	2	Preferred Brand			
H3156	026	0	1	01	01	H3156_026_0	3	1	Generic			
H3156	028	0	1	01	01	H3156_028_0	3	3	Non-Preferred Brand			
H3156	028	0	1	01	01	H3156_028_0	3	4	Specialty			
H3156	028	0	1	01	01	H3156_028_0	3	2	Preferred Brand			
H3156	028	0	1	01	01	H3156_028_0	3	1	Generic			
H3195	001	0	1	04	01	H3195_001_0	7	4	Specialty-Tier 4			
H3195	001	0	1	04	01	H3195_001_0	7	3	Non-Preferred Brand-Tier 3			
H3195	001	0	1	04	01	H3195_001_0	7	2	Preferred Brand-Tier 2			
H3195	001	0	1	04	01	H3195_001_0	7	1	Generic-Tier 1			
H3195	001	0	1	04	01	H3195_001_0	7	1	Generic-Tier 1	1		1
H3195	001	0	1	04	01	H3195_001_0	7	2	Preferred Brand-Tier 2	2		
H3195	001	0	1	04	01	H3195_001_0	7	3	Non-Preferred Brand-Tier 3	2		
H3195	001	0	1	04	01	H3195_001_0	7	4	Specialty-Tier 4	2		
H3204	001	0	1	01	01	H3204_001_0	5	3	Non-Preferred			
H3204	001	0	1	01	01	H3204_001_0	5	2	Preferred Brand			
H3204	001	0	1	01	01	H3204_001_0	5	1	Preferred Generic			
H3204	001	0	1	01	01	H3204_001_0	5	4	Specialty			
H3204	007	0	1	01	01	H3204_007_0	5	4	Specialty	2		
H3204	007	0	1	01	01	H3204_007_0	5	3	Non-Preferred	2		
H3204	007	0	1	01	01	H3204_007_0	5	2	Preferred Brand	2		
H3204	007	0	1	01	01	H3204_007_0	5	4	Specialty			
H3204	007	0	1	01	01	H3204_007_0	5	1	Preferred Generic	1	00100000	2
H3204	007	0	1	01	01	H3204_007_0	5	3	Non-Preferred			
H3204	007	0	1	01	01	H3204_007_0	5	2	Preferred Brand			
H3204	007	0	1	01	01	H3204_007_0	5	1	Preferred Generic			
H3206	001	0	1	04	01	H3206_001_0	5	3	Non-Preferred			
H3206	001	0	1	04	01	H3206_001_0	5	2	Preferred Brand			
H3206	001	0	1	04	01	H3206_001_0	5	1	Preferred Generic			
H3206	001	0	1	04	01	H3206_001_0	5	4	Specialty			
H3206	002	0	1	04	01	H3206_002_0	5	1	Preferred Generic	1	00100000	2
H3206	002	0	1	04	01	H3206_002_0	5	2	Preferred Brand	2		
H3206	002	0	1	04	01	H3206_002_0	5	3	Non-Preferred	2		
H3206	002	0	1	04	01	H3206_002_0	5	4	Specialty	2		
H3206	002	0	1	04	01	H3206_002_0	5	1	Preferred Generic			
H3206	002	0	1	04	01	H3206_002_0	5	2	Preferred Brand			
H3206	002	0	1	04	01	H3206_002_0	5	3	Non-Preferred			
H3206	002	0	1	04	01	H3206_002_0	5	4	Specialty			
H3207	001	0	1	04	01	H3207_001_0	11	3	Non Preferred			
H3207	001	0	1	04	01	H3207_001_0	11	4	Specialty Drug			
H3207	001	0	1	04	01	H3207_001_0	11	1	Preferred generic			
H3207	001	0	1	04	01	H3207_001_0	11	2	Preferred Brand			
H3207	002	0	1	04	01	H3207_002_0	11	1	Preferred generic			
H3207	002	0	1	04	01	H3207_002_0	11	2	Preferred Brand			
H3207	002	0	1	04	01	H3207_002_0	11	3	Non Preferred			
H3207	002	0	1	04	01	H3207_002_0	11	4	Specialty Drug			
H3207	003	0	1	04	01	H3207_003_0	9	1	Preferred generic			
H3207	003	0	1	04	01	H3207_003_0	9	2	Preferred brand			
H3207	003	0	1	04	01	H3207_003_0	9	3	Non Preferred	2		
H3207	003	0	1	04	01	H3207_003_0	9	4	Specialty Drug	2		
H3207	003	0	1	04	01	H3207_003_0	9	2	Preferred brand	2		
H3207	003	0	1	04	01	H3207_003_0	9	1	Preferred generic	1		1
H3207	003	0	1	04	01	H3207_003_0	9	3	Non Preferred			
H3207	003	0	1	04	01	H3207_003_0	9	4	Specialty Drug			
H3207	004	0	1	04	01	H3207_004_0	10	1	Preferred generic	1		1
H3207	004	0	1	04	01	H3207_004_0	10	4	Specialty Drug			
H3207	004	0	1	04	01	H3207_004_0	10	3	Non Preferred			
H3207	004	0	1	04	01	H3207_004_0	10	2	Preferred brand			
H3207	004	0	1	04	01	H3207_004_0	10	1	Preferred generic			
H3207	004	0	1	04	01	H3207_004_0	10	3	Non Preferred	2		
H3207	004	0	1	04	01	H3207_004_0	10	2	Preferred brand	2		
H3207	004	0	1	04	01	H3207_004_0	10	4	Specialty Drug	2		
H3208	001	0	1	04	01	H3208_001_0	10	4	Specialty			
H3208	001	0	1	04	01	H3208_001_0	10	3	Brand			
H3208	001	0	1	04	01	H3208_001_0	10	1	Generic			
H3208	001	0	1	04	01	H3208_001_0	10	2	Preferred Brand			
H3208	003	0	1	04	01	H3208_003_0	7	1	Generic			
H3208	003	0	1	04	01	H3208_003_0	7	2	Preferred Brand			
H3208	003	0	1	04	01	H3208_003_0	7	3	Brand			
H3208	003	0	1	04	01	H3208_003_0	7	4	Specialty			
H3208	004	0	1	04	01	H3208_004_0	10	3	Brand			
H3208	004	0	1	04	01	H3208_004_0	10	2	Preferred Brand			
H3208	004	0	1	04	01	H3208_004_0	10	1	Generic			
H3208	004	0	1	04	01	H3208_004_0	10	4	Specialty			
H3208	004	0	1	04	01	H3208_004_0	10	1	Generic	1		1
H3208	004	0	1	04	01	H3208_004_0	10	4	Specialty	1	01000000	2
H3208	004	0	1	04	01	H3208_004_0	10	3	Brand	2		
H3208	004	0	1	04	01	H3208_004_0	10	2	Preferred Brand	2		
H3209	001	0	1	04	01	H3209_001_0	4	1	Preferred Generic			
H3209	001	0	1	04	01	H3209_001_0	4	2	Preferred Brand			
H3209	001	0	1	04	01	H3209_001_0	4	3	Non Preferred			
H3209	001	0	1	04	01	H3209_001_0	4	4	Specialty			
H3209	003	0	1	04	01	H3209_003_0	3	1	Preferred Generic			
H3209	003	0	1	04	01	H3209_003_0	3	2	Preferred Brand			
H3209	003	0	1	04	01	H3209_003_0	3	3	Non Preferred			
H3209	003	0	1	04	01	H3209_003_0	3	4	Specialty			
H3240	008	0	1	01	01	H3240_008_0	5	1	Generic Drugs	1		1
H3240	008	0	1	01	01	H3240_008_0	5	4	Specialty Drugs			
H3240	008	0	1	01	01	H3240_008_0	5	3	Non-Preferred Brand Name Drugs			
H3240	008	0	1	01	01	H3240_008_0	5	2	Preferred Brand Name Drugs			
H3240	008	0	1	01	01	H3240_008_0	5	1	Generic Drugs			
H3240	008	0	1	01	01	H3240_008_0	5	2	Preferred Brand Name Drugs	2		
H3240	008	0	1	01	01	H3240_008_0	5	4	Specialty Drugs	2		
H3240	008	0	1	01	01	H3240_008_0	5	3	Non-Preferred Brand Name Drugs	2		
H3240	009	0	1	01	01	H3240_009_0	5	1	Generic Drugs			
H3240	009	0	1	01	01	H3240_009_0	5	3	Non-Preferred Brand Name Drugs			
H3240	009	0	1	01	01	H3240_009_0	5	2	Preferred Brand Name Drugs			
H3240	009	0	1	01	01	H3240_009_0	5	4	Specialty Drugs			
H3240	010	0	1	01	01	H3240_010_0	6	1	Generic Drugs	1		1
H3240	010	0	1	01	01	H3240_010_0	6	4	Specialty Drugs			
H3240	010	0	1	01	01	H3240_010_0	6	3	Non-Preferred Brand Name Drugs			
H3240	010	0	1	01	01	H3240_010_0	6	2	Preferred Brand Name Drugs			
H3240	010	0	1	01	01	H3240_010_0	6	1	Generic Drugs			
H3240	010	0	1	01	01	H3240_010_0	6	2	Preferred Brand Name Drugs	2		
H3240	010	0	1	01	01	H3240_010_0	6	4	Specialty Drugs	2		
H3240	010	0	1	01	01	H3240_010_0	6	3	Non-Preferred Brand Name Drugs	2		
H3240	013	0	1	01	01	H3240_013_0	4	3	Non-Preferred Brand Name Drugs			
H3240	013	0	1	01	01	H3240_013_0	4	2	Preferred Brand Name Drugs			
H3240	013	0	1	01	01	H3240_013_0	4	1	Generic Drugs			
H3240	013	0	1	01	01	H3240_013_0	4	4	Specialty Drugs			
H3240	014	0	1	02	01	H3240_014_0	3	3	Non-Preferred Brand Name Drugs			
H3240	014	0	1	02	01	H3240_014_0	3	2	Preferred Brand Name Drugs			
H3240	014	0	1	02	01	H3240_014_0	3	1	Generic Drugs			
H3240	014	0	1	02	01	H3240_014_0	3	4	Specialty Drugs			
H3240	014	0	1	02	01	H3240_014_0	3	4	Specialty Drugs	2		
H3240	014	0	1	02	01	H3240_014_0	3	3	Non-Preferred Brand Name Drugs	2		
H3240	014	0	1	02	01	H3240_014_0	3	2	Preferred Brand Name Drugs	2		
H3240	014	0	1	02	01	H3240_014_0	3	1	Generic Drugs	1		1
H3240	015	0	1	02	01	H3240_015_0	3	3	Non-Preferred Brand Name Drugs			
H3240	015	0	1	02	01	H3240_015_0	3	1	Generic Drugs			
H3240	015	0	1	02	01	H3240_015_0	3	2	Preferred Brand Name Drugs			
H3240	015	0	1	02	01	H3240_015_0	3	4	Specialty Drugs			
H3251	002	0	1	01	01	H3251_002_0	8	1	Preferred Generic			
H3251	002	0	1	01	01	H3251_002_0	8	2	Preferred Brand			
H3251	002	0	1	01	01	H3251_002_0	8	4	Specialty Drug	2		
H3251	002	0	1	01	01	H3251_002_0	8	3	Non Preferred	2		
H3251	002	0	1	01	01	H3251_002_0	8	2	Preferred Brand	2		
H3251	002	0	1	01	01	H3251_002_0	8	1	Preferred Generic	1		1
H3251	002	0	1	01	01	H3251_002_0	8	4	Specialty Drug			
H3251	002	0	1	01	01	H3251_002_0	8	3	Non Preferred			
H3251	021	0	1	01	01	H3251_021_0	8	1	Preferred Generic			
H3251	021	0	1	01	01	H3251_021_0	8	3	Non Preferred	2		
H3251	021	0	1	01	01	H3251_021_0	8	2	Preferred Brand	2		
H3251	021	0	1	01	01	H3251_021_0	8	1	Preferred Generic	1		1
H3251	021	0	1	01	01	H3251_021_0	8	4	Specialty Drug			
H3251	021	0	1	01	01	H3251_021_0	8	3	Non Preferred			
H3251	021	0	1	01	01	H3251_021_0	8	2	Preferred Brand			
H3251	021	0	1	01	01	H3251_021_0	8	4	Specialty Drug	2		
H3305	011	0	1	01	01	H3305_011_0	13	1	Tier 1			
H3305	011	0	1	01	01	H3305_011_0	13	2	Tier 2			
H3305	011	0	1	01	01	H3305_011_0	13	3	Tier 3			
H3307	002	0	1	01	01	H3307_002_0	7	4	Specialty			
H3307	002	0	1	01	01	H3307_002_0	7	3	Non Preferred			
H3307	002	0	1	01	01	H3307_002_0	7	1	Preferred Generic			
H3307	002	0	1	01	01	H3307_002_0	7	2	Preferred Brand			
H3307	011	0	1	01	01	H3307_011_0	5	2	Preferred Brand			
H3307	011	0	1	01	01	H3307_011_0	5	1	Preferred Generic			
H3307	011	0	1	01	01	H3307_011_0	5	4	Specialty			
H3307	011	0	1	01	01	H3307_011_0	5	3	Non Preferred			
H3307	012	0	1	01	01	H3307_012_0	6	4	Specialty			
H3307	012	0	1	01	01	H3307_012_0	6	3	Non Preferred			
H3307	012	0	1	01	01	H3307_012_0	6	2	Preferred Brand			
H3307	012	0	1	01	01	H3307_012_0	6	1	Preferred Generic			
H3307	013	0	1	01	01	H3307_013_0	5	2	Preferred Brand			
H3307	013	0	1	01	01	H3307_013_0	5	1	Preferred Generic			
H3307	013	0	1	01	01	H3307_013_0	5	4	Specialty			
H3307	013	0	1	01	01	H3307_013_0	5	3	Non Preferred			
H3307	015	0	1	01	01	H3307_015_0	6	2	Preferred Brand	2		
H3307	015	0	1	01	01	H3307_015_0	6	3	Non Preferred	2		
H3307	015	0	1	01	01	H3307_015_0	6	4	Specialty	2		
H3307	015	0	1	01	01	H3307_015_0	6	1	Preferred Generic	1		1
H3307	015	0	1	01	01	H3307_015_0	6	4	Specialty			
H3307	015	0	1	01	01	H3307_015_0	6	3	Non Preferred			
H3307	015	0	1	01	01	H3307_015_0	6	2	Preferred Brand			
H3307	015	0	1	01	01	H3307_015_0	6	1	Preferred Generic			
H3307	021	0	1	01	01	H3307_021_0	7	4	Specialty			
H3307	021	0	1	01	01	H3307_021_0	7	1	Preferred Generic	1		1
H3307	021	0	1	01	01	H3307_021_0	7	2	Preferred Brand	2		
H3307	021	0	1	01	01	H3307_021_0	7	3	Non Preferred	2		
H3307	021	0	1	01	01	H3307_021_0	7	4	Specialty	2		
H3307	021	0	1	01	01	H3307_021_0	7	2	Preferred Brand			
H3307	021	0	1	01	01	H3307_021_0	7	1	Preferred Generic			
H3307	021	0	1	01	01	H3307_021_0	7	3	Non Preferred			
H3312	002	0	1	01	01	H3312_002_0	5	1	Tier 1 - Preferred Generic			
H3312	002	0	1	01	01	H3312_002_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	002	0	1	01	01	H3312_002_0	5	3	Tier 3 - Preferred Brand			
H3312	002	0	1	01	01	H3312_002_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	002	0	1	01	01	H3312_002_0	5	5	Tier 5 - Specialty	2		
H3312	002	0	1	01	01	H3312_002_0	5	1	Tier 1 - Preferred Generic	1		1
H3312	002	0	1	01	01	H3312_002_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H3312	002	0	1	01	01	H3312_002_0	5	3	Tier 3 - Preferred Brand	2		
H3312	002	0	1	01	01	H3312_002_0	5	4	Tier 4 - Non-Preferred Brand	2		
H3312	002	0	1	01	01	H3312_002_0	5	5	Tier 5 - Specialty			
H3312	018	0	1	01	01	H3312_018_0	5	1	Tier 1 - Preferred Generic			
H3312	018	0	1	01	01	H3312_018_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	018	0	1	01	01	H3312_018_0	5	5	Tier 5 - Specialty			
H3312	018	0	1	01	01	H3312_018_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	018	0	1	01	01	H3312_018_0	5	3	Tier 3 - Preferred Brand			
H3312	025	0	1	01	01	H3312_025_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	025	0	1	01	01	H3312_025_0	5	3	Tier 3 - Preferred Brand			
H3312	025	0	1	01	01	H3312_025_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	025	0	1	01	01	H3312_025_0	5	1	Tier 1 - Preferred Generic			
H3312	025	0	1	01	01	H3312_025_0	5	5	Tier 5 - Specialty			
H3312	028	0	1	01	01	H3312_028_0	4	1	Tier 1 - Preferred Generic	1		1
H3312	028	0	1	01	01	H3312_028_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H3312	028	0	1	01	01	H3312_028_0	4	3	Tier 3 - Preferred Brand	1		1
H3312	028	0	1	01	01	H3312_028_0	4	4	Tier 4 - Non-Preferred Brand	1		1
H3312	028	0	1	01	01	H3312_028_0	4	5	Tier 5 - Specialty			
H3312	028	0	1	01	01	H3312_028_0	4	4	Tier 4 - Non-Preferred Brand			
H3312	028	0	1	01	01	H3312_028_0	4	5	Tier 5 - Specialty	1		1
H3312	028	0	1	01	01	H3312_028_0	4	2	Tier 2 - Non-Preferred Generic			
H3312	028	0	1	01	01	H3312_028_0	4	1	Tier 1 - Preferred Generic			
H3312	028	0	1	01	01	H3312_028_0	4	3	Tier 3 - Preferred Brand			
H3312	037	0	1	01	01	H3312_037_0	4	1	Tier 1 - Preferred Generic			
H3312	037	0	1	01	01	H3312_037_0	4	2	Tier 2 - Non-Preferred Generic			
H3312	037	0	1	01	01	H3312_037_0	4	3	Tier 3 - Preferred Brand			
H3312	037	0	1	01	01	H3312_037_0	4	4	Tier 4 - Non-Preferred Brand			
H3312	037	0	1	01	01	H3312_037_0	4	5	Tier 5 - Specialty	2		
H3312	037	0	1	01	01	H3312_037_0	4	1	Tier 1 - Preferred Generic	1		1
H3312	037	0	1	01	01	H3312_037_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H3312	037	0	1	01	01	H3312_037_0	4	3	Tier 3 - Preferred Brand	2		
H3312	037	0	1	01	01	H3312_037_0	4	4	Tier 4 - Non-Preferred Brand	2		
H3312	037	0	1	01	01	H3312_037_0	4	5	Tier 5 - Specialty			
H3312	043	0	1	01	01	H3312_043_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	043	0	1	01	01	H3312_043_0	5	3	Tier 3 - Preferred Brand			
H3312	043	0	1	01	01	H3312_043_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	043	0	1	01	01	H3312_043_0	5	1	Tier 1 - Preferred Generic			
H3312	043	0	1	01	01	H3312_043_0	5	5	Tier 5 - Specialty			
H3312	044	0	1	01	01	H3312_044_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	044	0	1	01	01	H3312_044_0	5	3	Tier 3 - Preferred Brand			
H3312	044	0	1	01	01	H3312_044_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	044	0	1	01	01	H3312_044_0	5	1	Tier 1 - Preferred Generic			
H3312	044	0	1	01	01	H3312_044_0	5	5	Tier 5 - Specialty			
H3312	044	0	1	01	01	H3312_044_0	5	5	Tier 5 - Specialty	2		
H3312	044	0	1	01	01	H3312_044_0	5	4	Tier 4 - Non-Preferred Brand	2		
H3312	044	0	1	01	01	H3312_044_0	5	3	Tier 3 - Preferred Brand	2		
H3312	044	0	1	01	01	H3312_044_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H3312	044	0	1	01	01	H3312_044_0	5	1	Tier 1 - Preferred Generic	1		1
H3312	048	0	1	01	01	H3312_048_0	5	3	Tier 3 - Preferred Brand			
H3312	048	0	1	01	01	H3312_048_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	048	0	1	01	01	H3312_048_0	5	1	Tier 1 - Preferred Generic			
H3312	048	0	1	01	01	H3312_048_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	048	0	1	01	01	H3312_048_0	5	5	Tier 5 - Specialty			
H3312	050	0	1	01	01	H3312_050_0	7	1	Tier 1 - Preferred Generic			
H3312	050	0	1	01	01	H3312_050_0	7	2	Tier 2 - Non-Preferred Generic			
H3312	050	0	1	01	01	H3312_050_0	7	3	Tier 3 - Preferred Brand			
H3312	050	0	1	01	01	H3312_050_0	7	4	Tier 4 - Non-Preferred Brand			
H3312	050	0	1	01	01	H3312_050_0	7	5	Tier 5 - Specialty	2		
H3312	050	0	1	01	01	H3312_050_0	7	1	Tier 1 - Preferred Generic	1		1
H3312	050	0	1	01	01	H3312_050_0	7	2	Tier 2 - Non-Preferred Generic	1		1
H3312	050	0	1	01	01	H3312_050_0	7	3	Tier 3 - Preferred Brand	2		
H3312	050	0	1	01	01	H3312_050_0	7	4	Tier 4 - Non-Preferred Brand	2		
H3312	050	0	1	01	01	H3312_050_0	7	5	Tier 5 - Specialty			
H3312	052	0	1	01	01	H3312_052_0	7	5	Tier 5 - Specialty			
H3312	052	0	1	01	01	H3312_052_0	7	1	Tier 1 - Preferred Generic	1		1
H3312	052	0	1	01	01	H3312_052_0	7	2	Tier 2 - Non-Preferred Generic	1		1
H3312	052	0	1	01	01	H3312_052_0	7	3	Tier 3 - Preferred Brand	2		
H3312	052	0	1	01	01	H3312_052_0	7	4	Tier 4 - Non-Preferred Brand	2		
H3312	052	0	1	01	01	H3312_052_0	7	5	Tier 5 - Specialty	2		
H3312	052	0	1	01	01	H3312_052_0	7	1	Tier 1 - Preferred Generic			
H3312	052	0	1	01	01	H3312_052_0	7	2	Tier 2 - Non-Preferred Generic			
H3312	052	0	1	01	01	H3312_052_0	7	3	Tier 3 - Preferred Brand			
H3312	052	0	1	01	01	H3312_052_0	7	4	Tier 4 - Non-Preferred Brand			
H3312	055	0	1	01	01	H3312_055_0	8	2	Tier 2 - Non-Preferred Generic			
H3312	055	0	1	01	01	H3312_055_0	8	1	Tier 1 - Preferred Generic			
H3312	055	0	1	01	01	H3312_055_0	8	3	Tier 3 - Preferred Brand			
H3312	055	0	1	01	01	H3312_055_0	8	4	Tier 4 - Non-Preferred Brand			
H3312	055	0	1	01	01	H3312_055_0	8	5	Tier 5 - Specialty	1		1
H3312	055	0	1	01	01	H3312_055_0	8	1	Tier 1 - Preferred Generic	1		1
H3312	055	0	1	01	01	H3312_055_0	8	2	Tier 2 - Non-Preferred Generic	1		1
H3312	055	0	1	01	01	H3312_055_0	8	3	Tier 3 - Preferred Brand	1		1
H3312	055	0	1	01	01	H3312_055_0	8	4	Tier 4 - Non-Preferred Brand	1		1
H3312	055	0	1	01	01	H3312_055_0	8	5	Tier 5 - Specialty			
H3312	057	0	1	01	01	H3312_057_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	057	0	1	01	01	H3312_057_0	5	1	Tier 1 - Preferred Generic			
H3312	057	0	1	01	01	H3312_057_0	5	3	Tier 3 - Preferred Brand			
H3312	057	0	1	01	01	H3312_057_0	5	5	Tier 5 - Specialty			
H3312	057	0	1	01	01	H3312_057_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	058	0	1	01	01	H3312_058_0	5	1	Tier 1 - Preferred Generic			
H3312	058	0	1	01	01	H3312_058_0	5	2	Tier 2 - Non-Preferred Generic			
H3312	058	0	1	01	01	H3312_058_0	5	3	Tier 3 - Preferred Brand			
H3312	058	0	1	01	01	H3312_058_0	5	4	Tier 4 - Non-Preferred Brand			
H3312	058	0	1	01	01	H3312_058_0	5	5	Tier 5 - Specialty	2		
H3312	058	0	1	01	01	H3312_058_0	5	1	Tier 1 - Preferred Generic	1		1
H3312	058	0	1	01	01	H3312_058_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H3312	058	0	1	01	01	H3312_058_0	5	4	Tier 4 - Non-Preferred Brand	2		
H3312	058	0	1	01	01	H3312_058_0	5	3	Tier 3 - Preferred Brand	2		
H3312	058	0	1	01	01	H3312_058_0	5	5	Tier 5 - Specialty			
H3327	001	0	1	01	01	H3327_001_0	15	1	Generic			
H3327	001	0	1	01	01	H3327_001_0	15	4	Biological and Specialty Injectibles	2		
H3327	001	0	1	01	01	H3327_001_0	15	3	Non-Preferred Brand	2		
H3327	001	0	1	01	01	H3327_001_0	15	2	Preferred Brand	2		
H3327	001	0	1	01	01	H3327_001_0	15	1	Generic	1		1
H3327	001	0	1	01	01	H3327_001_0	15	4	Biological and Specialty Injectibles			
H3327	001	0	1	01	01	H3327_001_0	15	3	Non-Preferred Brand			
H3327	001	0	1	01	01	H3327_001_0	15	2	Preferred Brand			
H3327	002	0	1	01	01	H3327_002_0	17	1	Generic			
H3327	002	0	1	01	01	H3327_002_0	17	2	Preferred Brand			
H3327	002	0	1	01	01	H3327_002_0	17	3	Non-Preferred Brand			
H3327	002	0	1	01	01	H3327_002_0	17	4	Biological and Specialty Injectibles			
H3327	002	0	1	01	01	H3327_002_0	17	1	Generic	1		1
H3327	002	0	1	01	01	H3327_002_0	17	2	Preferred Brand	2		
H3327	002	0	1	01	01	H3327_002_0	17	3	Non-Preferred Brand	2		
H3327	002	0	1	01	01	H3327_002_0	17	4	Biological and Specialty Injectibles	2		
H3327	003	0	1	02	01	H3327_003_0	15	4	Biological and Specialty Injectibles	2		
H3327	003	0	1	02	01	H3327_003_0	15	3	Non-Preferred Brand	2		
H3327	003	0	1	02	01	H3327_003_0	15	2	Preferred Brand	2		
H3327	003	0	1	02	01	H3327_003_0	15	1	Generic	1		1
H3327	003	0	1	02	01	H3327_003_0	15	4	Biological and Specialty Injectibles			
H3327	003	0	1	02	01	H3327_003_0	15	3	Non-Preferred Brand			
H3327	003	0	1	02	01	H3327_003_0	15	2	Preferred Brand			
H3327	003	0	1	02	01	H3327_003_0	15	1	Generic			
H3327	021	0	1	01	01	H3327_021_0	15	1	Generic			
H3327	021	0	1	01	01	H3327_021_0	15	2	Preferred Brand			
H3327	021	0	1	01	01	H3327_021_0	15	3	Non-Preferred Brand			
H3327	021	0	1	01	01	H3327_021_0	15	4	Biological and Specialty Injectibles			
H3327	021	0	1	01	01	H3327_021_0	15	1	Generic	1		1
H3327	021	0	1	01	01	H3327_021_0	15	2	Preferred Brand	2		
H3327	021	0	1	01	01	H3327_021_0	15	3	Non-Preferred Brand	2		
H3327	021	0	1	01	01	H3327_021_0	15	4	Biological and Specialty Injectibles	2		
H3327	023	0	1	02	01	H3327_023_0	14	3	Non-Preferred Brand	2		
H3327	023	0	1	02	01	H3327_023_0	14	4	Biological and Specialty Injectibles	2		
H3327	023	0	1	02	01	H3327_023_0	14	1	Generic			
H3327	023	0	1	02	01	H3327_023_0	14	2	Preferred Brand			
H3327	023	0	1	02	01	H3327_023_0	14	3	Non-Preferred Brand			
H3327	023	0	1	02	01	H3327_023_0	14	4	Biological and Specialty Injectibles			
H3327	023	0	1	02	01	H3327_023_0	14	1	Generic	1		1
H3327	023	0	1	02	01	H3327_023_0	14	2	Preferred Brand	2		
H3327	026	0	1	01	01	H3327_026_0	13	4	Biological and Specialty Injectibles			
H3327	026	0	1	01	01	H3327_026_0	13	1	Generic	1		1
H3327	026	0	1	01	01	H3327_026_0	13	2	Preferred Brand	2		
H3327	026	0	1	01	01	H3327_026_0	13	3	Non-Preferred Brand			
H3327	026	0	1	01	01	H3327_026_0	13	2	Preferred Brand			
H3327	026	0	1	01	01	H3327_026_0	13	1	Generic			
H3327	026	0	1	01	01	H3327_026_0	13	3	Non-Preferred Brand	2		
H3327	026	0	1	01	01	H3327_026_0	13	4	Biological and Specialty Injectibles	2		
H3327	027	0	1	01	01	H3327_027_0	9	3	Non-Preferred Brand			
H3327	027	0	1	01	01	H3327_027_0	9	2	Preferred Brand			
H3327	027	0	1	01	01	H3327_027_0	9	1	Generic			
H3327	027	0	1	01	01	H3327_027_0	9	4	Biological and Specialty Injectibles			
H3327	027	0	1	01	01	H3327_027_0	9	4	Biological and Specialty Injectibles	2		
H3327	027	0	1	01	01	H3327_027_0	9	3	Non-Preferred Brand	2		
H3327	027	0	1	01	01	H3327_027_0	9	2	Preferred Brand	2		
H3327	027	0	1	01	01	H3327_027_0	9	1	Generic	1		1
H3327	028	0	1	01	01	H3327_028_0	15	1	Generic			
H3327	028	0	1	01	01	H3327_028_0	15	2	Preferred Brand			
H3327	028	0	1	01	01	H3327_028_0	15	3	Non-Preferred Brand			
H3327	028	0	1	01	01	H3327_028_0	15	3	Non-Preferred Brand	2		
H3327	028	0	1	01	01	H3327_028_0	15	2	Preferred Brand	2		
H3327	028	0	1	01	01	H3327_028_0	15	1	Generic	1		1
H3327	028	0	1	01	01	H3327_028_0	15	4	Biological and Specialty Injectibles			
H3327	028	0	1	01	01	H3327_028_0	15	4	Biological and Specialty Injectibles	2		
H3327	029	0	1	01	01	H3327_029_0	13	2	Preferred Brand	2		
H3327	029	0	1	01	01	H3327_029_0	13	1	Generic	1		1
H3327	029	0	1	01	01	H3327_029_0	13	4	Biological and Specialty Injectibles	2		
H3327	029	0	1	01	01	H3327_029_0	13	3	Non-Preferred Brand			
H3327	029	0	1	01	01	H3327_029_0	13	2	Preferred Brand			
H3327	029	0	1	01	01	H3327_029_0	13	1	Generic			
H3327	029	0	1	01	01	H3327_029_0	13	4	Biological and Specialty Injectibles			
H3327	029	0	1	01	01	H3327_029_0	13	3	Non-Preferred Brand	2		
H3328	002	0	1	01	01	H3328_002_0	8	2	Preferred Brand			
H3328	002	0	1	01	01	H3328_002_0	8	3	Non-Preferred Brand			
H3328	002	0	1	01	01	H3328_002_0	8	1	Generic			
H3328	002	0	1	01	01	H3328_002_0	8	4	Specialty			
H3328	003	0	1	02	01	H3328_003_0	14	2	Preferred Brand			
H3328	003	0	1	02	01	H3328_003_0	14	1	Generic			
H3328	003	0	1	02	01	H3328_003_0	14	4	Specialty			
H3328	003	0	1	02	01	H3328_003_0	14	3	Non-Preferred Brand			
H3328	012	0	1	02	01	H3328_012_0	13	1	Generic	1		1
H3328	012	0	1	02	01	H3328_012_0	13	2	Preferred Brand	2		
H3328	012	0	1	02	01	H3328_012_0	13	4	Specialty	2		
H3328	012	0	1	02	01	H3328_012_0	13	4	Specialty			
H3328	012	0	1	02	01	H3328_012_0	13	3	Non-Preferred Brand			
H3328	012	0	1	02	01	H3328_012_0	13	2	Preferred Brand			
H3328	012	0	1	02	01	H3328_012_0	13	1	Generic			
H3328	012	0	1	02	01	H3328_012_0	13	3	Non-Preferred Brand	2		
H3328	013	0	1	01	01	H3328_013_0	9	2	Preferred Brand			
H3328	013	0	1	01	01	H3328_013_0	9	3	Non-Preferred Brand			
H3328	013	0	1	01	01	H3328_013_0	9	4	Specialty			
H3328	013	0	1	01	01	H3328_013_0	9	1	Generic			
H3328	014	0	1	02	01	H3328_014_0	10	1	Generic			
H3328	014	0	1	02	01	H3328_014_0	10	2	Preferred Brand			
H3328	014	0	1	02	01	H3328_014_0	10	4	Specialty			
H3328	014	0	1	02	01	H3328_014_0	10	3	Non-Preferred Brand			
H3330	021	1	1	01	01	H3330_021_1	6	3	Tier 3			
H3330	021	1	1	01	01	H3330_021_1	6	2	Tier 2			
H3330	021	1	1	01	01	H3330_021_1	6	1	Tier 1			
H3330	021	1	1	01	01	H3330_021_1	6	4	Tier 4			
H3330	021	1	1	01	01	H3330_021_1	6	1	Tier 1	1		1
H3330	021	1	1	01	01	H3330_021_1	6	2	Tier 2	2		
H3330	021	1	1	01	01	H3330_021_1	6	3	Tier 3	2		
H3330	021	1	1	01	01	H3330_021_1	6	4	Tier 4	2		
H3330	021	2	1	01	01	H3330_021_2	7	3	Tier 3			
H3330	021	2	1	01	01	H3330_021_2	7	2	Tier 2			
H3330	021	2	1	01	01	H3330_021_2	7	1	Tier 1			
H3330	021	2	1	01	01	H3330_021_2	7	4	Tier 4			
H3330	021	2	1	01	01	H3330_021_2	7	4	Tier 4	2		
H3330	021	2	1	01	01	H3330_021_2	7	3	Tier 3	2		
H3330	021	2	1	01	01	H3330_021_2	7	2	Tier 2	2		
H3330	021	2	1	01	01	H3330_021_2	7	1	Tier 1	1		1
H3330	021	3	1	01	01	H3330_021_3	6	1	Tier 1			
H3330	021	3	1	01	01	H3330_021_3	6	2	Tier 2			
H3330	021	3	1	01	01	H3330_021_3	6	3	Tier 3			
H3330	021	3	1	01	01	H3330_021_3	6	3	Tier 3	2		
H3330	021	3	1	01	01	H3330_021_3	6	2	Tier 2	2		
H3330	021	3	1	01	01	H3330_021_3	6	1	Tier 1	1		1
H3330	021	3	1	01	01	H3330_021_3	6	4	Tier 4			
H3330	021	3	1	01	01	H3330_021_3	6	4	Tier 4	2		
H3330	023	1	1	01	01	H3330_023_1	4	1	Tier 1			
H3330	023	1	1	01	01	H3330_023_1	4	2	Tier 2			
H3330	023	1	1	01	01	H3330_023_1	4	4	Tier 4	2		
H3330	023	1	1	01	01	H3330_023_1	4	3	Tier 3	2		
H3330	023	1	1	01	01	H3330_023_1	4	2	Tier 2	2		
H3330	023	1	1	01	01	H3330_023_1	4	1	Tier 1	1		1
H3330	023	1	1	01	01	H3330_023_1	4	4	Tier 4			
H3330	023	1	1	01	01	H3330_023_1	4	3	Tier 3			
H3330	023	2	1	01	01	H3330_023_2	5	1	Tier 1			
H3330	023	2	1	01	01	H3330_023_2	5	2	Tier 2			
H3330	023	2	1	01	01	H3330_023_2	5	3	Tier 3			
H3330	023	2	1	01	01	H3330_023_2	5	4	Tier 4			
H3330	023	2	1	01	01	H3330_023_2	5	1	Tier 1	1		1
H3330	023	2	1	01	01	H3330_023_2	5	2	Tier 2	2		
H3330	023	2	1	01	01	H3330_023_2	5	3	Tier 3	2		
H3330	023	2	1	01	01	H3330_023_2	5	4	Tier 4	2		
H3330	023	3	1	01	01	H3330_023_3	4	1	Tier 1			
H3330	023	3	1	01	01	H3330_023_3	4	2	Tier 2			
H3330	023	3	1	01	01	H3330_023_3	4	2	Tier 2	2		
H3330	023	3	1	01	01	H3330_023_3	4	3	Tier 3	2		
H3330	023	3	1	01	01	H3330_023_3	4	4	Tier 4	2		
H3330	023	3	1	01	01	H3330_023_3	4	3	Tier 3			
H3330	023	3	1	01	01	H3330_023_3	4	4	Tier 4			
H3330	023	3	1	01	01	H3330_023_3	4	1	Tier 1	1		1
H3330	029	0	1	01	01	H3330_029_0	7	1	Tier 1			
H3330	029	0	1	01	01	H3330_029_0	7	2	Tier 2			
H3330	029	0	1	01	01	H3330_029_0	7	3	Tier 3			
H3330	029	0	1	01	01	H3330_029_0	7	4	Tier 4			
H3330	030	1	1	01	01	H3330_030_1	8	1	Tier 1			
H3330	030	1	1	01	01	H3330_030_1	8	2	Tier 2			
H3330	030	1	1	01	01	H3330_030_1	8	3	Tier 3			
H3330	030	1	1	01	01	H3330_030_1	8	4	Tier 4			
H3330	030	1	1	01	01	H3330_030_1	8	5	Tier 5			
H3330	030	1	1	01	01	H3330_030_1	8	1	Tier 1	1		1
H3330	030	1	1	01	01	H3330_030_1	8	2	Tier 2	2		
H3330	030	1	1	01	01	H3330_030_1	8	3	Tier 3	2		
H3330	030	1	1	01	01	H3330_030_1	8	4	Tier 4	2		
H3330	030	1	1	01	01	H3330_030_1	8	5	Tier 5	1		1
H3330	030	2	1	01	01	H3330_030_2	9	1	Tier 1			
H3330	030	2	1	01	01	H3330_030_2	9	2	Tier 2			
H3330	030	2	1	01	01	H3330_030_2	9	3	Tier 3			
H3330	030	2	1	01	01	H3330_030_2	9	4	Tier 4			
H3330	030	2	1	01	01	H3330_030_2	9	5	Tier 5	1		1
H3330	030	2	1	01	01	H3330_030_2	9	1	Tier 1	1		1
H3330	030	2	1	01	01	H3330_030_2	9	2	Tier 2	2		
H3330	030	2	1	01	01	H3330_030_2	9	3	Tier 3	2		
H3330	030	2	1	01	01	H3330_030_2	9	4	Tier 4	2		
H3330	030	2	1	01	01	H3330_030_2	9	5	Tier 5			
H3330	030	3	1	01	01	H3330_030_3	8	1	Tier 1			
H3330	030	3	1	01	01	H3330_030_3	8	2	Tier 2			
H3330	030	3	1	01	01	H3330_030_3	8	5	Tier 5	1		1
H3330	030	3	1	01	01	H3330_030_3	8	4	Tier 4	2		
H3330	030	3	1	01	01	H3330_030_3	8	3	Tier 3	2		
H3330	030	3	1	01	01	H3330_030_3	8	3	Tier 3			
H3330	030	3	1	01	01	H3330_030_3	8	4	Tier 4			
H3330	030	3	1	01	01	H3330_030_3	8	5	Tier 5			
H3330	030	3	1	01	01	H3330_030_3	8	1	Tier 1	1		1
H3330	030	3	1	01	01	H3330_030_3	8	2	Tier 2	2		
H3330	031	1	1	01	01	H3330_031_1	6	1	Tier 1			
H3330	031	1	1	01	01	H3330_031_1	6	3	Tier 3			
H3330	031	1	1	01	01	H3330_031_1	6	2	Tier 2			
H3330	031	1	1	01	01	H3330_031_1	6	4	Tier 4			
H3330	031	2	1	01	01	H3330_031_2	8	1	Tier 1			
H3330	031	2	1	01	01	H3330_031_2	8	2	Tier 2			
H3330	031	2	1	01	01	H3330_031_2	8	4	Tier 4			
H3330	031	2	1	01	01	H3330_031_2	8	3	Tier 3			
H3333	049	0	1	09	04	H3333_049_0	4	2	Preferred Brand			
H3333	049	0	1	09	04	H3333_049_0	4	3	Non-Preferred Brand			
H3333	049	0	1	09	04	H3333_049_0	4	4	Specialty	2		
H3333	049	0	1	09	04	H3333_049_0	4	1	Generic			
H3333	049	0	1	09	04	H3333_049_0	4	3	Non-Preferred Brand	2		
H3333	049	0	1	09	04	H3333_049_0	4	2	Preferred Brand	2		
H3333	049	0	1	09	04	H3333_049_0	4	1	Generic	1		1
H3333	049	0	1	09	04	H3333_049_0	4	4	Specialty			
H3333	050	0	1	09	04	H3333_050_0	4	4	Specialty	2		
H3333	050	0	1	09	04	H3333_050_0	4	3	Non-Preferred Brand	2		
H3333	050	0	1	09	04	H3333_050_0	4	1	Generic	1		1
H3333	050	0	1	09	04	H3333_050_0	4	4	Specialty			
H3333	050	0	1	09	04	H3333_050_0	4	3	Non-Preferred Brand			
H3333	050	0	1	09	04	H3333_050_0	4	2	Preferred Brand			
H3333	050	0	1	09	04	H3333_050_0	4	1	Generic			
H3333	050	0	1	09	04	H3333_050_0	4	2	Preferred Brand	2		
H3333	051	0	1	09	04	H3333_051_0	4	3	Non-Preferred Brand			
H3333	051	0	1	09	04	H3333_051_0	4	4	Specialty			
H3333	051	0	1	09	04	H3333_051_0	4	1	Generic	1		1
H3333	051	0	1	09	04	H3333_051_0	4	2	Preferred Brand	2		
H3333	051	0	1	09	04	H3333_051_0	4	3	Non-Preferred Brand	2		
H3333	051	0	1	09	04	H3333_051_0	4	1	Generic			
H3333	051	0	1	09	04	H3333_051_0	4	4	Specialty	2		
H3333	051	0	1	09	04	H3333_051_0	4	2	Preferred Brand			
H3333	052	0	1	09	04	H3333_052_0	4	1	Generic			
H3333	052	0	1	09	04	H3333_052_0	4	2	Preferred Brand			
H3333	052	0	1	09	04	H3333_052_0	4	3	Non-Preferred Brand			
H3333	052	0	1	09	04	H3333_052_0	4	4	Specialty			
H3333	052	0	1	09	04	H3333_052_0	4	1	Generic	1		1
H3333	052	0	1	09	04	H3333_052_0	4	2	Preferred Brand	2		
H3333	052	0	1	09	04	H3333_052_0	4	3	Non-Preferred Brand	2		
H3333	052	0	1	09	04	H3333_052_0	4	4	Specialty	2		
H3333	053	0	1	09	04	H3333_053_0	4	3	Non-Preferred Brand			
H3333	053	0	1	09	04	H3333_053_0	4	2	Preferred Brand			
H3333	053	0	1	09	04	H3333_053_0	4	1	Generic			
H3333	053	0	1	09	04	H3333_053_0	4	4	Specialty	2		
H3333	053	0	1	09	04	H3333_053_0	4	3	Non-Preferred Brand	2		
H3333	053	0	1	09	04	H3333_053_0	4	2	Preferred Brand	2		
H3333	053	0	1	09	04	H3333_053_0	4	1	Generic	1		1
H3333	053	0	1	09	04	H3333_053_0	4	4	Specialty			
H3333	054	0	1	09	04	H3333_054_0	4	3	Non-Preferred Brand			
H3333	054	0	1	09	04	H3333_054_0	4	2	Preferred Brand			
H3333	054	0	1	09	04	H3333_054_0	4	1	Generic			
H3333	054	0	1	09	04	H3333_054_0	4	1	Generic	1		1
H3333	054	0	1	09	04	H3333_054_0	4	2	Preferred Brand	2		
H3333	054	0	1	09	04	H3333_054_0	4	4	Specialty			
H3333	054	0	1	09	04	H3333_054_0	4	4	Specialty	2		
H3333	054	0	1	09	04	H3333_054_0	4	3	Non-Preferred Brand	2		
H3333	055	0	1	09	04	H3333_055_0	4	3	Non-Preferred Brand			
H3333	055	0	1	09	04	H3333_055_0	4	4	Specialty			
H3333	055	0	1	09	04	H3333_055_0	4	2	Preferred Brand			
H3333	055	0	1	09	04	H3333_055_0	4	1	Generic			
H3333	056	0	1	09	04	H3333_056_0	4	4	Specialty			
H3333	056	0	1	09	04	H3333_056_0	4	3	Non-Preferred Brand			
H3333	056	0	1	09	04	H3333_056_0	4	2	Preferred Brand			
H3333	056	0	1	09	04	H3333_056_0	4	1	Generic			
H3333	057	0	1	09	04	H3333_057_0	4	3	Non-Preferred Brand			
H3333	057	0	1	09	04	H3333_057_0	4	4	Specialty			
H3333	057	0	1	09	04	H3333_057_0	4	2	Preferred Brand			
H3333	057	0	1	09	04	H3333_057_0	4	1	Generic			
H3333	058	0	1	09	04	H3333_058_0	4	4	Specialty			
H3333	058	0	1	09	04	H3333_058_0	4	3	Non-Preferred Brand			
H3333	058	0	1	09	04	H3333_058_0	4	2	Preferred Brand			
H3333	058	0	1	09	04	H3333_058_0	4	1	Generic			
H3333	059	0	1	09	04	H3333_059_0	4	1	Generic			
H3333	059	0	1	09	04	H3333_059_0	4	4	Specialty			
H3333	059	0	1	09	04	H3333_059_0	4	3	Non-Preferred Brand			
H3333	059	0	1	09	04	H3333_059_0	4	2	Preferred Brand			
H3333	060	0	1	09	04	H3333_060_0	4	1	Generic			
H3333	060	0	1	09	04	H3333_060_0	4	2	Preferred Brand			
H3333	060	0	1	09	04	H3333_060_0	4	3	Non-Preferred Brand			
H3333	060	0	1	09	04	H3333_060_0	4	4	Specialty			
H3335	002	0	1	04	01	H3335_002_0	7	1	Generics			
H3335	002	0	1	04	01	H3335_002_0	7	2	Preferred Brand			
H3335	002	0	1	04	01	H3335_002_0	7	3	Non-Preferred Brand			
H3335	002	0	1	04	01	H3335_002_0	7	4	Specialty			
H3335	005	0	1	04	01	H3335_005_0	7	3	Non-Preferred Brand			
H3335	005	0	1	04	01	H3335_005_0	7	2	Preferred Brand			
H3335	005	0	1	04	01	H3335_005_0	7	1	Generics			
H3335	005	0	1	04	01	H3335_005_0	7	4	Specialty			
H3335	005	0	1	04	01	H3335_005_0	7	4	Specialty	2		
H3335	005	0	1	04	01	H3335_005_0	7	3	Non-Preferred Brand	2		
H3335	005	0	1	04	01	H3335_005_0	7	2	Preferred Brand	2		
H3335	005	0	1	04	01	H3335_005_0	7	1	Generics	1		1
H3335	006	0	1	04	01	H3335_006_0	7	2	Preferred Brand			
H3335	006	0	1	04	01	H3335_006_0	7	1	Generics			
H3335	006	0	1	04	01	H3335_006_0	7	3	Non-Preferred Brand			
H3335	006	0	1	04	01	H3335_006_0	7	4	Specialty			
H3335	008	0	1	04	01	H3335_008_0	7	3	Non-Preferred Brand			
H3335	008	0	1	04	01	H3335_008_0	7	2	Preferred Brand			
H3335	008	0	1	04	01	H3335_008_0	7	1	Generics			
H3335	008	0	1	04	01	H3335_008_0	7	4	Specialty			
H3335	008	0	1	04	01	H3335_008_0	7	4	Specialty	2		
H3335	008	0	1	04	01	H3335_008_0	7	3	Non-Preferred Brand	2		
H3335	008	0	1	04	01	H3335_008_0	7	2	Preferred Brand	2		
H3335	008	0	1	04	01	H3335_008_0	7	1	Generics	1		1
H3335	009	0	1	04	01	H3335_009_0	7	3	Non-Preferred Brand			
H3335	009	0	1	04	01	H3335_009_0	7	2	Preferred Brand			
H3335	009	0	1	04	01	H3335_009_0	7	1	Generics			
H3335	009	0	1	04	01	H3335_009_0	7	4	Specialty			
H3335	014	0	1	04	01	H3335_014_0	7	3	Non-Preferred Brand			
H3335	014	0	1	04	01	H3335_014_0	7	2	Preferred Brand			
H3335	014	0	1	04	01	H3335_014_0	7	1	Generics			
H3335	014	0	1	04	01	H3335_014_0	7	4	Specialty			
H3335	014	0	1	04	01	H3335_014_0	7	4	Specialty	2		
H3335	014	0	1	04	01	H3335_014_0	7	3	Non-Preferred Brand	2		
H3335	014	0	1	04	01	H3335_014_0	7	2	Preferred Brand	2		
H3335	014	0	1	04	01	H3335_014_0	7	1	Generics	1		1
H3335	015	0	1	04	01	H3335_015_0	7	1	Generics			
H3335	015	0	1	04	01	H3335_015_0	7	2	Preferred Brand			
H3335	015	0	1	04	01	H3335_015_0	7	3	Non-Preferred Brand			
H3335	015	0	1	04	01	H3335_015_0	7	4	Specialty			
H3335	017	0	1	04	01	H3335_017_0	7	2	Preferred Brand			
H3335	017	0	1	04	01	H3335_017_0	7	3	Non-Preferred Brand			
H3335	017	0	1	04	01	H3335_017_0	7	4	Specialty			
H3335	017	0	1	04	01	H3335_017_0	7	1	Generics	1		1
H3335	017	0	1	04	01	H3335_017_0	7	2	Preferred Brand	2		
H3335	017	0	1	04	01	H3335_017_0	7	3	Non-Preferred Brand	2		
H3335	017	0	1	04	01	H3335_017_0	7	4	Specialty	2		
H3335	017	0	1	04	01	H3335_017_0	7	1	Generics			
H3335	018	0	1	04	01	H3335_018_0	7	1	Generics			
H3335	018	0	1	04	01	H3335_018_0	7	2	Preferred Brand			
H3335	018	0	1	04	01	H3335_018_0	7	4	Specialty			
H3335	018	0	1	04	01	H3335_018_0	7	3	Non-Preferred Brand			
H3335	020	0	1	04	01	H3335_020_0	7	4	Specialty	2		
H3335	020	0	1	04	01	H3335_020_0	7	3	Non-Preferred Brand	2		
H3335	020	0	1	04	01	H3335_020_0	7	2	Preferred Brand	2		
H3335	020	0	1	04	01	H3335_020_0	7	1	Generics	1		1
H3335	020	0	1	04	01	H3335_020_0	7	4	Specialty			
H3335	020	0	1	04	01	H3335_020_0	7	3	Non-Preferred Brand			
H3335	020	0	1	04	01	H3335_020_0	7	2	Preferred Brand			
H3335	020	0	1	04	01	H3335_020_0	7	1	Generics			
H3335	021	0	1	04	01	H3335_021_0	7	3	Non-Preferred Brand			
H3335	021	0	1	04	01	H3335_021_0	7	2	Preferred Brand			
H3335	021	0	1	04	01	H3335_021_0	7	1	Generics			
H3335	021	0	1	04	01	H3335_021_0	7	4	Specialty			
H3335	032	0	1	04	01	H3335_032_0	8	3	Non-Preferred Brand			
H3335	032	0	1	04	01	H3335_032_0	8	2	Preferred Brand			
H3335	032	0	1	04	01	H3335_032_0	8	1	Generics			
H3335	032	0	1	04	01	H3335_032_0	8	4	Specialty			
H3335	036	0	1	04	01	H3335_036_0	9	1	Generics			
H3335	036	0	1	04	01	H3335_036_0	9	3	Non-Preferred Brand			
H3335	036	0	1	04	01	H3335_036_0	9	4	Specialty			
H3335	036	0	1	04	01	H3335_036_0	9	2	Preferred Brand			
H3335	037	0	1	04	01	H3335_037_0	9	4	Specialty			
H3335	037	0	1	04	01	H3335_037_0	9	3	Non-Preferred Brand			
H3335	037	0	1	04	01	H3335_037_0	9	1	Generics			
H3335	037	0	1	04	01	H3335_037_0	9	2	Preferred Brand			
H3335	038	0	1	04	01	H3335_038_0	9	4	Specialty			
H3335	038	0	1	04	01	H3335_038_0	9	2	Preferred Brand			
H3335	038	0	1	04	01	H3335_038_0	9	1	Generics			
H3335	038	0	1	04	01	H3335_038_0	9	3	Non-Preferred Brand			
H3335	039	0	1	04	01	H3335_039_0	9	1	Generics			
H3335	039	0	1	04	01	H3335_039_0	9	3	Non-Preferred Brand			
H3335	039	0	1	04	01	H3335_039_0	9	2	Preferred Brand			
H3335	039	0	1	04	01	H3335_039_0	9	4	Specialty			
H3335	040	0	1	04	01	H3335_040_0	10	2	Preferred Brand			
H3335	040	0	1	04	01	H3335_040_0	10	1	Generics			
H3335	040	0	1	04	01	H3335_040_0	10	3	Non-Preferred Brand			
H3335	040	0	1	04	01	H3335_040_0	10	4	Specialty			
H3335	046	0	1	04	01	H3335_046_0	8	1	Generics			
H3335	046	0	1	04	01	H3335_046_0	8	2	Preferred Brand			
H3335	046	0	1	04	01	H3335_046_0	8	3	Non-Preferred Brand			
H3335	046	0	1	04	01	H3335_046_0	8	4	Specialty			
H3335	047	0	1	04	01	H3335_047_0	9	2	Preferred Brand			
H3335	047	0	1	04	01	H3335_047_0	9	4	Specialty			
H3335	047	0	1	04	01	H3335_047_0	9	3	Non-Preferred Brand			
H3335	047	0	1	04	01	H3335_047_0	9	1	Generics			
H3335	048	0	1	04	01	H3335_048_0	9	1	Generics			
H3335	048	0	1	04	01	H3335_048_0	9	4	Specialty			
H3335	048	0	1	04	01	H3335_048_0	9	2	Preferred Brand			
H3335	048	0	1	04	01	H3335_048_0	9	3	Non-Preferred Brand			
H3335	049	0	1	04	01	H3335_049_0	9	1	Generics			
H3335	049	0	1	04	01	H3335_049_0	9	2	Preferred Brand			
H3335	049	0	1	04	01	H3335_049_0	9	3	Non-Preferred Brand			
H3335	049	0	1	04	01	H3335_049_0	9	4	Specialty			
H3335	050	0	1	04	01	H3335_050_0	9	3	Non-Preferred Brand			
H3335	050	0	1	04	01	H3335_050_0	9	4	Specialty			
H3335	050	0	1	04	01	H3335_050_0	9	2	Preferred Brand			
H3335	050	0	1	04	01	H3335_050_0	9	1	Generics			
H3336	001	0	1	01	01	H3336_001_0	6	1	Tier 1 - Generic			
H3336	001	0	1	01	01	H3336_001_0	6	2	Tier 2 - Preferred Brand			
H3336	001	0	1	01	01	H3336_001_0	6	3	Tier 3 - Non-Preferred Brand			
H3336	001	0	1	01	01	H3336_001_0	6	4	Tier 4 - Specialty (Generic and Brand)			
H3337	001	0	1	01	01	H3337_001_0	7	1	Preferred Generics			
H3337	001	0	1	01	01	H3337_001_0	7	2	Generics			
H3337	001	0	1	01	01	H3337_001_0	7	6	Specialty Drugs	2		
H3337	001	0	1	01	01	H3337_001_0	7	5	Brands	2		
H3337	001	0	1	01	01	H3337_001_0	7	4	Preferred Brands	2		
H3337	001	0	1	01	01	H3337_001_0	7	3	Liberty Choice Drugs	1		1
H3337	001	0	1	01	01	H3337_001_0	7	2	Generics	1		1
H3337	001	0	1	01	01	H3337_001_0	7	1	Preferred Generics	1		1
H3337	001	0	1	01	01	H3337_001_0	7	6	Specialty Drugs			
H3337	001	0	1	01	01	H3337_001_0	7	5	Brands			
H3337	001	0	1	01	01	H3337_001_0	7	4	Preferred Brands			
H3337	001	0	1	01	01	H3337_001_0	7	3	Liberty Choice Drugs			
H3337	004	0	1	01	01	H3337_004_0	8	1	Preferred Generics			
H3337	004	0	1	01	01	H3337_004_0	8	5	Brands	2		
H3337	004	0	1	01	01	H3337_004_0	8	4	Preferred Brands	2		
H3337	004	0	1	01	01	H3337_004_0	8	3	Liberty Choice Drugs	1		1
H3337	004	0	1	01	01	H3337_004_0	8	2	Generics	1		1
H3337	004	0	1	01	01	H3337_004_0	8	6	Specialty Drugs	2		
H3337	004	0	1	01	01	H3337_004_0	8	6	Specialty Drugs			
H3337	004	0	1	01	01	H3337_004_0	8	5	Brands			
H3337	004	0	1	01	01	H3337_004_0	8	4	Preferred Brands			
H3337	004	0	1	01	01	H3337_004_0	8	3	Liberty Choice Drugs			
H3337	004	0	1	01	01	H3337_004_0	8	2	Generics			
H3337	004	0	1	01	01	H3337_004_0	8	1	Preferred Generics	1		1
H3342	001	0	1	04	01	H3342_001_0	7	1	Tier 1 Preferred Generic			
H3342	001	0	1	04	01	H3342_001_0	7	2	Tier 2 Preferred Brand			
H3342	001	0	1	04	01	H3342_001_0	7	5	Tier 5 Specialty	2		
H3342	001	0	1	04	01	H3342_001_0	7	4	Tier 4 Non-Specialty Injectable	2		
H3342	001	0	1	04	01	H3342_001_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H3342	001	0	1	04	01	H3342_001_0	7	2	Tier 2 Preferred Brand	2		
H3342	001	0	1	04	01	H3342_001_0	7	1	Tier 1 Preferred Generic	1		1
H3342	001	0	1	04	01	H3342_001_0	7	5	Tier 5 Specialty			
H3342	001	0	1	04	01	H3342_001_0	7	4	Tier 4 Non-Specialty Injectable			
H3342	001	0	1	04	01	H3342_001_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H3342	002	0	1	04	01	H3342_002_0	9	1	Tier 1 Preferred Generic			
H3342	002	0	1	04	01	H3342_002_0	9	4	Tier 4 Non-Specialty Injectable	2		
H3342	002	0	1	04	01	H3342_002_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H3342	002	0	1	04	01	H3342_002_0	9	2	Tier 2 Preferred Brand	2		
H3342	002	0	1	04	01	H3342_002_0	9	5	Tier 5 Specialty	2		
H3342	002	0	1	04	01	H3342_002_0	9	5	Tier 5 Specialty			
H3342	002	0	1	04	01	H3342_002_0	9	4	Tier 4 Non-Specialty Injectable			
H3342	002	0	1	04	01	H3342_002_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H3342	002	0	1	04	01	H3342_002_0	9	2	Tier 2 Preferred Brand			
H3342	002	0	1	04	01	H3342_002_0	9	1	Tier 1 Preferred Generic	1		1
H3342	004	0	1	04	01	H3342_004_0	8	5	Tier 5 Specialty			
H3342	004	0	1	04	01	H3342_004_0	8	1	Tier 1 Preferred Generic	1		1
H3342	004	0	1	04	01	H3342_004_0	8	2	Tier 2 Preferred Brand	2		
H3342	004	0	1	04	01	H3342_004_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H3342	004	0	1	04	01	H3342_004_0	8	4	Tier 4 Non-Specialty Injectable	2		
H3342	004	0	1	04	01	H3342_004_0	8	5	Tier 5 Specialty	2		
H3342	004	0	1	04	01	H3342_004_0	8	1	Tier 1 Preferred Generic			
H3342	004	0	1	04	01	H3342_004_0	8	2	Tier 2 Preferred Brand			
H3342	004	0	1	04	01	H3342_004_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H3342	004	0	1	04	01	H3342_004_0	8	4	Tier 4 Non-Specialty Injectable			
H3342	012	0	1	04	01	H3342_012_0	9	1	Tier 1 Preferred Generic			
H3342	012	0	1	04	01	H3342_012_0	9	2	Tier 2 Preferred Brand			
H3342	012	0	1	04	01	H3342_012_0	9	5	Tier 5 Specialty	2		
H3342	012	0	1	04	01	H3342_012_0	9	4	Tier 4 Non-Specialty Injectable	2		
H3342	012	0	1	04	01	H3342_012_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H3342	012	0	1	04	01	H3342_012_0	9	2	Tier 2 Preferred Brand	2		
H3342	012	0	1	04	01	H3342_012_0	9	1	Tier 1 Preferred Generic	1		1
H3342	012	0	1	04	01	H3342_012_0	9	5	Tier 5 Specialty			
H3342	012	0	1	04	01	H3342_012_0	9	4	Tier 4 Non-Specialty Injectable			
H3342	012	0	1	04	01	H3342_012_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H3344	001	0	1	04	01	H3344_001_0	9	3	Tier 3			
H3344	001	0	1	04	01	H3344_001_0	9	4	Specialty Tier 4			
H3344	001	0	1	04	01	H3344_001_0	9	1	Tier 1	1	10001000	2
H3344	001	0	1	04	01	H3344_001_0	9	2	Tier 2	2		
H3344	001	0	1	04	01	H3344_001_0	9	3	Tier 3	2		
H3344	001	0	1	04	01	H3344_001_0	9	4	Specialty Tier 4	2		
H3344	001	0	1	04	01	H3344_001_0	9	1	Tier 1			
H3344	001	0	1	04	01	H3344_001_0	9	2	Tier 2			
H3344	003	0	1	04	01	H3344_003_0	9	4	Specialty Tier 4			
H3344	003	0	1	04	01	H3344_003_0	9	4	Specialty Tier 4	2		
H3344	003	0	1	04	01	H3344_003_0	9	3	Tier 3	2		
H3344	003	0	1	04	01	H3344_003_0	9	2	Tier 2	2		
H3344	003	0	1	04	01	H3344_003_0	9	1	Tier 1	1		1
H3344	003	0	1	04	01	H3344_003_0	9	3	Tier 3			
H3344	003	0	1	04	01	H3344_003_0	9	2	Tier 2			
H3344	003	0	1	04	01	H3344_003_0	9	1	Tier 1			
H3346	002	0	1	04	01	H3346_002_0	14	1	Tier 1			
H3346	002	0	1	04	01	H3346_002_0	14	2	Tier 2			
H3346	002	0	1	04	01	H3346_002_0	14	3	Tier 3			
H3346	002	0	1	04	01	H3346_002_0	14	1	Tier 1	1		1
H3346	002	0	1	04	01	H3346_002_0	14	2	Tier 2	2		
H3346	002	0	1	04	01	H3346_002_0	14	3	Tier 3	2		
H3347	001	0	1	01	01	H3347_001_0	7	4	Specialty	2		
H3347	001	0	1	01	01	H3347_001_0	7	2	Preferred	1		1
H3347	001	0	1	01	01	H3347_001_0	7	1	Generic	1		1
H3347	001	0	1	01	01	H3347_001_0	7	4	Specialty			
H3347	001	0	1	01	01	H3347_001_0	7	3	Brand			
H3347	001	0	1	01	01	H3347_001_0	7	2	Preferred			
H3347	001	0	1	01	01	H3347_001_0	7	3	Brand	2		
H3347	001	0	1	01	01	H3347_001_0	7	1	Generic			
H3347	004	0	1	01	01	H3347_004_0	4	1	Generic			
H3347	004	0	1	01	01	H3347_004_0	4	4	Specialty			
H3347	004	0	1	01	01	H3347_004_0	4	3	Brand			
H3347	004	0	1	01	01	H3347_004_0	4	2	Preferred			
H3347	005	0	1	01	01	H3347_005_0	6	4	Specialty	2		
H3347	005	0	1	01	01	H3347_005_0	6	3	Brand	2		
H3347	005	0	1	01	01	H3347_005_0	6	2	Preferred	1		1
H3347	005	0	1	01	01	H3347_005_0	6	2	Preferred			
H3347	005	0	1	01	01	H3347_005_0	6	4	Specialty			
H3347	005	0	1	01	01	H3347_005_0	6	1	Generic	1		1
H3347	005	0	1	01	01	H3347_005_0	6	3	Brand			
H3347	005	0	1	01	01	H3347_005_0	6	1	Generic			
H3347	006	0	1	01	01	H3347_006_0	8	2	Preferred			
H3347	006	0	1	01	01	H3347_006_0	8	3	Brand			
H3347	006	0	1	01	01	H3347_006_0	8	1	Generic			
H3347	006	0	1	01	01	H3347_006_0	8	4	Specialty			
H3351	002	0	1	01	01	H3351_002_0	7	4	Specialty			
H3351	002	0	1	01	01	H3351_002_0	7	3	Non-Preferred Brand			
H3351	002	0	1	01	01	H3351_002_0	7	2	Preferred Brand			
H3351	002	0	1	01	01	H3351_002_0	7	1	Generic			
H3351	006	0	1	01	01	H3351_006_0	7	3	Non-Preferred Brand			
H3351	006	0	1	01	01	H3351_006_0	7	2	Preferred Brand			
H3351	006	0	1	01	01	H3351_006_0	7	1	Generics			
H3351	006	0	1	01	01	H3351_006_0	7	4	Specialty			
H3351	010	0	1	01	01	H3351_010_0	6	4	Specialty			
H3351	010	0	1	01	01	H3351_010_0	6	3	Non-Preferred Brand			
H3351	010	0	1	01	01	H3351_010_0	6	1	Generics			
H3351	010	0	1	01	01	H3351_010_0	6	2	Preferred Brand			
H3351	011	0	1	01	01	H3351_011_0	6	2	Preferred Brand			
H3351	011	0	1	01	01	H3351_011_0	6	3	Non-Preferred Brand			
H3351	011	0	1	01	01	H3351_011_0	6	4	Specialty			
H3351	011	0	1	01	01	H3351_011_0	6	1	Generics			
H3351	012	0	1	01	01	H3351_012_0	6	1	Generics			
H3351	012	0	1	01	01	H3351_012_0	6	2	Preferred Brand			
H3351	012	0	1	01	01	H3351_012_0	6	4	Specialty			
H3351	012	0	1	01	01	H3351_012_0	6	3	Non-Preferred Brand			
H3351	013	0	1	01	01	H3351_013_0	6	3	Non-Preferred Brand			
H3351	013	0	1	01	01	H3351_013_0	6	4	Specialty			
H3351	013	0	1	01	01	H3351_013_0	6	2	Preferred Brand			
H3351	013	0	1	01	01	H3351_013_0	6	1	Generics			
H3356	001	0	1	18	06	H3356_001_0	5	3	Non-Preferred Brand			
H3356	001	0	1	18	06	H3356_001_0	5	1	Generics			
H3356	001	0	1	18	06	H3356_001_0	5	2	Preferred Brand			
H3356	001	0	1	18	06	H3356_001_0	5	4	Specialty			
H3359	001	0	1	01	01	H3359_001_0	7	1	Tier 1			
H3359	001	0	1	01	01	H3359_001_0	7	2	Tier 2			
H3359	001	0	1	01	01	H3359_001_0	7	3	Tier 3			
H3359	001	0	1	01	01	H3359_001_0	7	4	Tier 4			
H3359	031	0	1	01	01	H3359_031_0	7	1	Tier 1			
H3359	031	0	1	01	01	H3359_031_0	7	4	Tier 4			
H3359	031	0	1	01	01	H3359_031_0	7	2	Tier 2			
H3359	031	0	1	01	01	H3359_031_0	7	3	Tier 3			
H3361	020	0	1	02	01	H3361_020_0	6	3	Tier 3			
H3361	020	0	1	02	01	H3361_020_0	6	4	Tier 4			
H3361	020	0	1	02	01	H3361_020_0	6	1	Tier 1			
H3361	020	0	1	02	01	H3361_020_0	6	2	Tier 2			
H3361	020	0	1	02	01	H3361_020_0	6	1	Tier 1	1		1
H3361	020	0	1	02	01	H3361_020_0	6	2	Tier 2	2		
H3361	020	0	1	02	01	H3361_020_0	6	3	Tier 3	2		
H3361	020	0	1	02	01	H3361_020_0	6	4	Tier 4	2		
H3361	021	0	1	02	01	H3361_021_0	6	1	Tier 1			
H3361	021	0	1	02	01	H3361_021_0	6	2	Tier 2			
H3361	021	0	1	02	01	H3361_021_0	6	3	Tier 3			
H3361	021	0	1	02	01	H3361_021_0	6	4	Tier 4	2		
H3361	021	0	1	02	01	H3361_021_0	6	3	Tier 3	2		
H3361	021	0	1	02	01	H3361_021_0	6	2	Tier 2	2		
H3361	021	0	1	02	01	H3361_021_0	6	1	Tier 1	1		1
H3361	021	0	1	02	01	H3361_021_0	6	4	Tier 4			
H3361	024	0	1	02	01	H3361_024_0	6	1	Tier 1			
H3361	024	0	1	02	01	H3361_024_0	6	4	Tier 4	2		
H3361	024	0	1	02	01	H3361_024_0	6	3	Tier 3			
H3361	024	0	1	02	01	H3361_024_0	6	2	Tier 2			
H3361	024	0	1	02	01	H3361_024_0	6	3	Tier 3	2		
H3361	024	0	1	02	01	H3361_024_0	6	2	Tier 2	2		
H3361	024	0	1	02	01	H3361_024_0	6	1	Tier 1	1		1
H3361	024	0	1	02	01	H3361_024_0	6	4	Tier 4			
H3361	027	0	1	02	01	H3361_027_0	6	3	Tier 3			
H3361	027	0	1	02	01	H3361_027_0	6	4	Tier 4			
H3361	027	0	1	02	01	H3361_027_0	6	1	Tier 1			
H3361	027	0	1	02	01	H3361_027_0	6	2	Tier 2			
H3361	031	0	1	01	01	H3361_031_0	7	3	Tier 3			
H3361	031	0	1	01	01	H3361_031_0	7	4	Tier 4			
H3361	031	0	1	01	01	H3361_031_0	7	2	Tier 2			
H3361	031	0	1	01	01	H3361_031_0	7	1	Tier 1			
H3361	043	0	1	02	01	H3361_043_0	7	3	Tier 3			
H3361	043	0	1	02	01	H3361_043_0	7	2	Tier 2			
H3361	043	0	1	02	01	H3361_043_0	7	1	Tier 1			
H3361	043	0	1	02	01	H3361_043_0	7	4	Tier 4			
H3361	051	0	1	02	01	H3361_051_0	6	4	Tier 4			
H3361	051	0	1	02	01	H3361_051_0	6	2	Tier 2			
H3361	051	0	1	02	01	H3361_051_0	6	1	Tier 1			
H3361	051	0	1	02	01	H3361_051_0	6	3	Tier 3			
H3361	065	0	1	01	01	H3361_065_0	6	4	Tier 4			
H3361	065	0	1	01	01	H3361_065_0	6	2	Tier 2			
H3361	065	0	1	01	01	H3361_065_0	6	1	Tier 1			
H3361	065	0	1	01	01	H3361_065_0	6	3	tier 3			
H3361	084	0	1	02	01	H3361_084_0	6	2	Tier 2			
H3361	084	0	1	02	01	H3361_084_0	6	4	Tier 4			
H3361	084	0	1	02	01	H3361_084_0	6	3	Tier 3			
H3361	084	0	1	02	01	H3361_084_0	6	1	Tier 1			
H3361	098	0	1	02	01	H3361_098_0	6	1	Tier 1			
H3361	098	0	1	02	01	H3361_098_0	6	3	Tier 3			
H3361	098	0	1	02	01	H3361_098_0	6	4	Tier 4			
H3361	098	0	1	02	01	H3361_098_0	6	2	Tier 2			
H3361	099	0	1	02	01	H3361_099_0	6	2	Tier 2			
H3361	099	0	1	02	01	H3361_099_0	6	3	Tier 3			
H3361	099	0	1	02	01	H3361_099_0	6	4	Tier 4			
H3361	099	0	1	02	01	H3361_099_0	6	1	Tier 1	1		1
H3361	099	0	1	02	01	H3361_099_0	6	2	Tier 2	2		
H3361	099	0	1	02	01	H3361_099_0	6	3	Tier 3	2		
H3361	099	0	1	02	01	H3361_099_0	6	4	Tier 4	2		
H3361	099	0	1	02	01	H3361_099_0	6	1	Tier 1			
H3361	102	0	1	02	01	H3361_102_0	6	1	Tier 1			
H3361	102	0	1	02	01	H3361_102_0	6	2	Tier 2			
H3361	102	0	1	02	01	H3361_102_0	6	3	Tier 3			
H3361	102	0	1	02	01	H3361_102_0	6	4	Tier 4			
H3361	104	0	1	02	01	H3361_104_0	6	1	Tier 1	1		1
H3361	104	0	1	02	01	H3361_104_0	6	2	Tier 2	2		
H3361	104	0	1	02	01	H3361_104_0	6	3	Tier 3	2		
H3361	104	0	1	02	01	H3361_104_0	6	4	Tier 4			
H3361	104	0	1	02	01	H3361_104_0	6	3	Tier 3			
H3361	104	0	1	02	01	H3361_104_0	6	4	Tier 4	2		
H3361	104	0	1	02	01	H3361_104_0	6	1	Tier 1			
H3361	104	0	1	02	01	H3361_104_0	6	2	Tier 2			
H3361	105	0	1	01	01	H3361_105_0	7	3	Tier 3			
H3361	105	0	1	01	01	H3361_105_0	7	2	Tier 2			
H3361	105	0	1	01	01	H3361_105_0	7	1	Tier 1			
H3361	105	0	1	01	01	H3361_105_0	7	4	Tier 4			
H3361	106	0	1	02	01	H3361_106_0	6	1	Tier 1			
H3361	106	0	1	02	01	H3361_106_0	6	2	Tier 2			
H3361	106	0	1	02	01	H3361_106_0	6	4	Tier 4	2		
H3361	106	0	1	02	01	H3361_106_0	6	3	Tier 3	2		
H3361	106	0	1	02	01	H3361_106_0	6	2	Tier 2	2		
H3361	106	0	1	02	01	H3361_106_0	6	1	Tier 1	1		1
H3361	106	0	1	02	01	H3361_106_0	6	4	Tier 4			
H3361	106	0	1	02	01	H3361_106_0	6	3	Tier 3			
H3361	107	0	1	02	01	H3361_107_0	6	1	Tier 1			
H3361	107	0	1	02	01	H3361_107_0	6	3	Tier 3	2		
H3361	107	0	1	02	01	H3361_107_0	6	2	Tier 2	2		
H3361	107	0	1	02	01	H3361_107_0	6	1	Tier 1	1		1
H3361	107	0	1	02	01	H3361_107_0	6	4	Tier 4			
H3361	107	0	1	02	01	H3361_107_0	6	3	Tier 3			
H3361	107	0	1	02	01	H3361_107_0	6	2	Tier 2			
H3361	107	0	1	02	01	H3361_107_0	6	4	Tier 4	2		
H3361	109	0	1	01	01	H3361_109_0	8	1	Tier 1			
H3361	109	0	1	01	01	H3361_109_0	8	2	Tier 2			
H3361	109	0	1	01	01	H3361_109_0	8	3	Tier 3			
H3361	109	0	1	01	01	H3361_109_0	8	4	Tier 4			
H3361	110	0	1	01	01	H3361_110_0	8	4	Tier 4			
H3361	110	0	1	01	01	H3361_110_0	8	2	Tier 2			
H3361	110	0	1	01	01	H3361_110_0	8	3	Tier 3			
H3361	110	0	1	01	01	H3361_110_0	8	1	Tier 1			
H3361	111	0	1	01	01	H3361_111_0	9	3	Tier 3			
H3361	111	0	1	01	01	H3361_111_0	9	2	Tier 2			
H3361	111	0	1	01	01	H3361_111_0	9	1	Tier 1			
H3361	111	0	1	01	01	H3361_111_0	9	4	Tier 4			
H3361	111	0	1	01	01	H3361_111_0	9	2	Tier 2	2		
H3361	111	0	1	01	01	H3361_111_0	9	3	Tier 3	2		
H3361	111	0	1	01	01	H3361_111_0	9	4	Tier 4	2		
H3361	111	0	1	01	01	H3361_111_0	9	1	Tier 1	2		
H3361	112	0	1	02	01	H3361_112_0	6	2	Tier 2	2		
H3361	112	0	1	02	01	H3361_112_0	6	3	Tier 3	2		
H3361	112	0	1	02	01	H3361_112_0	6	4	Tier 4	2		
H3361	112	0	1	02	01	H3361_112_0	6	1	Tier 1	1		1
H3361	112	0	1	02	01	H3361_112_0	6	4	Tier 4			
H3361	112	0	1	02	01	H3361_112_0	6	3	Tier 3			
H3361	112	0	1	02	01	H3361_112_0	6	2	Tier 2			
H3361	112	0	1	02	01	H3361_112_0	6	1	Tier 1			
H3361	113	0	1	02	01	H3361_113_0	6	2	Tier 2			
H3361	113	0	1	02	01	H3361_113_0	6	1	Tier 1			
H3361	113	0	1	02	01	H3361_113_0	6	3	Tier 3			
H3361	113	0	1	02	01	H3361_113_0	6	4	Tier 4			
H3361	115	0	1	02	01	H3361_115_0	6	3	Tier 3			
H3361	115	0	1	02	01	H3361_115_0	6	1	Tier 1			
H3361	115	0	1	02	01	H3361_115_0	6	2	Tier 2			
H3361	115	0	1	02	01	H3361_115_0	6	4	Tier 4			
H3361	116	0	1	01	01	H3361_116_0	6	2	Tier 2			
H3361	116	0	1	01	01	H3361_116_0	6	1	Tier 1			
H3361	116	0	1	01	01	H3361_116_0	6	3	Tier 3			
H3361	116	0	1	01	01	H3361_116_0	6	4	Tier 4			
H3361	117	0	1	02	01	H3361_117_0	6	2	Tier 2			
H3361	117	0	1	02	01	H3361_117_0	6	1	Tier 1			
H3361	117	0	1	02	01	H3361_117_0	6	3	Tier 3			
H3361	117	0	1	02	01	H3361_117_0	6	4	Tier 4			
H3361	125	0	1	02	01	H3361_125_0	7	4	Tier 4			
H3361	125	0	1	02	01	H3361_125_0	7	3	Tier 3			
H3361	125	0	1	02	01	H3361_125_0	7	2	Tier 2			
H3361	125	0	1	02	01	H3361_125_0	7	1	Tier 1			
H3361	125	0	1	02	01	H3361_125_0	7	1	Tier 1	1		1
H3361	125	0	1	02	01	H3361_125_0	7	2	Tier 2	2		
H3361	125	0	1	02	01	H3361_125_0	7	3	Tier 3	2		
H3361	125	0	1	02	01	H3361_125_0	7	4	Tier 4	2		
H3362	003	0	1	01	01	H3362_003_0	8	3	Tier 3	2		
H3362	003	0	1	01	01	H3362_003_0	8	2	Tier 2	2		
H3362	003	0	1	01	01	H3362_003_0	8	1	Tier 1	1	10001000	2
H3362	003	0	1	01	01	H3362_003_0	8	4	Specialty Tier 4			
H3362	003	0	1	01	01	H3362_003_0	8	3	Tier 3			
H3362	003	0	1	01	01	H3362_003_0	8	2	Tier 2			
H3362	003	0	1	01	01	H3362_003_0	8	1	Tier 1			
H3362	003	0	1	01	01	H3362_003_0	8	4	Specialty Tier 4	2		
H3362	004	0	1	01	01	H3362_004_0	7	3	Tier 3	2		
H3362	004	0	1	01	01	H3362_004_0	7	2	Tier 2	2		
H3362	004	0	1	01	01	H3362_004_0	7	1	Tier 1	1		1
H3362	004	0	1	01	01	H3362_004_0	7	4	Specialty Tier 4			
H3362	004	0	1	01	01	H3362_004_0	7	3	Tier 3			
H3362	004	0	1	01	01	H3362_004_0	7	2	Tier 2			
H3362	004	0	1	01	01	H3362_004_0	7	1	Tier 1			
H3362	004	0	1	01	01	H3362_004_0	7	4	Specialty Tier 4	2		
H3362	017	0	1	01	01	H3362_017_0	8	1	Tier 1			
H3362	017	0	1	01	01	H3362_017_0	8	2	Tier 2			
H3362	017	0	1	01	01	H3362_017_0	8	4	Specialty Tier 4	2		
H3362	017	0	1	01	01	H3362_017_0	8	3	Tier 3	2		
H3362	017	0	1	01	01	H3362_017_0	8	2	Tier 2	2		
H3362	017	0	1	01	01	H3362_017_0	8	1	Tier 1	1	10001000	2
H3362	017	0	1	01	01	H3362_017_0	8	4	Specialty Tier 4			
H3362	017	0	1	01	01	H3362_017_0	8	3	Tier 3			
H3362	020	0	1	01	01	H3362_020_0	8	1	Tier 1			
H3362	020	0	1	01	01	H3362_020_0	8	3	Tier 3	2		
H3362	020	0	1	01	01	H3362_020_0	8	2	Tier 2	2		
H3362	020	0	1	01	01	H3362_020_0	8	1	Tier 1	1	10001000	2
H3362	020	0	1	01	01	H3362_020_0	8	4	Specialty Tier 4			
H3362	020	0	1	01	01	H3362_020_0	8	3	Tier 3			
H3362	020	0	1	01	01	H3362_020_0	8	2	Tier 2			
H3362	020	0	1	01	01	H3362_020_0	8	4	Specialty Tier 4	2		
H3366	022	0	1	01	01	H3366_022_0	12	1	Generic			
H3366	022	0	1	01	01	H3366_022_0	12	2	Preferred Brand			
H3366	022	0	1	01	01	H3366_022_0	12	3	Non-Preferred Brand			
H3366	022	0	1	01	01	H3366_022_0	12	4	Biological and Specialty Injectibles	2		
H3366	022	0	1	01	01	H3366_022_0	12	1	Generic	1		1
H3366	022	0	1	01	01	H3366_022_0	12	2	Preferred Brand	2		
H3366	022	0	1	01	01	H3366_022_0	12	3	Non-Preferred Brand	2		
H3366	022	0	1	01	01	H3366_022_0	12	4	Biological and Specialty Injectibles			
H3370	001	0	1	01	01	H3370_001_0	11	3	Tier 3 Non-Preferred Brand or Generic	2		
H3370	001	0	1	01	01	H3370_001_0	11	2	Tier 2 Preferred Brand	2		
H3370	001	0	1	01	01	H3370_001_0	11	1	Tier 1 Preferred Generic	1		1
H3370	001	0	1	01	01	H3370_001_0	11	5	Tier 5 Specialty			
H3370	001	0	1	01	01	H3370_001_0	11	4	Tier 4 Non-Specialty Injectable	2		
H3370	001	0	1	01	01	H3370_001_0	11	3	Tier 3 Non-Preferred Brand or Generic			
H3370	001	0	1	01	01	H3370_001_0	11	2	Tier 2 Preferred Brand			
H3370	001	0	1	01	01	H3370_001_0	11	1	Tier 1 Preferred Generic			
H3370	001	0	1	01	01	H3370_001_0	11	5	Tier 5 Specialty	2		
H3370	001	0	1	01	01	H3370_001_0	11	4	Tier 4 Non-Specialty Injectable			
H3370	002	0	1	01	01	H3370_002_0	13	5	Tier 5 Specialty	2		
H3370	002	0	1	01	01	H3370_002_0	13	4	Tier 4 Non-Specialty Injectable	2		
H3370	002	0	1	01	01	H3370_002_0	13	3	Tier 3 Non-Preferred Brand or Generic	2		
H3370	002	0	1	01	01	H3370_002_0	13	2	Tier 2 Preferred Brand	2		
H3370	002	0	1	01	01	H3370_002_0	13	1	Tier 1 Preferred Generic	1		1
H3370	002	0	1	01	01	H3370_002_0	13	5	Tier 5 Specialty			
H3370	002	0	1	01	01	H3370_002_0	13	4	Tier 4 Non-Specialty Injectable			
H3370	002	0	1	01	01	H3370_002_0	13	2	Tier 2 Preferred Brand			
H3370	002	0	1	01	01	H3370_002_0	13	3	Tier 3 Non-Preferred Brand or Generic			
H3370	002	0	1	01	01	H3370_002_0	13	1	Tier 1 Preferred Generic			
H3370	003	0	1	01	01	H3370_003_0	8	2	Tier 2 Preferred Brand			
H3370	003	0	1	01	01	H3370_003_0	8	5	Tier 5 Specialty	2		
H3370	003	0	1	01	01	H3370_003_0	8	4	Tier 4 Non-Specialty Injectable	2		
H3370	003	0	1	01	01	H3370_003_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H3370	003	0	1	01	01	H3370_003_0	8	2	Tier 2 Preferred Brand	2		
H3370	003	0	1	01	01	H3370_003_0	8	1	Tier 1 Preferred Generic	1		1
H3370	003	0	1	01	01	H3370_003_0	8	5	Tier 5 Specialty			
H3370	003	0	1	01	01	H3370_003_0	8	4	Tier 4 Non-Specialty Injectable			
H3370	003	0	1	01	01	H3370_003_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H3370	003	0	1	01	01	H3370_003_0	8	1	Tier 1 Preferred Generic			
H3370	004	0	1	01	01	H3370_004_0	5	5	Tier 5 Specialty	2		
H3370	004	0	1	01	01	H3370_004_0	5	3	Tier 3 Non-Preferred Brand or Generic	2		
H3370	004	0	1	01	01	H3370_004_0	5	2	Tier 2 Preferred Brand	2		
H3370	004	0	1	01	01	H3370_004_0	5	1	Tier 1 Preferred Generic	1		1
H3370	004	0	1	01	01	H3370_004_0	5	4	Tier 4 Non-Specialty Injectable	2		
H3370	004	0	1	01	01	H3370_004_0	5	4	Tier 4 Non-Specialty Injectable			
H3370	004	0	1	01	01	H3370_004_0	5	3	Tier 3 Non-Preferred Brand or Generic			
H3370	004	0	1	01	01	H3370_004_0	5	2	Tier 2 Preferred Brand			
H3370	004	0	1	01	01	H3370_004_0	5	1	Tier 1 Preferred Generic			
H3370	004	0	1	01	01	H3370_004_0	5	5	Tier 5 Specialty			
H3370	014	0	1	01	01	H3370_014_0	8	5	Tier 5 Specialty			
H3370	014	0	1	01	01	H3370_014_0	8	1	Tier 1 Preferred Generic	1		1
H3370	014	0	1	01	01	H3370_014_0	8	2	Tier 2 Preferred Brand	2		
H3370	014	0	1	01	01	H3370_014_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H3370	014	0	1	01	01	H3370_014_0	8	4	Tier 4 Non-Specialty Injectable	2		
H3370	014	0	1	01	01	H3370_014_0	8	5	Tier 5 Specialty	2		
H3370	014	0	1	01	01	H3370_014_0	8	1	Tier 1 Preferred Generic			
H3370	014	0	1	01	01	H3370_014_0	8	2	Tier 2 Preferred Brand			
H3370	014	0	1	01	01	H3370_014_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H3370	014	0	1	01	01	H3370_014_0	8	4	Tier 4 Non-Specialty Injectable			
H3379	001	0	1	01	01	H3379_001_0	5	1	Preferred Generic			
H3379	001	0	1	01	01	H3379_001_0	5	2	Preferred Brand			
H3379	001	0	1	01	01	H3379_001_0	5	3	Non Preferred			
H3379	001	0	1	01	01	H3379_001_0	5	4	Specialty			
H3379	002	0	1	01	01	H3379_002_0	6	1	Preferred Generic			
H3379	002	0	1	01	01	H3379_002_0	6	2	Preferred Brand			
H3379	002	0	1	01	01	H3379_002_0	6	3	Non Preferred			
H3379	002	0	1	01	01	H3379_002_0	6	4	Specialty			
H3379	005	0	1	01	01	H3379_005_0	5	1	Preferred Generic			
H3379	005	0	1	01	01	H3379_005_0	5	2	Preferred Brand			
H3379	005	0	1	01	01	H3379_005_0	5	4	Specialty			
H3379	005	0	1	01	01	H3379_005_0	5	3	Non Preferred			
H3379	007	0	1	01	01	H3379_007_0	5	1	Preferred Generic			
H3379	007	0	1	01	01	H3379_007_0	5	2	Preferred Brand			
H3379	007	0	1	01	01	H3379_007_0	5	3	Non Preferred			
H3379	007	0	1	01	01	H3379_007_0	5	4	Specialty			
H3379	022	0	1	01	01	H3379_022_0	6	1	Preferred Generic			
H3379	022	0	1	01	01	H3379_022_0	6	3	Non Preferred			
H3379	022	0	1	01	01	H3379_022_0	6	2	Preferred Brand			
H3379	022	0	1	01	01	H3379_022_0	6	4	Specialty			
H3384	013	0	1	01	01	H3384_013_0	8	1	Formulary Generic			
H3384	013	0	1	01	01	H3384_013_0	8	2	Preferred Brand			
H3384	013	0	1	01	01	H3384_013_0	8	3	Non-Preferred Brand/Generic			
H3384	013	0	1	01	01	H3384_013_0	8	4	Specialty Injectables			
H3384	019	0	1	01	01	H3384_019_0	7	3	Non-Preferred Brand/Generic			
H3384	019	0	1	01	01	H3384_019_0	7	2	Preferred Brand			
H3384	019	0	1	01	01	H3384_019_0	7	1	Formulary Generic			
H3384	019	0	1	01	01	H3384_019_0	7	4	Specialty Injectables			
H3384	040	0	1	01	01	H3384_040_0	5	1	Formulary Generic			
H3384	040	0	1	01	01	H3384_040_0	5	2	Preferred Brand			
H3384	040	0	1	01	01	H3384_040_0	5	3	Non-Preferred Brand/Generic			
H3384	040	0	1	01	01	H3384_040_0	5	4	Specialty Injectables			
H3384	040	0	1	01	01	H3384_040_0	5	1	Formulary Generic	1		1
H3384	040	0	1	01	01	H3384_040_0	5	2	Preferred Brand	1	10000000	2
H3384	040	0	1	01	01	H3384_040_0	5	3	Non-Preferred Brand/Generic	2		
H3384	040	0	1	01	01	H3384_040_0	5	4	Specialty Injectables	2		
H3384	041	0	1	01	01	H3384_041_0	7	3	Non-Preferred Brand/Generic			
H3384	041	0	1	01	01	H3384_041_0	7	2	Preferred Brand			
H3384	041	0	1	01	01	H3384_041_0	7	1	Formulary Generic			
H3384	041	0	1	01	01	H3384_041_0	7	4	Specialty Injectables			
H3384	041	0	1	01	01	H3384_041_0	7	4	Specialty Injectables	2		
H3384	041	0	1	01	01	H3384_041_0	7	3	Non-Preferred Brand/Generic	2		
H3384	041	0	1	01	01	H3384_041_0	7	2	Preferred Brand	2		
H3384	041	0	1	01	01	H3384_041_0	7	1	Formulary Generic	1		1
H3384	052	0	1	01	01	H3384_052_0	8	3	Non-Preferred Brand/Generic			
H3384	052	0	1	01	01	H3384_052_0	8	2	Preferred Brand			
H3384	052	0	1	01	01	H3384_052_0	8	1	Formulary Generic			
H3384	052	0	1	01	01	H3384_052_0	8	4	Specialty Injectables			
H3384	053	0	1	01	01	H3384_053_0	4	3	Non-Preferred Brand/Generic			
H3384	053	0	1	01	01	H3384_053_0	4	2	Preferred Brand			
H3384	053	0	1	01	01	H3384_053_0	4	1	Formulary Generic			
H3384	053	0	1	01	01	H3384_053_0	4	4	Specialty Injectables			
H3384	054	0	1	01	01	H3384_054_0	10	1	Formulary Generic			
H3384	054	0	1	01	01	H3384_054_0	10	2	Preferred Brand			
H3384	054	0	1	01	01	H3384_054_0	10	3	Non-Preferred Brand/Generic			
H3384	054	0	1	01	01	H3384_054_0	10	3	Non-Preferred Brand/Generic	2		
H3384	054	0	1	01	01	H3384_054_0	10	2	Preferred Brand	1	10000000	2
H3384	054	0	1	01	01	H3384_054_0	10	1	Formulary Generic	1		1
H3384	054	0	1	01	01	H3384_054_0	10	4	Specialty Injectables			
H3384	054	0	1	01	01	H3384_054_0	10	4	Specialty Injectables	2		
H3388	002	0	1	01	01	H3388_002_0	9	6	Tier 6 Formulary Specialty	2		
H3388	002	0	1	01	01	H3388_002_0	9	1	Tier 1 Formulary Value Generics			
H3388	002	0	1	01	01	H3388_002_0	9	2	Tier 2 Formulary Generics			
H3388	002	0	1	01	01	H3388_002_0	9	3	Tier 3 Formulary Preferred Brand			
H3388	002	0	1	01	01	H3388_002_0	9	4	Tier 4 Formulary Preferred Brand Diagnostic			
H3388	002	0	1	01	01	H3388_002_0	9	5	Tier 5 Formulary Non-Preferred Brand			
H3388	002	0	1	01	01	H3388_002_0	9	6	Tier 6 Formulary Specialty			
H3388	002	0	1	01	01	H3388_002_0	9	1	Tier 1 Formulary Value Generics	1		1
H3388	002	0	1	01	01	H3388_002_0	9	2	Tier 2 Formulary Generics	1		1
H3388	002	0	1	01	01	H3388_002_0	9	3	Tier 3 Formulary Preferred Brand	2		
H3388	002	0	1	01	01	H3388_002_0	9	4	Tier 4 Formulary Preferred Brand Diagnostic	2		
H3388	002	0	1	01	01	H3388_002_0	9	5	Tier 5 Formulary Non-Preferred Brand	2		
H3388	004	0	1	01	01	H3388_004_0	8	5	Tier 5 Formulary Non-Preferred Brand			
H3388	004	0	1	01	01	H3388_004_0	8	4	Tier 4 Formulary Preferred Brand Diagnostic			
H3388	004	0	1	01	01	H3388_004_0	8	3	Tier 3 Formulary Preferred Brand			
H3388	004	0	1	01	01	H3388_004_0	8	2	Tier 2 Formulary Generics			
H3388	004	0	1	01	01	H3388_004_0	8	1	Tier 1 Formulary Value Generics			
H3388	004	0	1	01	01	H3388_004_0	8	6	Tier 6 Formulary Specialty			
H3388	010	0	1	01	01	H3388_010_0	6	1	Tier 1 Formulary Value Generics	1		1
H3388	010	0	1	01	01	H3388_010_0	6	2	Tier 2 Formulary Generics	1		1
H3388	010	0	1	01	01	H3388_010_0	6	3	Tier 3 Formulary Preferred Brand	2		
H3388	010	0	1	01	01	H3388_010_0	6	4	Tier 4 Formulary Preferred Brand Diagnostic	2		
H3388	010	0	1	01	01	H3388_010_0	6	5	Tier 5 Formulary Non-Preferred Brand	2		
H3388	010	0	1	01	01	H3388_010_0	6	6	Tier 6 Formulary Specialty			
H3388	010	0	1	01	01	H3388_010_0	6	5	Tier 5 Formulary Non-Preferred Brand			
H3388	010	0	1	01	01	H3388_010_0	6	4	Tier 4 Formulary Preferred Brand Diagnostic			
H3388	010	0	1	01	01	H3388_010_0	6	6	Tier 6 Formulary Specialty	2		
H3388	010	0	1	01	01	H3388_010_0	6	2	Tier 2 Formulary Generics			
H3388	010	0	1	01	01	H3388_010_0	6	1	Tier 1 Formulary Value Generics			
H3388	010	0	1	01	01	H3388_010_0	6	3	Tier 3 Formulary Preferred Brand			
H3404	001	0	1	04	01	H3404_001_0	4	1	Tier 1 - Generic			
H3404	001	0	1	04	01	H3404_001_0	4	2	Tier 2 - Preferred Brand			
H3404	001	0	1	04	01	H3404_001_0	4	4	Tier 4 - Specialty	2		
H3404	001	0	1	04	01	H3404_001_0	4	3	Tier 3 - Non-Preferred Brand	2		
H3404	001	0	1	04	01	H3404_001_0	4	2	Tier 2 - Preferred Brand	2		
H3404	001	0	1	04	01	H3404_001_0	4	1	Tier 1 - Generic	1		1
H3404	001	0	1	04	01	H3404_001_0	4	4	Tier 4 - Specialty			
H3404	001	0	1	04	01	H3404_001_0	4	3	Tier 3 - Non-Preferred Brand			
H3404	002	0	1	04	01	H3404_002_0	4	1	Tier 1 - Generic			
H3404	002	0	1	04	01	H3404_002_0	4	3	Tier 3 - Non-Preferred Brand	2		
H3404	002	0	1	04	01	H3404_002_0	4	2	Tier 2 - Preferred Brand	2		
H3404	002	0	1	04	01	H3404_002_0	4	1	Tier 1 - Generic	1		1
H3404	002	0	1	04	01	H3404_002_0	4	4	Tier 4 - Specialty			
H3404	002	0	1	04	01	H3404_002_0	4	3	Tier 3 - Non-Preferred Brand			
H3404	002	0	1	04	01	H3404_002_0	4	2	Tier 2 - Preferred Brand			
H3404	002	0	1	04	01	H3404_002_0	4	4	Tier 4 - Specialty	2		
H3405	001	0	1	04	01	H3405_001_0	4	1	Preferred Generic	1	00001000	2
H3405	001	0	1	04	01	H3405_001_0	4	2	Preferred Brand	1	10000000	2
H3405	001	0	1	04	01	H3405_001_0	4	3	Non-Preferred Brand	1	10000000	2
H3405	001	0	1	04	01	H3405_001_0	4	4	Specialty	1	10001000	2
H3405	001	0	1	04	01	H3405_001_0	4	1	Preferred Generic			
H3405	001	0	1	04	01	H3405_001_0	4	2	Preferred Brand			
H3405	001	0	1	04	01	H3405_001_0	4	3	Non-Preferred Brand			
H3405	001	0	1	04	01	H3405_001_0	4	4	Specialty			
H3405	002	0	1	04	01	H3405_002_0	5	1	Preferred Generic			
H3405	002	0	1	04	01	H3405_002_0	5	2	Preferred Brand			
H3405	002	0	1	04	01	H3405_002_0	5	3	Non-Preferred Brand			
H3405	002	0	1	04	01	H3405_002_0	5	4	Specialty			
H3405	002	0	1	04	01	H3405_002_0	5	1	Preferred Generic	1	00001000	2
H3405	002	0	1	04	01	H3405_002_0	5	2	Preferred Brand	1	10000000	2
H3405	002	0	1	04	01	H3405_002_0	5	3	Non-Preferred Brand	1	10000000	2
H3405	002	0	1	04	01	H3405_002_0	5	4	Specialty	1	10001000	2
H3415	001	0	1	04	01	H3415_001_0	7	3	Non-Preferred Brand			
H3415	001	0	1	04	01	H3415_001_0	7	4	Specialty			
H3415	001	0	1	04	01	H3415_001_0	7	2	Preferred Brand			
H3415	001	0	1	04	01	H3415_001_0	7	1	Generic			
H3435	001	0	1	37	05	H3435_001_0	4	2	Preferred Brand			
H3435	001	0	1	37	05	H3435_001_0	4	3	Non Preferred			
H3435	001	0	1	37	05	H3435_001_0	4	4	Specialty			
H3435	001	0	1	37	05	H3435_001_0	4	1	Preferred Generic			
H3435	003	0	1	37	05	H3435_003_0	4	2	Preferred Brand			
H3435	003	0	1	37	05	H3435_003_0	4	3	Non Preferred			
H3435	003	0	1	37	05	H3435_003_0	4	4	Specialty			
H3435	003	0	1	37	05	H3435_003_0	4	1	Preferred Generic			
H3437	002	0	1	04	01	H3437_002_0	3	1	Generic			
H3437	002	0	1	04	01	H3437_002_0	3	2	Preferred Brand			
H3437	002	0	1	04	01	H3437_002_0	3	3	Non-Preferred Brand			
H3437	002	0	1	04	01	H3437_002_0	3	4	Specialty			
H3437	002	0	1	04	01	H3437_002_0	3	1	Generic	1		1
H3437	002	0	1	04	01	H3437_002_0	3	2	Preferred Brand	2		
H3437	002	0	1	04	01	H3437_002_0	3	3	Non-Preferred Brand	2		
H3437	002	0	1	04	01	H3437_002_0	3	4	Specialty	2		
H3449	005	0	1	01	01	H3449_005_0	5	4	Tier 4 - Specialty	2		
H3449	005	0	1	01	01	H3449_005_0	5	3	Tier 3 - Non-Preferred Brand	2		
H3449	005	0	1	01	01	H3449_005_0	5	1	Tier 1 - Generic			
H3449	005	0	1	01	01	H3449_005_0	5	1	Tier 1 - Generic	1		1
H3449	005	0	1	01	01	H3449_005_0	5	2	Tier 2 - Preferred Brand	2		
H3449	005	0	1	01	01	H3449_005_0	5	2	Tier 2 - Preferred Brand			
H3449	005	0	1	01	01	H3449_005_0	5	3	Tier 3 - Non-Preferred Brand			
H3449	005	0	1	01	01	H3449_005_0	5	4	Tier 4 - Specialty			
H3449	013	0	1	01	01	H3449_013_0	5	1	Tier 1 - Generic			
H3449	013	0	1	01	01	H3449_013_0	5	2	Tier 2 - Preferred Brand			
H3449	013	0	1	01	01	H3449_013_0	5	3	Tier 3 - Non-preferred Brand			
H3449	013	0	1	01	01	H3449_013_0	5	4	Tier 4 - Specialty			
H3456	001	0	1	02	01	H3456_001_0	4	4	Specialty			
H3456	001	0	1	02	01	H3456_001_0	4	3	Non Preferred			
H3456	001	0	1	02	01	H3456_001_0	4	1	Preferred Generic			
H3456	001	0	1	02	01	H3456_001_0	4	2	Preferred Brand			
H3456	010	0	1	01	01	H3456_010_0	6	3	Non Preferred			
H3456	010	0	1	01	01	H3456_010_0	6	2	Preferred Brand			
H3456	010	0	1	01	01	H3456_010_0	6	1	Preferred Generic			
H3456	010	0	1	01	01	H3456_010_0	6	4	Specialty			
H3456	022	0	1	01	01	H3456_022_0	4	1	Preferred Generic			
H3456	022	0	1	01	01	H3456_022_0	4	2	Preferred Brand			
H3456	022	0	1	01	01	H3456_022_0	4	3	Non Preferred			
H3456	022	0	1	01	01	H3456_022_0	4	4	Specialty			
H3518	001	0	1	09	04	H3518_001_0	6	3	Tier 3 - Covered Brand			
H3518	001	0	1	09	04	H3518_001_0	6	1	Tier 1 - Covered Generic			
H3518	001	0	1	09	04	H3518_001_0	6	2	Tier 2 - Covered Preferred Brand			
H3518	001	0	1	09	04	H3518_001_0	6	4	Tier S - Covered Specialty			
H3528	001	0	1	01	01	H3528_001_0	6	2	Tier 2	2		
H3528	001	0	1	01	01	H3528_001_0	6	3	Tier 3	2		
H3528	001	0	1	01	01	H3528_001_0	6	4	Tier 4	2		
H3528	001	0	1	01	01	H3528_001_0	6	1	Tier 1	1		1
H3528	001	0	1	01	01	H3528_001_0	6	4	Tier 4			
H3528	001	0	1	01	01	H3528_001_0	6	3	Tier 3			
H3528	001	0	1	01	01	H3528_001_0	6	1	Tier 1			
H3528	001	0	1	01	01	H3528_001_0	6	2	Tier 2			
H3528	002	0	1	01	01	H3528_002_0	5	4	Tier 4	2		
H3528	002	0	1	01	01	H3528_002_0	5	3	Tier 3	2		
H3528	002	0	1	01	01	H3528_002_0	5	2	Tier 2	2		
H3528	002	0	1	01	01	H3528_002_0	5	1	Tier 1	1		1
H3528	002	0	1	01	01	H3528_002_0	5	4	Tier 4			
H3528	002	0	1	01	01	H3528_002_0	5	3	Tier 3			
H3528	002	0	1	01	01	H3528_002_0	5	2	Tier 2			
H3528	002	0	1	01	01	H3528_002_0	5	1	Tier 1			
H3528	004	0	1	01	01	H3528_004_0	5	5	Tier 5	1		1
H3528	004	0	1	01	01	H3528_004_0	5	4	Tier 4	2		
H3528	004	0	1	01	01	H3528_004_0	5	3	Tier 3	2		
H3528	004	0	1	01	01	H3528_004_0	5	2	Tier 2	2		
H3528	004	0	1	01	01	H3528_004_0	5	3	Tier 3			
H3528	004	0	1	01	01	H3528_004_0	5	4	Tier 4			
H3528	004	0	1	01	01	H3528_004_0	5	5	Tier 5			
H3528	004	0	1	01	01	H3528_004_0	5	1	Tier 1	1		1
H3528	004	0	1	01	01	H3528_004_0	5	1	Tier 1			
H3528	004	0	1	01	01	H3528_004_0	5	2	Tier 2			
H3528	005	0	1	01	01	H3528_005_0	5	4	Tier 4	2		
H3528	005	0	1	01	01	H3528_005_0	5	1	Tier 1			
H3528	005	0	1	01	01	H3528_005_0	5	2	Tier 2			
H3528	005	0	1	01	01	H3528_005_0	5	3	Tier 3			
H3528	005	0	1	01	01	H3528_005_0	5	4	Tier 4			
H3528	005	0	1	01	01	H3528_005_0	5	1	Tier 1	1		1
H3528	005	0	1	01	01	H3528_005_0	5	2	Tier 2	2		
H3528	005	0	1	01	01	H3528_005_0	5	3	Tier 3	2		
H3528	006	0	1	02	01	H3528_006_0	4	3	Tier 3	2		
H3528	006	0	1	02	01	H3528_006_0	4	1	Tier 1			
H3528	006	0	1	02	01	H3528_006_0	4	2	Tier 2			
H3528	006	0	1	02	01	H3528_006_0	4	3	Tier 3			
H3528	006	0	1	02	01	H3528_006_0	4	4	Tier 4			
H3528	006	0	1	02	01	H3528_006_0	4	4	Tier 4	2		
H3528	006	0	1	02	01	H3528_006_0	4	2	Tier 2	2		
H3528	006	0	1	02	01	H3528_006_0	4	1	Tier 1	1		1
H3533	001	0	1	01	01	H3533_001_0	9	4	Tier 4 - Specialty Drugs	2		
H3533	001	0	1	01	01	H3533_001_0	9	3	Tier 3 - Non - Preferred Brand	2		
H3533	001	0	1	01	01	H3533_001_0	9	2	Tier 2 - Preferred Brand	2		
H3533	001	0	1	01	01	H3533_001_0	9	1	Tier 1 - Generic	1		1
H3533	001	0	1	01	01	H3533_001_0	9	4	Tier 4 - Specialty Drugs			
H3533	001	0	1	01	01	H3533_001_0	9	3	Tier 3 - Non - Preferred Brand			
H3533	001	0	1	01	01	H3533_001_0	9	1	Tier 1 - Generic			
H3533	001	0	1	01	01	H3533_001_0	9	2	Tier 2 - Preferred Brand			
H3597	001	0	1	01	01	H3597_001_0	5	1	Tier 1 - Preferred Generic			
H3597	001	0	1	01	01	H3597_001_0	5	2	Tier 2 - Non-Preferred Generic			
H3597	001	0	1	01	01	H3597_001_0	5	3	Tier 3 - Preferred Brand			
H3597	001	0	1	01	01	H3597_001_0	5	4	Tier 4 - Non-Preferred Brand			
H3597	001	0	1	01	01	H3597_001_0	5	5	Tier 5 - Specialty			
H3597	002	0	1	01	01	H3597_002_0	5	1	Tier 1 - Preferred Generic	1		1
H3597	002	0	1	01	01	H3597_002_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H3597	002	0	1	01	01	H3597_002_0	5	3	Tier 3 - Preferred Brand	2		
H3597	002	0	1	01	01	H3597_002_0	5	4	Tier 4 - Non-Preferred Brand	2		
H3597	002	0	1	01	01	H3597_002_0	5	5	Tier 5 - Specialty	2		
H3597	002	0	1	01	01	H3597_002_0	5	1	Tier 1 - Preferred Generic			
H3597	002	0	1	01	01	H3597_002_0	5	2	Tier 2 - Non-Preferred Generic			
H3597	002	0	1	01	01	H3597_002_0	5	3	Tier 3 - Preferred Brand			
H3597	002	0	1	01	01	H3597_002_0	5	4	Tier 4 - Non-Preferred Brand			
H3597	002	0	1	01	01	H3597_002_0	5	5	Tier 5 - Specialty			
H3597	004	0	1	01	01	H3597_004_0	6	1	Tier 1 - Preferred Generic			
H3597	004	0	1	01	01	H3597_004_0	6	2	Tier 2 - Non-Preferred Generic			
H3597	004	0	1	01	01	H3597_004_0	6	3	Tier 3 - Preferred Brand			
H3597	004	0	1	01	01	H3597_004_0	6	4	Tier 4 - Non-Preferred Brand			
H3597	004	0	1	01	01	H3597_004_0	6	5	Tier 5 - Specialty	1		1
H3597	004	0	1	01	01	H3597_004_0	6	1	Tier 1 - Preferred Generic	1		1
H3597	004	0	1	01	01	H3597_004_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H3597	004	0	1	01	01	H3597_004_0	6	3	Tier 3 - Preferred Brand	1		1
H3597	004	0	1	01	01	H3597_004_0	6	4	Tier 4 - Non-Preferred Brand	1		1
H3597	004	0	1	01	01	H3597_004_0	6	5	Tier 5 - Specialty			
H3619	001	0	1	04	01	H3619_001_0	6	4	Specialty	1	10001000	2
H3619	001	0	1	04	01	H3619_001_0	6	1	Preferred Generic			
H3619	001	0	1	04	01	H3619_001_0	6	2	Preferred Brand			
H3619	001	0	1	04	01	H3619_001_0	6	3	Non-Preferred Brand			
H3619	001	0	1	04	01	H3619_001_0	6	4	Specialty			
H3619	001	0	1	04	01	H3619_001_0	6	1	Preferred Generic	1	00001000	2
H3619	001	0	1	04	01	H3619_001_0	6	2	Preferred Brand	1	10000000	2
H3619	001	0	1	04	01	H3619_001_0	6	3	Non-Preferred Brand	1	10000000	2
H3619	004	0	1	04	01	H3619_004_0	6	3	Non-Preferred Brand			
H3619	004	0	1	04	01	H3619_004_0	6	4	Specialty	1	10001000	2
H3619	004	0	1	04	01	H3619_004_0	6	3	Non-Preferred Brand	1	10000000	2
H3619	004	0	1	04	01	H3619_004_0	6	2	Preferred Brand	1	10000000	2
H3619	004	0	1	04	01	H3619_004_0	6	1	Preferred Generic	1	00001000	2
H3619	004	0	1	04	01	H3619_004_0	6	4	Specialty			
H3619	004	0	1	04	01	H3619_004_0	6	2	Preferred Brand			
H3619	004	0	1	04	01	H3619_004_0	6	1	Preferred Generic			
H3619	012	0	1	04	01	H3619_012_0	7	1	Preferred Generic	1	00001000	2
H3619	012	0	1	04	01	H3619_012_0	7	4	Specialty			
H3619	012	0	1	04	01	H3619_012_0	7	3	Non-Preferred Brand			
H3619	012	0	1	04	01	H3619_012_0	7	2	Preferred Brand			
H3619	012	0	1	04	01	H3619_012_0	7	3	Non-Preferred Brand	1	10000000	2
H3619	012	0	1	04	01	H3619_012_0	7	1	Preferred Generic			
H3619	012	0	1	04	01	H3619_012_0	7	2	Preferred Brand	1	10000000	2
H3619	012	0	1	04	01	H3619_012_0	7	4	Specialty	1	10001000	2
H3620	001	0	1	04	01	H3620_001_0	9	4	Specialty			
H3620	001	0	1	04	01	H3620_001_0	9	3	Non-Preferred Brand			
H3620	001	0	1	04	01	H3620_001_0	9	2	Preferred Brand			
H3620	001	0	1	04	01	H3620_001_0	9	1	Generic			
H3623	001	0	1	01	01	H3623_001_0	5	3	Tier 3 - Preferred Brand			
H3623	001	0	1	01	01	H3623_001_0	5	4	Tier 4 - Non-Preferred Brand			
H3623	001	0	1	01	01	H3623_001_0	5	1	Tier 1 - Preferred Generic			
H3623	001	0	1	01	01	H3623_001_0	5	2	Tier 2 - Non-Preferred Generic			
H3623	001	0	1	01	01	H3623_001_0	5	5	Tier 5 - Specialty			
H3623	002	0	1	01	01	H3623_002_0	5	5	Tier 5 - Specialty			
H3623	002	0	1	01	01	H3623_002_0	5	1	Tier 1 - Preferred Generic			
H3623	002	0	1	01	01	H3623_002_0	5	2	Tier 2 - Non-Preferred Generic			
H3623	002	0	1	01	01	H3623_002_0	5	3	Tier 3 - Preferred Brand			
H3623	002	0	1	01	01	H3623_002_0	5	4	Tier 4 - Non-Preferred Brand			
H3623	003	0	1	01	01	H3623_003_0	6	5	Tier 5 - Specialty			
H3623	003	0	1	01	01	H3623_003_0	6	4	Tier 4 - Non-Preferred Brand			
H3623	003	0	1	01	01	H3623_003_0	6	3	Tier 3 - Preferred Brand			
H3623	003	0	1	01	01	H3623_003_0	6	1	Tier 1 - Preferred Generic			
H3623	003	0	1	01	01	H3623_003_0	6	2	Tier 2 - Non-Preferred Generic			
H3623	004	0	1	01	01	H3623_004_0	5	5	Tier 5 - Specialty			
H3623	004	0	1	01	01	H3623_004_0	5	2	Tier 2 - Non-Preferred Generic			
H3623	004	0	1	01	01	H3623_004_0	5	3	Tier 3 - Preferred Brand			
H3623	004	0	1	01	01	H3623_004_0	5	4	Tier 4 - Non-Preferred Brand			
H3623	004	0	1	01	01	H3623_004_0	5	1	Tier 1 - Preferred Generic			
H3623	005	0	1	01	01	H3623_005_0	5	1	Tier 1 - Preferred Generic			
H3623	005	0	1	01	01	H3623_005_0	5	5	Tier 5 - Specialty			
H3623	005	0	1	01	01	H3623_005_0	5	3	Tier 3 - Preferred Brand			
H3623	005	0	1	01	01	H3623_005_0	5	2	Tier 2 - Non-Preferred Generic			
H3623	005	0	1	01	01	H3623_005_0	5	4	Tier 4 - Non-Preferred Brand			
H3623	006	0	1	01	01	H3623_006_0	5	4	Tier 4 - Non-Preferred Brand			
H3623	006	0	1	01	01	H3623_006_0	5	3	Tier 3 - Preferred Brand			
H3623	006	0	1	01	01	H3623_006_0	5	2	Tier 2 - Non-Preferred Generic			
H3623	006	0	1	01	01	H3623_006_0	5	1	Tier 1 - Preferred Generic			
H3623	006	0	1	01	01	H3623_006_0	5	5	Tier 5 - Specialty			
H3624	001	0	1	04	01	H3624_001_0	5	5	Tier 5 - Specialty			
H3624	001	0	1	04	01	H3624_001_0	5	4	Tier 4 - Non-Preferred Brand			
H3624	001	0	1	04	01	H3624_001_0	5	1	Tier 1 - Preferred Generic			
H3624	001	0	1	04	01	H3624_001_0	5	2	Tier 2 - Non-Preferred Generic			
H3624	001	0	1	04	01	H3624_001_0	5	3	Tier 3 - Preferred Brand			
H3624	002	0	1	04	01	H3624_002_0	5	4	Tier 4 - Non-Preferred Brand			
H3624	002	0	1	04	01	H3624_002_0	5	1	Tier 1 - Preferred Generic			
H3624	002	0	1	04	01	H3624_002_0	5	5	Tier 5 - Specialty			
H3624	002	0	1	04	01	H3624_002_0	5	3	Tier 3 - Preferred Brand			
H3624	002	0	1	04	01	H3624_002_0	5	2	Tier 2 - Non-Preferred Generic			
H3653	004	0	1	01	01	H3653_004_0	7	1	Tier 1 - Generic	1		1
H3653	004	0	1	01	01	H3653_004_0	7	3	Tier 3 - Non-Preferred Brand			
H3653	004	0	1	01	01	H3653_004_0	7	2	Tier 2 - Preferred Brand			
H3653	004	0	1	01	01	H3653_004_0	7	1	Tier 1 - Generic			
H3653	004	0	1	01	01	H3653_004_0	7	6	Tier 6 - Specialty Drugs	2		
H3653	004	0	1	01	01	H3653_004_0	7	5	Tier 5 - Part D Eligible Injectables	2		
H3653	004	0	1	01	01	H3653_004_0	7	4	Tier 4 - Multisource Brand and Isomerics	2		
H3653	004	0	1	01	01	H3653_004_0	7	3	Tier 3 - Non-Preferred Brand	2		
H3653	004	0	1	01	01	H3653_004_0	7	2	Tier 2 - Preferred Brand	2		
H3653	004	0	1	01	01	H3653_004_0	7	4	Tier 4 - Multisource Brand and Isomerics			
H3653	004	0	1	01	01	H3653_004_0	7	6	Tier 6 - Specialty Drugs			
H3653	004	0	1	01	01	H3653_004_0	7	5	Tier 5 - Part D Eligible Injectables			
H3653	015	0	1	01	01	H3653_015_0	7	3	Tier 3 - Part D Eligible Injectables			
H3653	015	0	1	01	01	H3653_015_0	7	1	Tier 1 - Generic			
H3653	015	0	1	01	01	H3653_015_0	7	2	Tier 2 - Brand			
H3653	015	0	1	01	01	H3653_015_0	7	4	Tier 4 - Specialty Drugs			
H3655	013	0	1	01	01	H3655_013_0	8	1	Tier 1 Preferred Generic	1		1
H3655	013	0	1	01	01	H3655_013_0	8	5	Tier 5 Specialty			
H3655	013	0	1	01	01	H3655_013_0	8	4	Tier 4 Non-Specialty Injectable			
H3655	013	0	1	01	01	H3655_013_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H3655	013	0	1	01	01	H3655_013_0	8	2	Tier 2 Preferred Brand			
H3655	013	0	1	01	01	H3655_013_0	8	2	Tier 2 Preferred Brand	2		
H3655	013	0	1	01	01	H3655_013_0	8	1	Tier 1 Preferred Generic			
H3655	013	0	1	01	01	H3655_013_0	8	4	Tier 4 Non-Specialty Injectable	2		
H3655	013	0	1	01	01	H3655_013_0	8	5	Tier 5 Specialty	2		
H3655	013	0	1	01	01	H3655_013_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H3655	023	0	1	01	01	H3655_023_0	9	5	Tier 5 Specialty	2		
H3655	023	0	1	01	01	H3655_023_0	9	1	Tier 1 Preferred Generic			
H3655	023	0	1	01	01	H3655_023_0	9	2	Tier 2 Preferred Brand			
H3655	023	0	1	01	01	H3655_023_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H3655	023	0	1	01	01	H3655_023_0	9	4	Tier 4 Non-Specialty Injectable			
H3655	023	0	1	01	01	H3655_023_0	9	5	Tier 5 Specialty			
H3655	023	0	1	01	01	H3655_023_0	9	1	Tier 1 Preferred Generic	1		1
H3655	023	0	1	01	01	H3655_023_0	9	2	Tier 2 Preferred Brand	2		
H3655	023	0	1	01	01	H3655_023_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H3655	023	0	1	01	01	H3655_023_0	9	4	Tier 4 Non-Specialty Injectable	2		
H3659	001	0	1	02	01	H3659_001_0	4	3	Non Preferred			
H3659	001	0	1	02	01	H3659_001_0	4	2	Preferred Brand			
H3659	001	0	1	02	01	H3659_001_0	4	1	Preferred Generic			
H3659	001	0	1	02	01	H3659_001_0	4	4	Specialty			
H3659	003	0	1	01	01	H3659_003_0	5	3	Non Preferred			
H3659	003	0	1	01	01	H3659_003_0	5	2	Preferred Brand			
H3659	003	0	1	01	01	H3659_003_0	5	1	Preferred Generic			
H3659	003	0	1	01	01	H3659_003_0	5	4	Speciality			
H3659	003	0	1	01	01	H3659_003_0	5	4	Speciality	2		
H3659	003	0	1	01	01	H3659_003_0	5	3	Non Preferred	2		
H3659	003	0	1	01	01	H3659_003_0	5	2	Preferred Brand	2		
H3659	003	0	1	01	01	H3659_003_0	5	1	Preferred Generic	1		1
H3659	031	0	1	01	01	H3659_031_0	5	2	Preferred Brand			
H3659	031	0	1	01	01	H3659_031_0	5	1	Preferred Generic			
H3659	031	0	1	01	01	H3659_031_0	5	3	Non Preferred			
H3659	031	0	1	01	01	H3659_031_0	5	4	Specialty			
H3659	057	0	1	01	01	H3659_057_0	5	1	Preferred Generic			
H3659	057	0	1	01	01	H3659_057_0	5	2	Preferred Brand			
H3659	057	0	1	01	01	H3659_057_0	5	4	Specialty			
H3659	057	0	1	01	01	H3659_057_0	5	3	Non Preferred			
H3659	058	0	1	01	01	H3659_058_0	5	3	Non Preferred			
H3659	058	0	1	01	01	H3659_058_0	5	2	Preferred Brand			
H3659	058	0	1	01	01	H3659_058_0	5	1	Preferred Generic			
H3659	058	0	1	01	01	H3659_058_0	5	4	Specialty			
H3659	059	0	1	01	01	H3659_059_0	4	3	Non-Preferred			
H3659	059	0	1	01	01	H3659_059_0	4	2	Preferred Brand			
H3659	059	0	1	01	01	H3659_059_0	4	1	Preferred Generic			
H3659	059	0	1	01	01	H3659_059_0	4	4	Specialty			
H3659	059	0	1	01	01	H3659_059_0	4	4	Specialty	2		
H3659	059	0	1	01	01	H3659_059_0	4	3	Non-Preferred	2		
H3659	059	0	1	01	01	H3659_059_0	4	2	Preferred Brand	2		
H3659	059	0	1	01	01	H3659_059_0	4	1	Preferred Generic	1		1
H3659	060	0	1	01	01	H3659_060_0	6	3	Non Preferred			
H3659	060	0	1	01	01	H3659_060_0	6	1	Preferred Generic			
H3659	060	0	1	01	01	H3659_060_0	6	2	Preferred Brand			
H3659	060	0	1	01	01	H3659_060_0	6	4	Specialty			
H3660	028	0	1	02	01	H3660_028_0	7	2	Tier 2			
H3660	028	0	1	02	01	H3660_028_0	7	1	Tier 1	1		1
H3660	028	0	1	02	01	H3660_028_0	7	4	Tier 4			
H3660	028	0	1	02	01	H3660_028_0	7	1	Tier 1			
H3660	028	0	1	02	01	H3660_028_0	7	3	Tier 3			
H3660	028	0	1	02	01	H3660_028_0	7	2	Tier 2	2		
H3660	028	0	1	02	01	H3660_028_0	7	3	Tier 3	2		
H3660	028	0	1	02	01	H3660_028_0	7	4	Tier 4	2		
H3660	029	0	1	02	01	H3660_029_0	8	2	Tier 2	2		
H3660	029	0	1	02	01	H3660_029_0	8	3	Tier 3	2		
H3660	029	0	1	02	01	H3660_029_0	8	4	Tier 4	2		
H3660	029	0	1	02	01	H3660_029_0	8	1	Tier 1			
H3660	029	0	1	02	01	H3660_029_0	8	2	Tier 2			
H3660	029	0	1	02	01	H3660_029_0	8	3	Tier 3			
H3660	029	0	1	02	01	H3660_029_0	8	4	Tier 4			
H3660	029	0	1	02	01	H3660_029_0	8	1	Tier 1	1		1
H3660	032	0	1	02	01	H3660_032_0	7	3	Tier 3	2		
H3660	032	0	1	02	01	H3660_032_0	7	2	Tier 2	2		
H3660	032	0	1	02	01	H3660_032_0	7	1	Tier 1	1		1
H3660	032	0	1	02	01	H3660_032_0	7	1	Tier 1			
H3660	032	0	1	02	01	H3660_032_0	7	2	Tier 2			
H3660	032	0	1	02	01	H3660_032_0	7	4	Tier 4	2		
H3660	032	0	1	02	01	H3660_032_0	7	4	Tier 4			
H3660	032	0	1	02	01	H3660_032_0	7	3	Tier 3			
H3664	001	0	1	02	01	H3664_001_0	5	4	Specialty			
H3664	001	0	1	02	01	H3664_001_0	5	3	Non-Preferred Brand			
H3664	001	0	1	02	01	H3664_001_0	5	1	Generic			
H3664	001	0	1	02	01	H3664_001_0	5	2	Preferred Brand			
H3664	011	0	1	02	01	H3664_011_0	6	2	Preferred Brand			
H3664	011	0	1	02	01	H3664_011_0	6	1	Generic			
H3664	011	0	1	02	01	H3664_011_0	6	3	Non-Preferred Brand			
H3664	011	0	1	02	01	H3664_011_0	6	4	Specialty			
H3664	012	0	1	02	01	H3664_012_0	5	1	Generic	1		1
H3664	012	0	1	02	01	H3664_012_0	5	2	Preferred Brand	2		
H3664	012	0	1	02	01	H3664_012_0	5	3	Non-Preferred Brand	2		
H3664	012	0	1	02	01	H3664_012_0	5	4	Specialty			
H3664	012	0	1	02	01	H3664_012_0	5	3	Non-Preferred Brand			
H3664	012	0	1	02	01	H3664_012_0	5	1	Generic			
H3664	012	0	1	02	01	H3664_012_0	5	4	Specialty	2		
H3664	012	0	1	02	01	H3664_012_0	5	2	Preferred Brand			
H3664	016	0	1	02	01	H3664_016_0	6	1	Generic			
H3664	016	0	1	02	01	H3664_016_0	6	3	Non-Preferred Brand			
H3664	016	0	1	02	01	H3664_016_0	6	4	Specialty			
H3664	016	0	1	02	01	H3664_016_0	6	2	Preferred Brand			
H3668	005	0	1	01	01	H3668_005_0	3	1	Generic			
H3668	005	0	1	01	01	H3668_005_0	3	2	Preferred Brand			
H3668	005	0	1	01	01	H3668_005_0	3	3	Non-Preferred Brand			
H3668	005	0	1	01	01	H3668_005_0	3	4	Specialty Drugs			
H3668	005	0	1	01	01	H3668_005_0	3	1	Generic	1		1
H3668	005	0	1	01	01	H3668_005_0	3	4	Specialty Drugs	2		
H3668	005	0	1	01	01	H3668_005_0	3	3	Non-Preferred Brand	2		
H3668	005	0	1	01	01	H3668_005_0	3	2	Preferred Brand	2		
H3668	011	0	1	01	01	H3668_011_0	5	3	Non Preferred Brand			
H3668	011	0	1	01	01	H3668_011_0	5	2	Preferred Brand			
H3668	011	0	1	01	01	H3668_011_0	5	1	Generic			
H3668	011	0	1	01	01	H3668_011_0	5	4	Specialty Drugs			
H3672	013	0	1	01	01	H3672_013_0	5	1	Generic			
H3672	013	0	1	01	01	H3672_013_0	5	2	Preferred Brand			
H3672	013	0	1	01	01	H3672_013_0	5	3	Non-Preferred Brand			
H3672	013	0	1	01	01	H3672_013_0	5	4	Specialty	2		
H3672	013	0	1	01	01	H3672_013_0	5	1	Generic	1		1
H3672	013	0	1	01	01	H3672_013_0	5	2	Preferred Brand	2		
H3672	013	0	1	01	01	H3672_013_0	5	3	Non-Preferred Brand	2		
H3672	013	0	1	01	01	H3672_013_0	5	4	Specialty			
H3706	001	0	1	01	01	H3706_001_0	3	2	Preferred Brand			
H3706	001	0	1	01	01	H3706_001_0	3	3	Non-Preferred Brand			
H3706	001	0	1	01	01	H3706_001_0	3	4	Specialty			
H3706	001	0	1	01	01	H3706_001_0	3	1	Generic			
H3706	006	0	1	01	01	H3706_006_0	3	1	Generic			
H3706	006	0	1	01	01	H3706_006_0	3	2	Preferred Brand			
H3706	006	0	1	01	01	H3706_006_0	3	3	Non-Preferred Brand			
H3706	006	0	1	01	01	H3706_006_0	3	4	Specialty			
H3706	014	0	1	01	01	H3706_014_0	3	3	Non-Preferred Brand			
H3706	014	0	1	01	01	H3706_014_0	3	2	Preferred Brand			
H3706	014	0	1	01	01	H3706_014_0	3	1	Generic			
H3706	014	0	1	01	01	H3706_014_0	3	4	Specialty			
H3706	014	0	1	01	01	H3706_014_0	3	4	Specialty	2		
H3706	014	0	1	01	01	H3706_014_0	3	3	Non-Preferred Brand	2		
H3706	014	0	1	01	01	H3706_014_0	3	2	Preferred Brand	2		
H3706	014	0	1	01	01	H3706_014_0	3	1	Generic	1		1
H3706	015	0	1	01	01	H3706_015_0	4	1	Generic			
H3706	015	0	1	01	01	H3706_015_0	4	2	Preferred Brand			
H3706	015	0	1	01	01	H3706_015_0	4	3	Non-Preferred Brand			
H3706	015	0	1	01	01	H3706_015_0	4	3	Non-Preferred Brand	2		
H3706	015	0	1	01	01	H3706_015_0	4	2	Preferred Brand	2		
H3706	015	0	1	01	01	H3706_015_0	4	1	Generic	1		1
H3706	015	0	1	01	01	H3706_015_0	4	4	Specialty			
H3706	015	0	1	01	01	H3706_015_0	4	4	Specialty	2		
H3706	016	0	1	01	01	H3706_016_0	4	4	Specialty			
H3706	016	0	1	01	01	H3706_016_0	4	3	Non-Preferred Brand			
H3706	016	0	1	01	01	H3706_016_0	4	2	Preferred Brand			
H3706	016	0	1	01	01	H3706_016_0	4	1	Generic			
H3706	016	0	1	01	01	H3706_016_0	4	1	Generic	1		1
H3706	016	0	1	01	01	H3706_016_0	4	4	Specialty	2		
H3706	016	0	1	01	01	H3706_016_0	4	3	Non-Preferred Brand	2		
H3706	016	0	1	01	01	H3706_016_0	4	2	Preferred Brand	2		
H3706	017	0	1	01	01	H3706_017_0	3	4	Specialty			
H3706	017	0	1	01	01	H3706_017_0	3	3	Non-Preferred Brand			
H3706	017	0	1	01	01	H3706_017_0	3	2	Preferred Brand			
H3706	017	0	1	01	01	H3706_017_0	3	1	Generic			
H3706	017	0	1	01	01	H3706_017_0	3	1	Generic	1		1
H3706	017	0	1	01	01	H3706_017_0	3	2	Preferred Brand	2		
H3706	017	0	1	01	01	H3706_017_0	3	3	Non-Preferred Brand	2		
H3706	017	0	1	01	01	H3706_017_0	3	4	Specialty	2		
H3709	001	0	1	04	01	H3709_001_0	8	4	Non-specialty injectables			
H3709	001	0	1	04	01	H3709_001_0	8	3	Non-Preferred Brand and Non-Preferred Generic			
H3709	001	0	1	04	01	H3709_001_0	8	2	Preferred Brand			
H3709	001	0	1	04	01	H3709_001_0	8	1	Preferred Generic			
H3709	001	0	1	04	01	H3709_001_0	8	5	Specialty drugs			
H3749	001	0	1	01	01	H3749_001_0	6	1	Preferred Generic			
H3749	001	0	1	01	01	H3749_001_0	6	2	Preferred Brand			
H3749	001	0	1	01	01	H3749_001_0	6	3	Non Preferred			
H3749	001	0	1	01	01	H3749_001_0	6	4	Specialty			
H3749	001	0	1	01	01	H3749_001_0	6	1	Preferred Generic	1		1
H3749	001	0	1	01	01	H3749_001_0	6	2	Preferred Brand	2		
H3749	001	0	1	01	01	H3749_001_0	6	4	Specialty	2		
H3749	001	0	1	01	01	H3749_001_0	6	3	Non Preferred	2		
H3749	004	0	1	01	01	H3749_004_0	5	3	Non Preferred			
H3749	004	0	1	01	01	H3749_004_0	5	1	Preferred Generic			
H3749	004	0	1	01	01	H3749_004_0	5	2	Preferred Brand			
H3749	004	0	1	01	01	H3749_004_0	5	4	Specialty			
H3749	013	0	1	01	01	H3749_013_0	6	4	Specialty			
H3749	013	0	1	01	01	H3749_013_0	6	1	Preferred Generic			
H3749	013	0	1	01	01	H3749_013_0	6	2	Preferred Brand			
H3749	013	0	1	01	01	H3749_013_0	6	3	Non Preferred			
H3749	014	0	1	01	01	H3749_014_0	6	1	Preferred Generic			
H3749	014	0	1	01	01	H3749_014_0	6	2	Preferred Brand			
H3749	014	0	1	01	01	H3749_014_0	6	3	Non Preferred			
H3749	014	0	1	01	01	H3749_014_0	6	4	Specialty			
H3749	015	0	1	01	01	H3749_015_0	6	1	Preferred Generic			
H3749	015	0	1	01	01	H3749_015_0	6	2	Preferred Brand			
H3749	015	0	1	01	01	H3749_015_0	6	4	Specialty			
H3749	015	0	1	01	01	H3749_015_0	6	3	Non Preferred			
H3749	016	0	1	01	01	H3749_016_0	6	1	Preferred Generic			
H3749	016	0	1	01	01	H3749_016_0	6	3	Non Preferred			
H3749	016	0	1	01	01	H3749_016_0	6	2	Preferred Brand			
H3749	016	0	1	01	01	H3749_016_0	6	4	Specialty			
H3749	017	0	1	01	01	H3749_017_0	5	3	Non Preferred			
H3749	017	0	1	01	01	H3749_017_0	5	4	Specialty			
H3749	017	0	1	01	01	H3749_017_0	5	2	Preferred Brand			
H3749	017	0	1	01	01	H3749_017_0	5	1	Preferred Generic			
H3755	001	0	1	01	01	H3755_001_0	5	2	Preferred Generics			
H3755	001	0	1	01	01	H3755_001_0	5	3	Preferred Brand			
H3755	001	0	1	01	01	H3755_001_0	5	4	Non-Preferred Drugs			
H3755	001	0	1	01	01	H3755_001_0	5	5	Non-Specialty Injectables			
H3755	001	0	1	01	01	H3755_001_0	5	6	Specialty Drugs			
H3755	001	0	1	01	01	H3755_001_0	5	1	Select Generics			
H3755	004	0	1	01	01	H3755_004_0	5	6	Specialty Drugs			
H3755	004	0	1	01	01	H3755_004_0	5	5	Non-Specialty Injectables			
H3755	004	0	1	01	01	H3755_004_0	5	3	Preferred Brand			
H3755	004	0	1	01	01	H3755_004_0	5	2	Preferred Generics			
H3755	004	0	1	01	01	H3755_004_0	5	1	Select Generics			
H3755	004	0	1	01	01	H3755_004_0	5	4	Non-Preferred Drugs			
H3805	001	0	1	01	01	H3805_001_0	5	1	Preferred Generic			
H3805	001	0	1	01	01	H3805_001_0	5	2	Preferred Brand			
H3805	001	0	1	01	01	H3805_001_0	5	3	Non Preferred			
H3805	001	0	1	01	01	H3805_001_0	5	4	Specialty			
H3805	007	0	1	01	01	H3805_007_0	6	1	Preferred Generic			
H3805	007	0	1	01	01	H3805_007_0	6	2	Preferred Brand			
H3805	007	0	1	01	01	H3805_007_0	6	3	Non Preferred			
H3805	007	0	1	01	01	H3805_007_0	6	4	Specialty			
H3810	003	0	1	01	01	H3810_003_0	6	1	Generic			
H3810	003	0	1	01	01	H3810_003_0	6	2	Preferred Brand			
H3810	003	0	1	01	01	H3810_003_0	6	3	Non-Preferred Brand			
H3810	003	0	1	01	01	H3810_003_0	6	4	Specialty			
H3810	005	0	1	02	01	H3810_005_0	6	1	Generic			
H3810	005	0	1	02	01	H3810_005_0	6	2	Preferred Brand			
H3810	005	0	1	02	01	H3810_005_0	6	3	Non-Preferred Brand			
H3810	005	0	1	02	01	H3810_005_0	6	4	Specialty			
H3810	007	0	1	01	01	H3810_007_0	8	2	Preferred Brand			
H3810	007	0	1	01	01	H3810_007_0	8	1	Generic			
H3810	007	0	1	01	01	H3810_007_0	8	3	Non-Preferred Brand			
H3810	007	0	1	01	01	H3810_007_0	8	4	Specialty			
H3810	010	0	1	01	01	H3810_010_0	6	4	Specialty			
H3810	010	0	1	01	01	H3810_010_0	6	1	Generic			
H3810	010	0	1	01	01	H3810_010_0	6	2	Preferred Brand			
H3810	010	0	1	01	01	H3810_010_0	6	3	Non-Preferred Brand			
H3810	012	0	1	02	01	H3810_012_0	6	1	Generic			
H3810	012	0	1	02	01	H3810_012_0	6	4	Specialty			
H3810	012	0	1	02	01	H3810_012_0	6	2	Preferred Brand			
H3810	012	0	1	02	01	H3810_012_0	6	3	Non-Preferred Brand			
H3810	014	0	1	01	01	H3810_014_0	6	4	Specialty			
H3810	014	0	1	01	01	H3810_014_0	6	3	Non-Preferred Brand			
H3810	014	0	1	01	01	H3810_014_0	6	2	Preferred Brand			
H3810	014	0	1	01	01	H3810_014_0	6	1	Generic			
H3811	002	0	1	01	01	H3811_002_0	6	3	Preferred Brands Tier			
H3811	002	0	1	01	01	H3811_002_0	6	2	Generic Tier			
H3811	002	0	1	01	01	H3811_002_0	6	5	Non-Preferred Brands Tier			
H3811	002	0	1	01	01	H3811_002_0	6	4	Speciality Tier			
H3811	002	0	1	01	01	H3811_002_0	6	1	Therapeutic Tier			
H3811	009	0	1	01	01	H3811_009_0	5	5	Non-Preferred Brands Tier			
H3811	009	0	1	01	01	H3811_009_0	5	4	Speciality Tier			
H3811	009	0	1	01	01	H3811_009_0	5	3	Preferred Brands Tier			
H3811	009	0	1	01	01	H3811_009_0	5	2	Generic Tier			
H3811	009	0	1	01	01	H3811_009_0	5	1	Therapeutic Tier	1		1
H3811	009	0	1	01	01	H3811_009_0	5	2	Generic Tier	1		1
H3811	009	0	1	01	01	H3811_009_0	5	1	Therapeutic Tier			
H3811	009	0	1	01	01	H3811_009_0	5	4	Speciality Tier	2		
H3811	009	0	1	01	01	H3811_009_0	5	5	Non-Preferred Brands Tier	2		
H3811	009	0	1	01	01	H3811_009_0	5	3	Preferred Brands Tier	2		
H3812	001	0	1	04	01	H3812_001_0	4	4	Specialty			
H3812	001	0	1	04	01	H3812_001_0	4	3	Non Preferred			
H3812	001	0	1	04	01	H3812_001_0	4	1	Preferred Generic			
H3812	001	0	1	04	01	H3812_001_0	4	2	Preferred Brand			
H3812	005	0	1	04	01	H3812_005_0	4	3	Non Preferred			
H3812	005	0	1	04	01	H3812_005_0	4	4	Specialty			
H3812	005	0	1	04	01	H3812_005_0	4	2	Preferred Brand			
H3812	005	0	1	04	01	H3812_005_0	4	1	Preferred Generic			
H3812	007	0	1	04	01	H3812_007_0	3	4	Specialty			
H3812	007	0	1	04	01	H3812_007_0	3	3	Non Preferred			
H3812	007	0	1	04	01	H3812_007_0	3	2	Preferred Brand			
H3812	007	0	1	04	01	H3812_007_0	3	1	Preferred Generic			
H3813	003	0	1	04	01	H3813_003_0	9	2	Tier 2	2		
H3813	003	0	1	04	01	H3813_003_0	9	1	Tier  1	1		1
H3814	004	0	1	01	01	H3814_004_0	8	4	TIER 4 - SPECIALTY			
H3814	004	0	1	01	01	H3814_004_0	8	3	TIER 3 - NON-PREFERRED BRAND			
H3814	004	0	1	01	01	H3814_004_0	8	2	TIER 2 PREFERRED BRAND			
H3814	004	0	1	01	01	H3814_004_0	8	1	TIER 1 - GENERICS			
H3814	006	0	1	01	01	H3814_006_0	9	1	TIER 1 - GENERICS			
H3814	006	0	1	01	01	H3814_006_0	9	2	TIER 2 PREFERRED BRAND			
H3814	006	0	1	01	01	H3814_006_0	9	3	TIER 3 - NON-PREFERRED BRAND			
H3814	006	0	1	01	01	H3814_006_0	9	4	TIER 4 - SPECIALTY			
H3814	008	0	1	01	01	H3814_008_0	9	4	TIER 4 - SPECIALTY			
H3814	008	0	1	01	01	H3814_008_0	9	3	TIER 3 - NON-PREFERRED BRAND			
H3814	008	0	1	01	01	H3814_008_0	9	4	TIER 4 - SPECIALTY	2		
H3814	008	0	1	01	01	H3814_008_0	9	3	TIER 3 - NON-PREFERRED BRAND	2		
H3814	008	0	1	01	01	H3814_008_0	9	2	TIER 2 - PREFERRED BRAND	2		
H3814	008	0	1	01	01	H3814_008_0	9	1	TIER 1 - GENERICS	1		1
H3814	008	0	1	01	01	H3814_008_0	9	1	TIER 1 - GENERICS			
H3814	008	0	1	01	01	H3814_008_0	9	2	TIER 2 - PREFERRED BRAND			
H3814	012	0	1	01	01	H3814_012_0	8	2	TIER 2 PREFERRED BRAND			
H3814	012	0	1	01	01	H3814_012_0	8	4	TIER 4 - SPECIALTY			
H3814	012	0	1	01	01	H3814_012_0	8	3	TIER 3 - NON-PREFERRED BRAND			
H3814	012	0	1	01	01	H3814_012_0	8	1	TIER 1 - GENERICS			
H3814	015	0	1	02	01	H3814_015_0	8	2	TIER 2 PREFERRED BRAND			
H3814	015	0	1	02	01	H3814_015_0	8	3	TIER 3 - NON-PREFERRED BRAND			
H3814	015	0	1	02	01	H3814_015_0	8	1	TIER 1 - GENERICS			
H3814	015	0	1	02	01	H3814_015_0	8	4	TIER 4 - SPECIALTY			
H3814	016	0	1	02	01	H3814_016_0	9	4	TIER 4 - SPECIALTY	2		
H3814	016	0	1	02	01	H3814_016_0	9	3	TIER 3 - NON-PREFERRED BRAND	2		
H3814	016	0	1	02	01	H3814_016_0	9	1	TIER 1 - GENERICS	1		1
H3814	016	0	1	02	01	H3814_016_0	9	2	TIER 2 - PREFERRED BRAND	2		
H3814	016	0	1	02	01	H3814_016_0	9	4	TIER 4 - SPECIALTY			
H3814	016	0	1	02	01	H3814_016_0	9	3	TIER 3 - NON-PREFERRED BRAND			
H3814	016	0	1	02	01	H3814_016_0	9	1	TIER 1 - GENERICS			
H3814	016	0	1	02	01	H3814_016_0	9	2	TIER 2 - PREFERRED BRAND			
H3814	019	0	1	01	01	H3814_019_0	8	4	TIER 4 - SPECIALTY			
H3814	019	0	1	01	01	H3814_019_0	8	3	TIER 3 - NON-PREFERRED BRAND			
H3814	019	0	1	01	01	H3814_019_0	8	2	TIER 2 PREFERRED BRAND			
H3814	019	0	1	01	01	H3814_019_0	8	1	TIER 1 - GENERICS			
H3814	021	0	1	02	01	H3814_021_0	8	3	TIER 3 - NON-PREFERRED BRAND			
H3814	021	0	1	02	01	H3814_021_0	8	4	TIER 4 - SPECIALTY			
H3814	021	0	1	02	01	H3814_021_0	8	2	TIER 2 PREFERRED BRAND			
H3814	021	0	1	02	01	H3814_021_0	8	1	TIER 1 - GENERICS			
H3814	024	0	1	01	01	H3814_024_0	8	2	TIER 2 PREFERRED BRAND			
H3814	024	0	1	01	01	H3814_024_0	8	3	TIER 3 - NON-PREFERRED BRAND			
H3814	024	0	1	01	01	H3814_024_0	8	1	TIER 1 - GENERICS			
H3814	024	0	1	01	01	H3814_024_0	8	4	TIER 4 - SPECIALTY			
H3815	001	0	1	01	01	H3815_001_0	9	1	Formulary Generic			
H3815	001	0	1	01	01	H3815_001_0	9	2	Formulary Preferred Brand			
H3815	001	0	1	01	01	H3815_001_0	9	3	Formulary Non-Preferred Brand			
H3815	001	0	1	01	01	H3815_001_0	9	4	Formulary Specialty			
H3817	002	0	1	04	01	H3817_002_0	6	3	Non-Preferred Brand			
H3817	002	0	1	04	01	H3817_002_0	6	2	Preferred Brand			
H3817	002	0	1	04	01	H3817_002_0	6	1	Generic			
H3817	002	0	1	04	01	H3817_002_0	6	4	Miscellaneous Injectables			
H3817	002	0	1	04	01	H3817_002_0	6	5	Specialty Medications			
H3817	003	0	1	04	01	H3817_003_0	9	1	Generic			
H3817	003	0	1	04	01	H3817_003_0	9	2	Preferred Brand			
H3817	003	0	1	04	01	H3817_003_0	9	3	Non-Preferred Brand			
H3817	003	0	1	04	01	H3817_003_0	9	4	Miscellaneous Injectables			
H3817	003	0	1	04	01	H3817_003_0	9	4	Miscellaneous Injectables	2		
H3817	003	0	1	04	01	H3817_003_0	9	1	Generic	1		1
H3817	003	0	1	04	01	H3817_003_0	9	2	Preferred Brand	2		
H3817	003	0	1	04	01	H3817_003_0	9	3	Non-Preferred Brand	2		
H3817	003	0	1	04	01	H3817_003_0	9	5	Specialty Medications	2		
H3817	003	0	1	04	01	H3817_003_0	9	5	Specialty Medications			
H3817	006	0	1	04	01	H3817_006_0	6	3	Non-Preferred Brand			
H3817	006	0	1	04	01	H3817_006_0	6	4	Miscellaneous Injectables			
H3817	006	0	1	04	01	H3817_006_0	6	5	Specialty Medications			
H3817	006	0	1	04	01	H3817_006_0	6	1	Generic			
H3817	006	0	1	04	01	H3817_006_0	6	2	Preferred Brand			
H3818	001	0	1	01	01	H3818_001_0	7	1	Generic			
H3818	001	0	1	01	01	H3818_001_0	7	2	Preferred Brand			
H3818	001	0	1	01	01	H3818_001_0	7	3	Non-Preferred Brand			
H3818	001	0	1	01	01	H3818_001_0	7	4	Specialty			
H3818	003	0	1	01	01	H3818_003_0	7	1	Generic			
H3818	003	0	1	01	01	H3818_003_0	7	2	Preferred Brand			
H3818	003	0	1	01	01	H3818_003_0	7	3	Non-Preferred Brand			
H3818	003	0	1	01	01	H3818_003_0	7	4	Specialty			
H3864	006	0	1	01	01	H3864_006_0	6	3	Specialty			
H3864	006	0	1	01	01	H3864_006_0	6	2	Brand			
H3864	006	0	1	01	01	H3864_006_0	6	1	Generc			
H3864	007	0	1	02	01	H3864_007_0	7	3	Non-Preferred Brand			
H3864	007	0	1	02	01	H3864_007_0	7	2	Preferred Brand			
H3864	007	0	1	02	01	H3864_007_0	7	4	Specialty			
H3864	007	0	1	02	01	H3864_007_0	7	1	Generic			
H3887	001	0	1	02	01	H3887_001_0	7	1	Preferred Generic			
H3887	001	0	1	02	01	H3887_001_0	7	2	Preferred Brand			
H3887	001	0	1	02	01	H3887_001_0	7	3	Non Preferred			
H3887	001	0	1	02	01	H3887_001_0	7	4	Specialty			
H3887	003	0	1	02	01	H3887_003_0	4	1	Preferred Generic			
H3887	003	0	1	02	01	H3887_003_0	4	2	Preferred Brand			
H3887	003	0	1	02	01	H3887_003_0	4	4	Specialty			
H3887	003	0	1	02	01	H3887_003_0	4	3	Non-Preferred			
H3887	005	0	1	02	01	H3887_005_0	3	1	Preferred Generic			
H3887	005	0	1	02	01	H3887_005_0	3	3	Non Preferred			
H3887	005	0	1	02	01	H3887_005_0	3	2	Preferred Brand			
H3887	005	0	1	02	01	H3887_005_0	3	4	Specialty			
H3907	006	0	1	01	01	H3907_006_0	4	1	Generic			
H3907	006	0	1	01	01	H3907_006_0	4	2	Preferred Brand			
H3907	006	0	1	01	01	H3907_006_0	4	3	Non-Preferred Brand			
H3907	006	0	1	01	01	H3907_006_0	4	4	Specialty			
H3907	020	0	1	01	01	H3907_020_0	5	4	Specialty			
H3907	020	0	1	01	01	H3907_020_0	5	3	Non-Preferred Brand			
H3907	020	0	1	01	01	H3907_020_0	5	2	Preferred Brand			
H3907	020	0	1	01	01	H3907_020_0	5	1	Generic			
H3907	029	0	1	01	01	H3907_029_0	5	3	Non-Preferred Brand			
H3907	029	0	1	01	01	H3907_029_0	5	4	Specialty			
H3907	029	0	1	01	01	H3907_029_0	5	2	Preferred Brand			
H3907	029	0	1	01	01	H3907_029_0	5	1	Generic			
H3909	001	0	1	04	01	H3909_001_0	8	1	Generic			
H3909	001	0	1	04	01	H3909_001_0	8	2	Preferred Brand			
H3909	001	0	1	04	01	H3909_001_0	8	3	Non-Preferred Brand			
H3909	001	0	1	04	01	H3909_001_0	8	4	Specialty			
H3912	001	0	1	04	01	H3912_001_0	4	3	Non Preferred			
H3912	001	0	1	04	01	H3912_001_0	4	2	Preferred Brand			
H3912	001	0	1	04	01	H3912_001_0	4	1	Preferred Generic			
H3912	001	0	1	04	01	H3912_001_0	4	4	Specialty			
H3912	008	0	1	04	01	H3912_008_0	3	1	Preferred Generic			
H3912	008	0	1	04	01	H3912_008_0	3	2	Preferred Brand			
H3912	008	0	1	04	01	H3912_008_0	3	4	Specialty			
H3912	008	0	1	04	01	H3912_008_0	3	3	Non Preferred			
H3912	009	0	1	04	01	H3912_009_0	3	1	Preferred Generic			
H3912	009	0	1	04	01	H3912_009_0	3	3	Non Preferred			
H3912	009	0	1	04	01	H3912_009_0	3	2	Preferred Brand			
H3912	009	0	1	04	01	H3912_009_0	3	4	Specialty			
H3912	011	0	1	04	01	H3912_011_0	3	1	Preferred Generic			
H3912	011	0	1	04	01	H3912_011_0	3	2	Preferred Brand			
H3912	011	0	1	04	01	H3912_011_0	3	4	Specialty			
H3912	011	0	1	04	01	H3912_011_0	3	3	Non Preferred			
H3916	001	0	1	04	01	H3916_001_0	7	1	Generic			
H3916	001	0	1	04	01	H3916_001_0	7	2	Preferred Brand			
H3916	001	0	1	04	01	H3916_001_0	7	3	Non-Preferred Brand			
H3916	001	0	1	04	01	H3916_001_0	7	4	Specialty			
H3916	002	0	1	04	01	H3916_002_0	7	1	Generic			
H3916	002	0	1	04	01	H3916_002_0	7	2	Preferred Brand			
H3916	002	0	1	04	01	H3916_002_0	7	4	Specialty			
H3916	002	0	1	04	01	H3916_002_0	7	3	Non-Preferred Brand			
H3916	003	0	1	04	01	H3916_003_0	7	1	Generic			
H3916	003	0	1	04	01	H3916_003_0	7	2	Preferred Brand			
H3916	003	0	1	04	01	H3916_003_0	7	3	Non-Preferred Brand			
H3916	003	0	1	04	01	H3916_003_0	7	4	Specialty			
H3916	005	0	1	04	01	H3916_005_0	7	3	Non-Preferred Brand			
H3916	005	0	1	04	01	H3916_005_0	7	2	Preferred Brand			
H3916	005	0	1	04	01	H3916_005_0	7	1	Generic			
H3916	005	0	1	04	01	H3916_005_0	7	4	Specialty			
H3916	005	0	1	04	01	H3916_005_0	7	4	Specialty	2		
H3916	005	0	1	04	01	H3916_005_0	7	3	Non-Preferred Brand	2		
H3916	005	0	1	04	01	H3916_005_0	7	2	Preferred Brand	2		
H3916	005	0	1	04	01	H3916_005_0	7	1	Generic	1		1
H3916	015	0	1	04	01	H3916_015_0	7	1	Generic			
H3916	015	0	1	04	01	H3916_015_0	7	2	Preferred Brand			
H3916	015	0	1	04	01	H3916_015_0	7	3	Non-Preferred Brand			
H3916	015	0	1	04	01	H3916_015_0	7	4	Specialty			
H3916	018	0	1	04	01	H3916_018_0	7	1	Generic			
H3916	018	0	1	04	01	H3916_018_0	7	2	Preferred Brand			
H3916	018	0	1	04	01	H3916_018_0	7	4	Specialty			
H3916	018	0	1	04	01	H3916_018_0	7	3	Non-Preferred Brand			
H3916	019	0	1	04	01	H3916_019_0	7	1	Generic			
H3916	019	0	1	04	01	H3916_019_0	7	3	Non-Preferred Brand			
H3916	019	0	1	04	01	H3916_019_0	7	2	Preferred Brand			
H3916	019	0	1	04	01	H3916_019_0	7	4	Specialty			
H3916	020	0	1	04	01	H3916_020_0	7	1	Generic			
H3916	020	0	1	04	01	H3916_020_0	7	2	Preferred Brand			
H3916	020	0	1	04	01	H3916_020_0	7	4	Specialty			
H3916	020	0	1	04	01	H3916_020_0	7	3	Non-Preferred Brand			
H3916	021	0	1	04	01	H3916_021_0	7	1	Generic			
H3916	021	0	1	04	01	H3916_021_0	7	2	Preferred Brand			
H3916	021	0	1	04	01	H3916_021_0	7	3	Non-Preferred Brand			
H3916	021	0	1	04	01	H3916_021_0	7	4	Specialty			
H3916	022	0	1	04	01	H3916_022_0	7	1	Generic			
H3916	022	0	1	04	01	H3916_022_0	7	2	Preferred Brand			
H3916	022	0	1	04	01	H3916_022_0	7	4	Specialty			
H3916	022	0	1	04	01	H3916_022_0	7	3	Non-Preferred Brand			
H3916	023	0	1	04	01	H3916_023_0	7	2	Preferred Brand			
H3916	023	0	1	04	01	H3916_023_0	7	3	Non-Preferred Brand			
H3916	023	0	1	04	01	H3916_023_0	7	1	Generic			
H3916	023	0	1	04	01	H3916_023_0	7	4	Specialty			
H3916	024	0	1	04	01	H3916_024_0	7	3	Non-Preferred Brand			
H3916	024	0	1	04	01	H3916_024_0	7	4	Specialty			
H3916	024	0	1	04	01	H3916_024_0	7	1	Generic			
H3916	024	0	1	04	01	H3916_024_0	7	2	Preferred Brand			
H3916	025	0	1	04	01	H3916_025_0	7	1	Generic			
H3916	025	0	1	04	01	H3916_025_0	7	2	Preferred Brand			
H3916	025	0	1	04	01	H3916_025_0	7	4	Specialty			
H3916	025	0	1	04	01	H3916_025_0	7	3	Non-Preferred Brand			
H3916	026	0	1	04	01	H3916_026_0	7	1	Generic			
H3916	026	0	1	04	01	H3916_026_0	7	3	Non-Preferred Brand			
H3916	026	0	1	04	01	H3916_026_0	7	2	Preferred Brand			
H3916	026	0	1	04	01	H3916_026_0	7	4	Specialty	2		
H3916	026	0	1	04	01	H3916_026_0	7	3	Non-Preferred Brand	2		
H3916	026	0	1	04	01	H3916_026_0	7	2	Preferred Brand	2		
H3916	026	0	1	04	01	H3916_026_0	7	1	Generic	1		1
H3916	026	0	1	04	01	H3916_026_0	7	4	Specialty			
H3916	027	0	1	04	01	H3916_027_0	7	4	Specialty	2		
H3916	027	0	1	04	01	H3916_027_0	7	4	Specialty			
H3916	027	0	1	04	01	H3916_027_0	7	3	Non-Preferred Brand	2		
H3916	027	0	1	04	01	H3916_027_0	7	2	Preferred Brand	2		
H3916	027	0	1	04	01	H3916_027_0	7	1	Generic			
H3916	027	0	1	04	01	H3916_027_0	7	3	Non-Preferred Brand			
H3916	027	0	1	04	01	H3916_027_0	7	2	Preferred Brand			
H3916	027	0	1	04	01	H3916_027_0	7	1	Generic	1		1
H3916	028	0	1	04	01	H3916_028_0	7	3	Non-Preferred Brand			
H3916	028	0	1	04	01	H3916_028_0	7	2	Preferred Brand			
H3916	028	0	1	04	01	H3916_028_0	7	1	Generic			
H3916	028	0	1	04	01	H3916_028_0	7	4	Specialty			
H3916	028	0	1	04	01	H3916_028_0	7	3	Non-Preferred Brand	2		
H3916	028	0	1	04	01	H3916_028_0	7	2	Preferred Brand	2		
H3916	028	0	1	04	01	H3916_028_0	7	1	Generic	1		1
H3916	028	0	1	04	01	H3916_028_0	7	4	Specialty	2		
H3920	001	0	1	01	01	H3920_001_0	10	3	Specialty			
H3920	001	0	1	01	01	H3920_001_0	10	2	Preferred Brand			
H3920	001	0	1	01	01	H3920_001_0	10	1	Preferred Generic			
H3920	001	0	1	01	01	H3920_001_0	10	4	Non-Preferred			
H3920	002	0	1	01	01	H3920_002_0	8	1	Preferred Generic	1		1
H3920	002	0	1	01	01	H3920_002_0	8	2	Preferred Brand	2		
H3920	002	0	1	01	01	H3920_002_0	8	3	Specialty	2		
H3920	002	0	1	01	01	H3920_002_0	8	4	Non-Preferred			
H3920	002	0	1	01	01	H3920_002_0	8	3	Specialty			
H3920	002	0	1	01	01	H3920_002_0	8	4	Non-Preferred	2		
H3920	002	0	1	01	01	H3920_002_0	8	1	Preferred Generic			
H3920	002	0	1	01	01	H3920_002_0	8	2	Preferred Brand			
H3921	001	0	1	04	01	H3921_001_0	5	1	Preferred Generic			
H3921	001	0	1	04	01	H3921_001_0	5	4	Specialty			
H3921	001	0	1	04	01	H3921_001_0	5	3	Non-Preferred			
H3921	001	0	1	04	01	H3921_001_0	5	2	Preferred Brand			
H3921	003	0	1	04	01	H3921_003_0	4	3	Non-Preferred			
H3921	003	0	1	04	01	H3921_003_0	4	2	Preferred Brand			
H3921	003	0	1	04	01	H3921_003_0	4	1	Preferred Generic			
H3921	003	0	1	04	01	H3921_003_0	4	4	Specialty			
H3921	008	0	1	04	01	H3921_008_0	3	4	Specialty			
H3921	008	0	1	04	01	H3921_008_0	3	3	Non-Preferred			
H3921	008	0	1	04	01	H3921_008_0	3	2	Preferred Brand			
H3921	008	0	1	04	01	H3921_008_0	3	1	Preferred Generic			
H3923	013	0	1	04	01	H3923_013_0	9	1	Generic Drugs			
H3923	013	0	1	04	01	H3923_013_0	9	2	Preferred Brand Drugs			
H3923	013	0	1	04	01	H3923_013_0	9	3	Non-Preferred Brand Drugs			
H3923	013	0	1	04	01	H3923_013_0	9	4	Specialty Drugs			
H3923	013	0	1	04	01	H3923_013_0	9	1	Generic Drugs	1		1
H3923	013	0	1	04	01	H3923_013_0	9	2	Preferred Brand Drugs	2		
H3923	013	0	1	04	01	H3923_013_0	9	3	Non-Preferred Brand Drugs	2		
H3923	013	0	1	04	01	H3923_013_0	9	4	Specialty Drugs	2		
H3923	017	0	1	04	01	H3923_017_0	8	1	Generic Drugs			
H3923	017	0	1	04	01	H3923_017_0	8	2	Preferred Brand Drugs			
H3923	017	0	1	04	01	H3923_017_0	8	4	Specialty Drugs	2		
H3923	017	0	1	04	01	H3923_017_0	8	3	Non-Preferred Brand Drugs	2		
H3923	017	0	1	04	01	H3923_017_0	8	3	Non-Preferred Brand Drugs			
H3923	017	0	1	04	01	H3923_017_0	8	4	Specialty Drugs			
H3923	017	0	1	04	01	H3923_017_0	8	1	Generic Drugs	1		1
H3923	017	0	1	04	01	H3923_017_0	8	2	Preferred Brand Drugs	2		
H3923	021	0	1	04	01	H3923_021_0	9	2	Formulary Brand Drugs			
H3923	021	0	1	04	01	H3923_021_0	9	1	Generic Drugs			
H3923	021	0	1	04	01	H3923_021_0	9	3	Specialty Drugs			
H3924	003	0	1	04	01	H3924_003_0	3	1	Tier 1			
H3924	003	0	1	04	01	H3924_003_0	3	2	Tier 2			
H3924	003	0	1	04	01	H3924_003_0	3	3	Tier 3			
H3924	003	0	1	04	01	H3924_003_0	3	4	Tier 4			
H3924	007	0	1	04	01	H3924_007_0	3	3	Tier 3			
H3924	007	0	1	04	01	H3924_007_0	3	2	Tier 2			
H3924	007	0	1	04	01	H3924_007_0	3	1	Tier 1			
H3924	007	0	1	04	01	H3924_007_0	3	4	Tier 4			
H3924	011	0	1	04	01	H3924_011_0	3	1	Tier 1			
H3924	011	0	1	04	01	H3924_011_0	3	2	Tier 2			
H3924	011	0	1	04	01	H3924_011_0	3	3	Tier 3			
H3924	011	0	1	04	01	H3924_011_0	3	4	Tier 4			
H3924	015	0	1	04	01	H3924_015_0	3	1	Tier 1			
H3924	015	0	1	04	01	H3924_015_0	3	2	Tier 2			
H3924	015	0	1	04	01	H3924_015_0	3	3	Tier 3			
H3924	015	0	1	04	01	H3924_015_0	3	4	Tier 4			
H3924	019	0	1	04	01	H3924_019_0	3	3	Tier 3			
H3924	019	0	1	04	01	H3924_019_0	3	2	Tier 2			
H3924	019	0	1	04	01	H3924_019_0	3	1	Tier 1			
H3924	019	0	1	04	01	H3924_019_0	3	4	Tier 4			
H3924	023	0	1	04	01	H3924_023_0	3	1	Tier 1			
H3924	023	0	1	04	01	H3924_023_0	3	2	Tier 2			
H3924	023	0	1	04	01	H3924_023_0	3	3	Tier 3			
H3924	023	0	1	04	01	H3924_023_0	3	4	Tier 4			
H3924	027	0	1	04	01	H3924_027_0	3	1	Tier 1			
H3924	027	0	1	04	01	H3924_027_0	3	2	Tier 2			
H3924	027	0	1	04	01	H3924_027_0	3	3	Tier 3			
H3924	027	0	1	04	01	H3924_027_0	3	4	Tier 4			
H3924	031	0	1	04	01	H3924_031_0	3	1	Tier 1			
H3924	031	0	1	04	01	H3924_031_0	3	2	Tier 2			
H3924	031	0	1	04	01	H3924_031_0	3	4	Tier 4			
H3924	031	0	1	04	01	H3924_031_0	3	3	Tier 3			
H3924	035	0	1	04	01	H3924_035_0	3	1	Tier 1			
H3924	035	0	1	04	01	H3924_035_0	3	2	Tier 2			
H3924	035	0	1	04	01	H3924_035_0	3	3	Tier 3			
H3924	035	0	1	04	01	H3924_035_0	3	4	Tier 4			
H3924	038	0	1	04	01	H3924_038_0	3	1	Tier 1			
H3924	038	0	1	04	01	H3924_038_0	3	3	Tier 3			
H3924	038	0	1	04	01	H3924_038_0	3	2	Tier 2			
H3924	038	0	1	04	01	H3924_038_0	3	4	Tier 4			
H3924	041	0	1	04	01	H3924_041_0	3	2	Tier 2			
H3924	041	0	1	04	01	H3924_041_0	3	3	Tier 3			
H3924	041	0	1	04	01	H3924_041_0	3	4	Tier 4			
H3924	041	0	1	04	01	H3924_041_0	3	1	Tier 1			
H3924	044	0	1	04	01	H3924_044_0	3	1	Tier 1			
H3924	044	0	1	04	01	H3924_044_0	3	4	Tier 4			
H3924	044	0	1	04	01	H3924_044_0	3	3	Tier 3			
H3924	044	0	1	04	01	H3924_044_0	3	2	Tier 2			
H3931	004	0	1	01	01	H3931_004_0	6	1	Tier 1 - Preferred Generic			
H3931	004	0	1	01	01	H3931_004_0	6	2	Tier 2 - Non-Preferred Generic			
H3931	004	0	1	01	01	H3931_004_0	6	3	Tier 3 - Preferred Brand			
H3931	004	0	1	01	01	H3931_004_0	6	4	Tier 4 - Non-Preferred Brand			
H3931	004	0	1	01	01	H3931_004_0	6	5	Tier 5 - Specialty			
H3931	058	0	1	01	01	H3931_058_0	5	1	Tier 1 - Preferred Generic			
H3931	058	0	1	01	01	H3931_058_0	5	2	Tier 2 - Non-Preferred Generic			
H3931	058	0	1	01	01	H3931_058_0	5	3	Tier 3 - Preferred Brand			
H3931	058	0	1	01	01	H3931_058_0	5	4	Tier 4 - Non-Preferred Brand			
H3931	058	0	1	01	01	H3931_058_0	5	5	Tier 5 - Specialty			
H3931	064	0	1	01	01	H3931_064_0	7	1	Tier 1 - Preferred Generic			
H3931	064	0	1	01	01	H3931_064_0	7	2	Tier 2 - Non-Preferred Generic			
H3931	064	0	1	01	01	H3931_064_0	7	3	Tier 3 - Preferred Brand			
H3931	064	0	1	01	01	H3931_064_0	7	4	Tier 4 - Non-Preferred Brand			
H3931	064	0	1	01	01	H3931_064_0	7	5	Tier 5 - Specialty			
H3931	065	0	1	01	01	H3931_065_0	7	5	Tier 5 - Specialty			
H3931	065	0	1	01	01	H3931_065_0	7	2	Tier 2 - Non-Preferred Generic			
H3931	065	0	1	01	01	H3931_065_0	7	3	Tier 3 - Preferred Brand			
H3931	065	0	1	01	01	H3931_065_0	7	4	Tier 4 - Non-Preferred Brand			
H3931	065	0	1	01	01	H3931_065_0	7	1	Tier 1 - Preferred Generic			
H3931	069	0	1	01	01	H3931_069_0	7	4	Tier 4 - Non-Preferred Brand			
H3931	069	0	1	01	01	H3931_069_0	7	5	Tier 5 - Specialty			
H3931	069	0	1	01	01	H3931_069_0	7	3	Tier 3 - Preferred Brand			
H3931	069	0	1	01	01	H3931_069_0	7	2	Tier 2 - Non-Preferred Generic			
H3931	069	0	1	01	01	H3931_069_0	7	1	Tier 1 - Preferred Generic			
H3931	070	0	1	01	01	H3931_070_0	6	4	Tier 4 - Non-Preferred Brand			
H3931	070	0	1	01	01	H3931_070_0	6	2	Tier 2 - Non-Preferred Generic			
H3931	070	0	1	01	01	H3931_070_0	6	1	Tier 1 - Preferred Generic			
H3931	070	0	1	01	01	H3931_070_0	6	3	Tier 3 - Preferred Brand			
H3931	070	0	1	01	01	H3931_070_0	6	5	Tier 5 - Specialty			
H3931	071	0	1	01	01	H3931_071_0	5	4	Tier 4 - Non-Preferred Brand	2		
H3931	071	0	1	01	01	H3931_071_0	5	1	Tier 1 - Preferred Generic			
H3931	071	0	1	01	01	H3931_071_0	5	2	Tier 2 - Non-Preferred Generic			
H3931	071	0	1	01	01	H3931_071_0	5	3	Tier 3 - Preferred Brand			
H3931	071	0	1	01	01	H3931_071_0	5	4	Tier 4 - Non-Preferred Brand			
H3931	071	0	1	01	01	H3931_071_0	5	5	Tier 5 - Specialty			
H3931	071	0	1	01	01	H3931_071_0	5	1	Tier 1 - Preferred Generic	1		1
H3931	071	0	1	01	01	H3931_071_0	5	5	Tier 5 - Specialty	2		
H3931	071	0	1	01	01	H3931_071_0	5	3	Tier 3 - Preferred Brand	2		
H3931	071	0	1	01	01	H3931_071_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H3931	075	0	1	01	01	H3931_075_0	6	5	Tier 5 - Specialty			
H3931	075	0	1	01	01	H3931_075_0	6	2	Tier 2 - Non-Preferred Generic			
H3931	075	0	1	01	01	H3931_075_0	6	3	Tier 3 - Preferred Brand			
H3931	075	0	1	01	01	H3931_075_0	6	4	Tier 4 - Non-Preferred Brand			
H3931	075	0	1	01	01	H3931_075_0	6	1	Tier 1 - Preferred Generic			
H3931	076	0	1	01	01	H3931_076_0	5	1	Tier 1 - Preferred Generic			
H3931	076	0	1	01	01	H3931_076_0	5	5	Tier 5 - Specialty			
H3931	076	0	1	01	01	H3931_076_0	5	1	Tier 1 - Preferred Generic	1		1
H3931	076	0	1	01	01	H3931_076_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H3931	076	0	1	01	01	H3931_076_0	5	3	Tier 3 - Preferred Brand	2		
H3931	076	0	1	01	01	H3931_076_0	5	4	Tier 4 - Non-Preferred Brand			
H3931	076	0	1	01	01	H3931_076_0	5	2	Tier 2 - Non-Preferred Generic			
H3931	076	0	1	01	01	H3931_076_0	5	3	Tier 3 - Preferred Brand			
H3931	076	0	1	01	01	H3931_076_0	5	5	Tier 5 - Specialty	2		
H3931	076	0	1	01	01	H3931_076_0	5	4	Tier 4 - Non-Preferred Brand	2		
H3931	077	0	1	01	01	H3931_077_0	5	4	Tier 4 - Non-Preferred Brand			
H3931	077	0	1	01	01	H3931_077_0	5	1	Tier 1 - Preferred Generic			
H3931	077	0	1	01	01	H3931_077_0	5	2	Tier 2 - Non-Preferred Generic			
H3931	077	0	1	01	01	H3931_077_0	5	3	Tier 3 - Preferred Brand			
H3931	077	0	1	01	01	H3931_077_0	5	5	Tier 5 - Specialty			
H3931	078	0	1	01	01	H3931_078_0	5	4	Tier 4 - Non-Preferred Brand			
H3931	078	0	1	01	01	H3931_078_0	5	1	Tier 1 - Preferred Generic			
H3931	078	0	1	01	01	H3931_078_0	5	5	Tier 5 - Specialty			
H3931	078	0	1	01	01	H3931_078_0	5	3	Tier 3 - Preferred Brand			
H3931	078	0	1	01	01	H3931_078_0	5	2	Tier 2 - Non-Preferred Generic			
H3949	002	0	1	01	01	H3949_002_0	2	4	Specialty			
H3949	002	0	1	01	01	H3949_002_0	2	2	Preferred Brand			
H3949	002	0	1	01	01	H3949_002_0	2	1	Generic			
H3949	002	0	1	01	01	H3949_002_0	2	3	Non-Preferred Brand			
H3949	012	0	1	01	01	H3949_012_0	2	4	Specialty			
H3949	012	0	1	01	01	H3949_012_0	2	1	Generic			
H3949	012	0	1	01	01	H3949_012_0	2	2	Preferred Brand			
H3949	012	0	1	01	01	H3949_012_0	2	3	Non-Preferred Brand			
H3949	013	0	1	01	01	H3949_013_0	2	3	Non-Preferred Brand			
H3949	013	0	1	01	01	H3949_013_0	2	4	Specialty			
H3949	013	0	1	01	01	H3949_013_0	2	2	Preferred Brand			
H3949	013	0	1	01	01	H3949_013_0	2	1	Generic			
H3949	015	0	1	02	01	H3949_015_0	2	4	Specialty			
H3949	015	0	1	02	01	H3949_015_0	2	2	Preferred Brand			
H3949	015	0	1	02	01	H3949_015_0	2	3	Non-Preferred Brand			
H3949	015	0	1	02	01	H3949_015_0	2	1	Generic			
H3949	017	0	1	01	01	H3949_017_0	2	4	Specialty			
H3949	017	0	1	01	01	H3949_017_0	2	3	Non-Preferred Brand			
H3949	017	0	1	01	01	H3949_017_0	2	2	Preferred Brand			
H3949	017	0	1	01	01	H3949_017_0	2	1	Generic			
H3949	020	0	1	01	01	H3949_020_0	2	1	Generic			
H3949	020	0	1	01	01	H3949_020_0	2	2	Preferred Brand			
H3949	020	0	1	01	01	H3949_020_0	2	3	Non-Preferred Brand			
H3949	020	0	1	01	01	H3949_020_0	2	4	Specialty			
H3952	018	0	1	01	01	H3952_018_0	5	1	Generic			
H3952	018	0	1	01	01	H3952_018_0	5	4	Specialty			
H3952	018	0	1	01	01	H3952_018_0	5	3	Non-Preferred Brand			
H3952	018	0	1	01	01	H3952_018_0	5	2	Preferred Brand			
H3952	020	0	1	01	01	H3952_020_0	6	1	Generic			
H3952	020	0	1	01	01	H3952_020_0	6	2	Preferred Brand			
H3952	020	0	1	01	01	H3952_020_0	6	4	Specialty	2		
H3952	020	0	1	01	01	H3952_020_0	6	3	Non-Preferred Brand	2		
H3952	020	0	1	01	01	H3952_020_0	6	2	Preferred Brand	2		
H3952	020	0	1	01	01	H3952_020_0	6	3	Non-Preferred Brand			
H3952	020	0	1	01	01	H3952_020_0	6	4	Specialty			
H3952	020	0	1	01	01	H3952_020_0	6	1	Generic	1		1
H3952	040	0	1	01	01	H3952_040_0	7	1	Generic			
H3952	040	0	1	01	01	H3952_040_0	7	2	Preferred Brand			
H3952	040	0	1	01	01	H3952_040_0	7	3	Non-Preferred Brand			
H3952	040	0	1	01	01	H3952_040_0	7	4	Specialty			
H3952	043	0	1	01	01	H3952_043_0	6	1	Generic	1		1
H3952	043	0	1	01	01	H3952_043_0	6	4	Specialty			
H3952	043	0	1	01	01	H3952_043_0	6	3	Non-Preferred Brand			
H3952	043	0	1	01	01	H3952_043_0	6	2	Preferred Brand			
H3952	043	0	1	01	01	H3952_043_0	6	1	Generic			
H3952	043	0	1	01	01	H3952_043_0	6	2	Preferred Brand	2		
H3952	043	0	1	01	01	H3952_043_0	6	3	Non-Preferred Brand	2		
H3952	043	0	1	01	01	H3952_043_0	6	4	Specialty	2		
H3954	021	0	1	01	01	H3954_021_0	5	1	Tier 1			
H3954	021	0	1	01	01	H3954_021_0	5	2	Tier 2			
H3954	021	0	1	01	01	H3954_021_0	5	3	Tier 3			
H3954	021	0	1	01	01	H3954_021_0	5	4	Tier 4			
H3954	024	0	1	01	01	H3954_024_0	3	1	Tier 1			
H3954	024	0	1	01	01	H3954_024_0	3	2	Tier 2			
H3954	024	0	1	01	01	H3954_024_0	3	4	Tier 4			
H3954	024	0	1	01	01	H3954_024_0	3	3	Tier 3			
H3954	027	0	1	01	01	H3954_027_0	5	1	Tier 1			
H3954	027	0	1	01	01	H3954_027_0	5	3	Tier 3			
H3954	027	0	1	01	01	H3954_027_0	5	2	Tier 2			
H3954	027	0	1	01	01	H3954_027_0	5	4	Tier 4			
H3954	033	0	1	01	01	H3954_033_0	5	1	Tier 1			
H3954	033	0	1	01	01	H3954_033_0	5	2	Tier 2			
H3954	033	0	1	01	01	H3954_033_0	5	4	Tier 4			
H3954	033	0	1	01	01	H3954_033_0	5	3	Tier 3			
H3954	039	0	1	01	01	H3954_039_0	5	1	Tier 1			
H3954	039	0	1	01	01	H3954_039_0	5	2	Tier 2			
H3954	039	0	1	01	01	H3954_039_0	5	3	Tier 3			
H3954	039	0	1	01	01	H3954_039_0	5	4	Tier 4			
H3954	042	0	1	01	01	H3954_042_0	5	1	Tier 1			
H3954	042	0	1	01	01	H3954_042_0	5	2	Tier 2			
H3954	042	0	1	01	01	H3954_042_0	5	4	Tier 4			
H3954	042	0	1	01	01	H3954_042_0	5	3	Tier 3			
H3954	045	0	1	01	01	H3954_045_0	5	1	Tier 1			
H3954	045	0	1	01	01	H3954_045_0	5	2	Tier 2			
H3954	045	0	1	01	01	H3954_045_0	5	3	Tier 3			
H3954	045	0	1	01	01	H3954_045_0	5	4	Tier 4			
H3954	048	0	1	01	01	H3954_048_0	5	1	Tier 1			
H3954	048	0	1	01	01	H3954_048_0	5	2	Tier 2			
H3954	048	0	1	01	01	H3954_048_0	5	3	Tier 3			
H3954	048	0	1	01	01	H3954_048_0	5	4	Tier 4			
H3954	051	0	1	01	01	H3954_051_0	5	1	Tier 1			
H3954	051	0	1	01	01	H3954_051_0	5	2	Tier 2			
H3954	051	0	1	01	01	H3954_051_0	5	3	Tier 3			
H3954	051	0	1	01	01	H3954_051_0	5	4	Tier 4			
H3954	057	0	1	01	01	H3954_057_0	8	1	Tier 1			
H3954	057	0	1	01	01	H3954_057_0	8	2	Tier 2			
H3954	057	0	1	01	01	H3954_057_0	8	3	Tier 3			
H3954	057	0	1	01	01	H3954_057_0	8	4	Tier 4			
H3954	060	0	1	01	01	H3954_060_0	7	1	Tier 1			
H3954	060	0	1	01	01	H3954_060_0	7	2	Tier 2			
H3954	060	0	1	01	01	H3954_060_0	7	4	Tier 4			
H3954	060	0	1	01	01	H3954_060_0	7	3	Tier 3			
H3954	063	0	1	01	01	H3954_063_0	7	1	Tier 1			
H3954	063	0	1	01	01	H3954_063_0	7	2	Tier 2			
H3954	063	0	1	01	01	H3954_063_0	7	3	Tier 3			
H3954	063	0	1	01	01	H3954_063_0	7	4	Tier 4			
H3954	067	0	1	01	01	H3954_067_0	4	1	Tier 1			
H3954	067	0	1	01	01	H3954_067_0	4	3	Tier 3			
H3954	067	0	1	01	01	H3954_067_0	4	2	Tier 2			
H3954	067	0	1	01	01	H3954_067_0	4	4	Tier 4			
H3954	079	0	1	01	01	H3954_079_0	3	1	Tier 1			
H3954	079	0	1	01	01	H3954_079_0	3	2	Tier 2			
H3954	079	0	1	01	01	H3954_079_0	3	4	Tier 4			
H3954	079	0	1	01	01	H3954_079_0	3	3	Tier 3			
H3954	091	0	1	01	01	H3954_091_0	3	1	Tier 1			
H3954	091	0	1	01	01	H3954_091_0	3	2	Tier 2			
H3954	091	0	1	01	01	H3954_091_0	3	3	Tier 3			
H3954	091	0	1	01	01	H3954_091_0	3	4	Tier 4			
H3954	097	0	1	01	01	H3954_097_0	4	1	Tier 1			
H3954	097	0	1	01	01	H3954_097_0	4	2	Tier 2			
H3954	097	0	1	01	01	H3954_097_0	4	3	Tier 3			
H3954	097	0	1	01	01	H3954_097_0	4	4	Tier 4			
H3954	100	0	1	01	01	H3954_100_0	2	1	Tier 1			
H3954	100	0	1	01	01	H3954_100_0	2	2	Tier 2			
H3954	100	0	1	01	01	H3954_100_0	2	4	Tier 4			
H3954	100	0	1	01	01	H3954_100_0	2	3	Tier 3			
H3954	106	0	1	01	01	H3954_106_0	2	1	Tier 1			
H3954	106	0	1	01	01	H3954_106_0	2	2	Tier 2			
H3954	106	0	1	01	01	H3954_106_0	2	3	Tier 3			
H3954	106	0	1	01	01	H3954_106_0	2	4	Tier 4			
H3954	109	0	1	01	01	H3954_109_0	3	1	Tier 1			
H3954	109	0	1	01	01	H3954_109_0	3	2	Tier 2			
H3954	109	0	1	01	01	H3954_109_0	3	3	Tier 3			
H3954	109	0	1	01	01	H3954_109_0	3	4	Tier 4			
H3954	112	0	1	01	01	H3954_112_0	3	1	Tier 1			
H3954	112	0	1	01	01	H3954_112_0	3	2	Tier 2			
H3954	112	0	1	01	01	H3954_112_0	3	3	Tier 3			
H3954	112	0	1	01	01	H3954_112_0	3	4	Tier 4			
H3954	115	0	1	01	01	H3954_115_0	2	3	Tier 3			
H3954	115	0	1	01	01	H3954_115_0	2	2	Tier 2			
H3954	115	0	1	01	01	H3954_115_0	2	1	Tier 1			
H3954	115	0	1	01	01	H3954_115_0	2	4	Tier 4			
H3954	121	0	1	01	01	H3954_121_0	2	1	Tier 1			
H3954	121	0	1	01	01	H3954_121_0	2	2	Tier 2			
H3954	121	0	1	01	01	H3954_121_0	2	3	Tier 3			
H3954	121	0	1	01	01	H3954_121_0	2	4	Tier 4			
H3954	124	0	1	01	01	H3954_124_0	2	3	Tier 3			
H3954	124	0	1	01	01	H3954_124_0	2	2	Tier 2			
H3954	124	0	1	01	01	H3954_124_0	2	1	Tier 1			
H3954	124	0	1	01	01	H3954_124_0	2	4	Tier 4			
H3954	127	0	1	01	01	H3954_127_0	2	1	Tier 1			
H3954	127	0	1	01	01	H3954_127_0	2	2	Tier 2			
H3954	127	0	1	01	01	H3954_127_0	2	3	Tier 3			
H3954	127	0	1	01	01	H3954_127_0	2	4	Tier 4			
H3954	130	0	1	01	01	H3954_130_0	3	1	Tier 1			
H3954	130	0	1	01	01	H3954_130_0	3	2	Tier 2			
H3954	130	0	1	01	01	H3954_130_0	3	4	Tier 4			
H3954	130	0	1	01	01	H3954_130_0	3	3	Tier 3			
H3954	133	0	1	01	01	H3954_133_0	4	1	Tier 1			
H3954	133	0	1	01	01	H3954_133_0	4	3	Tier 3			
H3954	133	0	1	01	01	H3954_133_0	4	2	Tier 2			
H3954	133	0	1	01	01	H3954_133_0	4	4	Tier 4			
H3957	003	0	1	01	01	H3957_003_0	9	4	Specialty Drugs			
H3957	003	0	1	01	01	H3957_003_0	9	2	Preferred Brand			
H3957	003	0	1	01	01	H3957_003_0	9	1	Generic			
H3957	003	0	1	01	01	H3957_003_0	9	3	Non-Preferred Brand			
H3957	006	0	1	01	01	H3957_006_0	8	1	Generic			
H3957	006	0	1	01	01	H3957_006_0	8	2	Preferred Brand			
H3957	006	0	1	01	01	H3957_006_0	8	4	Specialty Drugs			
H3957	006	0	1	01	01	H3957_006_0	8	3	Non-Preferred Brand			
H3957	016	0	1	01	01	H3957_016_0	8	2	Preferred Brand			
H3957	016	0	1	01	01	H3957_016_0	8	3	Non-Preferred Brand			
H3957	016	0	1	01	01	H3957_016_0	8	4	Specialty Drugs			
H3957	016	0	1	01	01	H3957_016_0	8	1	Generic			
H3957	020	0	1	01	01	H3957_020_0	7	2	Preferred Brand	2		
H3957	020	0	1	01	01	H3957_020_0	7	3	Non-Preferred Brand	2		
H3957	020	0	1	01	01	H3957_020_0	7	4	Specialty Drugs	2		
H3957	020	0	1	01	01	H3957_020_0	7	1	Generic	1		1
H3957	020	0	1	01	01	H3957_020_0	7	4	Specialty Drugs			
H3957	020	0	1	01	01	H3957_020_0	7	3	Non-Preferred Brand			
H3957	020	0	1	01	01	H3957_020_0	7	2	Preferred Brand			
H3957	020	0	1	01	01	H3957_020_0	7	1	Generic			
H3957	021	0	1	01	01	H3957_021_0	7	1	Generic			
H3957	021	0	1	01	01	H3957_021_0	7	2	Preferred Brand			
H3957	021	0	1	01	01	H3957_021_0	7	3	Non-Preferred Brand			
H3957	021	0	1	01	01	H3957_021_0	7	4	Specialty Drugs			
H3957	021	0	1	01	01	H3957_021_0	7	1	Generic	1		1
H3957	021	0	1	01	01	H3957_021_0	7	2	Preferred Brand	2		
H3957	021	0	1	01	01	H3957_021_0	7	3	Non-Preferred Brand	2		
H3957	021	0	1	01	01	H3957_021_0	7	4	Specialty Drugs	2		
H3957	022	0	1	01	01	H3957_022_0	7	1	Generic			
H3957	022	0	1	01	01	H3957_022_0	7	2	Preferred Brand	2		
H3957	022	0	1	01	01	H3957_022_0	7	3	Non-Preferred Brand	2		
H3957	022	0	1	01	01	H3957_022_0	7	4	Specialty Drugs	2		
H3957	022	0	1	01	01	H3957_022_0	7	1	Generic	1		1
H3957	022	0	1	01	01	H3957_022_0	7	2	Preferred Brand			
H3957	022	0	1	01	01	H3957_022_0	7	3	Non-Preferred Brand			
H3957	022	0	1	01	01	H3957_022_0	7	4	Specialty Drugs			
H3957	031	0	1	01	01	H3957_031_0	9	4	Specialty Drugs			
H3957	031	0	1	01	01	H3957_031_0	9	3	Non-Preferred Brand			
H3957	031	0	1	01	01	H3957_031_0	9	1	Generic			
H3957	031	0	1	01	01	H3957_031_0	9	2	Preferred Brand			
H3957	032	0	1	01	01	H3957_032_0	10	2	Preferred Brand			
H3957	032	0	1	01	01	H3957_032_0	10	1	Generic			
H3957	032	0	1	01	01	H3957_032_0	10	4	Specialty Drugs			
H3957	032	0	1	01	01	H3957_032_0	10	3	Non-Preferred Brand			
H3957	033	0	1	01	01	H3957_033_0	10	4	Specialty Drugs			
H3957	033	0	1	01	01	H3957_033_0	10	3	Non-Preferred Brand			
H3957	033	0	1	01	01	H3957_033_0	10	1	Generic			
H3957	033	0	1	01	01	H3957_033_0	10	2	Preferred Brand			
H3959	001	0	1	01	01	H3959_001_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	001	0	1	01	01	H3959_001_0	8	2	Tier 2 - Preferred Brand			
H3959	001	0	1	01	01	H3959_001_0	8	4	Tier 4 - Specialty Drugs	2		
H3959	001	0	1	01	01	H3959_001_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	001	0	1	01	01	H3959_001_0	8	2	Tier 2 - Preferred Brand	2		
H3959	001	0	1	01	01	H3959_001_0	8	1	Tier 1 - Preferred Generic	1		1
H3959	001	0	1	01	01	H3959_001_0	8	4	Tier 4 - Specialty Drugs			
H3959	001	0	1	01	01	H3959_001_0	8	1	Tier 1 - Preferred Generic			
H3959	002	0	1	01	01	H3959_002_0	8	1	Tier 1 - Preferred Generic			
H3959	002	0	1	01	01	H3959_002_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	002	0	1	01	01	H3959_002_0	8	2	Tier 2 - Preferred Brand	2		
H3959	002	0	1	01	01	H3959_002_0	8	1	Tier 1 - Preferred Generic	1		1
H3959	002	0	1	01	01	H3959_002_0	8	4	Tier 4 - Specialty Drugs			
H3959	002	0	1	01	01	H3959_002_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	002	0	1	01	01	H3959_002_0	8	2	Tier 2 - Preferred Brand			
H3959	002	0	1	01	01	H3959_002_0	8	4	Tier 4 - Specialty Drugs	2		
H3959	006	0	1	01	01	H3959_006_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	006	0	1	01	01	H3959_006_0	7	2	Tier 2 - Preferred Brand			
H3959	006	0	1	01	01	H3959_006_0	7	1	Tier 1 - Preferred Generic			
H3959	006	0	1	01	01	H3959_006_0	7	4	Tier 4 - Specialty Drugs			
H3959	006	0	1	01	01	H3959_006_0	7	4	Tier 4 - Specialty Drugs	2		
H3959	006	0	1	01	01	H3959_006_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	006	0	1	01	01	H3959_006_0	7	2	Tier 2 - Preferred Brand	2		
H3959	006	0	1	01	01	H3959_006_0	7	1	Tier 1 - Preferred Generic	1		1
H3959	010	0	1	01	01	H3959_010_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	010	0	1	01	01	H3959_010_0	8	2	Tier 2 - Preferred Brand			
H3959	010	0	1	01	01	H3959_010_0	8	1	Tier 1 - Preferred Generic			
H3959	010	0	1	01	01	H3959_010_0	8	4	Tier 4 - Specialty Drugs			
H3959	011	0	1	01	01	H3959_011_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	011	0	1	01	01	H3959_011_0	8	2	Tier 2 - Preferred Brand			
H3959	011	0	1	01	01	H3959_011_0	8	1	Tier 1 - Preferred Generic			
H3959	011	0	1	01	01	H3959_011_0	8	4	Tier 4 - Specialty Drugs			
H3959	011	0	1	01	01	H3959_011_0	8	4	Tier 4 - Specialty Drugs	2		
H3959	011	0	1	01	01	H3959_011_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	011	0	1	01	01	H3959_011_0	8	2	Tier 2 - Preferred Brand	2		
H3959	011	0	1	01	01	H3959_011_0	8	1	Tier 1 - Preferred Generic	1		1
H3959	023	0	1	01	01	H3959_023_0	6	1	Tier 1 - Preferred Generic			
H3959	023	0	1	01	01	H3959_023_0	6	2	Tier 2 - Preferred Brand			
H3959	023	0	1	01	01	H3959_023_0	6	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	023	0	1	01	01	H3959_023_0	6	4	Tier 4 - Specialty Drugs			
H3959	026	0	1	01	01	H3959_026_0	4	1	Tier 1 - Preferred Generic			
H3959	026	0	1	01	01	H3959_026_0	4	2	Tier 2 - Preferred Brand			
H3959	026	0	1	01	01	H3959_026_0	4	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	026	0	1	01	01	H3959_026_0	4	4	Tier 4 - Specialty			
H3959	027	0	1	01	01	H3959_027_0	7	4	Tier 4 - Specialty Drugs	2		
H3959	027	0	1	01	01	H3959_027_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	027	0	1	01	01	H3959_027_0	7	2	Tier 2 - Preferred Brand	2		
H3959	027	0	1	01	01	H3959_027_0	7	1	Tier 1 - Preferred Generic	2		
H3959	027	0	1	01	01	H3959_027_0	7	5	Tier 5 - Other - Special Needs	1		1
H3959	027	0	1	01	01	H3959_027_0	7	4	Tier 4 - Specialty Drugs			
H3959	027	0	1	01	01	H3959_027_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	027	0	1	01	01	H3959_027_0	7	2	Tier 2 - Preferred Brand			
H3959	027	0	1	01	01	H3959_027_0	7	1	Tier 1 - Preferred Generic			
H3959	027	0	1	01	01	H3959_027_0	7	5	Tier 5 - Other - Special Needs			
H3959	028	0	1	01	01	H3959_028_0	7	4	Tier 4 - Specialty Drugs	2		
H3959	028	0	1	01	01	H3959_028_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	028	0	1	01	01	H3959_028_0	7	2	Tier 2 - Preferred Brand	2		
H3959	028	0	1	01	01	H3959_028_0	7	1	Tier 1 - Preferred Generic	2		
H3959	028	0	1	01	01	H3959_028_0	7	5	Tier 5 - Other - Special Needs			
H3959	028	0	1	01	01	H3959_028_0	7	4	Tier 4 - Specialty Drugs			
H3959	028	0	1	01	01	H3959_028_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	028	0	1	01	01	H3959_028_0	7	2	Tier 2 - Preferred Brand			
H3959	028	0	1	01	01	H3959_028_0	7	1	Tier 1 - Preferred Generic			
H3959	028	0	1	01	01	H3959_028_0	7	5	Tier 5 - Other - Special Needs	1		1
H3959	029	0	1	01	01	H3959_029_0	6	1	Tier 1 - Preferred Generic			
H3959	029	0	1	01	01	H3959_029_0	6	2	Tier 2 - Preferred Brand			
H3959	029	0	1	01	01	H3959_029_0	6	5	Tier 5 - Other - Special Needs	1		1
H3959	029	0	1	01	01	H3959_029_0	6	4	Tier 4 - Specialty Drugs	2		
H3959	029	0	1	01	01	H3959_029_0	6	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	029	0	1	01	01	H3959_029_0	6	2	Tier 2 - Preferred Brand	2		
H3959	029	0	1	01	01	H3959_029_0	6	1	Tier 1 - Preferred Generic	2		
H3959	029	0	1	01	01	H3959_029_0	6	5	Tier 5 - Other - Special Needs			
H3959	029	0	1	01	01	H3959_029_0	6	4	Tier 4 - Specialty Drugs			
H3959	029	0	1	01	01	H3959_029_0	6	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	030	0	1	01	01	H3959_030_0	6	1	Tier 1 - Preferred Generic			
H3959	030	0	1	01	01	H3959_030_0	6	4	Tier 4 - Specialty Drugs	2		
H3959	030	0	1	01	01	H3959_030_0	6	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	030	0	1	01	01	H3959_030_0	6	2	Tier 2 - Preferred Brand	2		
H3959	030	0	1	01	01	H3959_030_0	6	5	Tier 5 - Other - Special Needs	1		1
H3959	030	0	1	01	01	H3959_030_0	6	5	Tier 5 - Other - Special Needs			
H3959	030	0	1	01	01	H3959_030_0	6	4	Tier 4 - Specialty Drugs			
H3959	030	0	1	01	01	H3959_030_0	6	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H3959	030	0	1	01	01	H3959_030_0	6	2	Tier 2 - Preferred Brand			
H3959	030	0	1	01	01	H3959_030_0	6	1	Tier 1 - Preferred Generic	2		
H3962	001	0	1	01	01	H3962_001_0	9	3	Non-Preferred Brand Drugs			
H3962	001	0	1	01	01	H3962_001_0	9	2	Preferred Brand Drugs			
H3962	001	0	1	01	01	H3962_001_0	9	1	Generic Drugs			
H3962	001	0	1	01	01	H3962_001_0	9	4	Specialty Drugs			
H3962	001	0	1	01	01	H3962_001_0	9	1	Generic Drugs	1		1
H3962	001	0	1	01	01	H3962_001_0	9	2	Preferred Brand Drugs	2		
H3962	001	0	1	01	01	H3962_001_0	9	3	Non-Preferred Brand Drugs	2		
H3962	001	0	1	01	01	H3962_001_0	9	4	Specialty Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	9	3	Non-Preferred Brand Drugs			
H3962	004	0	1	01	01	H3962_004_0	9	2	Preferred Brand Drugs			
H3962	004	0	1	01	01	H3962_004_0	9	1	Generic Drugs			
H3962	004	0	1	01	01	H3962_004_0	9	4	Specialty Drugs			
H3962	004	0	1	01	01	H3962_004_0	9	4	Specialty Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	9	3	Non-Preferred Brand Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	9	2	Preferred Brand Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	9	1	Generic Drugs	1		1
H3962	007	0	1	01	01	H3962_007_0	9	1	Generic Drugs			
H3962	007	0	1	01	01	H3962_007_0	9	2	Formulary Brand Drugs			
H3962	007	0	1	01	01	H3962_007_0	9	3	Specialty Drugs			
H3964	002	0	1	01	01	H3964_002_0	2	2	Preferred Brand			
H3964	002	0	1	01	01	H3964_002_0	2	1	Generic			
H3964	003	0	1	01	01	H3964_003_0	3	2	Preferred Brand			
H3964	003	0	1	01	01	H3964_003_0	3	1	Generic			
H3964	003	0	1	01	01	H3964_003_0	3	3	Specialty			
H4003	001	0	1	01	01	H4003_001_0	3	4	Specialty	2		
H4003	001	0	1	01	01	H4003_001_0	3	3	Non-Preferred Brand	2		
H4003	001	0	1	01	01	H4003_001_0	3	2	Brand	2		
H4003	001	0	1	01	01	H4003_001_0	3	1	Generic	1		1
H4003	001	0	1	01	01	H4003_001_0	3	4	Specialty			
H4003	001	0	1	01	01	H4003_001_0	3	2	Brand			
H4003	001	0	1	01	01	H4003_001_0	3	1	Generic			
H4003	001	0	1	01	01	H4003_001_0	3	3	Non-Preferred Brand			
H4003	009	0	1	01	01	H4003_009_0	4	3	Specialty	2		
H4003	009	0	1	01	01	H4003_009_0	4	2	Brand	2		
H4003	009	0	1	01	01	H4003_009_0	4	1	Generic	1	00001000	2
H4003	009	0	1	01	01	H4003_009_0	4	3	Specialty			
H4003	009	0	1	01	01	H4003_009_0	4	1	Generic			
H4003	009	0	1	01	01	H4003_009_0	4	2	Brand			
H4003	015	0	1	01	01	H4003_015_0	5	3	Specialty	2		
H4003	015	0	1	01	01	H4003_015_0	5	3	Specialty			
H4003	015	0	1	01	01	H4003_015_0	5	2	Brand			
H4003	015	0	1	01	01	H4003_015_0	5	2	Brand	2		
H4003	015	0	1	01	01	H4003_015_0	5	1	Generic			
H4003	015	0	1	01	01	H4003_015_0	5	1	Generic	1		1
H4004	015	0	1	01	01	H4004_015_0	3	1	Generic			
H4004	015	0	1	01	01	H4004_015_0	3	2	Brand			
H4004	015	0	1	01	01	H4004_015_0	3	4	Specialty			
H4004	015	0	1	01	01	H4004_015_0	3	1	Generic	1		1
H4004	015	0	1	01	01	H4004_015_0	3	2	Brand	2		
H4004	015	0	1	01	01	H4004_015_0	3	3	Non-Preferred Brand	2		
H4004	015	0	1	01	01	H4004_015_0	3	4	Specialty	2		
H4004	015	0	1	01	01	H4004_015_0	3	3	Non-Preferred Brand			
H4004	035	0	1	01	01	H4004_035_0	3	2	Brand	2		
H4004	035	0	1	01	01	H4004_035_0	3	1	Generic			
H4004	035	0	1	01	01	H4004_035_0	3	2	Brand			
H4004	035	0	1	01	01	H4004_035_0	3	3	Specialty			
H4004	035	0	1	01	01	H4004_035_0	3	1	Generic	1		1
H4004	035	0	1	01	01	H4004_035_0	3	3	Specialty	2		
H4004	049	0	1	01	01	H4004_049_0	5	2	Brand	2		
H4004	049	0	1	01	01	H4004_049_0	5	3	Specialty	2		
H4004	049	0	1	01	01	H4004_049_0	5	1	Generic	1		1
H4004	049	0	1	01	01	H4004_049_0	5	3	Specialty			
H4004	049	0	1	01	01	H4004_049_0	5	2	Brand			
H4004	049	0	1	01	01	H4004_049_0	5	1	Generic			
H4005	003	0	1	04	01	H4005_003_0	7	1	Tier 1/Nivel 1	1		1
H4005	003	0	1	04	01	H4005_003_0	7	2	Tier 2/Nivel 2	2		
H4005	003	0	1	04	01	H4005_003_0	7	3	Tier 3/ Nivel 3	2		
H4005	003	0	1	04	01	H4005_003_0	7	4	Tier 4/ Nivel 4	2		
H4005	003	0	1	04	01	H4005_003_0	7	5	Tier 5/ Nivel 5			
H4005	003	0	1	04	01	H4005_003_0	7	1	Tier 1/Nivel 1			
H4005	003	0	1	04	01	H4005_003_0	7	2	Tier 2/Nivel 2			
H4005	003	0	1	04	01	H4005_003_0	7	3	Tier 3/ Nivel 3			
H4005	003	0	1	04	01	H4005_003_0	7	4	Tier 4/ Nivel 4			
H4005	003	0	1	04	01	H4005_003_0	7	5	Tier 5/ Nivel 5	2		
H4005	004	0	1	04	01	H4005_004_0	6	4	Tier 4/ Nivel 4	2		
H4005	004	0	1	04	01	H4005_004_0	6	3	Tier 3/ Nivel 3	2		
H4005	004	0	1	04	01	H4005_004_0	6	2	Tier 2/Nivel 2	2		
H4005	004	0	1	04	01	H4005_004_0	6	1	Tier 1/Nivel 1	1		1
H4005	004	0	1	04	01	H4005_004_0	6	5	Tier 5/ Nivel 5			
H4005	004	0	1	04	01	H4005_004_0	6	1	Tier 1/Nivel 1			
H4005	004	0	1	04	01	H4005_004_0	6	2	Tier 2/Nivel 2			
H4005	004	0	1	04	01	H4005_004_0	6	5	Tier 5/ Nivel 5	2		
H4005	004	0	1	04	01	H4005_004_0	6	4	Tier 4/ Nivel 4			
H4005	004	0	1	04	01	H4005_004_0	6	3	Tier 3/ Nivel 3			
H4006	007	0	1	01	01	H4006_007_0	6	2	Preferred Brand	2		
H4006	007	0	1	01	01	H4006_007_0	6	3	Non-Preferred Brand	2		
H4006	007	0	1	01	01	H4006_007_0	6	4	Specialty	2		
H4006	007	0	1	01	01	H4006_007_0	6	1	Generic			
H4006	007	0	1	01	01	H4006_007_0	6	2	Preferred Brand			
H4006	007	0	1	01	01	H4006_007_0	6	3	Non-Preferred Brand			
H4006	007	0	1	01	01	H4006_007_0	6	4	Specialty			
H4006	007	0	1	01	01	H4006_007_0	6	1	Generic	1		1
H4006	008	0	1	02	01	H4006_008_0	6	1	Generic			
H4006	008	0	1	02	01	H4006_008_0	6	2	Preferred Brand			
H4006	008	0	1	02	01	H4006_008_0	6	4	Specialty	2		
H4006	008	0	1	02	01	H4006_008_0	6	3	Non-Preferred Brand	2		
H4006	008	0	1	02	01	H4006_008_0	6	2	Preferred Brand	2		
H4006	008	0	1	02	01	H4006_008_0	6	1	Generic	1		1
H4006	008	0	1	02	01	H4006_008_0	6	4	Specialty			
H4006	008	0	1	02	01	H4006_008_0	6	3	Non-Preferred Brand			
H4006	013	0	1	01	01	H4006_013_0	7	2	Preferred Brand			
H4006	013	0	1	01	01	H4006_013_0	7	1	Generic			
H4006	013	0	1	01	01	H4006_013_0	7	4	Specialty			
H4006	013	0	1	01	01	H4006_013_0	7	3	Non-Preferred Brand			
H4006	015	0	1	01	01	H4006_015_0	7	2	Preferred Brand			
H4006	015	0	1	01	01	H4006_015_0	7	4	Specialty			
H4006	015	0	1	01	01	H4006_015_0	7	3	Non-Preferred Brand			
H4006	015	0	1	01	01	H4006_015_0	7	1	Generic			
H4006	018	0	1	01	01	H4006_018_0	7	4	Specialty			
H4006	018	0	1	01	01	H4006_018_0	7	3	Non-Preferred Brand			
H4006	018	0	1	01	01	H4006_018_0	7	2	Preferred Brand			
H4006	018	0	1	01	01	H4006_018_0	7	1	Generic			
H4006	020	0	1	01	01	H4006_020_0	6	2	Preferred Brand			
H4006	020	0	1	01	01	H4006_020_0	6	1	Generic	1		1
H4006	020	0	1	01	01	H4006_020_0	6	2	Preferred Brand	2		
H4006	020	0	1	01	01	H4006_020_0	6	1	Generic			
H4006	020	0	1	01	01	H4006_020_0	6	4	Specialty			
H4006	020	0	1	01	01	H4006_020_0	6	3	Non-Preferred Brand			
H4006	020	0	1	01	01	H4006_020_0	6	4	Specialty	2		
H4006	020	0	1	01	01	H4006_020_0	6	3	Non-Preferred Brand	2		
H4006	022	0	1	01	01	H4006_022_0	6	2	Preferred Brand			
H4006	022	0	1	01	01	H4006_022_0	6	3	Non-Preferred Brand			
H4006	022	0	1	01	01	H4006_022_0	6	4	Specialty			
H4006	022	0	1	01	01	H4006_022_0	6	1	Generic			
H4007	002	0	1	01	01	H4007_002_0	3	1	Generic	1	00001000	2
H4007	002	0	1	01	01	H4007_002_0	3	2	Brand	1	10000000	2
H4007	002	0	1	01	01	H4007_002_0	3	3	Non-Preferred Brand	1	10000000	2
H4007	005	0	1	01	01	H4007_005_0	3	3	Non-Preferred Brand	1	10000000	2
H4007	005	0	1	01	01	H4007_005_0	3	1	Generic	1	00001000	2
H4007	005	0	1	01	01	H4007_005_0	3	2	Brand	1	10000000	2
H4007	008	0	1	01	01	H4007_008_0	4	3	Non-Preferred Brand	1	10000000	2
H4007	008	0	1	01	01	H4007_008_0	4	2	Brand	1	10000000	2
H4007	008	0	1	01	01	H4007_008_0	4	1	Generic	1	00001000	2
H4007	008	0	1	01	01	H4007_008_0	4	3	Non-Preferred Brand			
H4007	008	0	1	01	01	H4007_008_0	4	2	Brand			
H4007	008	0	1	01	01	H4007_008_0	4	1	Generic			
H4007	010	0	1	01	01	H4007_010_0	4	2	Preferred Brand	1	10000000	2
H4007	010	0	1	01	01	H4007_010_0	4	4	Specialty	1	10001000	2
H4007	010	0	1	01	01	H4007_010_0	4	3	Non-Preferred Brand	1	10000000	2
H4007	010	0	1	01	01	H4007_010_0	4	1	Preferred Generic	1	00001000	2
H4007	010	0	1	01	01	H4007_010_0	4	4	Specialty			
H4007	010	0	1	01	01	H4007_010_0	4	3	Non-Preferred Brand			
H4007	010	0	1	01	01	H4007_010_0	4	1	Preferred Generic			
H4007	010	0	1	01	01	H4007_010_0	4	2	Preferred Brand			
H4007	012	0	1	01	01	H4007_012_0	3	2	Brand			
H4007	012	0	1	01	01	H4007_012_0	3	3	Non-Preferred Brand			
H4007	012	0	1	01	01	H4007_012_0	3	1	Generic	1	00001000	2
H4007	012	0	1	01	01	H4007_012_0	3	1	Generic			
H4007	012	0	1	01	01	H4007_012_0	3	3	Non-Preferred Brand	1	10000000	2
H4007	012	0	1	01	01	H4007_012_0	3	2	Brand	1	10000000	2
H4008	001	0	1	09	04	H4008_001_0	4	1	Preferred Generic			
H4008	001	0	1	09	04	H4008_001_0	4	2	Preferred Brand			
H4008	001	0	1	09	04	H4008_001_0	4	3	Non-Preferred Brand			
H4008	001	0	1	09	04	H4008_001_0	4	4	Specialty	1	10001000	2
H4008	001	0	1	09	04	H4008_001_0	4	1	Preferred Generic	1	00001000	2
H4008	001	0	1	09	04	H4008_001_0	4	2	Preferred Brand	1	10000000	2
H4008	001	0	1	09	04	H4008_001_0	4	3	Non-Preferred Brand	1	10000000	2
H4008	001	0	1	09	04	H4008_001_0	4	4	Specialty			
H4011	003	0	1	04	01	H4011_003_0	9	1	Generic			
H4011	003	0	1	04	01	H4011_003_0	9	4	Specialty Tier Brand			
H4011	003	0	1	04	01	H4011_003_0	9	3	Non-Preferred Brand			
H4011	003	0	1	04	01	H4011_003_0	9	2	Preferred Brand			
H4011	004	0	1	04	01	H4011_004_0	9	1	Generic			
H4011	004	0	1	04	01	H4011_004_0	9	2	Preferred Brand			
H4011	004	0	1	04	01	H4011_004_0	9	3	Non-Preferred Brand			
H4011	004	0	1	04	01	H4011_004_0	9	4	Specialty Tier Brand			
H4011	004	0	1	04	01	H4011_004_0	9	1	Generic	1		1
H4011	004	0	1	04	01	H4011_004_0	9	2	Preferred Brand	2		
H4011	004	0	1	04	01	H4011_004_0	9	3	Non-Preferred Brand	2		
H4011	004	0	1	04	01	H4011_004_0	9	4	Specialty Tier Brand	2		
H4012	003	0	1	01	01	H4012_003_0	7	3	Tier 3/ Nivel 3	1		1
H4012	003	0	1	01	01	H4012_003_0	7	4	Tier 4/ Nivel 4			
H4012	003	0	1	01	01	H4012_003_0	7	3	Tier 3/ Nivel 3			
H4012	003	0	1	01	01	H4012_003_0	7	2	Tier 2/ Nivel 2			
H4012	003	0	1	01	01	H4012_003_0	7	1	Tier 1/ Nivel 1			
H4012	003	0	1	01	01	H4012_003_0	7	5	Tier 5/ Nivel 5	1		1
H4012	003	0	1	01	01	H4012_003_0	7	4	Tier 4/ Nivel 4	1		1
H4012	003	0	1	01	01	H4012_003_0	7	5	Tier 5/ Nivel 5			
H4012	003	0	1	01	01	H4012_003_0	7	2	Tier 2/ Nivel 2	1		1
H4012	003	0	1	01	01	H4012_003_0	7	1	Tier 1/ Nivel 1	1		1
H4012	004	0	1	01	01	H4012_004_0	6	1	Tier 1/ Nivel 1			
H4012	004	0	1	01	01	H4012_004_0	6	2	Tier 2/ Nivel 2			
H4012	004	0	1	01	01	H4012_004_0	6	3	Tier 3/ Nivel 3			
H4012	004	0	1	01	01	H4012_004_0	6	4	Tier 4/ Nivel 4			
H4012	004	0	1	01	01	H4012_004_0	6	5	Tier 5/ Nivel 5			
H4012	005	0	1	01	01	H4012_005_0	7	4	Tier 4/ Nivel 4	1		1
H4012	005	0	1	01	01	H4012_005_0	7	5	Tier 5/ Nivel 5	1		1
H4012	005	0	1	01	01	H4012_005_0	7	3	Tier 3/ Nivel 3	1		1
H4012	005	0	1	01	01	H4012_005_0	7	2	Tier 2/ Nivel 2	1		1
H4012	005	0	1	01	01	H4012_005_0	7	1	Tier 1/ Nivel 1	1		1
H4012	005	0	1	01	01	H4012_005_0	7	5	Tier 5/ Nivel 5			
H4012	005	0	1	01	01	H4012_005_0	7	4	Tier 4/ Nivel 4			
H4012	005	0	1	01	01	H4012_005_0	7	3	Tier 3/ Nivel 3			
H4012	005	0	1	01	01	H4012_005_0	7	2	Tier 2/ Nivel 2			
H4012	005	0	1	01	01	H4012_005_0	7	1	Tier 1/ Nivel 1			
H4036	001	0	1	04	01	H4036_001_0	10	1	Tier 1 Preferred Generics			
H4036	001	0	1	04	01	H4036_001_0	10	2	Tier 2 Preferred Brand			
H4036	001	0	1	04	01	H4036_001_0	10	3	Tier 3 Non-Preferred Brand or Generic			
H4036	001	0	1	04	01	H4036_001_0	10	4	Tier 4 Non- Specialty Injectable			
H4036	001	0	1	04	01	H4036_001_0	10	5	Tier 5 Specialty	2		
H4036	001	0	1	04	01	H4036_001_0	10	1	Tier 1 Preferred Generics	1		1
H4036	001	0	1	04	01	H4036_001_0	10	2	Tier 2 Preferred Brand	2		
H4036	001	0	1	04	01	H4036_001_0	10	3	Tier 3 Non-Preferred Brand or Generic	2		
H4036	001	0	1	04	01	H4036_001_0	10	4	Tier 4 Non- Specialty Injectable	2		
H4036	001	0	1	04	01	H4036_001_0	10	5	Tier 5 Specialty			
H4102	001	0	1	01	01	H4102_001_0	5	3	Non-Preferred			
H4102	001	0	1	01	01	H4102_001_0	5	2	Preferred Brand			
H4102	001	0	1	01	01	H4102_001_0	5	1	Preferred Generic			
H4102	001	0	1	01	01	H4102_001_0	5	4	Specialty			
H4106	002	0	1	01	01	H4106_002_0	4	3	Non Preferred			
H4106	002	0	1	01	01	H4106_002_0	4	2	Preferred Brand			
H4106	002	0	1	01	01	H4106_002_0	4	1	Preferred Generic			
H4106	002	0	1	01	01	H4106_002_0	4	4	Specialty			
H4125	001	0	1	01	01	H4125_001_0	9	4	Tier 4 - Specialty Drug	2		
H4125	001	0	1	01	01	H4125_001_0	9	3	Tier 3 - Non-Preferred Brand	2		
H4125	001	0	1	01	01	H4125_001_0	9	1	Tier 1 - Generic			
H4125	001	0	1	01	01	H4125_001_0	9	2	Tier 2 - Preferred Brand			
H4125	001	0	1	01	01	H4125_001_0	9	3	Tier 3 - Non-Preferred Brand			
H4125	001	0	1	01	01	H4125_001_0	9	4	Tier 4 - Specialty Drug			
H4125	001	0	1	01	01	H4125_001_0	9	1	Tier 1 - Generic	1		1
H4125	001	0	1	01	01	H4125_001_0	9	2	Tier 2 - Preferred Brand	2		
H4125	002	0	1	01	01	H4125_002_0	8	4	Tier 4 - Specialty Drug	2		
H4125	002	0	1	01	01	H4125_002_0	8	3	Tier 3 - Non-Preferred Brand	2		
H4125	002	0	1	01	01	H4125_002_0	8	2	Tier 2 - Preferred Brand	2		
H4125	002	0	1	01	01	H4125_002_0	8	1	Tier 1 - Generic	1		1
H4125	002	0	1	01	01	H4125_002_0	8	4	Tier 4 - Specialty Drug			
H4125	002	0	1	01	01	H4125_002_0	8	3	Tier 3 - Non-Preferred Brand			
H4125	002	0	1	01	01	H4125_002_0	8	2	Tier 2 - Preferred Brand			
H4125	002	0	1	01	01	H4125_002_0	8	1	Tier 1 - Generic			
H4125	003	0	1	01	01	H4125_003_0	9	3	Tier 3 - Non-Preferred Brand	2		
H4125	003	0	1	01	01	H4125_003_0	9	1	Tier 1 - Generic			
H4125	003	0	1	01	01	H4125_003_0	9	2	Tier 2 - Preferred Brand	2		
H4125	003	0	1	01	01	H4125_003_0	9	1	Tier 1 - Generic	1		1
H4125	003	0	1	01	01	H4125_003_0	9	4	Tier 4 - Specialty Drug			
H4125	003	0	1	01	01	H4125_003_0	9	3	Tier 3 - Non-Preferred Brand			
H4125	003	0	1	01	01	H4125_003_0	9	2	Tier 2 - Preferred Brand			
H4125	003	0	1	01	01	H4125_003_0	9	4	Tier 4 - Specialty Drug	2		
H4152	005	0	1	01	01	H4152_005_0	6	4	Tier 4			
H4152	005	0	1	01	01	H4152_005_0	6	2	Tier 2			
H4152	005	0	1	01	01	H4152_005_0	6	1	Tier 1			
H4152	005	0	1	01	01	H4152_005_0	6	5	Tier 5			
H4152	005	0	1	01	01	H4152_005_0	6	3	Tier  3			
H4152	007	0	1	02	01	H4152_007_0	6	5	Tier 5	2		
H4152	007	0	1	02	01	H4152_007_0	6	5	Tier 5			
H4152	007	0	1	02	01	H4152_007_0	6	4	Tier 4			
H4152	007	0	1	02	01	H4152_007_0	6	3	Tier 3			
H4152	007	0	1	02	01	H4152_007_0	6	2	Tier 2			
H4152	007	0	1	02	01	H4152_007_0	6	1	Tier 1			
H4152	007	0	1	02	01	H4152_007_0	6	3	Tier 3	2		
H4152	007	0	1	02	01	H4152_007_0	6	2	Tier 2	2		
H4152	007	0	1	02	01	H4152_007_0	6	4	Tier 4	2		
H4152	007	0	1	02	01	H4152_007_0	6	1	Tier 1	1		1
H4152	013	0	1	01	01	H4152_013_0	6	4	Tier 4			
H4152	013	0	1	01	01	H4152_013_0	6	1	Tier 1			
H4152	013	0	1	01	01	H4152_013_0	6	5	Tier 5			
H4152	013	0	1	01	01	H4152_013_0	6	2	Tier 2			
H4152	013	0	1	01	01	H4152_013_0	6	3	Tier  3			
H4204	030	0	1	09	04	H4204_030_0	5	1	Preferred Generic			
H4204	030	0	1	09	04	H4204_030_0	5	3	Brand			
H4204	030	0	1	09	04	H4204_030_0	5	2	Preferred Brand			
H4204	030	0	1	09	04	H4204_030_0	5	4	Specialty			
H4204	030	0	1	09	04	H4204_030_0	5	1	Preferred Generic	1		1
H4204	030	0	1	09	04	H4204_030_0	5	2	Preferred Brand	2		
H4204	030	0	1	09	04	H4204_030_0	5	3	Brand	2		
H4204	030	0	1	09	04	H4204_030_0	5	4	Specialty	2		
H4204	031	0	1	09	04	H4204_031_0	5	2	Preferred Brand			
H4204	031	0	1	09	04	H4204_031_0	5	1	Preferred Generic			
H4204	031	0	1	09	04	H4204_031_0	5	3	Brand			
H4204	031	0	1	09	04	H4204_031_0	5	4	Specialty			
H4204	031	0	1	09	04	H4204_031_0	5	1	Preferred Generic	1		1
H4204	031	0	1	09	04	H4204_031_0	5	2	Preferred Brand	2		
H4204	031	0	1	09	04	H4204_031_0	5	3	Brand	2		
H4204	031	0	1	09	04	H4204_031_0	5	4	Specialty	2		
H4205	005	0	1	09	04	H4205_005_0	6	3	Specialty			
H4205	005	0	1	09	04	H4205_005_0	6	2	Brand			
H4205	005	0	1	09	04	H4205_005_0	6	1	Generic			
H4205	006	0	1	09	04	H4205_006_0	6	2	Brand			
H4205	006	0	1	09	04	H4205_006_0	6	1	Generic			
H4205	006	0	1	09	04	H4205_006_0	6	3	Specialty			
H4205	007	0	1	09	04	H4205_007_0	6	2	Preferred Brand			
H4205	007	0	1	09	04	H4205_007_0	6	4	Specialty			
H4205	007	0	1	09	04	H4205_007_0	6	3	Non Preferred Brand			
H4205	007	0	1	09	04	H4205_007_0	6	1	Generic			
H4205	008	0	1	09	04	H4205_008_0	6	3	Non Preferred Brand			
H4205	008	0	1	09	04	H4205_008_0	6	4	Specialty			
H4205	008	0	1	09	04	H4205_008_0	6	2	Preferred Brand			
H4205	008	0	1	09	04	H4205_008_0	6	1	Generic			
H4209	001	0	1	04	01	H4209_001_0	5	3	Specialty			
H4209	001	0	1	04	01	H4209_001_0	5	1	Generic			
H4209	001	0	1	04	01	H4209_001_0	5	2	Brand			
H4209	003	0	1	04	01	H4209_003_0	5	1	Generic			
H4209	003	0	1	04	01	H4209_003_0	5	3	Specialty			
H4209	003	0	1	04	01	H4209_003_0	5	2	Brand			
H4209	004	0	1	04	01	H4209_004_0	5	4	Specialty			
H4209	004	0	1	04	01	H4209_004_0	5	4	Specialty	2		
H4209	004	0	1	04	01	H4209_004_0	5	3	Non-Preferred Brand	2		
H4209	004	0	1	04	01	H4209_004_0	5	2	Preferred Brand	2		
H4209	004	0	1	04	01	H4209_004_0	5	1	Generic	1		1
H4209	004	0	1	04	01	H4209_004_0	5	2	Preferred Brand			
H4209	004	0	1	04	01	H4209_004_0	5	1	Generic			
H4209	004	0	1	04	01	H4209_004_0	5	3	Non-Preferred Brand			
H4209	006	0	1	04	01	H4209_006_0	5	1	Generic			
H4209	006	0	1	04	01	H4209_006_0	5	2	Preferred Brand			
H4209	006	0	1	04	01	H4209_006_0	5	3	Non-Preferred Brand			
H4209	006	0	1	04	01	H4209_006_0	5	4	Specialty			
H4209	006	0	1	04	01	H4209_006_0	5	1	Generic	1		1
H4209	006	0	1	04	01	H4209_006_0	5	4	Specialty	2		
H4209	006	0	1	04	01	H4209_006_0	5	3	Non-Preferred Brand	2		
H4209	006	0	1	04	01	H4209_006_0	5	2	Preferred Brand	2		
H4270	002	0	1	02	01	H4270_002_0	5	1	Tier 1	1		1
H4270	002	0	1	02	01	H4270_002_0	5	4	Tier 4			
H4270	002	0	1	02	01	H4270_002_0	5	3	Tier 3			
H4270	002	0	1	02	01	H4270_002_0	5	4	Tier 4	2		
H4270	002	0	1	02	01	H4270_002_0	5	3	Tier 3	2		
H4270	002	0	1	02	01	H4270_002_0	5	2	Tier 2	2		
H4270	002	0	1	02	01	H4270_002_0	5	1	Tier 1			
H4270	002	0	1	02	01	H4270_002_0	5	2	Tier 2			
H4270	003	0	1	02	01	H4270_003_0	5	3	Tier 3			
H4270	003	0	1	02	01	H4270_003_0	5	2	Tier 2			
H4270	003	0	1	02	01	H4270_003_0	5	1	Tier 1			
H4270	003	0	1	02	01	H4270_003_0	5	4	Tier 4			
H4362	001	0	1	04	01	H4362_001_0	5	4	Tier 4 - Non-Preferred Brand			
H4362	001	0	1	04	01	H4362_001_0	5	3	Tier 3 - Preferred Brand			
H4362	001	0	1	04	01	H4362_001_0	5	2	Tier 2 - Non-Preferred Generic			
H4362	001	0	1	04	01	H4362_001_0	5	1	Tier 1 - Preferred Generic			
H4362	001	0	1	04	01	H4362_001_0	5	5	Tier 5 - Specialty			
H4362	002	0	1	04	01	H4362_002_0	5	1	Tier 1 - Preferred Generic	1		1
H4362	002	0	1	04	01	H4362_002_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H4362	002	0	1	04	01	H4362_002_0	5	3	Tier 3 - Preferred Brand	2		
H4362	002	0	1	04	01	H4362_002_0	5	4	Tier 4 - Non-Preferred Brand	2		
H4362	002	0	1	04	01	H4362_002_0	5	5	Tier 5 - Specialty			
H4362	002	0	1	04	01	H4362_002_0	5	4	Tier 4 - Non-Preferred Brand			
H4362	002	0	1	04	01	H4362_002_0	5	5	Tier 5 - Specialty	2		
H4362	002	0	1	04	01	H4362_002_0	5	2	Tier 2 - Non-Preferred Generic			
H4362	002	0	1	04	01	H4362_002_0	5	1	Tier 1 - Preferred Generic			
H4362	002	0	1	04	01	H4362_002_0	5	3	Tier 3 - Preferred Brand			
H4406	001	0	1	02	01	H4406_001_0	7	2	Preferred Brand			
H4406	001	0	1	02	01	H4406_001_0	7	1	Preferred Generic			
H4406	001	0	1	02	01	H4406_001_0	7	3	Non-Preferred			
H4406	001	0	1	02	01	H4406_001_0	7	4	Specialty			
H4407	001	0	1	01	01	H4407_001_0	5	5	Specialty	2		
H4407	001	0	1	01	01	H4407_001_0	5	4	Non-Preferred Brand	2		
H4407	001	0	1	01	01	H4407_001_0	5	2	Generic	1		1
H4407	001	0	1	01	01	H4407_001_0	5	3	Preferred Brand	2		
H4407	001	0	1	01	01	H4407_001_0	5	1	Preferred Generic	1		1
H4407	001	0	1	01	01	H4407_001_0	5	5	Specialty			
H4407	001	0	1	01	01	H4407_001_0	5	4	Non-Preferred Brand			
H4407	001	0	1	01	01	H4407_001_0	5	3	Preferred Brand			
H4407	001	0	1	01	01	H4407_001_0	5	2	Generic			
H4407	001	0	1	01	01	H4407_001_0	5	1	Preferred Generic			
H4407	002	0	1	01	01	H4407_002_0	5	4	Non-Preferred Brand	2		
H4407	002	0	1	01	01	H4407_002_0	5	5	Specialty	2		
H4407	002	0	1	01	01	H4407_002_0	5	3	Preferred Brand	2		
H4407	002	0	1	01	01	H4407_002_0	5	2	Generic	1		1
H4407	002	0	1	01	01	H4407_002_0	5	1	Preferred Generic			
H4407	002	0	1	01	01	H4407_002_0	5	5	Specialty			
H4407	002	0	1	01	01	H4407_002_0	5	4	Non-Preferred Brand			
H4407	002	0	1	01	01	H4407_002_0	5	3	Preferred Brand			
H4407	002	0	1	01	01	H4407_002_0	5	2	Generic			
H4407	002	0	1	01	01	H4407_002_0	5	1	Preferred Generic	1		1
H4407	007	0	1	01	01	H4407_007_0	4	1	Preferred Generic			
H4407	007	0	1	01	01	H4407_007_0	4	2	Generic			
H4407	007	0	1	01	01	H4407_007_0	4	3	Preferred Brand			
H4407	007	0	1	01	01	H4407_007_0	4	4	Non-Preferred Brand			
H4407	007	0	1	01	01	H4407_007_0	4	5	Specialty			
H4407	007	0	1	01	01	H4407_007_0	4	1	Preferred Generic	1		1
H4407	007	0	1	01	01	H4407_007_0	4	2	Generic	1	00001000	2
H4407	007	0	1	01	01	H4407_007_0	4	3	Preferred Brand	2		
H4407	007	0	1	01	01	H4407_007_0	4	4	Non-Preferred Brand	2		
H4407	007	0	1	01	01	H4407_007_0	4	5	Specialty	2		
H4407	009	0	1	01	01	H4407_009_0	5	4	Non-Preferred Brand	2		
H4407	009	0	1	01	01	H4407_009_0	5	3	Preferred Brand			
H4407	009	0	1	01	01	H4407_009_0	5	2	Generic			
H4407	009	0	1	01	01	H4407_009_0	5	1	Preferred Generic			
H4407	009	0	1	01	01	H4407_009_0	5	3	Preferred Brand	2		
H4407	009	0	1	01	01	H4407_009_0	5	4	Non-Preferred Brand			
H4407	009	0	1	01	01	H4407_009_0	5	5	Specialty			
H4407	009	0	1	01	01	H4407_009_0	5	1	Preferred Generic	1		1
H4407	009	0	1	01	01	H4407_009_0	5	2	Generic	1	00001000	2
H4407	009	0	1	01	01	H4407_009_0	5	5	Specialty	2		
H4407	012	0	1	01	01	H4407_012_0	5	3	Preferred Brand			
H4407	012	0	1	01	01	H4407_012_0	5	4	Non-Preferred Brand			
H4407	012	0	1	01	01	H4407_012_0	5	5	Specialty			
H4407	012	0	1	01	01	H4407_012_0	5	1	Preferred Generic	1		1
H4407	012	0	1	01	01	H4407_012_0	5	2	Generic	1		1
H4407	012	0	1	01	01	H4407_012_0	5	3	Preferred Brand	2		
H4407	012	0	1	01	01	H4407_012_0	5	2	Generic			
H4407	012	0	1	01	01	H4407_012_0	5	5	Specialty	2		
H4407	012	0	1	01	01	H4407_012_0	5	1	Preferred Generic			
H4407	012	0	1	01	01	H4407_012_0	5	4	Non-Preferred Brand	2		
H4407	013	0	1	01	01	H4407_013_0	4	3	Preferred Brand			
H4407	013	0	1	01	01	H4407_013_0	4	4	Non-Preferred Brand			
H4407	013	0	1	01	01	H4407_013_0	4	5	Specialty			
H4407	013	0	1	01	01	H4407_013_0	4	1	Preferred Generic	1		1
H4407	013	0	1	01	01	H4407_013_0	4	2	Generic	1	00001000	2
H4407	013	0	1	01	01	H4407_013_0	4	3	Preferred Brand	2		
H4407	013	0	1	01	01	H4407_013_0	4	2	Generic			
H4407	013	0	1	01	01	H4407_013_0	4	5	Specialty	2		
H4407	013	0	1	01	01	H4407_013_0	4	4	Non-Preferred Brand	2		
H4407	013	0	1	01	01	H4407_013_0	4	1	Preferred Generic			
H4407	018	0	1	01	01	H4407_018_0	5	5	Specialty	2		
H4407	018	0	1	01	01	H4407_018_0	5	1	Preferred Generic			
H4407	018	0	1	01	01	H4407_018_0	5	2	Generic			
H4407	018	0	1	01	01	H4407_018_0	5	3	Preferred Brand			
H4407	018	0	1	01	01	H4407_018_0	5	3	Preferred Brand	2		
H4407	018	0	1	01	01	H4407_018_0	5	5	Specialty			
H4407	018	0	1	01	01	H4407_018_0	5	1	Preferred Generic	1		1
H4407	018	0	1	01	01	H4407_018_0	5	2	Generic	1	00001000	2
H4407	018	0	1	01	01	H4407_018_0	5	4	Non-Preferred Brand	2		
H4407	018	0	1	01	01	H4407_018_0	5	4	Non-Preferred Brand			
H4407	019	0	1	01	01	H4407_019_0	6	5	Specialty			
H4407	019	0	1	01	01	H4407_019_0	6	4	Non-Preferred Brand			
H4407	019	0	1	01	01	H4407_019_0	6	3	Preferred Brand			
H4407	019	0	1	01	01	H4407_019_0	6	5	Specialty	2		
H4407	019	0	1	01	01	H4407_019_0	6	4	Non-Preferred Brand	2		
H4407	019	0	1	01	01	H4407_019_0	6	3	Preferred Brand	2		
H4407	019	0	1	01	01	H4407_019_0	6	2	Generic			
H4407	019	0	1	01	01	H4407_019_0	6	1	Preferred Generic	1		1
H4407	019	0	1	01	01	H4407_019_0	6	2	Generic	1	00001000	2
H4407	019	0	1	01	01	H4407_019_0	6	1	Preferred Generic			
H4407	020	0	1	01	01	H4407_020_0	5	3	Preferred Brand	2		
H4407	020	0	1	01	01	H4407_020_0	5	2	Generic	1		1
H4407	020	0	1	01	01	H4407_020_0	5	1	Preferred Generic	1		1
H4407	020	0	1	01	01	H4407_020_0	5	5	Specialty			
H4407	020	0	1	01	01	H4407_020_0	5	5	Specialty	2		
H4407	020	0	1	01	01	H4407_020_0	5	3	Preferred Brand			
H4407	020	0	1	01	01	H4407_020_0	5	2	Generic			
H4407	020	0	1	01	01	H4407_020_0	5	1	Preferred Generic			
H4407	020	0	1	01	01	H4407_020_0	5	4	Non-Preferred Brand	2		
H4407	020	0	1	01	01	H4407_020_0	5	4	Non-Preferred Brand			
H4408	001	0	1	04	01	H4408_001_0	4	1	Preferred Generic			
H4408	001	0	1	04	01	H4408_001_0	4	2	Preferred Brand			
H4408	001	0	1	04	01	H4408_001_0	4	4	Specialty	1	10001000	2
H4408	001	0	1	04	01	H4408_001_0	4	3	Non-Preferred Brand	1	10000000	2
H4408	001	0	1	04	01	H4408_001_0	4	2	Preferred Brand	1	10000000	2
H4408	001	0	1	04	01	H4408_001_0	4	1	Preferred Generic	1	00001000	2
H4408	001	0	1	04	01	H4408_001_0	4	4	Specialty			
H4408	001	0	1	04	01	H4408_001_0	4	3	Non-Preferred Brand			
H4408	002	0	1	04	01	H4408_002_0	4	1	Preferred Generic			
H4408	002	0	1	04	01	H4408_002_0	4	3	Non-Preferred Brand	1	10000000	2
H4408	002	0	1	04	01	H4408_002_0	4	2	Preferred Brand	1	10000000	2
H4408	002	0	1	04	01	H4408_002_0	4	1	Preferred Generic	1	00001000	2
H4408	002	0	1	04	01	H4408_002_0	4	4	Specialty			
H4408	002	0	1	04	01	H4408_002_0	4	3	Non-Preferred Brand			
H4408	002	0	1	04	01	H4408_002_0	4	2	Preferred Brand			
H4408	002	0	1	04	01	H4408_002_0	4	4	Specialty	1	10001000	2
H4408	006	0	1	04	01	H4408_006_0	4	3	Non-Preferred Brand			
H4408	006	0	1	04	01	H4408_006_0	4	4	Specialty			
H4408	006	0	1	04	01	H4408_006_0	4	1	Preferred Generic	1	00001000	2
H4408	006	0	1	04	01	H4408_006_0	4	2	Preferred Brand	1	10000000	2
H4408	006	0	1	04	01	H4408_006_0	4	3	Non-Preferred Brand	1	10000000	2
H4408	006	0	1	04	01	H4408_006_0	4	4	Specialty	1	10001000	2
H4408	006	0	1	04	01	H4408_006_0	4	1	Preferred Generic			
H4408	006	0	1	04	01	H4408_006_0	4	2	Preferred Brand			
H4408	007	0	1	04	01	H4408_007_0	4	1	Preferred Generic			
H4408	007	0	1	04	01	H4408_007_0	4	2	Preferred Brand			
H4408	007	0	1	04	01	H4408_007_0	4	3	Non-Preferred Brand			
H4408	007	0	1	04	01	H4408_007_0	4	4	Specialty	1	10001000	2
H4408	007	0	1	04	01	H4408_007_0	4	1	Preferred Generic	1	00001000	2
H4408	007	0	1	04	01	H4408_007_0	4	2	Preferred Brand	1	10000000	2
H4408	007	0	1	04	01	H4408_007_0	4	3	Non-Preferred Brand	1	10000000	2
H4408	007	0	1	04	01	H4408_007_0	4	4	Specialty			
H4449	013	0	1	09	04	H4449_013_0	8	1	Generic			
H4449	013	0	1	09	04	H4449_013_0	8	3	Specialty			
H4449	013	0	1	09	04	H4449_013_0	8	2	Preferred Brand			
H4454	002	0	1	01	01	H4454_002_0	3	4	Non-Preferred Brand	2		
H4454	002	0	1	01	01	H4454_002_0	3	3	Preferred Brand	2		
H4454	002	0	1	01	01	H4454_002_0	3	2	Generic	1		1
H4454	002	0	1	01	01	H4454_002_0	3	1	Preferred Generic	1		1
H4454	002	0	1	01	01	H4454_002_0	3	5	Specialty	2		
H4454	002	0	1	01	01	H4454_002_0	3	4	Non-Preferred Brand			
H4454	002	0	1	01	01	H4454_002_0	3	3	Preferred Brand			
H4454	002	0	1	01	01	H4454_002_0	3	2	Generic			
H4454	002	0	1	01	01	H4454_002_0	3	1	Preferred Generic			
H4454	002	0	1	01	01	H4454_002_0	3	5	Specialty			
H4454	007	0	1	01	01	H4454_007_0	3	4	Non-Preferred Brand	2		
H4454	007	0	1	01	01	H4454_007_0	3	3	Preferred Brand	2		
H4454	007	0	1	01	01	H4454_007_0	3	2	Generic	1	00001000	2
H4454	007	0	1	01	01	H4454_007_0	3	1	Preferred Generic	1		1
H4454	007	0	1	01	01	H4454_007_0	3	5	Specialty			
H4454	007	0	1	01	01	H4454_007_0	3	4	Non-Preferred Brand			
H4454	007	0	1	01	01	H4454_007_0	3	3	Preferred Brand			
H4454	007	0	1	01	01	H4454_007_0	3	2	Generic			
H4454	007	0	1	01	01	H4454_007_0	3	1	Preferred Generic			
H4454	007	0	1	01	01	H4454_007_0	3	5	Specialty	2		
H4454	018	0	1	01	01	H4454_018_0	2	1	Preferred Generic			
H4454	018	0	1	01	01	H4454_018_0	2	2	Generic			
H4454	018	0	1	01	01	H4454_018_0	2	5	Specialty	2		
H4454	018	0	1	01	01	H4454_018_0	2	4	Non-Preferred Brand	2		
H4454	018	0	1	01	01	H4454_018_0	2	3	Preferred Brand	2		
H4454	018	0	1	01	01	H4454_018_0	2	2	Generic	1	00001000	2
H4454	018	0	1	01	01	H4454_018_0	2	1	Preferred Generic	1		1
H4454	018	0	1	01	01	H4454_018_0	2	5	Specialty			
H4454	018	0	1	01	01	H4454_018_0	2	4	Non-Preferred Brand			
H4454	018	0	1	01	01	H4454_018_0	2	3	Preferred Brand			
H4454	019	0	1	01	01	H4454_019_0	3	1	Preferred Generic			
H4454	019	0	1	01	01	H4454_019_0	3	4	Non-Preferred Brand	2		
H4454	019	0	1	01	01	H4454_019_0	3	3	Preferred Brand	2		
H4454	019	0	1	01	01	H4454_019_0	3	2	Generic	1		1
H4454	019	0	1	01	01	H4454_019_0	3	5	Specialty	2		
H4454	019	0	1	01	01	H4454_019_0	3	5	Specialty			
H4454	019	0	1	01	01	H4454_019_0	3	4	Non-Preferred Brand			
H4454	019	0	1	01	01	H4454_019_0	3	3	Preferred Brand			
H4454	019	0	1	01	01	H4454_019_0	3	2	Generic			
H4454	019	0	1	01	01	H4454_019_0	3	1	Preferred Generic	1		1
H4454	021	0	1	01	01	H4454_021_0	3	1	Preferred Generic			
H4454	021	0	1	01	01	H4454_021_0	3	2	Generic			
H4454	021	0	1	01	01	H4454_021_0	3	3	Preferred Brand			
H4454	021	0	1	01	01	H4454_021_0	3	4	Non-Preferred Brand			
H4454	021	0	1	01	01	H4454_021_0	3	5	Specialty			
H4454	021	0	1	01	01	H4454_021_0	3	1	Preferred Generic	1		1
H4454	021	0	1	01	01	H4454_021_0	3	2	Generic	1		1
H4454	021	0	1	01	01	H4454_021_0	3	3	Preferred Brand	2		
H4454	021	0	1	01	01	H4454_021_0	3	4	Non-Preferred Brand	2		
H4454	021	0	1	01	01	H4454_021_0	3	5	Specialty	2		
H4454	022	0	1	01	01	H4454_022_0	2	4	Non-Preferred Brand			
H4454	022	0	1	01	01	H4454_022_0	2	3	Preferred Brand			
H4454	022	0	1	01	01	H4454_022_0	2	5	Specialty	2		
H4454	022	0	1	01	01	H4454_022_0	2	4	Non-Preferred Brand	2		
H4454	022	0	1	01	01	H4454_022_0	2	3	Preferred Brand	2		
H4454	022	0	1	01	01	H4454_022_0	2	2	Generic	1	00001000	2
H4454	022	0	1	01	01	H4454_022_0	2	1	Preferred Generic	1		1
H4454	022	0	1	01	01	H4454_022_0	2	5	Specialty			
H4454	022	0	1	01	01	H4454_022_0	2	1	Preferred Generic			
H4454	022	0	1	01	01	H4454_022_0	2	2	Generic			
H4454	023	0	1	01	01	H4454_023_0	2	1	Preferred Generic			
H4454	023	0	1	01	01	H4454_023_0	2	4	Non-Preferred Brand	2		
H4454	023	0	1	01	01	H4454_023_0	2	3	Preferred Brand	2		
H4454	023	0	1	01	01	H4454_023_0	2	2	Generic	1	00001000	2
H4454	023	0	1	01	01	H4454_023_0	2	5	Specialty	2		
H4454	023	0	1	01	01	H4454_023_0	2	5	Specialty			
H4454	023	0	1	01	01	H4454_023_0	2	4	Non-Preferred Brand			
H4454	023	0	1	01	01	H4454_023_0	2	3	Preferred Brand			
H4454	023	0	1	01	01	H4454_023_0	2	2	Generic			
H4454	023	0	1	01	01	H4454_023_0	2	1	Preferred Generic	1		1
H4454	024	0	1	01	01	H4454_024_0	2	4	Non-Preferred Brand			
H4454	024	0	1	01	01	H4454_024_0	2	3	Preferred Brand			
H4454	024	0	1	01	01	H4454_024_0	2	2	Generic			
H4454	024	0	1	01	01	H4454_024_0	2	1	Preferred Generic			
H4454	024	0	1	01	01	H4454_024_0	2	5	Specialty			
H4454	024	0	1	01	01	H4454_024_0	2	5	Specialty	2		
H4454	024	0	1	01	01	H4454_024_0	2	4	Non-Preferred Brand	2		
H4454	024	0	1	01	01	H4454_024_0	2	3	Preferred Brand	2		
H4454	024	0	1	01	01	H4454_024_0	2	2	Generic	1	00001000	2
H4454	024	0	1	01	01	H4454_024_0	2	1	Preferred Generic	1		1
H4454	025	0	1	01	01	H4454_025_0	2	1	Preferred Generic			
H4454	025	0	1	01	01	H4454_025_0	2	2	Generic			
H4454	025	0	1	01	01	H4454_025_0	2	5	Specialty	2		
H4454	025	0	1	01	01	H4454_025_0	2	4	Non-Preferred Brand	2		
H4454	025	0	1	01	01	H4454_025_0	2	3	Preferred Brand	2		
H4454	025	0	1	01	01	H4454_025_0	2	2	Generic	1	00001000	2
H4454	025	0	1	01	01	H4454_025_0	2	1	Preferred Generic	1		1
H4454	025	0	1	01	01	H4454_025_0	2	5	Specialty			
H4454	025	0	1	01	01	H4454_025_0	2	4	Non-Preferred Brand			
H4454	025	0	1	01	01	H4454_025_0	2	3	Preferred Brand			
H4454	027	0	1	01	01	H4454_027_0	6	1	Preferred Generic			
H4454	027	0	1	01	01	H4454_027_0	6	5	Specialty			
H4454	027	0	1	01	01	H4454_027_0	6	1	Preferred Generic	1		1
H4454	027	0	1	01	01	H4454_027_0	6	2	Generic	1	00001000	2
H4454	027	0	1	01	01	H4454_027_0	6	5	Specialty	2		
H4454	027	0	1	01	01	H4454_027_0	6	4	Non-Preferred Brand	2		
H4454	027	0	1	01	01	H4454_027_0	6	4	Non-Preferred Brand			
H4454	027	0	1	01	01	H4454_027_0	6	3	Preferred Brand			
H4454	027	0	1	01	01	H4454_027_0	6	2	Generic			
H4454	027	0	1	01	01	H4454_027_0	6	3	Preferred Brand	2		
H4456	010	0	1	01	01	H4456_010_0	5	3	Non-Preferred			
H4456	010	0	1	01	01	H4456_010_0	5	2	Preferred Brand			
H4456	010	0	1	01	01	H4456_010_0	5	1	Preferred Generic			
H4456	010	0	1	01	01	H4456_010_0	5	4	Specialty			
H4456	013	0	1	01	01	H4456_013_0	5	1	Preferred Generic			
H4456	013	0	1	01	01	H4456_013_0	5	2	Preferred Brand			
H4456	013	0	1	01	01	H4456_013_0	5	3	Non-Preferred			
H4456	013	0	1	01	01	H4456_013_0	5	4	Specialty			
H4456	015	0	1	01	01	H4456_015_0	5	3	Non Preferred			
H4456	015	0	1	01	01	H4456_015_0	5	2	Preferred Brand			
H4456	015	0	1	01	01	H4456_015_0	5	1	Preferred Generic			
H4456	015	0	1	01	01	H4456_015_0	5	4	Specialty			
H4456	017	0	1	01	01	H4456_017_0	6	1	Preferred Generic			
H4456	017	0	1	01	01	H4456_017_0	6	2	Preferred Brand			
H4456	017	0	1	01	01	H4456_017_0	6	3	Non Preferred			
H4456	017	0	1	01	01	H4456_017_0	6	4	Specialty			
H4456	019	0	1	01	01	H4456_019_0	5	1	Preferred Generic			
H4456	019	0	1	01	01	H4456_019_0	5	2	Preferred Brand			
H4456	019	0	1	01	01	H4456_019_0	5	4	Specialty			
H4456	019	0	1	01	01	H4456_019_0	5	3	Non Preferred			
H4456	021	0	1	01	01	H4456_021_0	5	1	Preferred Generic			
H4456	021	0	1	01	01	H4456_021_0	5	3	Non Preferred			
H4456	021	0	1	01	01	H4456_021_0	5	2	Preferred Brand			
H4456	021	0	1	01	01	H4456_021_0	5	4	Specialty			
H4456	024	0	1	02	01	H4456_024_0	5	4	Specialty			
H4456	024	0	1	02	01	H4456_024_0	5	1	Preferred Generic			
H4456	024	0	1	02	01	H4456_024_0	5	2	Preferred Brand			
H4456	024	0	1	02	01	H4456_024_0	5	3	Non Preferred			
H4456	025	0	1	01	01	H4456_025_0	4	1	Preferred Generic			
H4456	025	0	1	01	01	H4456_025_0	4	2	Preferred Brand			
H4456	025	0	1	01	01	H4456_025_0	4	3	Non-Preferred			
H4456	025	0	1	01	01	H4456_025_0	4	4	Specialty			
H4456	026	0	1	02	01	H4456_026_0	6	1	Preferred Generic			
H4456	026	0	1	02	01	H4456_026_0	6	2	Preferred Brand			
H4456	026	0	1	02	01	H4456_026_0	6	4	Specialty			
H4456	026	0	1	02	01	H4456_026_0	6	3	Non-Preferred			
H4456	027	0	1	02	01	H4456_027_0	3	1	Preferred Generic			
H4456	027	0	1	02	01	H4456_027_0	3	3	Non Preferred			
H4456	027	0	1	02	01	H4456_027_0	3	2	Preferred Brand			
H4456	027	0	1	02	01	H4456_027_0	3	4	Specialty			
H4461	001	0	1	01	01	H4461_001_0	7	1	Generic			
H4461	001	0	1	01	01	H4461_001_0	7	2	Preferred Brand			
H4461	001	0	1	01	01	H4461_001_0	7	3	Non-Preferred Brand			
H4461	001	0	1	01	01	H4461_001_0	7	4	Specialty			
H4461	012	0	1	01	01	H4461_012_0	7	1	Generic			
H4461	012	0	1	01	01	H4461_012_0	7	2	Preferred Brand			
H4461	012	0	1	01	01	H4461_012_0	7	4	Specialty			
H4461	012	0	1	01	01	H4461_012_0	7	3	Non-Preferred Brand			
H4461	015	0	1	01	01	H4461_015_0	11	1	Generic			
H4461	015	0	1	01	01	H4461_015_0	11	3	Non-Preferred Brand			
H4461	015	0	1	01	01	H4461_015_0	11	2	Preferred Brand			
H4461	015	0	1	01	01	H4461_015_0	11	4	Specialty			
H4461	016	0	1	01	01	H4461_016_0	10	1	Generic			
H4461	016	0	1	01	01	H4461_016_0	10	2	Preferred Brand			
H4461	016	0	1	01	01	H4461_016_0	10	4	Specialty	2		
H4461	016	0	1	01	01	H4461_016_0	10	3	Non-Preferred Brand	2		
H4461	016	0	1	01	01	H4461_016_0	10	2	Preferred Brand	2		
H4461	016	0	1	01	01	H4461_016_0	10	1	Generic	1		1
H4461	016	0	1	01	01	H4461_016_0	10	4	Specialty			
H4461	016	0	1	01	01	H4461_016_0	10	3	Non-Preferred Brand			
H4461	017	0	1	01	01	H4461_017_0	10	1	Generic			
H4461	017	0	1	01	01	H4461_017_0	10	3	Non-Preferred Brand	2		
H4461	017	0	1	01	01	H4461_017_0	10	2	Preferred Brand	2		
H4461	017	0	1	01	01	H4461_017_0	10	1	Generic	1		1
H4461	017	0	1	01	01	H4461_017_0	10	4	Specialty			
H4461	017	0	1	01	01	H4461_017_0	10	3	Non-Preferred Brand			
H4461	017	0	1	01	01	H4461_017_0	10	2	Preferred Brand			
H4461	017	0	1	01	01	H4461_017_0	10	4	Specialty	2		
H4506	003	0	1	01	01	H4506_003_0	5	1	Generic			
H4506	003	0	1	01	01	H4506_003_0	5	2	Preferred Brand			
H4506	003	0	1	01	01	H4506_003_0	5	3	Non-Preferred Brand			
H4506	003	0	1	01	01	H4506_003_0	5	4	Specialty			
H4506	003	0	1	01	01	H4506_003_0	5	1	Generic	1		1
H4506	003	0	1	01	01	H4506_003_0	5	2	Preferred Brand	2		
H4506	003	0	1	01	01	H4506_003_0	5	3	Non-Preferred Brand	2		
H4506	003	0	1	01	01	H4506_003_0	5	4	Specialty	2		
H4506	023	0	1	01	01	H4506_023_0	6	1	Generic			
H4506	023	0	1	01	01	H4506_023_0	6	2	Preferred Brand			
H4506	023	0	1	01	01	H4506_023_0	6	4	Specialty			
H4506	023	0	1	01	01	H4506_023_0	6	3	Non-Preferred Brand			
H4506	025	0	1	01	01	H4506_025_0	6	1	Generic			
H4506	025	0	1	01	01	H4506_025_0	6	2	Preferred Brand			
H4506	025	0	1	01	01	H4506_025_0	6	3	Non-Preferred Brand			
H4506	025	0	1	01	01	H4506_025_0	6	4	Specialty			
H4506	025	0	1	01	01	H4506_025_0	6	1	Generic	1		1
H4506	025	0	1	01	01	H4506_025_0	6	3	Non-Preferred Brand	2		
H4506	025	0	1	01	01	H4506_025_0	6	2	Preferred Brand	2		
H4506	025	0	1	01	01	H4506_025_0	6	4	Specialty	2		
H4510	012	0	1	01	01	H4510_012_0	7	3	Non-Preferred Brand			
H4510	012	0	1	01	01	H4510_012_0	7	2	Preferred Brand			
H4510	012	0	1	01	01	H4510_012_0	7	4	Specialty	1	10001000	2
H4510	012	0	1	01	01	H4510_012_0	7	3	Non-Preferred Brand	1	10000000	2
H4510	012	0	1	01	01	H4510_012_0	7	2	Preferred Brand	1	10000000	2
H4510	012	0	1	01	01	H4510_012_0	7	1	Preferred Generic	1		1
H4510	012	0	1	01	01	H4510_012_0	7	4	Specialty			
H4510	012	0	1	01	01	H4510_012_0	7	1	Preferred Generic			
H4510	015	0	1	01	01	H4510_015_0	7	1	Preferred Generic			
H4510	015	0	1	01	01	H4510_015_0	7	3	Non-Preferred Brand	1	10000000	2
H4510	015	0	1	01	01	H4510_015_0	7	2	Preferred Brand	1	10000000	2
H4510	015	0	1	01	01	H4510_015_0	7	1	Preferred Generic	1		1
H4510	015	0	1	01	01	H4510_015_0	7	4	Specialty			
H4510	015	0	1	01	01	H4510_015_0	7	3	Non-Preferred Brand			
H4510	015	0	1	01	01	H4510_015_0	7	2	Preferred Brand			
H4510	015	0	1	01	01	H4510_015_0	7	4	Specialty	1	10001000	2
H4510	017	0	1	01	01	H4510_017_0	4	3	Non-Preferred Brand			
H4510	017	0	1	01	01	H4510_017_0	4	2	Preferred Brand			
H4510	017	0	1	01	01	H4510_017_0	4	1	Preferred Generic			
H4510	017	0	1	01	01	H4510_017_0	4	4	Specialty			
H4510	017	0	1	01	01	H4510_017_0	4	4	Specialty	1	10000000	2
H4510	017	0	1	01	01	H4510_017_0	4	3	Non-Preferred Brand	1	10000000	2
H4510	017	0	1	01	01	H4510_017_0	4	2	Preferred Brand	1	10000000	2
H4510	017	0	1	01	01	H4510_017_0	4	1	Preferred Generic	1	00001000	2
H4510	018	0	1	01	01	H4510_018_0	5	1	Preferred Generic			
H4510	018	0	1	01	01	H4510_018_0	5	2	Preferred Brand			
H4510	018	0	1	01	01	H4510_018_0	5	4	Specialty	1	10001000	2
H4510	018	0	1	01	01	H4510_018_0	5	3	Non-Preferred Brand	1	10000000	2
H4510	018	0	1	01	01	H4510_018_0	5	2	Preferred Brand	1	10000000	2
H4510	018	0	1	01	01	H4510_018_0	5	1	Preferred Generic	1	00001000	2
H4510	018	0	1	01	01	H4510_018_0	5	4	Specialty			
H4510	018	0	1	01	01	H4510_018_0	5	3	Non-Preferred Brand			
H4510	019	0	1	01	01	H4510_019_0	4	1	Preferred Generic			
H4510	019	0	1	01	01	H4510_019_0	4	4	Specialty			
H4510	019	0	1	01	01	H4510_019_0	4	1	Preferred Generic	1	00001000	2
H4510	019	0	1	01	01	H4510_019_0	4	2	Preferred Brand	1	10000000	2
H4510	019	0	1	01	01	H4510_019_0	4	3	Non-Preferred Brand	1	10000000	2
H4510	019	0	1	01	01	H4510_019_0	4	3	Non-Preferred Brand			
H4510	019	0	1	01	01	H4510_019_0	4	2	Preferred Brand			
H4510	019	0	1	01	01	H4510_019_0	4	4	Specialty	1	10000000	2
H4513	001	0	1	01	01	H4513_001_0	3	4	Non-Preferred Brand			
H4513	001	0	1	01	01	H4513_001_0	3	3	Preferred Brand			
H4513	001	0	1	01	01	H4513_001_0	3	2	Generic			
H4513	001	0	1	01	01	H4513_001_0	3	1	Preferred Generic			
H4513	001	0	1	01	01	H4513_001_0	3	5	Specialty	2		
H4513	001	0	1	01	01	H4513_001_0	3	1	Preferred Generic	1		1
H4513	001	0	1	01	01	H4513_001_0	3	2	Generic	1		1
H4513	001	0	1	01	01	H4513_001_0	3	3	Preferred Brand	2		
H4513	001	0	1	01	01	H4513_001_0	3	4	Non-Preferred Brand	2		
H4513	001	0	1	01	01	H4513_001_0	3	5	Specialty			
H4513	014	0	1	01	01	H4513_014_0	3	4	Non-Preferred Brand			
H4513	014	0	1	01	01	H4513_014_0	3	3	Preferred Brand			
H4513	014	0	1	01	01	H4513_014_0	3	2	Generic			
H4513	014	0	1	01	01	H4513_014_0	3	1	Preferred Generic			
H4513	014	0	1	01	01	H4513_014_0	3	5	Specialty			
H4513	014	0	1	01	01	H4513_014_0	3	5	Specialty	2		
H4513	014	0	1	01	01	H4513_014_0	3	4	Non-Preferred Brand	2		
H4513	014	0	1	01	01	H4513_014_0	3	3	Preferred Brand	2		
H4513	014	0	1	01	01	H4513_014_0	3	2	Generic	1		1
H4513	014	0	1	01	01	H4513_014_0	3	1	Preferred Generic	1		1
H4513	019	0	1	01	01	H4513_019_0	3	1	Preferred Generic			
H4513	019	0	1	01	01	H4513_019_0	3	2	Generic			
H4513	019	0	1	01	01	H4513_019_0	3	3	Preferred Brand			
H4513	019	0	1	01	01	H4513_019_0	3	4	Non-Preferred Brand			
H4513	019	0	1	01	01	H4513_019_0	3	5	Specialty	2		
H4513	019	0	1	01	01	H4513_019_0	3	3	Preferred Brand	2		
H4513	019	0	1	01	01	H4513_019_0	3	2	Generic	1		1
H4513	019	0	1	01	01	H4513_019_0	3	1	Preferred Generic	1		1
H4513	019	0	1	01	01	H4513_019_0	3	5	Specialty			
H4513	019	0	1	01	01	H4513_019_0	3	4	Non-Preferred Brand	2		
H4513	020	0	1	01	01	H4513_020_0	3	1	Preferred Generic	1		1
H4513	020	0	1	01	01	H4513_020_0	3	2	Generic	1		1
H4513	020	0	1	01	01	H4513_020_0	3	3	Preferred Brand	2		
H4513	020	0	1	01	01	H4513_020_0	3	4	Non-Preferred Brand	2		
H4513	020	0	1	01	01	H4513_020_0	3	5	Specialty	2		
H4513	020	0	1	01	01	H4513_020_0	3	1	Preferred Generic			
H4513	020	0	1	01	01	H4513_020_0	3	2	Generic			
H4513	020	0	1	01	01	H4513_020_0	3	3	Preferred Brand			
H4513	020	0	1	01	01	H4513_020_0	3	4	Non-Preferred Brand			
H4513	020	0	1	01	01	H4513_020_0	3	5	Specialty			
H4513	021	0	1	01	01	H4513_021_0	4	1	Preferred Generic	1		1
H4513	021	0	1	01	01	H4513_021_0	4	5	Specialty			
H4513	021	0	1	01	01	H4513_021_0	4	4	Non-Preferred Brand			
H4513	021	0	1	01	01	H4513_021_0	4	3	Preferred Brand			
H4513	021	0	1	01	01	H4513_021_0	4	5	Specialty	2		
H4513	021	0	1	01	01	H4513_021_0	4	1	Preferred Generic			
H4513	021	0	1	01	01	H4513_021_0	4	2	Generic	1		1
H4513	021	0	1	01	01	H4513_021_0	4	3	Preferred Brand	2		
H4513	021	0	1	01	01	H4513_021_0	4	4	Non-Preferred Brand	2		
H4513	021	0	1	01	01	H4513_021_0	4	2	Generic			
H4514	004	0	1	01	01	H4514_004_0	4	2	Preferred Brand	2		
H4514	004	0	1	01	01	H4514_004_0	4	1	Preferred Generic	1		1
H4514	004	0	1	01	01	H4514_004_0	4	4	Specialty			
H4514	004	0	1	01	01	H4514_004_0	4	3	Non Preferred			
H4514	004	0	1	01	01	H4514_004_0	4	2	Preferred Brand			
H4514	004	0	1	01	01	H4514_004_0	4	1	Preferred Generic			
H4514	004	0	1	01	01	H4514_004_0	4	3	Non Preferred	2		
H4514	004	0	1	01	01	H4514_004_0	4	4	Specialty	2		
H4514	005	0	1	01	01	H4514_005_0	5	3	Non Preferred			
H4514	005	0	1	01	01	H4514_005_0	5	2	Preferred Brand			
H4514	005	0	1	01	01	H4514_005_0	5	1	Preferred Generic			
H4514	005	0	1	01	01	H4514_005_0	5	4	Specialty			
H4514	007	0	1	01	01	H4514_007_0	5	3	Non Preferred			
H4514	007	0	1	01	01	H4514_007_0	5	2	Preferred Brand			
H4514	007	0	1	01	01	H4514_007_0	5	1	Preferred Generic			
H4514	007	0	1	01	01	H4514_007_0	5	4	Specialty			
H4514	007	0	1	01	01	H4514_007_0	5	4	Specialty	2		
H4514	007	0	1	01	01	H4514_007_0	5	3	Non Preferred	2		
H4514	007	0	1	01	01	H4514_007_0	5	2	Preferred Brand	2		
H4514	007	0	1	01	01	H4514_007_0	5	1	Preferred Generic	1		1
H4514	010	0	1	01	01	H4514_010_0	5	2	Preferred Brand			
H4514	010	0	1	01	01	H4514_010_0	5	1	Preferred Generic			
H4514	010	0	1	01	01	H4514_010_0	5	3	Non Preferred			
H4514	010	0	1	01	01	H4514_010_0	5	4	Specialty			
H4520	001	0	1	04	01	H4520_001_0	6	1	Preferred Generic			
H4520	001	0	1	04	01	H4520_001_0	6	2	Preferred Brand			
H4520	001	0	1	04	01	H4520_001_0	6	3	Non-Preferred Brand			
H4520	001	0	1	04	01	H4520_001_0	6	4	Specialty			
H4520	001	0	1	04	01	H4520_001_0	6	1	Preferred Generic	1	00001000	2
H4520	001	0	1	04	01	H4520_001_0	6	2	Preferred Brand	1	10000000	2
H4520	001	0	1	04	01	H4520_001_0	6	3	Non-Preferred Brand	1	10000000	2
H4520	001	0	1	04	01	H4520_001_0	6	4	Specialty	1	10001000	2
H4520	002	0	1	04	01	H4520_002_0	10	4	Specialty	1	10001000	2
H4520	002	0	1	04	01	H4520_002_0	10	3	Non-Preferred Brand	1	10000000	2
H4520	002	0	1	04	01	H4520_002_0	10	2	Preferred Brand	1	10000000	2
H4520	002	0	1	04	01	H4520_002_0	10	1	Preferred Generic			
H4520	002	0	1	04	01	H4520_002_0	10	1	Preferred Generic	1		1
H4520	002	0	1	04	01	H4520_002_0	10	4	Specialty			
H4520	002	0	1	04	01	H4520_002_0	10	3	Non-Preferred Brand			
H4520	002	0	1	04	01	H4520_002_0	10	2	Preferred Brand			
H4520	003	0	1	04	01	H4520_003_0	9	1	Preferred Generic			
H4520	003	0	1	04	01	H4520_003_0	9	3	Non-Preferred Brand			
H4520	003	0	1	04	01	H4520_003_0	9	4	Specialty			
H4520	003	0	1	04	01	H4520_003_0	9	1	Preferred Generic	1	00001000	2
H4520	003	0	1	04	01	H4520_003_0	9	2	Preferred Brand	1	10000000	2
H4520	003	0	1	04	01	H4520_003_0	9	3	Non-Preferred Brand	1	10000000	2
H4520	003	0	1	04	01	H4520_003_0	9	4	Specialty	1	10001000	2
H4520	003	0	1	04	01	H4520_003_0	9	2	Preferred Brand			
H4520	005	0	1	04	01	H4520_005_0	5	1	Preferred Generic			
H4520	005	0	1	04	01	H4520_005_0	5	4	Specialty	1	10001000	2
H4520	005	0	1	04	01	H4520_005_0	5	3	Non-Preferred Brand	1	10000000	2
H4520	005	0	1	04	01	H4520_005_0	5	2	Preferred Brand	1	10000000	2
H4520	005	0	1	04	01	H4520_005_0	5	1	Preferred Generic	1	00001000	2
H4520	005	0	1	04	01	H4520_005_0	5	4	Specialty			
H4520	005	0	1	04	01	H4520_005_0	5	3	Non-Preferred Brand			
H4520	005	0	1	04	01	H4520_005_0	5	2	Preferred Brand			
H4520	006	0	1	04	01	H4520_006_0	7	4	Specialty	1	10001000	2
H4520	006	0	1	04	01	H4520_006_0	7	3	Non-Preferred Brand	1	10000000	2
H4520	006	0	1	04	01	H4520_006_0	7	2	Preferred Brand	1	10000000	2
H4520	006	0	1	04	01	H4520_006_0	7	4	Specialty			
H4520	006	0	1	04	01	H4520_006_0	7	3	Non-Preferred Brand			
H4520	006	0	1	04	01	H4520_006_0	7	2	Preferred Brand			
H4520	006	0	1	04	01	H4520_006_0	7	1	Preferred Generic			
H4520	006	0	1	04	01	H4520_006_0	7	1	Preferred Generic	1	00001000	2
H4520	016	0	1	04	01	H4520_016_0	5	4	Specialty			
H4520	016	0	1	04	01	H4520_016_0	5	1	Preferred Generic	1	00001000	2
H4520	016	0	1	04	01	H4520_016_0	5	2	Preferred Brand	1	10000000	2
H4520	016	0	1	04	01	H4520_016_0	5	3	Non-Preferred Brand	1	10000000	2
H4520	016	0	1	04	01	H4520_016_0	5	4	Specialty	1	10001000	2
H4520	016	0	1	04	01	H4520_016_0	5	1	Preferred Generic			
H4520	016	0	1	04	01	H4520_016_0	5	2	Preferred Brand			
H4520	016	0	1	04	01	H4520_016_0	5	3	Non-Preferred Brand			
H4520	018	0	1	04	01	H4520_018_0	7	3	Non-Preferred Brand	1	10000000	2
H4520	018	0	1	04	01	H4520_018_0	7	2	Preferred Brand	1	10000000	2
H4520	018	0	1	04	01	H4520_018_0	7	1	Preferred Generic	1	00001000	2
H4520	018	0	1	04	01	H4520_018_0	7	4	Specialty			
H4520	018	0	1	04	01	H4520_018_0	7	4	Specialty	1	10001000	2
H4520	018	0	1	04	01	H4520_018_0	7	1	Preferred Generic			
H4520	018	0	1	04	01	H4520_018_0	7	2	Preferred Brand			
H4520	018	0	1	04	01	H4520_018_0	7	3	Non-Preferred Brand			
H4521	001	0	1	01	01	H4521_001_0	6	1	Generic			
H4521	001	0	1	01	01	H4521_001_0	6	2	Brand			
H4521	001	0	1	01	01	H4521_001_0	6	3	Specialty			
H4521	001	0	1	01	01	H4521_001_0	6	1	Generic	1		1
H4521	001	0	1	01	01	H4521_001_0	6	2	Brand	2		
H4521	001	0	1	01	01	H4521_001_0	6	3	Specialty	2		
H4521	004	0	1	01	01	H4521_004_0	4	1	Generic			
H4521	004	0	1	01	01	H4521_004_0	4	3	Specialty			
H4521	004	0	1	01	01	H4521_004_0	4	2	Brand			
H4522	001	0	1	04	01	H4522_001_0	6	4	Specialty			
H4522	001	0	1	04	01	H4522_001_0	6	1	Preferred Generic	1		1
H4522	001	0	1	04	01	H4522_001_0	6	2	Preferred Brand	2		
H4522	001	0	1	04	01	H4522_001_0	6	3	Non Preferred	2		
H4522	001	0	1	04	01	H4522_001_0	6	4	Specialty	2		
H4522	001	0	1	04	01	H4522_001_0	6	2	Preferred Brand			
H4522	001	0	1	04	01	H4522_001_0	6	1	Preferred Generic			
H4522	001	0	1	04	01	H4522_001_0	6	3	Non Preferred			
H4522	008	0	1	04	01	H4522_008_0	3	1	Preferred Generic			
H4522	008	0	1	04	01	H4522_008_0	3	2	Preferred Brand			
H4522	008	0	1	04	01	H4522_008_0	3	3	Non Preferred			
H4522	008	0	1	04	01	H4522_008_0	3	4	Specialty			
H4522	008	0	1	04	01	H4522_008_0	3	1	Preferred Generic	1		1
H4522	008	0	1	04	01	H4522_008_0	3	2	Preferred Brand	2		
H4522	008	0	1	04	01	H4522_008_0	3	4	Specialty	2		
H4522	008	0	1	04	01	H4522_008_0	3	3	Non Preferred	2		
H4523	001	0	1	01	01	H4523_001_0	5	1	Tier 1 - Preferred Generic			
H4523	001	0	1	01	01	H4523_001_0	5	4	Tier 4 - Non-Preferred Brand			
H4523	001	0	1	01	01	H4523_001_0	5	3	Tier 3 - Preferred Brand			
H4523	001	0	1	01	01	H4523_001_0	5	2	Tier 2 - Non-Preferred Generic			
H4523	001	0	1	01	01	H4523_001_0	5	5	Tier 5 - Specialty			
H4523	001	0	1	01	01	H4523_001_0	5	1	Tier 1 - Preferred Generic	1		1
H4523	001	0	1	01	01	H4523_001_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H4523	001	0	1	01	01	H4523_001_0	5	3	Tier 3 - Preferred Brand	2		
H4523	001	0	1	01	01	H4523_001_0	5	5	Tier 5 - Specialty	2		
H4523	001	0	1	01	01	H4523_001_0	5	4	Tier 4 - Non-Preferred Brand	2		
H4523	005	0	1	01	01	H4523_005_0	5	1	Tier 1 - Preferred Generic			
H4523	005	0	1	01	01	H4523_005_0	5	2	Tier 2 - Non-Preferred Generic			
H4523	005	0	1	01	01	H4523_005_0	5	3	Tier 3 - Preferred Brand			
H4523	005	0	1	01	01	H4523_005_0	5	4	Tier 4 - Non-Preferred Brand			
H4523	005	0	1	01	01	H4523_005_0	5	5	Tier 5 - Specialty			
H4523	009	0	1	01	01	H4523_009_0	4	5	Tier 5 - Specialty	2		
H4523	009	0	1	01	01	H4523_009_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H4523	009	0	1	01	01	H4523_009_0	4	3	Tier 3 - Preferred Brand	2		
H4523	009	0	1	01	01	H4523_009_0	4	4	Tier 4 - Non-Preferred Brand	2		
H4523	009	0	1	01	01	H4523_009_0	4	1	Tier 1 - Preferred Generic	1		1
H4523	009	0	1	01	01	H4523_009_0	4	5	Tier 5 - Specialty			
H4523	009	0	1	01	01	H4523_009_0	4	4	Tier 4 - Non-Preferred Brand			
H4523	009	0	1	01	01	H4523_009_0	4	3	Tier 3 - Preferred Brand			
H4523	009	0	1	01	01	H4523_009_0	4	2	Tier 2 - Non-Preferred Generic			
H4523	009	0	1	01	01	H4523_009_0	4	1	Tier 1 - Preferred Generic			
H4523	010	0	1	01	01	H4523_010_0	6	2	Tier 2 - Non-Preferred Generic			
H4523	010	0	1	01	01	H4523_010_0	6	5	Tier 5 - Specialty			
H4523	010	0	1	01	01	H4523_010_0	6	3	Tier 3 - Preferred Brand			
H4523	010	0	1	01	01	H4523_010_0	6	4	Tier 4 - Non-Preferred Brand			
H4523	010	0	1	01	01	H4523_010_0	6	1	Tier 1 - Preferred Generic			
H4523	012	0	1	01	01	H4523_012_0	6	3	Tier 3 - Preferred Brand			
H4523	012	0	1	01	01	H4523_012_0	6	5	Tier 5 - Specialty			
H4523	012	0	1	01	01	H4523_012_0	6	4	Tier 4 - Non-Preferred Brand			
H4523	012	0	1	01	01	H4523_012_0	6	1	Tier 1 - Preferred Generic			
H4523	012	0	1	01	01	H4523_012_0	6	2	Tier 2 - Non-Preferred Generic			
H4523	014	0	1	01	01	H4523_014_0	5	1	Tier 1 - Preferred Generic			
H4523	014	0	1	01	01	H4523_014_0	5	2	Tier 2 - Non-Preferred Generic			
H4523	014	0	1	01	01	H4523_014_0	5	3	Tier 3 - Preferred Brand			
H4523	014	0	1	01	01	H4523_014_0	5	5	Tier 5 - Specialty			
H4523	014	0	1	01	01	H4523_014_0	5	4	Tier 4 - Non-Preferred Brand			
H4523	015	0	1	01	01	H4523_015_0	4	3	Tier 3 - Preferred Brand			
H4523	015	0	1	01	01	H4523_015_0	4	4	Tier 4 - Non-Preferred Brand			
H4523	015	0	1	01	01	H4523_015_0	4	5	Tier 5 - Specialty			
H4523	015	0	1	01	01	H4523_015_0	4	1	Tier 1 - Preferred Generic	1		1
H4523	015	0	1	01	01	H4523_015_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H4523	015	0	1	01	01	H4523_015_0	4	3	Tier 3 - Preferred Brand	2		
H4523	015	0	1	01	01	H4523_015_0	4	4	Tier 4 - Non-Preferred Brand	2		
H4523	015	0	1	01	01	H4523_015_0	4	5	Tier 5 - Specialty	2		
H4523	015	0	1	01	01	H4523_015_0	4	2	Tier 2 - Non-Preferred Generic			
H4523	015	0	1	01	01	H4523_015_0	4	1	Tier 1 - Preferred Generic			
H4524	001	0	1	04	01	H4524_001_0	7	1	Tier 1 - Preferred Generic			
H4524	001	0	1	04	01	H4524_001_0	7	2	Tier 2 - Non-Preferred Generic			
H4524	001	0	1	04	01	H4524_001_0	7	3	Tier 3 - Preferred Brand			
H4524	001	0	1	04	01	H4524_001_0	7	4	Tier 4 - Non-Preferred Brand			
H4524	001	0	1	04	01	H4524_001_0	7	5	Tier 5 - Specialty			
H4524	002	0	1	04	01	H4524_002_0	6	1	Tier 1 - Preferred Generic	1		1
H4524	002	0	1	04	01	H4524_002_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H4524	002	0	1	04	01	H4524_002_0	6	3	Tier 3 - Preferred Brand	2		
H4524	002	0	1	04	01	H4524_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4524	002	0	1	04	01	H4524_002_0	6	5	Tier 5 - Specialty			
H4524	002	0	1	04	01	H4524_002_0	6	4	Tier 4 - Non-Preferred Brand			
H4524	002	0	1	04	01	H4524_002_0	6	5	Tier 5 - Specialty	2		
H4524	002	0	1	04	01	H4524_002_0	6	2	Tier 2 - Non-Preferred Generic			
H4524	002	0	1	04	01	H4524_002_0	6	1	Tier 1 - Preferred Generic			
H4524	002	0	1	04	01	H4524_002_0	6	3	Tier 3 - Preferred Brand			
H4524	003	0	1	04	01	H4524_003_0	7	4	Tier 4 - Non-Preferred Brand			
H4524	003	0	1	04	01	H4524_003_0	7	3	Tier 3 - Preferred Brand			
H4524	003	0	1	04	01	H4524_003_0	7	2	Tier 2 - Non-Preferred Generic			
H4524	003	0	1	04	01	H4524_003_0	7	1	Tier 1 - Preferred Generic			
H4524	003	0	1	04	01	H4524_003_0	7	5	Tier 5 - Specialty			
H4524	005	0	1	04	01	H4524_005_0	7	4	Tier 4 - Non-Preferred Brand			
H4524	005	0	1	04	01	H4524_005_0	7	3	Tier 3 - Preferred Brand			
H4524	005	0	1	04	01	H4524_005_0	7	2	Tier 2 - Non-Preferred Generic			
H4524	005	0	1	04	01	H4524_005_0	7	1	Tier 1 - Preferred Generic			
H4524	005	0	1	04	01	H4524_005_0	7	5	Tier 5 - Specialty			
H4524	007	0	1	04	01	H4524_007_0	7	4	Tier 4 - Non-Preferred Brand			
H4524	007	0	1	04	01	H4524_007_0	7	3	Tier 3 - Preferred Brand			
H4524	007	0	1	04	01	H4524_007_0	7	2	Tier 2 - Non-Preferred Generic			
H4524	007	0	1	04	01	H4524_007_0	7	1	Tier 1 - Preferred Generic			
H4524	007	0	1	04	01	H4524_007_0	7	5	Tier 5 - Specialty			
H4524	008	0	1	04	01	H4524_008_0	5	1	Tier 1 - Preferred Generic			
H4524	008	0	1	04	01	H4524_008_0	5	2	Tier 2 - Non-Preferred Generic			
H4524	008	0	1	04	01	H4524_008_0	5	3	Tier 3 - Preferred Brand			
H4524	008	0	1	04	01	H4524_008_0	5	4	Tier 4 - Non-Preferred Brand			
H4524	008	0	1	04	01	H4524_008_0	5	5	Tier 5 - Specialty	2		
H4524	008	0	1	04	01	H4524_008_0	5	1	Tier 1 - Preferred Generic	1		1
H4524	008	0	1	04	01	H4524_008_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H4524	008	0	1	04	01	H4524_008_0	5	3	Tier 3 - Preferred Brand	2		
H4524	008	0	1	04	01	H4524_008_0	5	4	Tier 4 - Non-Preferred Brand	2		
H4524	008	0	1	04	01	H4524_008_0	5	5	Tier 5 - Specialty			
H4524	009	0	1	04	01	H4524_009_0	6	2	Tier 2 - Non-Preferred Generic			
H4524	009	0	1	04	01	H4524_009_0	6	3	Tier 3 - Preferred Brand			
H4524	009	0	1	04	01	H4524_009_0	6	4	Tier 4 - Non-Preferred Brand			
H4524	009	0	1	04	01	H4524_009_0	6	5	Tier 5 - Specialty			
H4524	009	0	1	04	01	H4524_009_0	6	1	Tier 1 - Preferred Generic			
H4524	011	0	1	04	01	H4524_011_0	5	4	Tier 4 - Non-Preferred Brand			
H4524	011	0	1	04	01	H4524_011_0	5	3	Tier 3 - Preferred Brand			
H4524	011	0	1	04	01	H4524_011_0	5	2	Tier 2 - Non-Preferred Generic			
H4524	011	0	1	04	01	H4524_011_0	5	1	Tier 1 - Preferred Generic			
H4524	011	0	1	04	01	H4524_011_0	5	5	Tier 5 - Specialty			
H4524	012	0	1	04	01	H4524_012_0	6	1	Tier 1 - Preferred Generic	1		1
H4524	012	0	1	04	01	H4524_012_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H4524	012	0	1	04	01	H4524_012_0	6	3	Tier 3 - Preferred Brand	2		
H4524	012	0	1	04	01	H4524_012_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4524	012	0	1	04	01	H4524_012_0	6	5	Tier 5 - Specialty			
H4524	012	0	1	04	01	H4524_012_0	6	4	Tier 4 - Non-Preferred Brand			
H4524	012	0	1	04	01	H4524_012_0	6	3	Tier 3 - Preferred Brand			
H4524	012	0	1	04	01	H4524_012_0	6	2	Tier 2 - Non-Preferred Generic			
H4524	012	0	1	04	01	H4524_012_0	6	1	Tier 1 - Preferred Generic			
H4524	012	0	1	04	01	H4524_012_0	6	5	Tier 5 - Specialty	2		
H4524	013	0	1	04	01	H4524_013_0	5	4	Tier 4 - Non-Preferred Brand			
H4524	013	0	1	04	01	H4524_013_0	5	3	Tier 3 - Preferred Brand			
H4524	013	0	1	04	01	H4524_013_0	5	2	Tier 2 - Non-Preferred Generic			
H4524	013	0	1	04	01	H4524_013_0	5	1	Tier 1 - Preferred Generic			
H4524	013	0	1	04	01	H4524_013_0	5	5	Tier 5 - Specialty			
H4524	014	0	1	04	01	H4524_014_0	5	1	Tier 1 - Preferred Generic	1		1
H4524	014	0	1	04	01	H4524_014_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H4524	014	0	1	04	01	H4524_014_0	5	3	Tier 3 - Preferred Brand	2		
H4524	014	0	1	04	01	H4524_014_0	5	4	Tier 4 - Non-Preferred Brand	2		
H4524	014	0	1	04	01	H4524_014_0	5	5	Tier 5 - Specialty			
H4524	014	0	1	04	01	H4524_014_0	5	4	Tier 4 - Non-Preferred Brand			
H4524	014	0	1	04	01	H4524_014_0	5	5	Tier 5 - Specialty	2		
H4524	014	0	1	04	01	H4524_014_0	5	2	Tier 2 - Non-Preferred Generic			
H4524	014	0	1	04	01	H4524_014_0	5	1	Tier 1 - Preferred Generic			
H4524	014	0	1	04	01	H4524_014_0	5	3	Tier 3 - Preferred Brand			
H4525	001	0	1	01	01	H4525_001_0	5	3	Specialty			
H4525	001	0	1	01	01	H4525_001_0	5	2	Brand			
H4525	001	0	1	01	01	H4525_001_0	5	1	Generic			
H4525	002	0	1	01	01	H4525_002_0	6	1	Generic			
H4525	002	0	1	01	01	H4525_002_0	6	3	Specialty			
H4525	002	0	1	01	01	H4525_002_0	6	2	Brand			
H4525	006	0	1	01	01	H4525_006_0	6	2	Brand			
H4525	006	0	1	01	01	H4525_006_0	6	3	Specialty			
H4525	006	0	1	01	01	H4525_006_0	6	1	Generic			
H4525	006	0	1	01	01	H4525_006_0	6	1	Generic	1		1
H4525	006	0	1	01	01	H4525_006_0	6	2	Brand	2		
H4525	006	0	1	01	01	H4525_006_0	6	3	Specialty	2		
H4525	007	0	1	01	01	H4525_007_0	5	1	Generic			
H4525	007	0	1	01	01	H4525_007_0	5	2	Brand			
H4525	007	0	1	01	01	H4525_007_0	5	3	Specialty			
H4525	007	0	1	01	01	H4525_007_0	5	1	Generic	1		1
H4525	007	0	1	01	01	H4525_007_0	5	2	Brand	2		
H4525	007	0	1	01	01	H4525_007_0	5	3	Specialty	2		
H4525	008	0	1	01	01	H4525_008_0	5	1	Generic			
H4525	008	0	1	01	01	H4525_008_0	5	2	Brand			
H4525	008	0	1	01	01	H4525_008_0	5	3	Specialty			
H4525	008	0	1	01	01	H4525_008_0	5	1	Generic	1		1
H4525	008	0	1	01	01	H4525_008_0	5	2	Brand	2		
H4525	008	0	1	01	01	H4525_008_0	5	3	Specialty	2		
H4525	009	0	1	01	01	H4525_009_0	6	1	Generic			
H4525	009	0	1	01	01	H4525_009_0	6	2	Brand			
H4525	009	0	1	01	01	H4525_009_0	6	3	Specialty			
H4525	009	0	1	01	01	H4525_009_0	6	1	Generic	1		1
H4525	009	0	1	01	01	H4525_009_0	6	2	Brand	2		
H4525	009	0	1	01	01	H4525_009_0	6	3	Specialty	2		
H4527	001	0	1	01	01	H4527_001_0	4	1	Generic			
H4527	001	0	1	01	01	H4527_001_0	4	2	Preferred Brand			
H4527	001	0	1	01	01	H4527_001_0	4	3	Non Preferred Brand			
H4527	001	0	1	01	01	H4527_001_0	4	4	Specialty Drugs	2		
H4527	001	0	1	01	01	H4527_001_0	4	1	Generic	1		1
H4527	001	0	1	01	01	H4527_001_0	4	2	Preferred Brand	1		1
H4527	001	0	1	01	01	H4527_001_0	4	3	Non Preferred Brand	2		
H4527	001	0	1	01	01	H4527_001_0	4	4	Specialty Drugs			
H4527	002	0	1	01	01	H4527_002_0	4	2	Preferred Brand			
H4527	002	0	1	01	01	H4527_002_0	4	3	Non Preferred Brand			
H4527	002	0	1	01	01	H4527_002_0	4	4	Specialty Drugs			
H4527	002	0	1	01	01	H4527_002_0	4	1	Generic	1		1
H4527	002	0	1	01	01	H4527_002_0	4	2	Preferred Brand	2		
H4527	002	0	1	01	01	H4527_002_0	4	3	Non Preferred Brand	2		
H4527	002	0	1	01	01	H4527_002_0	4	4	Specialty Drugs	2		
H4527	002	0	1	01	01	H4527_002_0	4	1	Generic			
H4527	005	0	1	01	01	H4527_005_0	4	3	Non Preferred Brand			
H4527	005	0	1	01	01	H4527_005_0	4	2	Preferred Brand			
H4527	005	0	1	01	01	H4527_005_0	4	1	Generic			
H4527	005	0	1	01	01	H4527_005_0	4	4	Specialty Drugs			
H4527	005	0	1	01	01	H4527_005_0	4	1	Generic	1		1
H4527	005	0	1	01	01	H4527_005_0	4	2	Preferred Brand	2		
H4527	005	0	1	01	01	H4527_005_0	4	3	Non Preferred Brand	2		
H4527	005	0	1	01	01	H4527_005_0	4	4	Specialty Drugs	2		
H4527	008	0	1	01	01	H4527_008_0	4	3	Non Preferred Brand			
H4527	008	0	1	01	01	H4527_008_0	4	2	Preferred Brand			
H4527	008	0	1	01	01	H4527_008_0	4	1	Generic			
H4527	008	0	1	01	01	H4527_008_0	4	4	Specialty Drugs			
H4527	008	0	1	01	01	H4527_008_0	4	4	Specialty Drugs	2		
H4527	008	0	1	01	01	H4527_008_0	4	3	Non Preferred Brand	2		
H4527	008	0	1	01	01	H4527_008_0	4	2	Preferred Brand	2		
H4527	008	0	1	01	01	H4527_008_0	4	1	Generic	1		1
H4527	011	0	1	01	01	H4527_011_0	4	1	Generic			
H4527	011	0	1	01	01	H4527_011_0	4	2	Preferred Brand			
H4527	011	0	1	01	01	H4527_011_0	4	3	Non Preferred Brand			
H4527	011	0	1	01	01	H4527_011_0	4	3	Non Preferred Brand	2		
H4527	011	0	1	01	01	H4527_011_0	4	2	Preferred Brand	2		
H4527	011	0	1	01	01	H4527_011_0	4	1	Generic	1		1
H4527	011	0	1	01	01	H4527_011_0	4	4	Specialty Drugs			
H4527	011	0	1	01	01	H4527_011_0	4	4	Specialty Drugs	2		
H4527	013	0	1	01	01	H4527_013_0	5	1	Generic			
H4527	013	0	1	01	01	H4527_013_0	5	2	Preferred Brand			
H4527	013	0	1	01	01	H4527_013_0	5	4	Specialty Drugs			
H4527	013	0	1	01	01	H4527_013_0	5	3	Non Preferred Brand			
H4527	014	0	1	01	01	H4527_014_0	5	1	Generic			
H4527	014	0	1	01	01	H4527_014_0	5	2	Preferred Brand			
H4527	014	0	1	01	01	H4527_014_0	5	3	Non Preferred Brand			
H4527	014	0	1	01	01	H4527_014_0	5	4	Specialty Drugs			
H4527	014	0	1	01	01	H4527_014_0	5	1	Generic	1		1
H4527	014	0	1	01	01	H4527_014_0	5	4	Specialty Drugs	2		
H4527	014	0	1	01	01	H4527_014_0	5	3	Non Preferred Brand	2		
H4527	014	0	1	01	01	H4527_014_0	5	2	Preferred Brand	2		
H4527	017	0	1	01	01	H4527_017_0	4	3	Non Preferred Brand			
H4527	017	0	1	01	01	H4527_017_0	4	4	Specialty Drugs			
H4527	017	0	1	01	01	H4527_017_0	4	2	Preferred Brand			
H4527	017	0	1	01	01	H4527_017_0	4	1	Generic			
H4527	018	0	1	01	01	H4527_018_0	5	4	Specialty Drugs	2		
H4527	018	0	1	01	01	H4527_018_0	5	2	Preferred Brand			
H4527	018	0	1	01	01	H4527_018_0	5	1	Generic	1		1
H4527	018	0	1	01	01	H4527_018_0	5	2	Preferred Brand	2		
H4527	018	0	1	01	01	H4527_018_0	5	3	Non Preferred Brand	2		
H4527	018	0	1	01	01	H4527_018_0	5	3	Non Preferred Brand			
H4527	018	0	1	01	01	H4527_018_0	5	4	Specialty Drugs			
H4527	018	0	1	01	01	H4527_018_0	5	1	Generic			
H4527	023	0	1	01	01	H4527_023_0	3	4	Specialty Drugs			
H4527	023	0	1	01	01	H4527_023_0	3	3	Non Preferred Brand			
H4527	023	0	1	01	01	H4527_023_0	3	2	Preferred Brand			
H4527	023	0	1	01	01	H4527_023_0	3	1	Generic			
H4528	001	0	1	02	01	H4528_001_0	2	3	Non-Preferred Brand			
H4528	001	0	1	02	01	H4528_001_0	2	2	Preferred Brand			
H4528	001	0	1	02	01	H4528_001_0	2	1	Generic			
H4528	001	0	1	02	01	H4528_001_0	2	4	Specialty			
H4528	005	0	1	02	01	H4528_005_0	2	3	Non-Preferred Brand			
H4528	005	0	1	02	01	H4528_005_0	2	2	Preferred Brand			
H4528	005	0	1	02	01	H4528_005_0	2	1	Generic			
H4528	005	0	1	02	01	H4528_005_0	2	4	Specialty			
H4528	009	0	1	01	01	H4528_009_0	2	1	Generic			
H4528	009	0	1	01	01	H4528_009_0	2	2	Preferred Brand			
H4528	009	0	1	01	01	H4528_009_0	2	3	Non-Preferred Brand			
H4528	009	0	1	01	01	H4528_009_0	2	4	Specialty			
H4528	010	0	1	01	01	H4528_010_0	2	1	Generic			
H4528	010	0	1	01	01	H4528_010_0	2	2	Preferred Brand			
H4528	010	0	1	01	01	H4528_010_0	2	3	Non-Preferred Brand			
H4528	010	0	1	01	01	H4528_010_0	2	4	Specialty			
H4529	002	0	1	01	01	H4529_002_0	9	1	Tier 1 - Generic			
H4529	002	0	1	01	01	H4529_002_0	9	2	Tier 2 - Preferred Brand			
H4529	002	0	1	01	01	H4529_002_0	9	3	Tier 3 - Non - Preferred Brand			
H4529	002	0	1	01	01	H4529_002_0	9	4	Tier 4 - Specialty Drugs			
H4529	002	0	1	01	01	H4529_002_0	9	1	Tier 1 - Generic	1		1
H4529	002	0	1	01	01	H4529_002_0	9	2	Tier 2 - Preferred Brand	2		
H4529	002	0	1	01	01	H4529_002_0	9	4	Tier 4 - Specialty Drugs	2		
H4529	002	0	1	01	01	H4529_002_0	9	3	Tier 3 - Non - Preferred Brand	2		
H4529	004	0	1	01	01	H4529_004_0	11	4	Tier 4 - Specialty Drugs	2		
H4529	004	0	1	01	01	H4529_004_0	11	3	Tier 3 - Non - Preferred Brand	2		
H4529	004	0	1	01	01	H4529_004_0	11	2	Tier 2 - Preferred Brand	2		
H4529	004	0	1	01	01	H4529_004_0	11	1	Tier 1 - Generic	1		1
H4529	004	0	1	01	01	H4529_004_0	11	4	Tier 4 - Specialty Drugs			
H4529	004	0	1	01	01	H4529_004_0	11	3	Tier 3 - Non - Preferred Brand			
H4529	004	0	1	01	01	H4529_004_0	11	2	Tier 2 - Preferred Brand			
H4529	004	0	1	01	01	H4529_004_0	11	1	Tier 1 - Generic			
H4529	014	0	1	01	01	H4529_014_0	12	4	Tier 4 - Specialty Drugs	2		
H4529	014	0	1	01	01	H4529_014_0	12	2	Tier 2 - Preferred Brand	2		
H4529	014	0	1	01	01	H4529_014_0	12	1	Tier 1 - Generic	1		1
H4529	014	0	1	01	01	H4529_014_0	12	4	Tier 4 - Specialty Drugs			
H4529	014	0	1	01	01	H4529_014_0	12	3	Tier 3 - Non - Preferred Brand			
H4529	014	0	1	01	01	H4529_014_0	12	2	Tier 2 - Preferred Brand			
H4529	014	0	1	01	01	H4529_014_0	12	1	Tier 1 - Generic			
H4529	014	0	1	01	01	H4529_014_0	12	3	Tier 3 - Non - Preferred Brand	2		
H4531	001	0	1	04	01	H4531_001_0	9	4	Specialty			
H4531	001	0	1	04	01	H4531_001_0	9	3	Brand			
H4531	001	0	1	04	01	H4531_001_0	9	2	Preferred Brand			
H4531	001	0	1	04	01	H4531_001_0	9	1	Generic			
H4531	003	0	1	04	01	H4531_003_0	7	2	Preferred Brand			
H4531	003	0	1	04	01	H4531_003_0	7	1	Generic			
H4531	003	0	1	04	01	H4531_003_0	7	4	Specialty			
H4531	003	0	1	04	01	H4531_003_0	7	3	Brand			
H4531	004	0	1	04	01	H4531_004_0	8	4	Specialty	1	01000000	2
H4531	004	0	1	04	01	H4531_004_0	8	3	Brand	2		
H4531	004	0	1	04	01	H4531_004_0	8	2	Preferred Brand	2		
H4531	004	0	1	04	01	H4531_004_0	8	1	Generic	1		1
H4531	004	0	1	04	01	H4531_004_0	8	4	Specialty			
H4531	004	0	1	04	01	H4531_004_0	8	3	Brand			
H4531	004	0	1	04	01	H4531_004_0	8	2	Preferred Brand			
H4531	004	0	1	04	01	H4531_004_0	8	1	Generic			
H4564	001	0	1	18	06	H4564_001_0	8	2	Preferred Brand			
H4564	001	0	1	18	06	H4564_001_0	8	1	Preferred Generic			
H4564	001	0	1	18	06	H4564_001_0	8	3	Non-Preferred Brand or Generic			
H4564	001	0	1	18	06	H4564_001_0	8	4	Specialty			
H4564	002	0	1	18	06	H4564_002_0	8	3	Non-Preferred Brand or Generic			
H4564	002	0	1	18	06	H4564_002_0	8	1	Preferred Generic			
H4564	002	0	1	18	06	H4564_002_0	8	2	Preferred Brand			
H4564	002	0	1	18	06	H4564_002_0	8	4	Specialty			
H4564	003	0	1	18	06	H4564_003_0	8	2	Preferred Brand			
H4564	003	0	1	18	06	H4564_003_0	8	1	Preferred Generic			
H4564	003	0	1	18	06	H4564_003_0	8	3	Non-Preferred Brand or Generic			
H4564	003	0	1	18	06	H4564_003_0	8	4	Specialty			
H4564	004	0	1	18	06	H4564_004_0	8	4	Specialty	2		
H4564	004	0	1	18	06	H4564_004_0	8	3	Non-Preferred Brand or Generic	2		
H4564	004	0	1	18	06	H4564_004_0	8	2	Preferred Brand	2		
H4564	004	0	1	18	06	H4564_004_0	8	1	Preferred Generic	1		1
H4564	004	0	1	18	06	H4564_004_0	8	2	Preferred Brand			
H4564	004	0	1	18	06	H4564_004_0	8	3	Non-Preferred Brand or Generic			
H4564	004	0	1	18	06	H4564_004_0	8	4	Specialty			
H4564	004	0	1	18	06	H4564_004_0	8	1	Preferred Generic			
H4564	005	0	1	18	06	H4564_005_0	8	4	Specialty	2		
H4564	005	0	1	18	06	H4564_005_0	8	3	Non-Preferred Brand or Generic	2		
H4564	005	0	1	18	06	H4564_005_0	8	1	Preferred Generic			
H4564	005	0	1	18	06	H4564_005_0	8	2	Preferred Brand			
H4564	005	0	1	18	06	H4564_005_0	8	3	Non-Preferred Brand or Generic			
H4564	005	0	1	18	06	H4564_005_0	8	4	Specialty			
H4564	005	0	1	18	06	H4564_005_0	8	1	Preferred Generic	1		1
H4564	005	0	1	18	06	H4564_005_0	8	2	Preferred Brand	2		
H4564	006	0	1	18	06	H4564_006_0	8	1	Preferred Generic	1		1
H4564	006	0	1	18	06	H4564_006_0	8	3	Non-Preferred Brand or Generic	2		
H4564	006	0	1	18	06	H4564_006_0	8	4	Specialty	2		
H4564	006	0	1	18	06	H4564_006_0	8	2	Preferred Brand	2		
H4564	006	0	1	18	06	H4564_006_0	8	1	Preferred Generic			
H4564	006	0	1	18	06	H4564_006_0	8	2	Preferred Brand			
H4564	006	0	1	18	06	H4564_006_0	8	3	Non-Preferred Brand or Generic			
H4564	006	0	1	18	06	H4564_006_0	8	4	Specialty			
H4564	013	0	1	18	06	H4564_013_0	8	3	Non-Preferred Brand or Generic			
H4564	013	0	1	18	06	H4564_013_0	8	4	Specialty			
H4564	013	0	1	18	06	H4564_013_0	8	2	Preferred Brand			
H4564	013	0	1	18	06	H4564_013_0	8	1	Preferred Generic			
H4564	014	0	1	18	06	H4564_014_0	8	2	Preferred Brand			
H4564	014	0	1	18	06	H4564_014_0	8	3	Non-Preferred Brand or Generic			
H4564	014	0	1	18	06	H4564_014_0	8	4	Specialty			
H4564	014	0	1	18	06	H4564_014_0	8	1	Preferred Generic			
H4564	015	0	1	18	06	H4564_015_0	8	4	Specialty			
H4564	015	0	1	18	06	H4564_015_0	8	3	Non-Preferred Brand or Generic			
H4564	015	0	1	18	06	H4564_015_0	8	2	Preferred Brand			
H4564	015	0	1	18	06	H4564_015_0	8	1	Preferred Generic			
H4577	012	0	1	09	04	H4577_012_0	6	1	Tier 1			
H4577	012	0	1	09	04	H4577_012_0	6	2	Tier 2			
H4577	012	0	1	09	04	H4577_012_0	6	3	Tier 3			
H4577	012	0	1	09	04	H4577_012_0	6	4	Tier 4			
H4577	029	0	1	09	04	H4577_029_0	7	1	Tier 1			
H4577	029	0	1	09	04	H4577_029_0	7	2	Tier 2			
H4577	029	0	1	09	04	H4577_029_0	7	3	Tier 3			
H4577	029	0	1	09	04	H4577_029_0	7	4	Tier 4			
H4577	030	0	1	09	04	H4577_030_0	7	1	Tier 1			
H4577	030	0	1	09	04	H4577_030_0	7	2	Tier 2			
H4577	030	0	1	09	04	H4577_030_0	7	4	Tier 4			
H4577	030	0	1	09	04	H4577_030_0	7	3	Tier 3			
H4577	031	0	1	09	04	H4577_031_0	7	1	Tier 1			
H4577	031	0	1	09	04	H4577_031_0	7	2	Tier 2			
H4577	031	0	1	09	04	H4577_031_0	7	3	Tier 3			
H4577	031	0	1	09	04	H4577_031_0	7	4	Tier 4			
H4577	032	0	1	09	04	H4577_032_0	7	1	Tier 1			
H4577	032	0	1	09	04	H4577_032_0	7	3	Tier 3			
H4577	032	0	1	09	04	H4577_032_0	7	2	Tier 2			
H4577	032	0	1	09	04	H4577_032_0	7	4	Tier 4			
H4590	010	0	1	01	01	H4590_010_0	9	3	Non Preferred			
H4590	010	0	1	01	01	H4590_010_0	9	2	Preferred Brand			
H4590	010	0	1	01	01	H4590_010_0	9	1	Preferred Generic			
H4590	010	0	1	01	01	H4590_010_0	9	4	Specialty			
H4590	010	0	1	01	01	H4590_010_0	9	1	Preferred Generic	1		1
H4590	010	0	1	01	01	H4590_010_0	9	2	Preferred Brand	2		
H4590	010	0	1	01	01	H4590_010_0	9	3	Non Preferred	2		
H4590	010	0	1	01	01	H4590_010_0	9	4	Specialty	2		
H4590	012	0	1	01	01	H4590_012_0	7	3	Non Preferred			
H4590	012	0	1	01	01	H4590_012_0	7	2	Preferred Brand			
H4590	012	0	1	01	01	H4590_012_0	7	1	Preferred Generic			
H4590	012	0	1	01	01	H4590_012_0	7	4	Specialty			
H4590	012	0	1	01	01	H4590_012_0	7	4	Specialty	2		
H4590	012	0	1	01	01	H4590_012_0	7	3	Non Preferred	2		
H4590	012	0	1	01	01	H4590_012_0	7	2	Preferred Brand	2		
H4590	012	0	1	01	01	H4590_012_0	7	1	Preferred Generic	1		1
H4590	025	0	1	01	01	H4590_025_0	7	1	Preferred Generic			
H4590	025	0	1	01	01	H4590_025_0	7	2	Preferred Brand			
H4590	025	0	1	01	01	H4590_025_0	7	3	Non Preferred			
H4590	025	0	1	01	01	H4590_025_0	7	4	Specialty			
H4590	031	0	1	01	01	H4590_031_0	5	3	Non Preferred			
H4590	031	0	1	01	01	H4590_031_0	5	2	Preferred Brand			
H4590	031	0	1	01	01	H4590_031_0	5	1	Preferred Generic			
H4590	031	0	1	01	01	H4590_031_0	5	4	Specialty			
H4590	034	0	1	01	01	H4590_034_0	6	1	Preferred Generic			
H4590	034	0	1	01	01	H4590_034_0	6	2	Preferred Brand			
H4590	034	0	1	01	01	H4590_034_0	6	4	Specialty			
H4590	034	0	1	01	01	H4590_034_0	6	3	Non Preferred			
H4590	035	0	1	01	01	H4590_035_0	6	3	Non Preferred			
H4590	035	0	1	01	01	H4590_035_0	6	2	Preferred Brand			
H4590	035	0	1	01	01	H4590_035_0	6	1	Preferred Generic			
H4590	035	0	1	01	01	H4590_035_0	6	4	Specialty			
H4590	035	0	1	01	01	H4590_035_0	6	1	Preferred Generic	1		1
H4590	035	0	1	01	01	H4590_035_0	6	2	Preferred Brand	2		
H4590	035	0	1	01	01	H4590_035_0	6	3	Non Preferred	2		
H4590	035	0	1	01	01	H4590_035_0	6	4	Specialty	2		
H4590	036	0	1	01	01	H4590_036_0	7	3	Non Preferred			
H4590	036	0	1	01	01	H4590_036_0	7	2	Preferred Brand			
H4590	036	0	1	01	01	H4590_036_0	7	1	Preferred Generic			
H4590	036	0	1	01	01	H4590_036_0	7	4	Specialty			
H4590	036	0	1	01	01	H4590_036_0	7	4	Specialty	2		
H4590	036	0	1	01	01	H4590_036_0	7	3	Non Preferred	2		
H4590	036	0	1	01	01	H4590_036_0	7	2	Preferred Brand	2		
H4590	036	0	1	01	01	H4590_036_0	7	1	Preferred Generic	1		1
H4590	037	0	1	01	01	H4590_037_0	5	1	Preferred Generic			
H4590	037	0	1	01	01	H4590_037_0	5	2	Preferred Brand			
H4590	037	0	1	01	01	H4590_037_0	5	3	Non Preferred			
H4590	037	0	1	01	01	H4590_037_0	5	2	Preferred Brand	2		
H4590	037	0	1	01	01	H4590_037_0	5	3	Non Preferred	2		
H4590	037	0	1	01	01	H4590_037_0	5	1	Preferred Generic	1		1
H4590	037	0	1	01	01	H4590_037_0	5	4	Specialty			
H4590	037	0	1	01	01	H4590_037_0	5	4	Specialty	2		
H4604	003	0	1	02	01	H4604_003_0	3	4	Specialty			
H4604	003	0	1	02	01	H4604_003_0	3	3	Non Preferred			
H4604	003	0	1	02	01	H4604_003_0	3	1	Preferred Generic			
H4604	003	0	1	02	01	H4604_003_0	3	2	Preferred Brand			
H4604	007	0	1	02	01	H4604_007_0	3	1	Preferred Generic			
H4604	007	0	1	02	01	H4604_007_0	3	4	Specialty			
H4604	007	0	1	02	01	H4604_007_0	3	3	Non Preferred			
H4604	007	0	1	02	01	H4604_007_0	3	2	Preferred Brand			
H4604	008	0	1	02	01	H4604_008_0	3	2	Preferred Brand			
H4604	008	0	1	02	01	H4604_008_0	3	3	Non Preferred			
H4604	008	0	1	02	01	H4604_008_0	3	1	Preferred Generic			
H4604	008	0	1	02	01	H4604_008_0	3	4	Specialty			
H4604	009	0	1	02	01	H4604_009_0	3	4	Specialty			
H4604	009	0	1	02	01	H4604_009_0	3	3	Non Preferred			
H4604	009	0	1	02	01	H4604_009_0	3	2	Preferred Brand			
H4604	009	0	1	02	01	H4604_009_0	3	1	Preferred Generic			
H4605	002	0	1	04	01	H4605_002_0	6	1	Generic			
H4605	002	0	1	04	01	H4605_002_0	6	2	Preferred Brand			
H4605	002	0	1	04	01	H4605_002_0	6	3	Non-Preferred Brand			
H4605	002	0	1	04	01	H4605_002_0	6	4	Miscellaneous Injectables			
H4605	002	0	1	04	01	H4605_002_0	6	5	Specialty Medications			
H4605	004	0	1	04	01	H4605_004_0	7	4	Miscellaneous Injectables			
H4605	004	0	1	04	01	H4605_004_0	7	3	Non-Preferred Brand			
H4605	004	0	1	04	01	H4605_004_0	7	2	Preferred Brand			
H4605	004	0	1	04	01	H4605_004_0	7	1	Generic			
H4605	004	0	1	04	01	H4605_004_0	7	5	Specialty Medications			
H4605	004	0	1	04	01	H4605_004_0	7	5	Specialty Medications	2		
H4605	004	0	1	04	01	H4605_004_0	7	4	Miscellaneous Injectables	2		
H4605	004	0	1	04	01	H4605_004_0	7	3	Non-Preferred Brand	2		
H4605	004	0	1	04	01	H4605_004_0	7	2	Preferred Brand	2		
H4605	004	0	1	04	01	H4605_004_0	7	1	Generic	1		1
H4605	006	0	1	04	01	H4605_006_0	5	1	Generic			
H4605	006	0	1	04	01	H4605_006_0	5	2	Preferred Brand			
H4605	006	0	1	04	01	H4605_006_0	5	3	Non-Preferred Brand			
H4605	006	0	1	04	01	H4605_006_0	5	4	Miscellaneous Injectables			
H4605	006	0	1	04	01	H4605_006_0	5	5	Specialty Medications			
H4606	001	0	1	04	01	H4606_001_0	7	1	Preferred Generic	1	00001000	2
H4606	001	0	1	04	01	H4606_001_0	7	2	Preferred Brand	1	10000000	2
H4606	001	0	1	04	01	H4606_001_0	7	3	Non-Preferred Brand	1	10000000	2
H4606	001	0	1	04	01	H4606_001_0	7	4	Specialty	1	10001000	2
H4606	001	0	1	04	01	H4606_001_0	7	4	Specialty			
H4606	001	0	1	04	01	H4606_001_0	7	3	Non-Preferred Brand			
H4606	001	0	1	04	01	H4606_001_0	7	2	Preferred Brand			
H4606	001	0	1	04	01	H4606_001_0	7	1	Preferred Generic			
H4606	004	0	1	04	01	H4606_004_0	5	2	Preferred Brand			
H4606	004	0	1	04	01	H4606_004_0	5	1	Preferred Generic			
H4606	004	0	1	04	01	H4606_004_0	5	4	Specialty	1	10001000	2
H4606	004	0	1	04	01	H4606_004_0	5	3	Non-Preferred Brand	1	10000000	2
H4606	004	0	1	04	01	H4606_004_0	5	2	Preferred Brand	1	10000000	2
H4606	004	0	1	04	01	H4606_004_0	5	1	Preferred Generic	1		1
H4606	004	0	1	04	01	H4606_004_0	5	4	Specialty			
H4606	004	0	1	04	01	H4606_004_0	5	3	Non-Preferred Brand			
H4720	001	0	1	09	04	H4720_001_0	7	1	Preferred Generic			
H4720	001	0	1	09	04	H4720_001_0	7	2	Preferred Brand			
H4720	001	0	1	09	04	H4720_001_0	7	3	Non-Preferred			
H4720	001	0	1	09	04	H4720_001_0	7	4	Specialty			
H4779	001	0	1	37	05	H4779_001_0	4	4	Specialty			
H4779	001	0	1	37	05	H4779_001_0	4	3	Non Preferred			
H4779	001	0	1	37	05	H4779_001_0	4	1	Preferred Generic			
H4779	001	0	1	37	05	H4779_001_0	4	2	Preferred Brand			
H4779	003	0	1	37	05	H4779_003_0	5	2	Preferred Brand			
H4779	003	0	1	37	05	H4779_003_0	5	3	Non Preferred			
H4779	003	0	1	37	05	H4779_003_0	5	1	Preferred Generic			
H4779	003	0	1	37	05	H4779_003_0	5	4	Specialty			
H4781	001	0	1	04	01	H4781_001_0	7	2	Tier 2 - Non-Preferred Generic			
H4781	001	0	1	04	01	H4781_001_0	7	1	Tier 1 - Preferred Generic			
H4781	001	0	1	04	01	H4781_001_0	7	3	Tier 3 - Preferred Brand			
H4781	001	0	1	04	01	H4781_001_0	7	5	Tier 5 - Specialty			
H4781	001	0	1	04	01	H4781_001_0	7	4	Tier 4 - Non-Preferred Brand			
H4781	002	0	1	04	01	H4781_002_0	7	1	Tier 1 - Preferred Generic			
H4781	002	0	1	04	01	H4781_002_0	7	2	Tier 2 - Non-Preferred Generic			
H4781	002	0	1	04	01	H4781_002_0	7	4	Tier 4 - Non-Preferred Brand			
H4781	002	0	1	04	01	H4781_002_0	7	3	Tier 3 - Preferred Brand			
H4781	002	0	1	04	01	H4781_002_0	7	5	Tier 5 - Specialty			
H4836	002	0	1	09	04	H4836_002_0	10	1	Generic			
H4836	002	0	1	09	04	H4836_002_0	10	4	Specialty			
H4836	002	0	1	09	04	H4836_002_0	10	3	Non-Preferred Brand			
H4836	002	0	1	09	04	H4836_002_0	10	2	Preferred Brand			
H4908	002	0	1	04	01	H4908_002_0	4	3	Non-Preferred Brand			
H4908	002	0	1	04	01	H4908_002_0	4	4	Specialty			
H4908	002	0	1	04	01	H4908_002_0	4	1	Generic			
H4908	002	0	1	04	01	H4908_002_0	4	2	Preferred Brand			
H4908	006	0	1	04	01	H4908_006_0	5	4	Specialty			
H4908	006	0	1	04	01	H4908_006_0	5	3	Non-Preferred Brand			
H4908	006	0	1	04	01	H4908_006_0	5	2	Preferred Brand			
H4908	006	0	1	04	01	H4908_006_0	5	1	Generic			
H4909	001	0	1	04	01	H4909_001_0	12	4	Tier 4 Non-Specialty Injectable	2		
H4909	001	0	1	04	01	H4909_001_0	12	3	Tier 3 Non-Preferred Brand or Generic	2		
H4909	001	0	1	04	01	H4909_001_0	12	2	Tier 2 Preferred Brand	2		
H4909	001	0	1	04	01	H4909_001_0	12	1	Tier 1 Preferred Generic	1		1
H4909	001	0	1	04	01	H4909_001_0	12	5	Tier 5 Specialty			
H4909	001	0	1	04	01	H4909_001_0	12	4	Tier 4 Non-Specialty Injectable			
H4909	001	0	1	04	01	H4909_001_0	12	3	Tier 3 Non-Preferred Brand or Generic			
H4909	001	0	1	04	01	H4909_001_0	12	2	Tier 2 Preferred Brand			
H4909	001	0	1	04	01	H4909_001_0	12	5	Tier 5 Specialty	2		
H4909	001	0	1	04	01	H4909_001_0	12	1	Tier 1 Preferred Generic			
H4909	004	0	1	04	01	H4909_004_0	13	3	Tier 3 Non-Preferred Brand or Generic			
H4909	004	0	1	04	01	H4909_004_0	13	2	Tier 2 Preferred Brand			
H4909	004	0	1	04	01	H4909_004_0	13	1	Tier 1 Preferred Generic			
H4909	004	0	1	04	01	H4909_004_0	13	4	Tier 4 Non-Specialty Injectable			
H4909	004	0	1	04	01	H4909_004_0	13	5	Tier 5 Specialty	2		
H4909	004	0	1	04	01	H4909_004_0	13	4	Tier 4 Non-Specialty Injectable	2		
H4909	004	0	1	04	01	H4909_004_0	13	3	Tier 3 Non-Preferred Brand or Generic	2		
H4909	004	0	1	04	01	H4909_004_0	13	2	Tier 2 Preferred Brand	2		
H4909	004	0	1	04	01	H4909_004_0	13	1	Tier 1 Preferred Generic	1		1
H4909	004	0	1	04	01	H4909_004_0	13	5	Tier 5 Specialty			
H4910	002	0	1	01	01	H4910_002_0	5	3	Tier 3 - Preferred Brand	2		
H4910	002	0	1	01	01	H4910_002_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H4910	002	0	1	01	01	H4910_002_0	5	1	Tier 1 - Preferred Generic	1		1
H4910	002	0	1	01	01	H4910_002_0	5	5	Tier 5 - Specialty			
H4910	002	0	1	01	01	H4910_002_0	5	4	Tier 4 - Non-Preferred Brand			
H4910	002	0	1	01	01	H4910_002_0	5	5	Tier 5 - Specialty	2		
H4910	002	0	1	01	01	H4910_002_0	5	4	Tier 4 - Non-Preferred Brand	2		
H4910	002	0	1	01	01	H4910_002_0	5	1	Tier 1 - Preferred Generic			
H4910	002	0	1	01	01	H4910_002_0	5	2	Tier 2 - Non-Preferred Generic			
H4910	002	0	1	01	01	H4910_002_0	5	3	Tier 3 - Preferred Brand			
H4910	004	0	1	01	01	H4910_004_0	6	1	Tier 1 - Preferred Generic			
H4910	004	0	1	01	01	H4910_004_0	6	2	Tier 2 - Non-Preferred Generic			
H4910	004	0	1	01	01	H4910_004_0	6	3	Tier 3 - Preferred Brand			
H4910	004	0	1	01	01	H4910_004_0	6	4	Tier 4 - Non-Preferred Brand			
H4910	004	0	1	01	01	H4910_004_0	6	5	Tier 5 - Specialty			
H4910	005	0	1	01	01	H4910_005_0	6	4	Tier 4 - Non-Preferred Brand			
H4910	005	0	1	01	01	H4910_005_0	6	5	Tier 5 - Specialty			
H4910	005	0	1	01	01	H4910_005_0	6	3	Tier 3 - Preferred Brand			
H4910	005	0	1	01	01	H4910_005_0	6	2	Tier 2 - Non-Preferred Generic			
H4910	005	0	1	01	01	H4910_005_0	6	1	Tier 1 - Preferred Generic			
H4911	002	0	1	04	01	H4911_002_0	6	5	Tier 5 - Specialty	2		
H4911	002	0	1	04	01	H4911_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4911	002	0	1	04	01	H4911_002_0	6	1	Tier 1 - Preferred Generic			
H4911	002	0	1	04	01	H4911_002_0	6	2	Tier 2 - Non-Preferred Generic			
H4911	002	0	1	04	01	H4911_002_0	6	3	Tier 3 - Preferred Brand			
H4911	002	0	1	04	01	H4911_002_0	6	4	Tier 4 - Non-Preferred Brand			
H4911	002	0	1	04	01	H4911_002_0	6	3	Tier 3 - Preferred Brand	2		
H4911	002	0	1	04	01	H4911_002_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H4911	002	0	1	04	01	H4911_002_0	6	1	Tier 1 - Preferred Generic	1		1
H4911	002	0	1	04	01	H4911_002_0	6	5	Tier 5 - Specialty			
H4911	003	0	1	04	01	H4911_003_0	7	4	Tier 4 - Non-Preferred Brand			
H4911	003	0	1	04	01	H4911_003_0	7	3	Tier 3 - Preferred Brand			
H4911	003	0	1	04	01	H4911_003_0	7	2	Tier 2 - Non-Preferred Generic			
H4911	003	0	1	04	01	H4911_003_0	7	1	Tier 1 - Preferred Generic			
H4911	003	0	1	04	01	H4911_003_0	7	5	Tier 5 - Specialty			
H4917	001	0	1	09	04	H4917_001_0	11	5	Specialty Injectibles	2		
H4917	001	0	1	09	04	H4917_001_0	11	1	Generic			
H4917	001	0	1	09	04	H4917_001_0	11	2	Preferred Brand			
H4917	001	0	1	09	04	H4917_001_0	11	3	Non-Preferred Brand			
H4917	001	0	1	09	04	H4917_001_0	11	4	Non-Specialty Injectibles			
H4917	001	0	1	09	04	H4917_001_0	11	5	Specialty Injectibles			
H4917	001	0	1	09	04	H4917_001_0	11	1	Generic	1		1
H4917	001	0	1	09	04	H4917_001_0	11	2	Preferred Brand	2		
H4917	001	0	1	09	04	H4917_001_0	11	3	Non-Preferred Brand	2		
H4917	001	0	1	09	04	H4917_001_0	11	4	Non-Specialty Injectibles	2		
H4917	002	0	1	09	04	H4917_002_0	10	1	Generic			
H4917	002	0	1	09	04	H4917_002_0	10	2	Preferred Brand			
H4917	002	0	1	09	04	H4917_002_0	10	3	Non-Preferred Brand			
H4917	002	0	1	09	04	H4917_002_0	10	4	Non-Specialty Injectibles			
H4917	002	0	1	09	04	H4917_002_0	10	5	Specialty Injectibles	2		
H4917	002	0	1	09	04	H4917_002_0	10	1	Generic	1		1
H4917	002	0	1	09	04	H4917_002_0	10	2	Preferred Brand	2		
H4917	002	0	1	09	04	H4917_002_0	10	3	Non-Preferred Brand	2		
H4917	002	0	1	09	04	H4917_002_0	10	4	Non-Specialty Injectibles	2		
H4917	002	0	1	09	04	H4917_002_0	10	5	Specialty Injectibles			
H4956	001	0	1	04	01	H4956_001_0	5	1	Preferred Generic			
H4956	001	0	1	04	01	H4956_001_0	5	4	Specialty	1	10001000	2
H4956	001	0	1	04	01	H4956_001_0	5	3	Non-Preferred Brand	1	10000000	2
H4956	001	0	1	04	01	H4956_001_0	5	2	Preferred Brand	1	10000000	2
H4956	001	0	1	04	01	H4956_001_0	5	1	Preferred Generic	1	00001000	2
H4956	001	0	1	04	01	H4956_001_0	5	4	Specialty			
H4956	001	0	1	04	01	H4956_001_0	5	3	Non-Preferred Brand			
H4956	001	0	1	04	01	H4956_001_0	5	2	Preferred Brand			
H4956	002	0	1	04	01	H4956_002_0	4	4	Specialty			
H4956	002	0	1	04	01	H4956_002_0	4	1	Preferred Generic	1	00001000	2
H4956	002	0	1	04	01	H4956_002_0	4	2	Preferred Brand	1	10000000	2
H4956	002	0	1	04	01	H4956_002_0	4	3	Non-Preferred Brand	1	10000000	2
H4956	002	0	1	04	01	H4956_002_0	4	3	Non-Preferred Brand			
H4956	002	0	1	04	01	H4956_002_0	4	2	Preferred Brand			
H4956	002	0	1	04	01	H4956_002_0	4	4	Specialty	1	10001000	2
H4956	002	0	1	04	01	H4956_002_0	4	1	Preferred Generic			
H4971	001	0	1	02	01	H4971_001_0	5	4	Specialty			
H4971	001	0	1	02	01	H4971_001_0	5	2	Preferred Brand			
H4971	001	0	1	02	01	H4971_001_0	5	3	Non-Preferred			
H4971	001	0	1	02	01	H4971_001_0	5	1	Preferred Generic			
H5005	001	0	1	01	01	H5005_001_0	5	3	Non Preferred			
H5005	001	0	1	01	01	H5005_001_0	5	4	Specialty			
H5005	001	0	1	01	01	H5005_001_0	5	2	Preferred Brand			
H5005	001	0	1	01	01	H5005_001_0	5	1	Preferred Generic			
H5005	010	0	1	01	01	H5005_010_0	5	1	Preferred Generic			
H5005	010	0	1	01	01	H5005_010_0	5	4	Specialty			
H5005	010	0	1	01	01	H5005_010_0	5	3	Non Preferred			
H5005	010	0	1	01	01	H5005_010_0	5	2	Preferred Brand			
H5005	011	0	1	01	01	H5005_011_0	5	3	Non Preferred			
H5005	011	0	1	01	01	H5005_011_0	5	1	Preferred Generic			
H5005	011	0	1	01	01	H5005_011_0	5	2	Preferred Brand			
H5005	011	0	1	01	01	H5005_011_0	5	4	Specialty			
H5005	019	0	1	01	01	H5005_019_0	5	1	Preferred Generic			
H5005	019	0	1	01	01	H5005_019_0	5	4	Specialty			
H5005	019	0	1	01	01	H5005_019_0	5	2	Preferred Brand			
H5005	019	0	1	01	01	H5005_019_0	5	3	Non Preferred			
H5005	024	0	1	01	01	H5005_024_0	5	2	Preferred Brand	2		
H5005	024	0	1	01	01	H5005_024_0	5	3	Non Preferred	2		
H5005	024	0	1	01	01	H5005_024_0	5	4	Specialty	2		
H5005	024	0	1	01	01	H5005_024_0	5	1	Preferred Generic			
H5005	024	0	1	01	01	H5005_024_0	5	2	Preferred Brand			
H5005	024	0	1	01	01	H5005_024_0	5	1	Preferred Generic	1		1
H5005	024	0	1	01	01	H5005_024_0	5	4	Specialty			
H5005	024	0	1	01	01	H5005_024_0	5	3	Non Preferred			
H5006	016	1	1	09	04	H5006_016_1	3	4	Specialty			
H5006	016	1	1	09	04	H5006_016_1	3	3	Non-Preferred Brand			
H5006	016	1	1	09	04	H5006_016_1	3	1	Generic			
H5006	016	1	1	09	04	H5006_016_1	3	2	Preferred Brand			
H5006	016	2	1	09	04	H5006_016_2	3	1	Generic			
H5006	016	2	1	09	04	H5006_016_2	3	2	Preferred Brand			
H5006	016	2	1	09	04	H5006_016_2	3	3	Non-Preferred Brand			
H5006	016	2	1	09	04	H5006_016_2	3	4	Specialty			
H5006	016	3	1	09	04	H5006_016_3	3	4	Specialty			
H5006	016	3	1	09	04	H5006_016_3	3	3	Non-Preferred Brand			
H5006	016	3	1	09	04	H5006_016_3	3	2	Preferred Brand			
H5006	016	3	1	09	04	H5006_016_3	3	1	Generic			
H5006	017	1	1	09	04	H5006_017_1	3	4	Specialty			
H5006	017	1	1	09	04	H5006_017_1	3	3	Non-Preferred Brand			
H5006	017	1	1	09	04	H5006_017_1	3	2	Preferred Brand			
H5006	017	1	1	09	04	H5006_017_1	3	1	Generic			
H5006	017	2	1	09	04	H5006_017_2	3	1	Generic			
H5006	017	2	1	09	04	H5006_017_2	3	4	Specialty			
H5006	017	2	1	09	04	H5006_017_2	3	3	Non-Preferred Brand			
H5006	017	2	1	09	04	H5006_017_2	3	2	Preferred Brand			
H5006	017	3	1	09	04	H5006_017_3	4	1	Generic			
H5006	017	3	1	09	04	H5006_017_3	4	4	Specialty			
H5006	017	3	1	09	04	H5006_017_3	4	3	Non-Preferred Brand			
H5006	017	3	1	09	04	H5006_017_3	4	2	Preferred Brand			
H5008	001	0	1	01	01	H5008_001_0	8	1	Preferred Generic			
H5008	001	0	1	01	01	H5008_001_0	8	2	Preferred Brand			
H5008	001	0	1	01	01	H5008_001_0	8	3	Non Preferred			
H5008	001	0	1	01	01	H5008_001_0	8	4	Specialty			
H5008	004	0	1	01	01	H5008_004_0	4	4	Specialty			
H5008	004	0	1	01	01	H5008_004_0	4	1	Preferred Generic			
H5008	004	0	1	01	01	H5008_004_0	4	2	Preferred Brand			
H5008	004	0	1	01	01	H5008_004_0	4	3	Non Preferred			
H5008	005	0	1	01	01	H5008_005_0	5	4	Specialty			
H5008	005	0	1	01	01	H5008_005_0	5	1	Preferred Generic			
H5008	005	0	1	01	01	H5008_005_0	5	2	Preferred Brand			
H5008	005	0	1	01	01	H5008_005_0	5	3	Non Preferred			
H5008	006	0	1	01	01	H5008_006_0	4	1	Preferred Generic			
H5008	006	0	1	01	01	H5008_006_0	4	2	Preferred Brand			
H5008	006	0	1	01	01	H5008_006_0	4	3	Non Preferred			
H5008	006	0	1	01	01	H5008_006_0	4	4	Specialty			
H5009	002	0	1	04	01	H5009_002_0	7	3	Non-Preferred Brand			
H5009	002	0	1	04	01	H5009_002_0	7	4	Miscellaneous Injectables			
H5009	002	0	1	04	01	H5009_002_0	7	5	Specialty Medications			
H5009	002	0	1	04	01	H5009_002_0	7	1	Generic			
H5009	002	0	1	04	01	H5009_002_0	7	2	Preferred Brand			
H5009	004	0	1	04	01	H5009_004_0	6	1	Generic			
H5009	004	0	1	04	01	H5009_004_0	6	2	Preferred Brand			
H5009	004	0	1	04	01	H5009_004_0	6	5	Specialty Medications	2		
H5009	004	0	1	04	01	H5009_004_0	6	4	Miscellaneous Injectables	2		
H5009	004	0	1	04	01	H5009_004_0	6	3	Non-Preferred Brand	2		
H5009	004	0	1	04	01	H5009_004_0	6	2	Preferred Brand	2		
H5009	004	0	1	04	01	H5009_004_0	6	3	Non-Preferred Brand			
H5009	004	0	1	04	01	H5009_004_0	6	4	Miscellaneous Injectables			
H5009	004	0	1	04	01	H5009_004_0	6	5	Specialty Medications			
H5009	004	0	1	04	01	H5009_004_0	6	1	Generic	1		1
H5009	006	0	1	04	01	H5009_006_0	5	4	Miscellaneous Injectables			
H5009	006	0	1	04	01	H5009_006_0	5	3	Non-Preferred Brand			
H5009	006	0	1	04	01	H5009_006_0	5	2	Preferred Brand			
H5009	006	0	1	04	01	H5009_006_0	5	1	Generic			
H5009	006	0	1	04	01	H5009_006_0	5	5	Specialty Medications			
H5010	002	0	1	04	01	H5010_002_0	7	2	Preferred Brand			
H5010	002	0	1	04	01	H5010_002_0	7	5	Specialty Medications			
H5010	002	0	1	04	01	H5010_002_0	7	4	Miscellaneous Injectables			
H5010	002	0	1	04	01	H5010_002_0	7	3	Non-Preferred Brand			
H5010	002	0	1	04	01	H5010_002_0	7	1	Generic			
H5010	004	0	1	04	01	H5010_004_0	8	2	Preferred Brand	2		
H5010	004	0	1	04	01	H5010_004_0	8	3	Non-Preferred Brand	2		
H5010	004	0	1	04	01	H5010_004_0	8	4	Miscellaneous Injectables	2		
H5010	004	0	1	04	01	H5010_004_0	8	5	Specialty Medications	2		
H5010	004	0	1	04	01	H5010_004_0	8	5	Specialty Medications			
H5010	004	0	1	04	01	H5010_004_0	8	4	Miscellaneous Injectables			
H5010	004	0	1	04	01	H5010_004_0	8	3	Non-Preferred Brand			
H5010	004	0	1	04	01	H5010_004_0	8	2	Preferred Brand			
H5010	004	0	1	04	01	H5010_004_0	8	1	Generic			
H5010	004	0	1	04	01	H5010_004_0	8	1	Generic	1		1
H5010	006	0	1	04	01	H5010_006_0	5	2	Preferred Brand			
H5010	006	0	1	04	01	H5010_006_0	5	3	Non-Preferred Brand			
H5010	006	0	1	04	01	H5010_006_0	5	4	Miscellaneous Injectables			
H5010	006	0	1	04	01	H5010_006_0	5	5	Specialty Medications			
H5010	006	0	1	04	01	H5010_006_0	5	1	Generic			
H5031	001	0	1	04	01	H5031_001_0	6	1	Generic			
H5031	001	0	1	04	01	H5031_001_0	6	4	Specialty			
H5031	001	0	1	04	01	H5031_001_0	6	3	Non-Preferred Brand			
H5031	001	0	1	04	01	H5031_001_0	6	2	Preferred Brand			
H5041	001	0	1	04	01	H5041_001_0	6	2	Preferred Brand			
H5041	001	0	1	04	01	H5041_001_0	6	1	Preferred Generic			
H5041	001	0	1	04	01	H5041_001_0	6	4	Specialty	1	10001000	2
H5041	001	0	1	04	01	H5041_001_0	6	3	Non-Preferred Brand	1	10000000	2
H5041	001	0	1	04	01	H5041_001_0	6	2	Preferred Brand	1	10000000	2
H5041	001	0	1	04	01	H5041_001_0	6	1	Preferred Generic	1	00001000	2
H5041	001	0	1	04	01	H5041_001_0	6	4	Specialty			
H5041	001	0	1	04	01	H5041_001_0	6	3	Non-Preferred Brand			
H5042	001	0	1	04	01	H5042_001_0	8	3	Tier 3 Formulary Preferred Brand	2		
H5042	001	0	1	04	01	H5042_001_0	8	4	Tier 4 Formulary Preferred Brand Diagnostic	2		
H5042	001	0	1	04	01	H5042_001_0	8	2	Tier 2 Formulary Generics	1		1
H5042	001	0	1	04	01	H5042_001_0	8	1	Tier 1 Formulary Value Generics	1		1
H5042	001	0	1	04	01	H5042_001_0	8	6	Tier 6 Formulary Specialty			
H5042	001	0	1	04	01	H5042_001_0	8	5	Tier 5 Formulary Non-Preferred Brand			
H5042	001	0	1	04	01	H5042_001_0	8	4	Tier 4 Formulary Preferred Brand Diagnostic			
H5042	001	0	1	04	01	H5042_001_0	8	3	Tier 3 Formulary Preferred Brand			
H5042	001	0	1	04	01	H5042_001_0	8	2	Tier 2 Formulary Generics			
H5042	001	0	1	04	01	H5042_001_0	8	1	Tier 1 Formulary Value Generics			
H5042	001	0	1	04	01	H5042_001_0	8	5	Tier 5 Formulary Non-Preferred Brand	2		
H5042	001	0	1	04	01	H5042_001_0	8	6	Tier 6 Formulary Specialty	2		
H5042	005	0	1	04	01	H5042_005_0	8	5	Tier 5 Formulary Non-Preferred Brand			
H5042	005	0	1	04	01	H5042_005_0	8	4	Tier 4 Formulary Preferred Brand Diagnostic			
H5042	005	0	1	04	01	H5042_005_0	8	3	Tier 3 Formulary Preferred Brand			
H5042	005	0	1	04	01	H5042_005_0	8	2	Tier 2 Formulary Generics			
H5042	005	0	1	04	01	H5042_005_0	8	1	Tier 1 Formulary Value Generics			
H5042	005	0	1	04	01	H5042_005_0	8	6	Tier 6 Formulary Specialty			
H5042	007	0	1	04	01	H5042_007_0	8	1	Tier 1 Formulary Value Generics	1		1
H5042	007	0	1	04	01	H5042_007_0	8	2	Tier 2 Formulary Generics	1		1
H5042	007	0	1	04	01	H5042_007_0	8	3	Tier 3 Formulary Preferred Brand	2		
H5042	007	0	1	04	01	H5042_007_0	8	4	Tier 4 Formulary Preferred Brand Diagnostic	2		
H5042	007	0	1	04	01	H5042_007_0	8	5	Tier 5 Formulary Non-Preferred Brand	2		
H5042	007	0	1	04	01	H5042_007_0	8	6	Tier 6 Formulary Specialty			
H5042	007	0	1	04	01	H5042_007_0	8	5	Tier 5 Formulary Non-Preferred Brand			
H5042	007	0	1	04	01	H5042_007_0	8	4	Tier 4 Formulary Preferred Brand Diagnostic			
H5042	007	0	1	04	01	H5042_007_0	8	6	Tier 6 Formulary Specialty	2		
H5042	007	0	1	04	01	H5042_007_0	8	2	Tier 2 Formulary Generics			
H5042	007	0	1	04	01	H5042_007_0	8	1	Tier 1 Formulary Value Generics			
H5042	007	0	1	04	01	H5042_007_0	8	3	Tier 3 Formulary Preferred Brand			
H5050	004	0	1	01	01	H5050_004_0	6	2	Preferred Brand			
H5050	004	0	1	01	01	H5050_004_0	6	1	Preferred Generic			
H5050	004	0	1	01	01	H5050_004_0	6	3	Non-Preferred			
H5050	009	0	1	01	01	H5050_009_0	6	2	Preferred Brand			
H5050	009	0	1	01	01	H5050_009_0	6	1	Preferred Generic			
H5050	009	0	1	01	01	H5050_009_0	6	3	Non-Preferred			
H5050	012	0	1	01	01	H5050_012_0	6	1	Preferred Generic			
H5050	012	0	1	01	01	H5050_012_0	6	2	Preferred Brand			
H5050	012	0	1	01	01	H5050_012_0	6	3	Non-Preferred			
H5050	012	0	1	01	01	H5050_012_0	6	1	Preferred Generic	1		1
H5050	012	0	1	01	01	H5050_012_0	6	2	Preferred Brand	2		
H5050	012	0	1	01	01	H5050_012_0	6	3	Non-Preferred	2		
H5087	001	0	1	01	01	H5087_001_0	12	2	Preferred Brand			
H5087	001	0	1	01	01	H5087_001_0	12	1	Preferred Generic			
H5087	001	0	1	01	01	H5087_001_0	12	4	Specialty Drugs	2		
H5087	001	0	1	01	01	H5087_001_0	12	3	Non-Preferred Drugs	2		
H5087	001	0	1	01	01	H5087_001_0	12	2	Preferred Brand	2		
H5087	001	0	1	01	01	H5087_001_0	12	1	Preferred Generic	1		1
H5087	001	0	1	01	01	H5087_001_0	12	4	Specialty Drugs			
H5087	001	0	1	01	01	H5087_001_0	12	3	Non-Preferred Drugs			
H5087	002	0	1	01	01	H5087_002_0	11	2	Preferred Brand			
H5087	002	0	1	01	01	H5087_002_0	11	1	Preferred Generic			
H5087	002	0	1	01	01	H5087_002_0	11	4	Specialty Drugs			
H5087	002	0	1	01	01	H5087_002_0	11	1	Preferred Generic	1		1
H5087	002	0	1	01	01	H5087_002_0	11	2	Preferred Brand	2		
H5087	002	0	1	01	01	H5087_002_0	11	3	Non-Preferred Drugs	2		
H5087	002	0	1	01	01	H5087_002_0	11	4	Specialty Drugs	2		
H5087	002	0	1	01	01	H5087_002_0	11	3	Non-Preferred Drugs			
H5087	005	0	1	01	01	H5087_005_0	14	2	Preferred Brand			
H5087	005	0	1	01	01	H5087_005_0	14	1	Preferred Generic			
H5087	005	0	1	01	01	H5087_005_0	14	4	Specialty Drugs	2		
H5087	005	0	1	01	01	H5087_005_0	14	3	Non-Preferred Drugs	2		
H5087	005	0	1	01	01	H5087_005_0	14	2	Preferred Brand	1		1
H5087	005	0	1	01	01	H5087_005_0	14	3	Non-Preferred Drugs			
H5087	005	0	1	01	01	H5087_005_0	14	4	Specialty Drugs			
H5087	005	0	1	01	01	H5087_005_0	14	1	Preferred Generic	1		1
H5106	013	0	1	04	01	H5106_013_0	7	1	Generic			
H5106	013	0	1	04	01	H5106_013_0	7	2	Preferred Brand			
H5106	013	0	1	04	01	H5106_013_0	7	4	Specialty			
H5106	013	0	1	04	01	H5106_013_0	7	3	Non-Preferred Brand			
H5106	014	0	1	04	01	H5106_014_0	7	1	Generic			
H5106	014	0	1	04	01	H5106_014_0	7	3	Non-Preferred Brand			
H5106	014	0	1	04	01	H5106_014_0	7	2	Preferred Brand			
H5106	014	0	1	04	01	H5106_014_0	7	4	Specialty			
H5106	014	0	1	04	01	H5106_014_0	7	1	Generic	1		1
H5106	014	0	1	04	01	H5106_014_0	7	2	Preferred Brand	2		
H5106	014	0	1	04	01	H5106_014_0	7	3	Non-Preferred Brand	2		
H5106	014	0	1	04	01	H5106_014_0	7	4	Specialty	2		
H5106	015	0	1	04	01	H5106_015_0	7	4	Specialty			
H5106	015	0	1	04	01	H5106_015_0	7	1	Generic			
H5106	015	0	1	04	01	H5106_015_0	7	2	Preferred Brand			
H5106	015	0	1	04	01	H5106_015_0	7	3	Non-Preferred Brand			
H5106	016	0	1	04	01	H5106_016_0	7	1	Generic			
H5106	016	0	1	04	01	H5106_016_0	7	4	Specialty			
H5106	016	0	1	04	01	H5106_016_0	7	2	Preferred Brand			
H5106	016	0	1	04	01	H5106_016_0	7	3	Non-Preferred Brand			
H5106	016	0	1	04	01	H5106_016_0	7	1	Generic	1		1
H5106	016	0	1	04	01	H5106_016_0	7	2	Preferred Brand	2		
H5106	016	0	1	04	01	H5106_016_0	7	4	Specialty	2		
H5106	016	0	1	04	01	H5106_016_0	7	3	Non-Preferred Brand	2		
H5144	001	0	1	04	01	H5144_001_0	6	5	Tier 5 - Specialty			
H5144	001	0	1	04	01	H5144_001_0	6	4	Tier 4 - Non-Preferred Brand			
H5144	001	0	1	04	01	H5144_001_0	6	3	Tier 3 - Preferred Brand			
H5144	001	0	1	04	01	H5144_001_0	6	1	Tier 1 - Preferred Generic			
H5144	001	0	1	04	01	H5144_001_0	6	2	Tier 2 - Non-Preferred Generic			
H5151	002	0	1	01	01	H5151_002_0	6	2	Preferred Brand	2		
H5151	002	0	1	01	01	H5151_002_0	6	1	Generic			
H5151	002	0	1	01	01	H5151_002_0	6	2	Preferred Brand			
H5151	002	0	1	01	01	H5151_002_0	6	3	Non-Preferred Brand			
H5151	002	0	1	01	01	H5151_002_0	6	4	Specialty	2		
H5151	002	0	1	01	01	H5151_002_0	6	3	Non-Preferred Brand	2		
H5151	002	0	1	01	01	H5151_002_0	6	1	Generic	1		1
H5151	002	0	1	01	01	H5151_002_0	6	4	Specialty			
H5179	001	0	1	09	04	H5179_001_0	4	4	Tier 4			
H5179	001	0	1	09	04	H5179_001_0	4	1	Tier 1			
H5179	001	0	1	09	04	H5179_001_0	4	2	Tier 2			
H5179	001	0	1	09	04	H5179_001_0	4	3	Tier 3			
H5179	002	0	1	09	04	H5179_002_0	4	4	Tier 4			
H5179	002	0	1	09	04	H5179_002_0	4	3	Tier 3			
H5179	002	0	1	09	04	H5179_002_0	4	1	Tier 1			
H5179	002	0	1	09	04	H5179_002_0	4	2	Tier 2			
H5179	006	0	1	09	04	H5179_006_0	6	3	Tier 3			
H5179	006	0	1	09	04	H5179_006_0	6	2	Tier 2			
H5179	006	0	1	09	04	H5179_006_0	6	1	Tier 1			
H5179	006	0	1	09	04	H5179_006_0	6	4	Tier 4			
H5189	001	0	1	01	01	H5189_001_0	7	1	Preferred Generic			
H5189	001	0	1	01	01	H5189_001_0	7	2	Preferred Brand			
H5189	001	0	1	01	01	H5189_001_0	7	3	Specialty			
H5189	001	0	1	01	01	H5189_001_0	7	4	Non-Preferred			
H5189	002	0	1	01	01	H5189_002_0	7	3	Specialty			
H5189	002	0	1	01	01	H5189_002_0	7	2	Preferred Brand			
H5189	002	0	1	01	01	H5189_002_0	7	1	Preferred Generic			
H5189	002	0	1	01	01	H5189_002_0	7	4	Non-Preferred	2		
H5189	002	0	1	01	01	H5189_002_0	7	4	Non-Preferred			
H5189	002	0	1	01	01	H5189_002_0	7	1	Preferred Generic	1		1
H5189	002	0	1	01	01	H5189_002_0	7	2	Preferred Brand	2		
H5189	002	0	1	01	01	H5189_002_0	7	3	Specialty	2		
H5211	002	0	1	02	01	H5211_002_0	9	1	Tier 1			
H5211	002	0	1	02	01	H5211_002_0	9	2	Tier 2			
H5211	002	0	1	02	01	H5211_002_0	9	3	Tier 3			
H5211	002	0	1	02	01	H5211_002_0	9	4	Tier 4			
H5211	004	0	1	02	01	H5211_004_0	9	1	Tier 1			
H5211	004	0	1	02	01	H5211_004_0	9	2	Tier 2			
H5211	004	0	1	02	01	H5211_004_0	9	4	Tier 4			
H5211	004	0	1	02	01	H5211_004_0	9	3	Tier 3			
H5211	005	0	1	02	01	H5211_005_0	8	1	Tier 1			
H5211	005	0	1	02	01	H5211_005_0	8	3	Tier 3			
H5211	005	0	1	02	01	H5211_005_0	8	2	Tier 2			
H5211	005	0	1	02	01	H5211_005_0	8	4	Tier 4			
H5214	003	0	1	04	01	H5214_003_0	4	1	Preferred Generic			
H5214	003	0	1	04	01	H5214_003_0	4	2	Preferred Brand			
H5214	003	0	1	04	01	H5214_003_0	4	3	Non-Preferred Brand			
H5214	003	0	1	04	01	H5214_003_0	4	4	Specialty			
H5214	003	0	1	04	01	H5214_003_0	4	1	Preferred Generic	1	00001000	2
H5214	003	0	1	04	01	H5214_003_0	4	2	Preferred Brand	1	10000000	2
H5214	003	0	1	04	01	H5214_003_0	4	3	Non-Preferred Brand	1	10000000	2
H5214	003	0	1	04	01	H5214_003_0	4	4	Specialty	1	10001000	2
H5214	004	0	1	04	01	H5214_004_0	4	1	Preferred Generic			
H5214	004	0	1	04	01	H5214_004_0	4	2	Preferred Brand			
H5214	004	0	1	04	01	H5214_004_0	4	3	Non-Preferred Brand			
H5214	004	0	1	04	01	H5214_004_0	4	4	Specialty			
H5214	004	0	1	04	01	H5214_004_0	4	1	Preferred Generic	1		1
H5214	004	0	1	04	01	H5214_004_0	4	2	Preferred Brand	1	10000000	2
H5214	004	0	1	04	01	H5214_004_0	4	3	Non-Preferred Brand	1	10000000	2
H5214	004	0	1	04	01	H5214_004_0	4	4	Specialty	1	10001000	2
H5215	002	0	1	04	01	H5215_002_0	8	3	Formulary Non-Preferred Brand			
H5215	002	0	1	04	01	H5215_002_0	8	4	Specialty Products			
H5215	002	0	1	04	01	H5215_002_0	8	2	Formulary Preferred Brand			
H5215	002	0	1	04	01	H5215_002_0	8	1	Formulary Generic			
H5215	002	0	1	04	01	H5215_002_0	8	1	Formulary Generic	1		1
H5215	002	0	1	04	01	H5215_002_0	8	2	Formulary Preferred Brand	2		
H5215	002	0	1	04	01	H5215_002_0	8	3	Formulary Non-Preferred Brand	2		
H5215	002	0	1	04	01	H5215_002_0	8	4	Specialty Products	2		
H5215	005	0	1	04	01	H5215_005_0	8	4	Specialty Products			
H5215	005	0	1	04	01	H5215_005_0	8	3	Formulary Non-Preferred Brand			
H5215	005	0	1	04	01	H5215_005_0	8	2	Formulary Preferred Brand			
H5215	005	0	1	04	01	H5215_005_0	8	1	Formulary Generic			
H5215	005	0	1	04	01	H5215_005_0	8	1	Formulary Generic	1		1
H5215	005	0	1	04	01	H5215_005_0	8	2	Formulary Preferred Brand	2		
H5215	005	0	1	04	01	H5215_005_0	8	4	Specialty Products	2		
H5215	005	0	1	04	01	H5215_005_0	8	3	Formulary Non-Preferred Brand	2		
H5215	007	0	1	04	01	H5215_007_0	6	1	Basic Alternative			
H5215	007	0	1	04	01	H5215_007_0	6	3	Basic Alternative			
H5215	007	0	1	04	01	H5215_007_0	6	2	Basic Alternative			
H5215	007	0	1	04	01	H5215_007_0	6	4	Basic Alternative			
H5215	008	0	1	04	01	H5215_008_0	7	3	Formulary Non-Preferred Brand			
H5215	008	0	1	04	01	H5215_008_0	7	4	Specialty Products			
H5215	008	0	1	04	01	H5215_008_0	7	2	Formulary Preferred Brand			
H5215	008	0	1	04	01	H5215_008_0	7	1	Formulary Generic			
H5216	001	0	1	04	01	H5216_001_0	4	2	Preferred Brand	1	10000000	2
H5216	001	0	1	04	01	H5216_001_0	4	3	Non-Preferred Brand	1	10000000	2
H5216	001	0	1	04	01	H5216_001_0	4	4	Specialty	1	10001000	2
H5216	001	0	1	04	01	H5216_001_0	4	1	Preferred Generic			
H5216	001	0	1	04	01	H5216_001_0	4	2	Preferred Brand			
H5216	001	0	1	04	01	H5216_001_0	4	3	Non-Preferred Brand			
H5216	001	0	1	04	01	H5216_001_0	4	4	Specialty			
H5216	001	0	1	04	01	H5216_001_0	4	1	Preferred Generic	1	00001000	2
H5216	003	0	1	04	01	H5216_003_0	5	3	Non-Preferred Brand	1	10000000	2
H5216	003	0	1	04	01	H5216_003_0	5	2	Preferred Brand	1	10000000	2
H5216	003	0	1	04	01	H5216_003_0	5	1	Preferred Generic	1	00001000	2
H5216	003	0	1	04	01	H5216_003_0	5	1	Preferred Generic			
H5216	003	0	1	04	01	H5216_003_0	5	2	Preferred Brand			
H5216	003	0	1	04	01	H5216_003_0	5	4	Specialty	1	10001000	2
H5216	003	0	1	04	01	H5216_003_0	5	4	Specialty			
H5216	003	0	1	04	01	H5216_003_0	5	3	Non-Preferred Brand			
H5227	001	0	1	09	04	H5227_001_0	9	3	Non Preferred Generic/Non Preferred Brand			
H5227	001	0	1	09	04	H5227_001_0	9	2	Preferred Brand			
H5227	001	0	1	09	04	H5227_001_0	9	1	Preferred Generic			
H5227	001	0	1	09	04	H5227_001_0	9	4	Specialty-Generic and Brand			
H5227	002	0	1	09	04	H5227_002_0	5	3	Non Preferred Generic/Non Preferred Brand			
H5227	002	0	1	09	04	H5227_002_0	5	2	Preferred Brand			
H5227	002	0	1	09	04	H5227_002_0	5	1	Preferred Generic			
H5227	002	0	1	09	04	H5227_002_0	5	4	Specialty-Generic and Brand			
H5227	004	0	1	09	04	H5227_004_0	5	1	Preferred Generic			
H5227	004	0	1	09	04	H5227_004_0	5	2	Preferred Brand			
H5227	004	0	1	09	04	H5227_004_0	5	3	Non Preferred Generic/Non Preferred Brand			
H5227	004	0	1	09	04	H5227_004_0	5	4	Specialty-Generic and Brand			
H5227	004	0	1	09	04	H5227_004_0	5	1	Preferred Generic	1		1
H5227	004	0	1	09	04	H5227_004_0	5	2	Preferred Brand	2		
H5227	004	0	1	09	04	H5227_004_0	5	3	Non Preferred Generic/Non Preferred Brand	2		
H5227	004	0	1	09	04	H5227_004_0	5	4	Specialty-Generic and Brand	2		
H5227	005	0	1	09	04	H5227_005_0	6	1	Preferred Generic			
H5227	005	0	1	09	04	H5227_005_0	6	2	Preferred Brand			
H5227	005	0	1	09	04	H5227_005_0	6	3	Non Preferred Generic/Non Preferred Brand			
H5227	005	0	1	09	04	H5227_005_0	6	4	Specialty-Generic and Brand			
H5253	004	0	1	02	01	H5253_004_0	5	1	Preferred Generic			
H5253	004	0	1	02	01	H5253_004_0	5	2	Preferred Brand			
H5253	004	0	1	02	01	H5253_004_0	5	4	Specialty			
H5253	004	0	1	02	01	H5253_004_0	5	3	Non Preferred			
H5253	007	0	1	02	01	H5253_007_0	9	4	Specialty			
H5253	007	0	1	02	01	H5253_007_0	9	3	Non Preferred			
H5253	007	0	1	02	01	H5253_007_0	9	2	Preferred Brnad			
H5253	007	0	1	02	01	H5253_007_0	9	1	Preferred Generic			
H5253	011	0	1	02	01	H5253_011_0	5	3	Non Preferred			
H5253	011	0	1	02	01	H5253_011_0	5	2	Preferred Brand			
H5253	011	0	1	02	01	H5253_011_0	5	1	Preferred Generic			
H5253	011	0	1	02	01	H5253_011_0	5	4	Specialty			
H5253	027	0	1	02	01	H5253_027_0	4	3	Non Preferred	2		
H5253	027	0	1	02	01	H5253_027_0	4	1	Preferred Generic			
H5253	027	0	1	02	01	H5253_027_0	4	2	Preferred Brand			
H5253	027	0	1	02	01	H5253_027_0	4	3	Non Preferred			
H5253	027	0	1	02	01	H5253_027_0	4	2	Preferred Brand	2		
H5253	027	0	1	02	01	H5253_027_0	4	4	Specialty	2		
H5253	027	0	1	02	01	H5253_027_0	4	1	Preferred Generic	1		1
H5253	027	0	1	02	01	H5253_027_0	4	4	Specialty			
H5262	001	0	1	01	01	H5262_001_0	4	4	Tier 4 - Specialty High Cost Drugs			
H5262	001	0	1	01	01	H5262_001_0	4	3	Tier 3 - Formulary Non-Preferred Brand Drugs			
H5262	001	0	1	01	01	H5262_001_0	4	1	Tier 1 - Generic Drugs			
H5262	001	0	1	01	01	H5262_001_0	4	2	Tier 2 - Formulary Preferred Brand Drugs			
H5262	003	0	1	01	01	H5262_003_0	4	4	Tier 4 - Specialty High Cost Drugs			
H5262	003	0	1	01	01	H5262_003_0	4	3	Tier 3 - Formulary Non-Preferred Brand Drugs			
H5262	003	0	1	01	01	H5262_003_0	4	1	Tier 1 - Generic Drugs			
H5262	003	0	1	01	01	H5262_003_0	4	2	Tier 2 - Formulary Preferred Brand Drugs			
H5270	001	0	1	01	01	H5270_001_0	6	4	Specialty- Tier 4			
H5270	001	0	1	01	01	H5270_001_0	6	1	Generic- Tier 1			
H5270	001	0	1	01	01	H5270_001_0	6	3	Non-Preferred Brand-Tier 3			
H5270	001	0	1	01	01	H5270_001_0	6	2	Preferred Brand - Tier 2			
H5291	001	0	1	01	01	H5291_001_0	7	1	Preferred Generic			
H5291	001	0	1	01	01	H5291_001_0	7	2	Preferred Brand			
H5291	001	0	1	01	01	H5291_001_0	7	3	Non-Preferred Brand			
H5291	001	0	1	01	01	H5291_001_0	7	4	Specialty			
H5291	001	0	1	01	01	H5291_001_0	7	1	Preferred Generic	1	00001000	2
H5291	001	0	1	01	01	H5291_001_0	7	2	Preferred Brand	1	10000000	2
H5291	001	0	1	01	01	H5291_001_0	7	3	Non-Preferred Brand	1	10000000	2
H5291	001	0	1	01	01	H5291_001_0	7	4	Specialty	1	10001000	2
H5294	001	0	1	01	01	H5294_001_0	7	4	Injectable			
H5294	001	0	1	01	01	H5294_001_0	7	3	Non-Preferred Brand			
H5294	001	0	1	01	01	H5294_001_0	7	2	Brand			
H5294	001	0	1	01	01	H5294_001_0	7	1	Generic			
H5302	003	0	1	02	01	H5302_003_0	6	4	Specialty-Generic and Brand	2		
H5302	003	0	1	02	01	H5302_003_0	6	3	Non-preferred Generic/Non-Preferred Brand	2		
H5302	003	0	1	02	01	H5302_003_0	6	2	Preferred Brand	2		
H5302	003	0	1	02	01	H5302_003_0	6	1	Preferred Generic	1		1
H5302	003	0	1	02	01	H5302_003_0	6	3	Non-preferred Generic/Non-Preferred Brand			
H5302	003	0	1	02	01	H5302_003_0	6	4	Specialty-Generic and Brand			
H5302	003	0	1	02	01	H5302_003_0	6	1	Preferred Generic			
H5302	003	0	1	02	01	H5302_003_0	6	2	Preferred Brand			
H5302	004	0	1	02	01	H5302_004_0	7	4	Specialty-Generic and Brand	2		
H5302	004	0	1	02	01	H5302_004_0	7	3	Non-preferred Generic/Non-Preferred Brand	2		
H5302	004	0	1	02	01	H5302_004_0	7	2	Preferred Brand	2		
H5302	004	0	1	02	01	H5302_004_0	7	1	Preferred Generic	1		1
H5302	004	0	1	02	01	H5302_004_0	7	3	Non-preferred Generic/Non-Preferred Brand			
H5302	004	0	1	02	01	H5302_004_0	7	4	Specialty-Generic and Brand			
H5302	004	0	1	02	01	H5302_004_0	7	1	Preferred Generic			
H5302	004	0	1	02	01	H5302_004_0	7	2	Preferred Brand			
H5304	006	0	1	09	04	H5304_006_0	8	5	Tier 5 Specialty			
H5304	006	0	1	09	04	H5304_006_0	8	1	Tier 1 Preferred Generic			
H5304	006	0	1	09	04	H5304_006_0	8	2	Tier 2 Preferred Brand			
H5304	006	0	1	09	04	H5304_006_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H5304	006	0	1	09	04	H5304_006_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H5304	006	0	1	09	04	H5304_006_0	8	2	Tier 2 Preferred Brand	2		
H5304	006	0	1	09	04	H5304_006_0	8	1	Tier 1 Preferred Generic	1		1
H5304	006	0	1	09	04	H5304_006_0	8	5	Tier 5 Specialty	2		
H5304	006	0	1	09	04	H5304_006_0	8	4	Tier 4 Non-Specialty Injectable	2		
H5304	006	0	1	09	04	H5304_006_0	8	4	Tier 4 Non-Specialty Injectable			
H5304	007	0	1	09	04	H5304_007_0	10	4	Tier 4 Non-Specialty Injectable			
H5304	007	0	1	09	04	H5304_007_0	10	3	Tier 3 Non-Preferred Brand or Generic			
H5304	007	0	1	09	04	H5304_007_0	10	2	Tier 2 Preferred Brand			
H5304	007	0	1	09	04	H5304_007_0	10	1	Tier 1 Preferred Generic			
H5304	007	0	1	09	04	H5304_007_0	10	5	Tier 5 Specialty	2		
H5304	007	0	1	09	04	H5304_007_0	10	4	Tier 4 Non-Specialty Injectable	2		
H5304	007	0	1	09	04	H5304_007_0	10	3	Tier 3 Non-Preferred Brand or Generic	2		
H5304	007	0	1	09	04	H5304_007_0	10	2	Tier 2 Preferred Brand	2		
H5304	007	0	1	09	04	H5304_007_0	10	5	Tier 5 Specialty			
H5304	007	0	1	09	04	H5304_007_0	10	1	Tier 1 Preferred Generic	1		1
H5378	004	0	1	04	01	H5378_004_0	3	1	Generic			
H5378	004	0	1	04	01	H5378_004_0	3	4	Specialty	2		
H5378	004	0	1	04	01	H5378_004_0	3	3	Non-Preferred Brand	2		
H5378	004	0	1	04	01	H5378_004_0	3	2	Preferred Brand	2		
H5378	004	0	1	04	01	H5378_004_0	3	1	Generic	1		1
H5378	004	0	1	04	01	H5378_004_0	3	4	Specialty			
H5378	004	0	1	04	01	H5378_004_0	3	3	Non-Preferred Brand			
H5378	004	0	1	04	01	H5378_004_0	3	2	Preferred Brand			
H5378	005	0	1	04	01	H5378_005_0	3	4	Specialty	2		
H5378	005	0	1	04	01	H5378_005_0	3	2	Preferred Brand	2		
H5378	005	0	1	04	01	H5378_005_0	3	1	Generic	1		1
H5378	005	0	1	04	01	H5378_005_0	3	4	Specialty			
H5378	005	0	1	04	01	H5378_005_0	3	3	Non-Preferred Brand			
H5378	005	0	1	04	01	H5378_005_0	3	2	Preferred Brand			
H5378	005	0	1	04	01	H5378_005_0	3	1	Generic			
H5378	005	0	1	04	01	H5378_005_0	3	3	Non-Preferred Brand	2		
H5378	006	0	1	04	01	H5378_006_0	3	3	Non-Preferred Brand	2		
H5378	006	0	1	04	01	H5378_006_0	3	1	Generic			
H5378	006	0	1	04	01	H5378_006_0	3	2	Preferred Brand			
H5378	006	0	1	04	01	H5378_006_0	3	3	Non-Preferred Brand			
H5378	006	0	1	04	01	H5378_006_0	3	4	Specialty			
H5378	006	0	1	04	01	H5378_006_0	3	4	Specialty	2		
H5378	006	0	1	04	01	H5378_006_0	3	2	Preferred Brand	2		
H5378	006	0	1	04	01	H5378_006_0	3	1	Generic	1		1
H5402	007	0	1	01	01	H5402_007_0	6	3	Tier 3			
H5402	007	0	1	01	01	H5402_007_0	6	2	Tier 2 - Health Management			
H5402	007	0	1	01	01	H5402_007_0	6	1	Tier 1			
H5402	007	0	1	01	01	H5402_007_0	6	6	Tier 6 - Specialty Medications	2		
H5402	007	0	1	01	01	H5402_007_0	6	5	Tier 5	2		
H5402	007	0	1	01	01	H5402_007_0	6	4	Tier 4	2		
H5402	007	0	1	01	01	H5402_007_0	6	5	Tier 5			
H5402	007	0	1	01	01	H5402_007_0	6	6	Tier 6 - Specialty Medications			
H5402	007	0	1	01	01	H5402_007_0	6	1	Tier 1	1		1
H5402	007	0	1	01	01	H5402_007_0	6	2	Tier 2 - Health Management	1		1
H5402	007	0	1	01	01	H5402_007_0	6	3	Tier 3	2		
H5402	007	0	1	01	01	H5402_007_0	6	4	Tier 4			
H5402	010	0	1	01	01	H5402_010_0	6	5	Tier 5			
H5402	010	0	1	01	01	H5402_010_0	6	4	Tier 4			
H5402	010	0	1	01	01	H5402_010_0	6	3	Tier 3			
H5402	010	0	1	01	01	H5402_010_0	6	2	Tier 2 - Health Management			
H5402	010	0	1	01	01	H5402_010_0	6	1	Tier 1			
H5402	010	0	1	01	01	H5402_010_0	6	6	Tier 6 - Specialty Medications			
H5402	010	0	1	01	01	H5402_010_0	6	6	Tier 6 - Specialty Medications	2		
H5402	010	0	1	01	01	H5402_010_0	6	5	Tier 5	2		
H5402	010	0	1	01	01	H5402_010_0	6	4	Tier 4	2		
H5402	010	0	1	01	01	H5402_010_0	6	3	Tier 3	1		1
H5402	010	0	1	01	01	H5402_010_0	6	2	Tier 2 - Health Management	1		1
H5402	010	0	1	01	01	H5402_010_0	6	1	Tier 1	1		1
H5402	032	0	1	01	01	H5402_032_0	6	1	Tier 1			
H5402	032	0	1	01	01	H5402_032_0	6	2	Tier 2 - Health Management			
H5402	032	0	1	01	01	H5402_032_0	6	3	Tier 3			
H5402	032	0	1	01	01	H5402_032_0	6	4	Tier 4			
H5402	032	0	1	01	01	H5402_032_0	6	5	Tier 5			
H5402	032	0	1	01	01	H5402_032_0	6	6	Tier 6 - Specialty Medications	2		
H5402	032	0	1	01	01	H5402_032_0	6	4	Tier 4	2		
H5402	032	0	1	01	01	H5402_032_0	6	3	Tier 3	1		1
H5402	032	0	1	01	01	H5402_032_0	6	2	Tier 2 - Health Management	1		1
H5402	032	0	1	01	01	H5402_032_0	6	1	Tier 1	1		1
H5402	032	0	1	01	01	H5402_032_0	6	6	Tier 6 - Specialty Medications			
H5402	032	0	1	01	01	H5402_032_0	6	5	Tier 5	2		
H5402	034	0	1	01	01	H5402_034_0	6	1	Tier 1			
H5402	034	0	1	01	01	H5402_034_0	6	2	Tier 2 - Health Management			
H5402	034	0	1	01	01	H5402_034_0	6	3	Tier 3			
H5402	034	0	1	01	01	H5402_034_0	6	4	Tier 4			
H5402	034	0	1	01	01	H5402_034_0	6	5	Tier 5			
H5402	034	0	1	01	01	H5402_034_0	6	6	Tier 6 - Specialty Medications			
H5402	035	0	1	01	01	H5402_035_0	9	5	Tier 5	2		
H5402	035	0	1	01	01	H5402_035_0	9	4	Tier 4	2		
H5402	035	0	1	01	01	H5402_035_0	9	3	Tier 3	2		
H5402	035	0	1	01	01	H5402_035_0	9	2	Tier 2 - Health Management	1		1
H5402	035	0	1	01	01	H5402_035_0	9	1	Tier 1	1		1
H5402	035	0	1	01	01	H5402_035_0	9	6	Tier 6 - Specialty Medications	2		
H5402	035	0	1	01	01	H5402_035_0	9	5	Tier 5			
H5402	035	0	1	01	01	H5402_035_0	9	4	Tier 4			
H5402	035	0	1	01	01	H5402_035_0	9	3	Tier 3			
H5402	035	0	1	01	01	H5402_035_0	9	2	Tier 2 - Health Management			
H5402	035	0	1	01	01	H5402_035_0	9	1	Tier 1			
H5402	035	0	1	01	01	H5402_035_0	9	6	Tier 6 - Specialty Medications			
H5402	036	0	1	01	01	H5402_036_0	7	5	Tier 5	2		
H5402	036	0	1	01	01	H5402_036_0	7	4	Tier 4	2		
H5402	036	0	1	01	01	H5402_036_0	7	3	Tier 3	2		
H5402	036	0	1	01	01	H5402_036_0	7	2	Tier 2 - Health Management	1		1
H5402	036	0	1	01	01	H5402_036_0	7	1	Tier 1	1		1
H5402	036	0	1	01	01	H5402_036_0	7	6	Tier 6 - Specialty Medications			
H5402	036	0	1	01	01	H5402_036_0	7	5	Tier 5			
H5402	036	0	1	01	01	H5402_036_0	7	4	Tier 4			
H5402	036	0	1	01	01	H5402_036_0	7	3	Tier 3			
H5402	036	0	1	01	01	H5402_036_0	7	2	Tier 2 - Health Management			
H5402	036	0	1	01	01	H5402_036_0	7	1	Tier 1			
H5402	036	0	1	01	01	H5402_036_0	7	6	Tier 6 - Specialty Medications	2		
H5402	038	0	1	01	01	H5402_038_0	6	1	Tier 1			
H5402	038	0	1	01	01	H5402_038_0	6	2	Tier 2 - Health Management			
H5402	038	0	1	01	01	H5402_038_0	6	6	Tier 6 - Specialty Medications	2		
H5402	038	0	1	01	01	H5402_038_0	6	5	Tier 5	2		
H5402	038	0	1	01	01	H5402_038_0	6	4	Tier 4	2		
H5402	038	0	1	01	01	H5402_038_0	6	3	Tier 3	2		
H5402	038	0	1	01	01	H5402_038_0	6	2	Tier 2 - Health Management	1		1
H5402	038	0	1	01	01	H5402_038_0	6	1	Tier 1	1		1
H5402	038	0	1	01	01	H5402_038_0	6	6	Tier 6 - Specialty Medications			
H5402	038	0	1	01	01	H5402_038_0	6	5	Tier 5			
H5402	038	0	1	01	01	H5402_038_0	6	4	Tier 4			
H5402	038	0	1	01	01	H5402_038_0	6	3	Tier 3			
H5402	039	0	1	01	01	H5402_039_0	7	2	Tier 2 - Health Management			
H5402	039	0	1	01	01	H5402_039_0	7	3	Tier 3			
H5402	039	0	1	01	01	H5402_039_0	7	4	Tier 4			
H5402	039	0	1	01	01	H5402_039_0	7	5	Tier 5			
H5402	039	0	1	01	01	H5402_039_0	7	6	Tier 6 - Specialty Medications			
H5402	039	0	1	01	01	H5402_039_0	7	1	Tier 1			
H5402	041	0	1	01	01	H5402_041_0	8	6	Tier 6 - Specialty Medications			
H5402	041	0	1	01	01	H5402_041_0	8	2	Tier 2 - Health Management			
H5402	041	0	1	01	01	H5402_041_0	8	3	Tier 3			
H5402	041	0	1	01	01	H5402_041_0	8	4	Tier 4			
H5402	041	0	1	01	01	H5402_041_0	8	5	Tier 5			
H5402	041	0	1	01	01	H5402_041_0	8	1	Tier 1			
H5404	001	0	1	01	01	H5404_001_0	7	1	Generic			
H5404	001	0	1	01	01	H5404_001_0	7	4	Specialty			
H5404	001	0	1	01	01	H5404_001_0	7	2	Preferred Brand			
H5404	001	0	1	01	01	H5404_001_0	7	3	Non-Preferred Brand			
H5404	002	0	1	01	01	H5404_002_0	7	1	Generic			
H5404	002	0	1	01	01	H5404_002_0	7	3	Non-Preferred Brand			
H5404	002	0	1	01	01	H5404_002_0	7	4	Specialty			
H5404	002	0	1	01	01	H5404_002_0	7	2	Preferred Brand			
H5404	003	0	1	01	01	H5404_003_0	8	3	Non-Preferred Brand			
H5404	003	0	1	01	01	H5404_003_0	8	2	Preferred Brand			
H5404	003	0	1	01	01	H5404_003_0	8	1	Generic			
H5404	003	0	1	01	01	H5404_003_0	8	4	Specialty			
H5404	004	0	1	01	01	H5404_004_0	7	2	Preferred Brand			
H5404	004	0	1	01	01	H5404_004_0	7	3	Non-Preferred Brand			
H5404	004	0	1	01	01	H5404_004_0	7	4	Specialty			
H5404	004	0	1	01	01	H5404_004_0	7	1	Generic			
H5404	013	0	1	01	01	H5404_013_0	7	2	Preferred Brand			
H5404	013	0	1	01	01	H5404_013_0	7	3	Non-Preferred Brand			
H5404	013	0	1	01	01	H5404_013_0	7	4	Specialty			
H5404	013	0	1	01	01	H5404_013_0	7	1	Generic			
H5404	016	0	1	01	01	H5404_016_0	7	1	Generic			
H5404	016	0	1	01	01	H5404_016_0	7	2	Preferred Brand			
H5404	016	0	1	01	01	H5404_016_0	7	3	Non-Preferred Brand			
H5404	016	0	1	01	01	H5404_016_0	7	4	Specialty			
H5404	022	0	1	01	01	H5404_022_0	7	3	Non-Preferred Brand			
H5404	022	0	1	01	01	H5404_022_0	7	4	Specialty			
H5404	022	0	1	01	01	H5404_022_0	7	2	Preferred Brand			
H5404	022	0	1	01	01	H5404_022_0	7	1	Generic			
H5404	025	0	1	01	01	H5404_025_0	7	2	Preferred Brand			
H5404	025	0	1	01	01	H5404_025_0	7	3	Non-Preferred Brand			
H5404	025	0	1	01	01	H5404_025_0	7	4	Specialty			
H5404	025	0	1	01	01	H5404_025_0	7	1	Generic			
H5404	028	0	1	01	01	H5404_028_0	7	4	Specialty			
H5404	028	0	1	01	01	H5404_028_0	7	1	Generic			
H5404	028	0	1	01	01	H5404_028_0	7	2	Preferred Brand			
H5404	028	0	1	01	01	H5404_028_0	7	3	Non-Preferred Brand			
H5404	034	0	1	01	01	H5404_034_0	8	4	Specialty			
H5404	034	0	1	01	01	H5404_034_0	8	3	Non-Preferred Brand			
H5404	034	0	1	01	01	H5404_034_0	8	1	Generic			
H5404	034	0	1	01	01	H5404_034_0	8	2	Preferred Brand			
H5404	037	0	1	01	01	H5404_037_0	7	3	Non-Preferred Brand			
H5404	037	0	1	01	01	H5404_037_0	7	4	Specialty			
H5404	037	0	1	01	01	H5404_037_0	7	2	Preferred Brand			
H5404	037	0	1	01	01	H5404_037_0	7	1	Generic			
H5404	043	0	1	01	01	H5404_043_0	7	3	Non-Preferred Brand			
H5404	043	0	1	01	01	H5404_043_0	7	1	Generic			
H5404	043	0	1	01	01	H5404_043_0	7	2	Preferred Brand			
H5404	043	0	1	01	01	H5404_043_0	7	4	Specialty			
H5404	053	0	1	01	01	H5404_053_0	8	1	Generic			
H5404	053	0	1	01	01	H5404_053_0	8	2	Preferred Brand			
H5404	053	0	1	01	01	H5404_053_0	8	3	Non-Preferred Brand			
H5404	053	0	1	01	01	H5404_053_0	8	4	Specialty			
H5404	086	0	1	02	01	H5404_086_0	10	1	Generic			
H5404	086	0	1	02	01	H5404_086_0	10	4	Specialty			
H5404	086	0	1	02	01	H5404_086_0	10	2	Preferred Brand			
H5404	086	0	1	02	01	H5404_086_0	10	3	Non-Preferred Brand			
H5404	094	0	1	01	01	H5404_094_0	7	1	Generic			
H5404	094	0	1	01	01	H5404_094_0	7	2	Preferred Brand			
H5404	094	0	1	01	01	H5404_094_0	7	3	Non-Preferred Brand			
H5404	094	0	1	01	01	H5404_094_0	7	4	Specialty			
H5404	114	0	1	01	01	H5404_114_0	7	1	Generic			
H5404	114	0	1	01	01	H5404_114_0	7	4	Specialty			
H5404	114	0	1	01	01	H5404_114_0	7	3	Non-Preferred Brand			
H5404	114	0	1	01	01	H5404_114_0	7	2	Preferred Brand			
H5407	001	0	1	02	01	H5407_001_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	001	0	1	02	01	H5407_001_0	5	6	Tier 6 - Specialty			
H5407	001	0	1	02	01	H5407_001_0	5	5	Tier 5 - Brands			
H5407	001	0	1	02	01	H5407_001_0	5	4	Tier 4 - Preferred Brands			
H5407	001	0	1	02	01	H5407_001_0	5	3	Tier 3 - Plus Brands			
H5407	001	0	1	02	01	H5407_001_0	5	2	Tier 2 - Generics	2		
H5407	001	0	1	02	01	H5407_001_0	5	1	Tier 1 - Preferred Generics			
H5407	001	0	1	02	01	H5407_001_0	5	6	Tier 6 - Specialty	2		
H5407	001	0	1	02	01	H5407_001_0	5	5	Tier 5 - Brands	2		
H5407	001	0	1	02	01	H5407_001_0	5	4	Tier 4 - Preferred Brands	2		
H5407	001	0	1	02	01	H5407_001_0	5	3	Tier 3 - Plus Brands	1		1
H5407	001	0	1	02	01	H5407_001_0	5	2	Tier 2 - Generics			
H5407	004	0	1	02	01	H5407_004_0	4	2	Tier 2 - Generics	2		
H5407	004	0	1	02	01	H5407_004_0	4	6	Tier 6 - Specialty	2		
H5407	004	0	1	02	01	H5407_004_0	4	5	Tier 5 - Brands	2		
H5407	004	0	1	02	01	H5407_004_0	4	4	Tier 4 - Preferred Brands	2		
H5407	004	0	1	02	01	H5407_004_0	4	3	Tier 3 - Plus Brands	1		1
H5407	004	0	1	02	01	H5407_004_0	4	1	Tier 1 - Preferred Generics	1		1
H5407	004	0	1	02	01	H5407_004_0	4	6	Tier 6 - Specialty			
H5407	004	0	1	02	01	H5407_004_0	4	5	Tier 5 - Brands			
H5407	004	0	1	02	01	H5407_004_0	4	4	Tier 4 - Preferred Brands			
H5407	004	0	1	02	01	H5407_004_0	4	3	Tier 3 - Plus Brands			
H5407	004	0	1	02	01	H5407_004_0	4	2	Tier 2 - Generics			
H5407	004	0	1	02	01	H5407_004_0	4	1	Tier 1 - Preferred Generics			
H5407	005	0	1	02	01	H5407_005_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	005	0	1	02	01	H5407_005_0	5	6	Tier 6 - Specialty			
H5407	005	0	1	02	01	H5407_005_0	5	5	Tier 5 - Brands			
H5407	005	0	1	02	01	H5407_005_0	5	3	Tier 3 - Plus Brands	1		1
H5407	005	0	1	02	01	H5407_005_0	5	4	Tier 4 - Preferred Brands	2		
H5407	005	0	1	02	01	H5407_005_0	5	2	Tier 2 - Generics	2		
H5407	005	0	1	02	01	H5407_005_0	5	6	Tier 6 - Specialty	2		
H5407	005	0	1	02	01	H5407_005_0	5	4	Tier 4 - Preferred Brands			
H5407	005	0	1	02	01	H5407_005_0	5	3	Tier 3 - Plus Brands			
H5407	005	0	1	02	01	H5407_005_0	5	2	Tier 2 - Generics			
H5407	005	0	1	02	01	H5407_005_0	5	1	Tier 1 - Preferred Generics			
H5407	005	0	1	02	01	H5407_005_0	5	5	Tier 5 - Brands	2		
H5407	006	0	1	02	01	H5407_006_0	4	4	Tier 4 - Preferred Brands	2		
H5407	006	0	1	02	01	H5407_006_0	4	5	Tier 5 - Brands	2		
H5407	006	0	1	02	01	H5407_006_0	4	6	Tier 6 - Specialty	2		
H5407	006	0	1	02	01	H5407_006_0	4	1	Tier 1 - Preferred Generics			
H5407	006	0	1	02	01	H5407_006_0	4	2	Tier 2 - Generics			
H5407	006	0	1	02	01	H5407_006_0	4	3	Tier 3 - Plus Brands			
H5407	006	0	1	02	01	H5407_006_0	4	2	Tier 2 - Generics	2		
H5407	006	0	1	02	01	H5407_006_0	4	1	Tier 1 - Preferred Generics	1		1
H5407	006	0	1	02	01	H5407_006_0	4	6	Tier 6 - Specialty			
H5407	006	0	1	02	01	H5407_006_0	4	3	Tier 3 - Plus Brands	1		1
H5407	006	0	1	02	01	H5407_006_0	4	4	Tier 4 - Preferred Brands			
H5407	006	0	1	02	01	H5407_006_0	4	5	Tier 5 - Brands			
H5407	007	0	1	02	01	H5407_007_0	4	5	Tier 5 - Brands			
H5407	007	0	1	02	01	H5407_007_0	4	4	Tier 4 - Preferred Brands			
H5407	007	0	1	02	01	H5407_007_0	4	3	Tier 3 - Plus Brands			
H5407	007	0	1	02	01	H5407_007_0	4	2	Tier 2 - Generics			
H5407	007	0	1	02	01	H5407_007_0	4	6	Tier 6 - Specialty	2		
H5407	007	0	1	02	01	H5407_007_0	4	5	Tier 5 - Brands	2		
H5407	007	0	1	02	01	H5407_007_0	4	1	Tier 1 - Preferred Generics			
H5407	007	0	1	02	01	H5407_007_0	4	4	Tier 4 - Preferred Brands	2		
H5407	007	0	1	02	01	H5407_007_0	4	3	Tier 3 - Plus Brands	1		1
H5407	007	0	1	02	01	H5407_007_0	4	6	Tier 6 - Specialty			
H5407	007	0	1	02	01	H5407_007_0	4	1	Tier 1 - Preferred Generics	1		1
H5407	007	0	1	02	01	H5407_007_0	4	2	Tier 2 - Generics	2		
H5407	009	0	1	02	01	H5407_009_0	5	3	Tier 3 - Plus Brands			
H5407	009	0	1	02	01	H5407_009_0	5	4	Tier 4 - Preferred Brands			
H5407	009	0	1	02	01	H5407_009_0	5	5	Tier 5 - Brands			
H5407	009	0	1	02	01	H5407_009_0	5	6	Tier 6 - Specialty			
H5407	009	0	1	02	01	H5407_009_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	009	0	1	02	01	H5407_009_0	5	2	Tier 2 - Generics	2		
H5407	009	0	1	02	01	H5407_009_0	5	3	Tier 3 - Plus Brands	1		1
H5407	009	0	1	02	01	H5407_009_0	5	4	Tier 4 - Preferred Brands	2		
H5407	009	0	1	02	01	H5407_009_0	5	5	Tier 5 - Brands	2		
H5407	009	0	1	02	01	H5407_009_0	5	6	Tier 6 - Specialty	2		
H5407	009	0	1	02	01	H5407_009_0	5	1	Tier 1 - Preferred Generics			
H5407	009	0	1	02	01	H5407_009_0	5	2	Tier 2 - Generics			
H5407	014	0	1	02	01	H5407_014_0	5	1	Tier 1 - Preferred Generics			
H5407	014	0	1	02	01	H5407_014_0	5	5	Tier 5 - Brands			
H5407	014	0	1	02	01	H5407_014_0	5	6	Tier 6 - Specialty	2		
H5407	014	0	1	02	01	H5407_014_0	5	5	Tier 5 - Brands	2		
H5407	014	0	1	02	01	H5407_014_0	5	4	Tier 4 - Preferred Brands	2		
H5407	014	0	1	02	01	H5407_014_0	5	3	Tier 3 - Plus Brands	1		1
H5407	014	0	1	02	01	H5407_014_0	5	2	Tier 2 - Generics	2		
H5407	014	0	1	02	01	H5407_014_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	014	0	1	02	01	H5407_014_0	5	6	Tier 6 - Specialty			
H5407	014	0	1	02	01	H5407_014_0	5	2	Tier 2 - Generics			
H5407	014	0	1	02	01	H5407_014_0	5	3	Tier 3 - Plus Brands			
H5407	014	0	1	02	01	H5407_014_0	5	4	Tier 4 - Preferred Brands			
H5407	015	0	1	02	01	H5407_015_0	5	1	Tier 1 - Preferred Generics			
H5407	015	0	1	02	01	H5407_015_0	5	5	Tier 5 - Brands	2		
H5407	015	0	1	02	01	H5407_015_0	5	4	Tier 4 - Preferred Brands	2		
H5407	015	0	1	02	01	H5407_015_0	5	3	Tier 3 - Plus Brands	1		1
H5407	015	0	1	02	01	H5407_015_0	5	2	Tier 2 - Generics	2		
H5407	015	0	1	02	01	H5407_015_0	5	6	Tier 6 - Specialty	2		
H5407	015	0	1	02	01	H5407_015_0	5	6	Tier 6 - Specialty			
H5407	015	0	1	02	01	H5407_015_0	5	5	Tier 5 - Brands			
H5407	015	0	1	02	01	H5407_015_0	5	4	Tier 4 - Preferred Brands			
H5407	015	0	1	02	01	H5407_015_0	5	3	Tier 3 - Plus Brands			
H5407	015	0	1	02	01	H5407_015_0	5	2	Tier 2 - Generics			
H5407	015	0	1	02	01	H5407_015_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	016	0	1	02	01	H5407_016_0	5	5	Tier 5 - Brands			
H5407	016	0	1	02	01	H5407_016_0	5	4	Tier 4 - Preferred Brands			
H5407	016	0	1	02	01	H5407_016_0	5	3	Tier 3 - Plus Brands			
H5407	016	0	1	02	01	H5407_016_0	5	2	Tier 2 - Generics			
H5407	016	0	1	02	01	H5407_016_0	5	1	Tier 1 - Preferred Generics			
H5407	016	0	1	02	01	H5407_016_0	5	6	Tier 6 - Specialty			
H5407	016	0	1	02	01	H5407_016_0	5	6	Tier 6 - Specialty	2		
H5407	016	0	1	02	01	H5407_016_0	5	5	Tier 5 - Brands	2		
H5407	016	0	1	02	01	H5407_016_0	5	4	Tier 4 - Preferred Brands	2		
H5407	016	0	1	02	01	H5407_016_0	5	3	Tier 3 - Plus Brands	1		1
H5407	016	0	1	02	01	H5407_016_0	5	2	Tier 2 - Generics	2		
H5407	016	0	1	02	01	H5407_016_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	021	0	1	02	01	H5407_021_0	5	1	Tier 1 - Preferred Generics			
H5407	021	0	1	02	01	H5407_021_0	5	2	Tier 2 - Generics			
H5407	021	0	1	02	01	H5407_021_0	5	6	Tier 6 - Specialty	2		
H5407	021	0	1	02	01	H5407_021_0	5	5	Tier 5 - Brands	2		
H5407	021	0	1	02	01	H5407_021_0	5	4	Tier 4 - Preferred Brands	2		
H5407	021	0	1	02	01	H5407_021_0	5	3	Tier 3 - Plus Brands	1		1
H5407	021	0	1	02	01	H5407_021_0	5	2	Tier 2 - Generics	2		
H5407	021	0	1	02	01	H5407_021_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	021	0	1	02	01	H5407_021_0	5	6	Tier 6 - Specialty			
H5407	021	0	1	02	01	H5407_021_0	5	5	Tier 5 - Brands			
H5407	021	0	1	02	01	H5407_021_0	5	4	Tier 4 - Preferred Brands			
H5407	021	0	1	02	01	H5407_021_0	5	3	Tier 3 - Plus Brands			
H5407	022	0	1	02	01	H5407_022_0	5	1	Tier 1 - Preferred Generics			
H5407	022	0	1	02	01	H5407_022_0	5	6	Tier 6 - Specialty			
H5407	022	0	1	02	01	H5407_022_0	5	1	Tier 1 - Preferred Generics	1		1
H5407	022	0	1	02	01	H5407_022_0	5	2	Tier 2 - Generics	2		
H5407	022	0	1	02	01	H5407_022_0	5	3	Tier 3 - Plus Brands	1		1
H5407	022	0	1	02	01	H5407_022_0	5	6	Tier 6 - Specialty	2		
H5407	022	0	1	02	01	H5407_022_0	5	5	Tier 5 - Brands	2		
H5407	022	0	1	02	01	H5407_022_0	5	5	Tier 5 - Brands			
H5407	022	0	1	02	01	H5407_022_0	5	4	Tier 4 - Preferred Brands			
H5407	022	0	1	02	01	H5407_022_0	5	3	Tier 3 - Plus Brands			
H5407	022	0	1	02	01	H5407_022_0	5	2	Tier 2 - Generics			
H5407	022	0	1	02	01	H5407_022_0	5	4	Tier 4 - Preferred Brands	2		
H5410	001	0	1	01	01	H5410_001_0	6	3	Specialty Drugs	2		
H5410	001	0	1	01	01	H5410_001_0	6	2	Brand Name Drugs	2		
H5410	001	0	1	01	01	H5410_001_0	6	1	Generic Drugs	1		1
H5410	001	0	1	01	01	H5410_001_0	6	3	Specialty Drugs			
H5410	001	0	1	01	01	H5410_001_0	6	2	Brand Name Drugs			
H5410	001	0	1	01	01	H5410_001_0	6	1	Generic Drugs			
H5410	003	0	1	01	01	H5410_003_0	8	1	Preferred Generic	1		1
H5410	003	0	1	01	01	H5410_003_0	8	5	Specialty			
H5410	003	0	1	01	01	H5410_003_0	8	4	Non-Preferred Brand			
H5410	003	0	1	01	01	H5410_003_0	8	3	Preferred Brand			
H5410	003	0	1	01	01	H5410_003_0	8	2	Generic			
H5410	003	0	1	01	01	H5410_003_0	8	1	Preferred Generic			
H5410	003	0	1	01	01	H5410_003_0	8	2	Generic	1		1
H5410	003	0	1	01	01	H5410_003_0	8	5	Specialty	2		
H5410	003	0	1	01	01	H5410_003_0	8	4	Non-Preferred Brand	2		
H5410	003	0	1	01	01	H5410_003_0	8	3	Preferred Brand	2		
H5410	005	0	1	01	01	H5410_005_0	6	1	Preferred Generic			
H5410	005	0	1	01	01	H5410_005_0	6	2	Generic			
H5410	005	0	1	01	01	H5410_005_0	6	3	Preferred Brand			
H5410	005	0	1	01	01	H5410_005_0	6	4	Non-Preferred Brand			
H5410	005	0	1	01	01	H5410_005_0	6	5	Specialty	2		
H5410	005	0	1	01	01	H5410_005_0	6	1	Preferred Generic	1		1
H5410	005	0	1	01	01	H5410_005_0	6	4	Non-Preferred Brand	2		
H5410	005	0	1	01	01	H5410_005_0	6	3	Preferred Brand	2		
H5410	005	0	1	01	01	H5410_005_0	6	2	Generic	1		1
H5410	005	0	1	01	01	H5410_005_0	6	5	Specialty			
H5414	002	0	1	01	01	H5414_002_0	4	1	Tier 1 - Preferred Generic			
H5414	002	0	1	01	01	H5414_002_0	4	2	Tier 2 - Non-Preferred Generic			
H5414	002	0	1	01	01	H5414_002_0	4	3	Tier 3 - Preferred Brand			
H5414	002	0	1	01	01	H5414_002_0	4	4	Tier 4 - Non-Preferred Brand			
H5414	002	0	1	01	01	H5414_002_0	4	5	Tier 5 - Specialty			
H5414	004	0	1	01	01	H5414_004_0	4	2	Tier 2 - Non-Preferred Generic			
H5414	004	0	1	01	01	H5414_004_0	4	3	Tier 3 - Preferred Brand			
H5414	004	0	1	01	01	H5414_004_0	4	4	Tier 4 - Non-Preferred Brand			
H5414	004	0	1	01	01	H5414_004_0	4	1	Tier 1 - Preferred Generic			
H5414	004	0	1	01	01	H5414_004_0	4	5	Tier 5 - Specialty			
H5414	009	0	1	01	01	H5414_009_0	6	1	Tier 1 - Preferred Generic			
H5414	009	0	1	01	01	H5414_009_0	6	2	Tier 2 - Non-Preferred Generic			
H5414	009	0	1	01	01	H5414_009_0	6	4	Tier 4 - Non-Preferred Brand			
H5414	009	0	1	01	01	H5414_009_0	6	3	Tier 3 - Preferred Brand			
H5414	009	0	1	01	01	H5414_009_0	6	5	Tier 5 - Specialty			
H5414	010	0	1	01	01	H5414_010_0	5	1	Tier 1 - Preferred Generic			
H5414	010	0	1	01	01	H5414_010_0	5	2	Tier 2 - Non-Preferred Generic			
H5414	010	0	1	01	01	H5414_010_0	5	3	Tier 3 - Preferred Brand			
H5414	010	0	1	01	01	H5414_010_0	5	4	Tier 4 - Non-Preferred Brand			
H5414	010	0	1	01	01	H5414_010_0	5	5	Tier 5 - Specialty			
H5414	011	0	1	01	01	H5414_011_0	4	4	Tier 4 - Non-Preferred Brand	2		
H5414	011	0	1	01	01	H5414_011_0	4	3	Tier 3 - Preferred Brand	2		
H5414	011	0	1	01	01	H5414_011_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H5414	011	0	1	01	01	H5414_011_0	4	1	Tier 1 - Preferred Generic	1		1
H5414	011	0	1	01	01	H5414_011_0	4	5	Tier 5 - Specialty			
H5414	011	0	1	01	01	H5414_011_0	4	4	Tier 4 - Non-Preferred Brand			
H5414	011	0	1	01	01	H5414_011_0	4	3	Tier 3 - Preferred Brand			
H5414	011	0	1	01	01	H5414_011_0	4	2	Tier 2 - Non-Preferred Generic			
H5414	011	0	1	01	01	H5414_011_0	4	1	Tier 1 - Preferred Generic			
H5414	011	0	1	01	01	H5414_011_0	4	5	Tier 5 - Specialty	2		
H5414	012	0	1	01	01	H5414_012_0	4	2	Tier 2 - Non-Preferred Generic			
H5414	012	0	1	01	01	H5414_012_0	4	1	Tier 1 - Preferred Generic			
H5414	012	0	1	01	01	H5414_012_0	4	3	Tier 3 - Preferred Brand			
H5414	012	0	1	01	01	H5414_012_0	4	4	Tier 4 - Non-Preferred Brand			
H5414	012	0	1	01	01	H5414_012_0	4	5	Tier 5 - Specialty			
H5414	014	0	1	01	01	H5414_014_0	5	1	Tier 1 - Preferred Generic			
H5414	014	0	1	01	01	H5414_014_0	5	2	Tier 2 - Non-Preferred Generic			
H5414	014	0	1	01	01	H5414_014_0	5	3	Tier 3 - Preferred Brand			
H5414	014	0	1	01	01	H5414_014_0	5	4	Tier 4 - Non-Preferred Brand			
H5414	014	0	1	01	01	H5414_014_0	5	5	Tier 5 - Specialty			
H5414	015	0	1	01	01	H5414_015_0	4	2	Tier 2 - Non-Preferred Generic			
H5414	015	0	1	01	01	H5414_015_0	4	1	Tier 1 - Preferred Generic			
H5414	015	0	1	01	01	H5414_015_0	4	3	Tier 3 - Preferred Brand			
H5414	015	0	1	01	01	H5414_015_0	4	5	Tier 5 - Specialty			
H5414	015	0	1	01	01	H5414_015_0	4	4	Tier 4 - Non-Preferred Brand			
H5414	016	0	1	01	01	H5414_016_0	4	1	Tier 1 - Preferred Generic			
H5414	016	0	1	01	01	H5414_016_0	4	2	Tier 2 - Non-Preferred Generic			
H5414	016	0	1	01	01	H5414_016_0	4	3	Tier 3 - Preferred Brand			
H5414	016	0	1	01	01	H5414_016_0	4	4	Tier 4 - Non-Preferred Brand			
H5414	016	0	1	01	01	H5414_016_0	4	5	Tier 5 - Specialty	2		
H5414	016	0	1	01	01	H5414_016_0	4	1	Tier 1 - Preferred Generic	1		1
H5414	016	0	1	01	01	H5414_016_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H5414	016	0	1	01	01	H5414_016_0	4	4	Tier 4 - Non-Preferred Brand	2		
H5414	016	0	1	01	01	H5414_016_0	4	3	Tier 3 - Preferred Brand	2		
H5414	016	0	1	01	01	H5414_016_0	4	5	Tier 5 - Specialty			
H5415	039	0	1	04	01	H5415_039_0	3	1	Preferred Generic			
H5415	039	0	1	04	01	H5415_039_0	3	2	Preferred Brand			
H5415	039	0	1	04	01	H5415_039_0	3	3	Non-Preferred Brand			
H5415	039	0	1	04	01	H5415_039_0	3	4	Specialty	1	10001000	2
H5415	039	0	1	04	01	H5415_039_0	3	1	Preferred Generic	1	00001000	2
H5415	039	0	1	04	01	H5415_039_0	3	2	Preferred Brand	1	10000000	2
H5415	039	0	1	04	01	H5415_039_0	3	3	Non-Preferred Brand	1	10000000	2
H5415	039	0	1	04	01	H5415_039_0	3	4	Specialty			
H5416	001	0	1	01	01	H5416_001_0	8	3	Tier 3 - Non-Preferred Brand	2		
H5416	001	0	1	01	01	H5416_001_0	8	2	Tier 2 - Preferred Brand	2		
H5416	001	0	1	01	01	H5416_001_0	8	1	Tier 1 - Generic	1		1
H5416	001	0	1	01	01	H5416_001_0	8	4	Tier 4 - Specialty Drug			
H5416	001	0	1	01	01	H5416_001_0	8	3	Tier 3 - Non-Preferred Brand			
H5416	001	0	1	01	01	H5416_001_0	8	2	Tier 2 - Preferred Brand			
H5416	001	0	1	01	01	H5416_001_0	8	1	Tier 1 - Generic			
H5416	001	0	1	01	01	H5416_001_0	8	4	Tier 4 - Specialty Drug	2		
H5416	002	0	1	01	01	H5416_002_0	9	3	Tier 3 - Non-Preferred Brand	2		
H5416	002	0	1	01	01	H5416_002_0	9	2	Tier 2 - Preferred Brand	2		
H5416	002	0	1	01	01	H5416_002_0	9	1	Tier 1 - Generic	1		1
H5416	002	0	1	01	01	H5416_002_0	9	4	Tier 4 - Specialty Drug			
H5416	002	0	1	01	01	H5416_002_0	9	3	Tier 3 - Non-Preferred Brand			
H5416	002	0	1	01	01	H5416_002_0	9	2	Tier 2 - Preferred Brand			
H5416	002	0	1	01	01	H5416_002_0	9	1	Tier 1 - Generic			
H5416	002	0	1	01	01	H5416_002_0	9	4	Tier 4 - Specialty Drug	2		
H5416	004	0	1	01	01	H5416_004_0	9	1	Tier 1 - Generic			
H5416	004	0	1	01	01	H5416_004_0	9	2	Tier 2 - Preferred Brand			
H5416	004	0	1	01	01	H5416_004_0	9	4	Tier 4 - Specialty Drug	2		
H5416	004	0	1	01	01	H5416_004_0	9	3	Tier 3 - Non-Preferred Brand	2		
H5416	004	0	1	01	01	H5416_004_0	9	2	Tier 2 - Preferred Brand	2		
H5416	004	0	1	01	01	H5416_004_0	9	1	Tier 1 - Generic	1		1
H5416	004	0	1	01	01	H5416_004_0	9	4	Tier 4 - Specialty Drug			
H5416	004	0	1	01	01	H5416_004_0	9	3	Tier 3 - Non-Preferred Brand			
H5416	009	0	1	01	01	H5416_009_0	9	1	Tier 1 - Generic			
H5416	009	0	1	01	01	H5416_009_0	9	3	Tier 3 - Non-Preferred Brand	2		
H5416	009	0	1	01	01	H5416_009_0	9	2	Tier 2 - Preferred Brand	2		
H5416	009	0	1	01	01	H5416_009_0	9	1	Tier 1 - Generic	1		1
H5416	009	0	1	01	01	H5416_009_0	9	4	Tier 4 - Specialty Drug			
H5416	009	0	1	01	01	H5416_009_0	9	3	Tier 3 - Non-Preferred Brand			
H5416	009	0	1	01	01	H5416_009_0	9	2	Tier 2 - Preferred Brand			
H5416	009	0	1	01	01	H5416_009_0	9	4	Tier 4 - Specialty Drug	2		
H5416	010	0	1	02	01	H5416_010_0	11	3	Tier 3 - Non-Preferred Brand	2		
H5416	010	0	1	02	01	H5416_010_0	11	4	Tier 4 - Specialty Drug	2		
H5416	010	0	1	02	01	H5416_010_0	11	1	Tier 1 - Generic			
H5416	010	0	1	02	01	H5416_010_0	11	2	Tier 2 - Preferred Brand			
H5416	010	0	1	02	01	H5416_010_0	11	3	Tier 3 - Non-Preferred Brand			
H5416	010	0	1	02	01	H5416_010_0	11	4	Tier 4 - Specialty Drug			
H5416	010	0	1	02	01	H5416_010_0	11	1	Tier 1 - Generic	1		1
H5416	010	0	1	02	01	H5416_010_0	11	2	Tier 2 - Preferred Brand	2		
H5417	001	0	1	04	01	H5417_001_0	3	2	Preferred Brand			
H5417	001	0	1	04	01	H5417_001_0	3	1	Preferred Generic			
H5417	001	0	1	04	01	H5417_001_0	3	3	Non Preferred			
H5417	001	0	1	04	01	H5417_001_0	3	4	Specialty			
H5417	005	0	1	04	01	H5417_005_0	3	1	Preferred Generic			
H5417	005	0	1	04	01	H5417_005_0	3	2	Preferred Brand			
H5417	005	0	1	04	01	H5417_005_0	3	3	Non Preferred			
H5417	005	0	1	04	01	H5417_005_0	3	4	Specialty			
H5417	006	0	1	04	01	H5417_006_0	5	2	Preferred Brand			
H5417	006	0	1	04	01	H5417_006_0	5	1	Preferred Generic			
H5417	006	0	1	04	01	H5417_006_0	5	3	Non-Preferred			
H5417	006	0	1	04	01	H5417_006_0	5	4	Specialty			
H5419	004	0	1	09	04	H5419_004_0	9	1	Tier 1 Preferred Generic			
H5419	004	0	1	09	04	H5419_004_0	9	2	Tier 2 Preferred Brand			
H5419	004	0	1	09	04	H5419_004_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H5419	004	0	1	09	04	H5419_004_0	9	4	Tier 4 Non-Specialty Injectable			
H5419	004	0	1	09	04	H5419_004_0	9	5	Tier 5 Specialty	2		
H5419	004	0	1	09	04	H5419_004_0	9	1	Tier 1 Preferred Generic	1		1
H5419	004	0	1	09	04	H5419_004_0	9	2	Tier 2 Preferred Brand	2		
H5419	004	0	1	09	04	H5419_004_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H5419	004	0	1	09	04	H5419_004_0	9	4	Tier 4 Non-Specialty Injectable	2		
H5419	004	0	1	09	04	H5419_004_0	9	5	Tier 5 Specialty			
H5420	001	0	1	05	01	H5420_001_0	6	1	Generic			
H5420	001	0	1	05	01	H5420_001_0	6	5	Specialty	2		
H5420	001	0	1	05	01	H5420_001_0	6	4	Non-Preferred Brand	2		
H5420	001	0	1	05	01	H5420_001_0	6	3	Formulary Brand	2		
H5420	001	0	1	05	01	H5420_001_0	6	2	Preferred Brand	1		1
H5420	001	0	1	05	01	H5420_001_0	6	1	Generic	1		1
H5420	001	0	1	05	01	H5420_001_0	6	5	Specialty			
H5420	001	0	1	05	01	H5420_001_0	6	4	Non-Preferred Brand			
H5420	001	0	1	05	01	H5420_001_0	6	3	Formulary Brand			
H5420	001	0	1	05	01	H5420_001_0	6	2	Preferred Brand			
H5420	003	0	1	05	01	H5420_003_0	6	1	Generic			
H5420	003	0	1	05	01	H5420_003_0	6	2	Preferred Brand			
H5420	003	0	1	05	01	H5420_003_0	6	3	Formulary Brand			
H5420	003	0	1	05	01	H5420_003_0	6	4	Non-Preferred Brand			
H5420	003	0	1	05	01	H5420_003_0	6	5	Specialty	2		
H5420	003	0	1	05	01	H5420_003_0	6	1	Generic	1		1
H5420	003	0	1	05	01	H5420_003_0	6	2	Preferred Brand	2		
H5420	003	0	1	05	01	H5420_003_0	6	3	Formulary Brand	2		
H5420	003	0	1	05	01	H5420_003_0	6	4	Non-Preferred Brand	2		
H5420	003	0	1	05	01	H5420_003_0	6	5	Specialty			
H5420	004	0	1	05	01	H5420_004_0	5	5	Specialty	2		
H5420	004	0	1	05	01	H5420_004_0	5	4	Non-Preferred Brand	2		
H5420	004	0	1	05	01	H5420_004_0	5	3	Formulary Brand	2		
H5420	004	0	1	05	01	H5420_004_0	5	2	Preferred Brand	1		1
H5420	004	0	1	05	01	H5420_004_0	5	1	Generic	1		1
H5420	004	0	1	05	01	H5420_004_0	5	5	Specialty			
H5420	004	0	1	05	01	H5420_004_0	5	4	Non-Preferred Brand			
H5420	004	0	1	05	01	H5420_004_0	5	3	Formulary Brand			
H5420	004	0	1	05	01	H5420_004_0	5	2	Preferred Brand			
H5420	004	0	1	05	01	H5420_004_0	5	1	Generic			
H5420	005	0	1	05	01	H5420_005_0	5	1	Generic			
H5420	005	0	1	05	01	H5420_005_0	5	5	Specialty			
H5420	005	0	1	05	01	H5420_005_0	5	4	Non-Preferred Brand			
H5420	005	0	1	05	01	H5420_005_0	5	3	Formulary Brand			
H5420	005	0	1	05	01	H5420_005_0	5	1	Generic	1		1
H5420	005	0	1	05	01	H5420_005_0	5	5	Specialty	2		
H5420	005	0	1	05	01	H5420_005_0	5	4	Non-Preferred Brand	2		
H5420	005	0	1	05	01	H5420_005_0	5	3	Formulary Brand	2		
H5420	005	0	1	05	01	H5420_005_0	5	2	Preferred Brand	2		
H5420	005	0	1	05	01	H5420_005_0	5	2	Preferred Brand			
H5420	006	0	1	05	01	H5420_006_0	5	3	Specialty	2		
H5420	006	0	1	05	01	H5420_006_0	5	2	Brand	2		
H5420	006	0	1	05	01	H5420_006_0	5	2	Brand			
H5420	006	0	1	05	01	H5420_006_0	5	3	Specialty			
H5420	006	0	1	05	01	H5420_006_0	5	1	Generic	1		1
H5420	006	0	1	05	01	H5420_006_0	5	1	Generic			
H5420	009	0	1	05	01	H5420_009_0	5	3	Formulary Brand			
H5420	009	0	1	05	01	H5420_009_0	5	2	Preferred Brand			
H5420	009	0	1	05	01	H5420_009_0	5	1	Generic			
H5420	009	0	1	05	01	H5420_009_0	5	4	Non-Preferred Brand			
H5420	009	0	1	05	01	H5420_009_0	5	5	Specialty			
H5421	064	0	1	09	04	H5421_064_0	4	1	Generic			
H5421	064	0	1	09	04	H5421_064_0	4	1	Generic	1		1
H5421	064	0	1	09	04	H5421_064_0	4	3	Non-Preferred Brand			
H5421	064	0	1	09	04	H5421_064_0	4	4	Specialty			
H5421	064	0	1	09	04	H5421_064_0	4	2	Preferred Brand			
H5421	064	0	1	09	04	H5421_064_0	4	2	Preferred Brand	2		
H5421	064	0	1	09	04	H5421_064_0	4	3	Non-Preferred Brand	2		
H5421	064	0	1	09	04	H5421_064_0	4	4	Specialty	2		
H5421	065	0	1	09	04	H5421_065_0	4	4	Specialty			
H5421	065	0	1	09	04	H5421_065_0	4	3	Non-Preferred Brand			
H5421	065	0	1	09	04	H5421_065_0	4	2	Preferred Brand			
H5421	065	0	1	09	04	H5421_065_0	4	1	Generic			
H5421	065	0	1	09	04	H5421_065_0	4	3	Non-Preferred Brand	2		
H5421	065	0	1	09	04	H5421_065_0	4	2	Preferred Brand	2		
H5421	065	0	1	09	04	H5421_065_0	4	1	Generic	1		1
H5421	065	0	1	09	04	H5421_065_0	4	4	Specialty	2		
H5421	066	0	1	09	04	H5421_066_0	4	3	Non-Preferred Brand			
H5421	066	0	1	09	04	H5421_066_0	4	2	Preferred Brand			
H5421	066	0	1	09	04	H5421_066_0	4	1	Generic			
H5421	066	0	1	09	04	H5421_066_0	4	4	Specialty			
H5421	066	0	1	09	04	H5421_066_0	4	1	Generic	1		1
H5421	066	0	1	09	04	H5421_066_0	4	4	Specialty	2		
H5421	066	0	1	09	04	H5421_066_0	4	3	Non-Preferred Brand	2		
H5421	066	0	1	09	04	H5421_066_0	4	2	Preferred Brand	2		
H5421	067	0	1	09	04	H5421_067_0	6	3	Non-Preferred Brand	2		
H5421	067	0	1	09	04	H5421_067_0	6	4	Specialty	2		
H5421	067	0	1	09	04	H5421_067_0	6	1	Generic			
H5421	067	0	1	09	04	H5421_067_0	6	2	Preferred Brand			
H5421	067	0	1	09	04	H5421_067_0	6	3	Non-Preferred Brand			
H5421	067	0	1	09	04	H5421_067_0	6	4	Specialty			
H5421	067	0	1	09	04	H5421_067_0	6	1	Generic	1		1
H5421	067	0	1	09	04	H5421_067_0	6	2	Preferred Brand	2		
H5421	068	0	1	09	04	H5421_068_0	4	2	Preferred Brand			
H5421	068	0	1	09	04	H5421_068_0	4	1	Generic			
H5421	068	0	1	09	04	H5421_068_0	4	4	Specialty	2		
H5421	068	0	1	09	04	H5421_068_0	4	3	Non-Preferred Brand	2		
H5421	068	0	1	09	04	H5421_068_0	4	2	Preferred Brand	2		
H5421	068	0	1	09	04	H5421_068_0	4	3	Non-Preferred Brand			
H5421	068	0	1	09	04	H5421_068_0	4	4	Specialty			
H5421	068	0	1	09	04	H5421_068_0	4	1	Generic	1		1
H5421	069	0	1	09	04	H5421_069_0	4	2	Preferred Brand	2		
H5421	069	0	1	09	04	H5421_069_0	4	1	Generic	1		1
H5421	069	0	1	09	04	H5421_069_0	4	3	Non-Preferred Brand	2		
H5421	069	0	1	09	04	H5421_069_0	4	4	Specialty	2		
H5421	069	0	1	09	04	H5421_069_0	4	1	Generic			
H5421	069	0	1	09	04	H5421_069_0	4	2	Preferred Brand			
H5421	069	0	1	09	04	H5421_069_0	4	3	Non-Preferred Brand			
H5421	069	0	1	09	04	H5421_069_0	4	4	Specialty			
H5421	070	0	1	09	04	H5421_070_0	4	2	Preferred Brand			
H5421	070	0	1	09	04	H5421_070_0	4	3	Non-Preferred Brand			
H5421	070	0	1	09	04	H5421_070_0	4	1	Generic			
H5421	070	0	1	09	04	H5421_070_0	4	4	Specialty			
H5421	071	0	1	09	04	H5421_071_0	4	2	Preferred Brand			
H5421	071	0	1	09	04	H5421_071_0	4	4	Specialty			
H5421	071	0	1	09	04	H5421_071_0	4	3	Non-Preferred Brand			
H5421	071	0	1	09	04	H5421_071_0	4	1	Generic			
H5421	072	0	1	09	04	H5421_072_0	4	1	Generic			
H5421	072	0	1	09	04	H5421_072_0	4	2	Preferred Brand			
H5421	072	0	1	09	04	H5421_072_0	4	3	Non-Preferred Brand			
H5421	072	0	1	09	04	H5421_072_0	4	4	Specialty			
H5421	073	0	1	09	04	H5421_073_0	6	1	Generic			
H5421	073	0	1	09	04	H5421_073_0	6	2	Preferred Brand			
H5421	073	0	1	09	04	H5421_073_0	6	3	Non-Preferred Brand			
H5421	073	0	1	09	04	H5421_073_0	6	4	Specialty			
H5421	074	0	1	09	04	H5421_074_0	4	3	Non-Preferred Brand			
H5421	074	0	1	09	04	H5421_074_0	4	4	Specialty			
H5421	074	0	1	09	04	H5421_074_0	4	1	Generic			
H5421	074	0	1	09	04	H5421_074_0	4	2	Preferred Brand			
H5421	075	0	1	09	04	H5421_075_0	4	1	Generic			
H5421	075	0	1	09	04	H5421_075_0	4	2	Preferred Brand			
H5421	075	0	1	09	04	H5421_075_0	4	3	Non-Preferred Brand			
H5421	075	0	1	09	04	H5421_075_0	4	4	Specialty			
H5421	103	0	1	09	04	H5421_103_0	4	4	Specialty			
H5421	103	0	1	09	04	H5421_103_0	4	1	Generic			
H5421	103	0	1	09	04	H5421_103_0	4	2	Preferred Brand			
H5421	103	0	1	09	04	H5421_103_0	4	3	Non-Preferred Brand			
H5421	103	0	1	09	04	H5421_103_0	4	4	Specialty	2		
H5421	103	0	1	09	04	H5421_103_0	4	3	Non-Preferred Brand	2		
H5421	103	0	1	09	04	H5421_103_0	4	2	Preferred Brand	2		
H5421	103	0	1	09	04	H5421_103_0	4	1	Generic	1		1
H5421	104	0	1	09	04	H5421_104_0	4	3	Non-Preferred Brand			
H5421	104	0	1	09	04	H5421_104_0	4	4	Specialty			
H5421	104	0	1	09	04	H5421_104_0	4	2	Preferred Brand			
H5421	104	0	1	09	04	H5421_104_0	4	1	Generic			
H5421	109	0	1	09	04	H5421_109_0	6	3	Non-Preferred Brand	2		
H5421	109	0	1	09	04	H5421_109_0	6	4	Specialty	2		
H5421	109	0	1	09	04	H5421_109_0	6	2	Preferred Brand	2		
H5421	109	0	1	09	04	H5421_109_0	6	1	Generic	1		1
H5421	109	0	1	09	04	H5421_109_0	6	4	Specialty			
H5421	109	0	1	09	04	H5421_109_0	6	3	Non-Preferred Brand			
H5421	109	0	1	09	04	H5421_109_0	6	2	Preferred Brand			
H5421	109	0	1	09	04	H5421_109_0	6	1	Generic			
H5421	110	0	1	09	04	H5421_110_0	6	1	Generic			
H5421	110	0	1	09	04	H5421_110_0	6	3	Non-Preferred Brand			
H5421	110	0	1	09	04	H5421_110_0	6	4	Specialty			
H5421	110	0	1	09	04	H5421_110_0	6	2	Preferred Brand			
H5421	115	0	1	09	04	H5421_115_0	4	3	Non-Preferred Brand			
H5421	115	0	1	09	04	H5421_115_0	4	2	Preferred Brand	2		
H5421	115	0	1	09	04	H5421_115_0	4	3	Non-Preferred Brand	2		
H5421	115	0	1	09	04	H5421_115_0	4	4	Specialty	2		
H5421	115	0	1	09	04	H5421_115_0	4	2	Preferred Brand			
H5421	115	0	1	09	04	H5421_115_0	4	1	Generic			
H5421	115	0	1	09	04	H5421_115_0	4	4	Specialty			
H5421	115	0	1	09	04	H5421_115_0	4	1	Generic	1		1
H5421	116	0	1	09	04	H5421_116_0	4	4	Specialty			
H5421	116	0	1	09	04	H5421_116_0	4	3	Non-Preferred Brand			
H5421	116	0	1	09	04	H5421_116_0	4	2	Preferred Brand			
H5421	116	0	1	09	04	H5421_116_0	4	1	Generic			
H5421	127	0	1	09	04	H5421_127_0	4	2	Preferred Brand	2		
H5421	127	0	1	09	04	H5421_127_0	4	3	Non-Preferred Brand	2		
H5421	127	0	1	09	04	H5421_127_0	4	4	Specialty	2		
H5421	127	0	1	09	04	H5421_127_0	4	1	Generic			
H5421	127	0	1	09	04	H5421_127_0	4	2	Preferred Brand			
H5421	127	0	1	09	04	H5421_127_0	4	4	Specialty			
H5421	127	0	1	09	04	H5421_127_0	4	1	Generic	1		1
H5421	127	0	1	09	04	H5421_127_0	4	3	Non-Preferred Brand			
H5421	128	0	1	09	04	H5421_128_0	4	2	Preferred Brand			
H5421	128	0	1	09	04	H5421_128_0	4	3	Non-Preferred Brand			
H5421	128	0	1	09	04	H5421_128_0	4	4	Specialty			
H5421	128	0	1	09	04	H5421_128_0	4	1	Generic			
H5421	133	0	1	09	04	H5421_133_0	5	2	Preferred Brand	2		
H5421	133	0	1	09	04	H5421_133_0	5	3	Non-Preferred Brand	2		
H5421	133	0	1	09	04	H5421_133_0	5	4	Specialty	2		
H5421	133	0	1	09	04	H5421_133_0	5	4	Specialty			
H5421	133	0	1	09	04	H5421_133_0	5	1	Generic			
H5421	133	0	1	09	04	H5421_133_0	5	1	Generic	1		1
H5421	133	0	1	09	04	H5421_133_0	5	2	Preferred Brand			
H5421	133	0	1	09	04	H5421_133_0	5	3	Non-Preferred Brand			
H5421	134	0	1	09	04	H5421_134_0	5	1	Generic			
H5421	134	0	1	09	04	H5421_134_0	5	2	Preferred Brand			
H5421	134	0	1	09	04	H5421_134_0	5	4	Specialty			
H5421	134	0	1	09	04	H5421_134_0	5	3	Non-Preferred Brand			
H5422	002	0	1	01	01	H5422_002_0	10	1	Tier 1 Preferred Generic			
H5422	002	0	1	01	01	H5422_002_0	10	2	Tier 2 Preferred Brand			
H5422	002	0	1	01	01	H5422_002_0	10	3	Tier 3 Non-Preferred Brand or Generic			
H5422	002	0	1	01	01	H5422_002_0	10	4	Tier 4 Non-Specialty Injectable			
H5422	002	0	1	01	01	H5422_002_0	10	5	Tier 5 Specialty	2		
H5422	002	0	1	01	01	H5422_002_0	10	1	Tier 1 Preferred Generic	1		1
H5422	002	0	1	01	01	H5422_002_0	10	2	Tier 2 Preferred Brand	2		
H5422	002	0	1	01	01	H5422_002_0	10	3	Tier 3 Non-Preferred Brand or Generic	2		
H5422	002	0	1	01	01	H5422_002_0	10	4	Tier 4 Non-Specialty Injectable	2		
H5422	002	0	1	01	01	H5422_002_0	10	5	Tier 5 Specialty			
H5422	006	0	1	01	01	H5422_006_0	10	1	Tier 1 Preferred Generic			
H5422	006	0	1	01	01	H5422_006_0	10	2	Tier 2 Preferred Brand			
H5422	006	0	1	01	01	H5422_006_0	10	3	Tier 3 Non-Preferred Brand or Generic			
H5422	006	0	1	01	01	H5422_006_0	10	4	Tier 4 Non-Specialty Injectable			
H5422	006	0	1	01	01	H5422_006_0	10	5	Tier 5 Specialty			
H5422	006	0	1	01	01	H5422_006_0	10	1	Tier 1 Preferred Generic	1		1
H5422	006	0	1	01	01	H5422_006_0	10	2	Tier 2 Preferred Brand	2		
H5422	006	0	1	01	01	H5422_006_0	10	3	Tier 3 Non-Preferred Brand or Generic	2		
H5422	006	0	1	01	01	H5422_006_0	10	4	Tier 4 Non-Specialty Injectable	2		
H5422	006	0	1	01	01	H5422_006_0	10	5	Tier 5 Specialty	2		
H5424	001	0	1	04	01	H5424_001_0	4	1	Preferred Generic			
H5424	001	0	1	04	01	H5424_001_0	4	4	Specialty			
H5424	001	0	1	04	01	H5424_001_0	4	3	Non-Preferred			
H5424	001	0	1	04	01	H5424_001_0	4	2	Preferred Brand			
H5425	001	0	1	01	01	H5425_001_0	8	2	Preferred Generic			
H5425	001	0	1	01	01	H5425_001_0	8	1	Select Generic			
H5425	001	0	1	01	01	H5425_001_0	8	5	Specialty	2		
H5425	001	0	1	01	01	H5425_001_0	8	4	Additional Brand	2		
H5425	001	0	1	01	01	H5425_001_0	8	3	Brand			
H5425	001	0	1	01	01	H5425_001_0	8	2	Preferred Generic	1		1
H5425	001	0	1	01	01	H5425_001_0	8	1	Select Generic	1		1
H5425	001	0	1	01	01	H5425_001_0	8	5	Specialty			
H5425	001	0	1	01	01	H5425_001_0	8	4	Additional Brand			
H5425	001	0	1	01	01	H5425_001_0	8	3	Brand	2		
H5425	003	0	1	01	01	H5425_003_0	10	3	Brand			
H5425	003	0	1	01	01	H5425_003_0	10	5	Specialty	2		
H5425	003	0	1	01	01	H5425_003_0	10	4	Additional Brand	2		
H5425	003	0	1	01	01	H5425_003_0	10	3	Brand	2		
H5425	003	0	1	01	01	H5425_003_0	10	2	Preferred Generic	1		1
H5425	003	0	1	01	01	H5425_003_0	10	1	Select Generic	1		1
H5425	003	0	1	01	01	H5425_003_0	10	5	Specialty			
H5425	003	0	1	01	01	H5425_003_0	10	4	Additional Brand			
H5425	003	0	1	01	01	H5425_003_0	10	2	Preferred Generic			
H5425	003	0	1	01	01	H5425_003_0	10	1	Select Generic			
H5425	004	0	1	01	01	H5425_004_0	11	2	Preferred Generic	1		1
H5425	004	0	1	01	01	H5425_004_0	11	3	Brand	2		
H5425	004	0	1	01	01	H5425_004_0	11	4	Additional Brand			
H5425	004	0	1	01	01	H5425_004_0	11	5	Specialty			
H5425	004	0	1	01	01	H5425_004_0	11	1	Select Generic	1		1
H5425	004	0	1	01	01	H5425_004_0	11	3	Brand			
H5425	004	0	1	01	01	H5425_004_0	11	2	Preferred Generic			
H5425	004	0	1	01	01	H5425_004_0	11	1	Select Generic			
H5425	004	0	1	01	01	H5425_004_0	11	5	Specialty	2		
H5425	004	0	1	01	01	H5425_004_0	11	4	Additional Brand	2		
H5425	005	0	1	01	01	H5425_005_0	11	4	Additional Brand			
H5425	005	0	1	01	01	H5425_005_0	11	4	Additional Brand	2		
H5425	005	0	1	01	01	H5425_005_0	11	5	Specialty	2		
H5425	005	0	1	01	01	H5425_005_0	11	1	Select Generic	1		1
H5425	005	0	1	01	01	H5425_005_0	11	5	Specialty			
H5425	005	0	1	01	01	H5425_005_0	11	2	Preferred Generic			
H5425	005	0	1	01	01	H5425_005_0	11	1	Select Generic			
H5425	005	0	1	01	01	H5425_005_0	11	2	Preferred Generic	1		1
H5425	005	0	1	01	01	H5425_005_0	11	3	Brand	2		
H5425	005	0	1	01	01	H5425_005_0	11	3	Brand			
H5425	006	0	1	01	01	H5425_006_0	8	4	Additional Brand	2		
H5425	006	0	1	01	01	H5425_006_0	8	3	Brand	2		
H5425	006	0	1	01	01	H5425_006_0	8	1	Select Generic			
H5425	006	0	1	01	01	H5425_006_0	8	2	Preferred Generic	1		1
H5425	006	0	1	01	01	H5425_006_0	8	1	Select Generic	1		1
H5425	006	0	1	01	01	H5425_006_0	8	5	Specialty			
H5425	006	0	1	01	01	H5425_006_0	8	4	Additional Brand			
H5425	006	0	1	01	01	H5425_006_0	8	3	Brand			
H5425	006	0	1	01	01	H5425_006_0	8	5	Specialty	2		
H5425	006	0	1	01	01	H5425_006_0	8	2	Preferred Generic			
H5425	007	0	1	01	01	H5425_007_0	9	4	Additional Brand			
H5425	007	0	1	01	01	H5425_007_0	9	5	Specialty			
H5425	007	0	1	01	01	H5425_007_0	9	1	Select Generic	1		1
H5425	007	0	1	01	01	H5425_007_0	9	2	Preferred Generic	1		1
H5425	007	0	1	01	01	H5425_007_0	9	3	Brand	2		
H5425	007	0	1	01	01	H5425_007_0	9	4	Additional Brand	2		
H5425	007	0	1	01	01	H5425_007_0	9	5	Specialty	2		
H5425	007	0	1	01	01	H5425_007_0	9	1	Select Generic			
H5425	007	0	1	01	01	H5425_007_0	9	2	Preferred Generic			
H5425	007	0	1	01	01	H5425_007_0	9	3	Brand			
H5425	008	0	1	01	01	H5425_008_0	8	1	Select Generic			
H5425	008	0	1	01	01	H5425_008_0	8	2	Preferred Generic			
H5425	008	0	1	01	01	H5425_008_0	8	5	Specialty	2		
H5425	008	0	1	01	01	H5425_008_0	8	4	Additional Brand	2		
H5425	008	0	1	01	01	H5425_008_0	8	3	Brand	2		
H5425	008	0	1	01	01	H5425_008_0	8	2	Preferred Generic	1		1
H5425	008	0	1	01	01	H5425_008_0	8	1	Select Generic	1		1
H5425	008	0	1	01	01	H5425_008_0	8	5	Specialty			
H5425	008	0	1	01	01	H5425_008_0	8	4	Additional Brand			
H5425	008	0	1	01	01	H5425_008_0	8	3	Brand			
H5425	009	0	1	01	01	H5425_009_0	9	1	Select Generic			
H5425	009	0	1	01	01	H5425_009_0	9	4	Additional Brand	2		
H5425	009	0	1	01	01	H5425_009_0	9	3	Brand	2		
H5425	009	0	1	01	01	H5425_009_0	9	2	Preferred Generic	1		1
H5425	009	0	1	01	01	H5425_009_0	9	5	Specialty	2		
H5425	009	0	1	01	01	H5425_009_0	9	5	Specialty			
H5425	009	0	1	01	01	H5425_009_0	9	4	Additional Brand			
H5425	009	0	1	01	01	H5425_009_0	9	3	Brand			
H5425	009	0	1	01	01	H5425_009_0	9	2	Preferred Generic			
H5425	009	0	1	01	01	H5425_009_0	9	1	Select Generic	1		1
H5425	010	0	1	01	01	H5425_010_0	9	1	Select Generic			
H5425	010	0	1	01	01	H5425_010_0	9	2	Preferred Generic			
H5425	010	0	1	01	01	H5425_010_0	9	3	Preferred Brand			
H5425	010	0	1	01	01	H5425_010_0	9	4	Additional Brand			
H5425	010	0	1	01	01	H5425_010_0	9	5	Specialty			
H5425	011	0	1	01	01	H5425_011_0	9	1	Select Generic			
H5425	011	0	1	01	01	H5425_011_0	9	2	Preferred Generic			
H5425	011	0	1	01	01	H5425_011_0	9	3	Preferred Brand			
H5425	011	0	1	01	01	H5425_011_0	9	4	Additional Brand			
H5425	011	0	1	01	01	H5425_011_0	9	5	Specialty			
H5425	012	0	1	01	01	H5425_012_0	9	2	Preferred Generic			
H5425	012	0	1	01	01	H5425_012_0	9	1	Select Generic			
H5425	012	0	1	01	01	H5425_012_0	9	3	Preferred Brand			
H5425	012	0	1	01	01	H5425_012_0	9	5	Specialty			
H5425	012	0	1	01	01	H5425_012_0	9	4	Additional Brand			
H5425	013	0	1	01	01	H5425_013_0	10	1	Select Generic			
H5425	013	0	1	01	01	H5425_013_0	10	2	Preferred Generic			
H5425	013	0	1	01	01	H5425_013_0	10	3	Brand			
H5425	013	0	1	01	01	H5425_013_0	10	4	Additional Brand			
H5425	013	0	1	01	01	H5425_013_0	10	5	Specialty	2		
H5425	013	0	1	01	01	H5425_013_0	10	1	Select Generic	1		1
H5425	013	0	1	01	01	H5425_013_0	10	2	Preferred Generic	1		1
H5425	013	0	1	01	01	H5425_013_0	10	4	Additional Brand	2		
H5425	013	0	1	01	01	H5425_013_0	10	3	Brand	2		
H5425	013	0	1	01	01	H5425_013_0	10	5	Specialty			
H5425	014	0	1	01	01	H5425_014_0	10	2	Preferred Generic			
H5425	014	0	1	01	01	H5425_014_0	10	1	Select Generic			
H5425	014	0	1	01	01	H5425_014_0	10	3	Brand			
H5425	014	0	1	01	01	H5425_014_0	10	5	Specialty	2		
H5425	014	0	1	01	01	H5425_014_0	10	4	Additional Brand	2		
H5425	014	0	1	01	01	H5425_014_0	10	3	Brand	2		
H5425	014	0	1	01	01	H5425_014_0	10	2	Preferred Generic	1		1
H5425	014	0	1	01	01	H5425_014_0	10	1	Select Generic	1		1
H5425	014	0	1	01	01	H5425_014_0	10	5	Specialty			
H5425	014	0	1	01	01	H5425_014_0	10	4	Additional Brand			
H5425	015	0	1	01	01	H5425_015_0	11	1	Select Generic			
H5425	015	0	1	01	01	H5425_015_0	11	2	Preferred Generic			
H5425	015	0	1	01	01	H5425_015_0	11	5	Specialty	2		
H5425	015	0	1	01	01	H5425_015_0	11	4	Additional Brand	2		
H5425	015	0	1	01	01	H5425_015_0	11	3	Brand	2		
H5425	015	0	1	01	01	H5425_015_0	11	2	Preferred Generic	1		1
H5425	015	0	1	01	01	H5425_015_0	11	1	Select Generic	1		1
H5425	015	0	1	01	01	H5425_015_0	11	5	Specialty			
H5425	015	0	1	01	01	H5425_015_0	11	4	Additional Brand			
H5425	015	0	1	01	01	H5425_015_0	11	3	Brand			
H5425	016	0	1	01	01	H5425_016_0	11	1	Select Generic			
H5425	016	0	1	01	01	H5425_016_0	11	3	Brand			
H5425	016	0	1	01	01	H5425_016_0	11	4	Additional Brand			
H5425	016	0	1	01	01	H5425_016_0	11	5	Specialty			
H5425	016	0	1	01	01	H5425_016_0	11	5	Specialty	2		
H5425	016	0	1	01	01	H5425_016_0	11	2	Preferred Generic	1		1
H5425	016	0	1	01	01	H5425_016_0	11	3	Brand	2		
H5425	016	0	1	01	01	H5425_016_0	11	4	Additional Brand	2		
H5425	016	0	1	01	01	H5425_016_0	11	2	Preferred Generic			
H5425	016	0	1	01	01	H5425_016_0	11	1	Select Generic	1		1
H5426	001	0	1	02	01	H5426_001_0	8	3	Non-Preferred Brand			
H5426	001	0	1	02	01	H5426_001_0	8	4	Specialty			
H5426	001	0	1	02	01	H5426_001_0	8	1	Generic	1		1
H5426	001	0	1	02	01	H5426_001_0	8	2	Preferred Brand	2		
H5426	001	0	1	02	01	H5426_001_0	8	3	Non-Preferred Brand	2		
H5426	001	0	1	02	01	H5426_001_0	8	4	Specialty	2		
H5426	001	0	1	02	01	H5426_001_0	8	1	Generic			
H5426	001	0	1	02	01	H5426_001_0	8	2	Preferred Brand			
H5426	002	0	1	02	01	H5426_002_0	8	1	Generic			
H5426	002	0	1	02	01	H5426_002_0	8	2	Preferred Brand			
H5426	002	0	1	02	01	H5426_002_0	8	3	Non-Preferred Brand			
H5426	002	0	1	02	01	H5426_002_0	8	4	Specialty			
H5426	002	0	1	02	01	H5426_002_0	8	1	Generic	1		1
H5426	002	0	1	02	01	H5426_002_0	8	2	Preferred Brand	2		
H5426	002	0	1	02	01	H5426_002_0	8	3	Non-Preferred Brand	2		
H5426	002	0	1	02	01	H5426_002_0	8	4	Specialty	2		
H5426	007	0	1	02	01	H5426_007_0	9	4	Specialty			
H5426	007	0	1	02	01	H5426_007_0	9	2	Preferred Brand			
H5426	007	0	1	02	01	H5426_007_0	9	3	Non-Preferred Brand			
H5426	007	0	1	02	01	H5426_007_0	9	1	Generic			
H5426	008	0	1	02	01	H5426_008_0	9	3	Non-Preferred Brand			
H5426	008	0	1	02	01	H5426_008_0	9	4	Specialty			
H5426	008	0	1	02	01	H5426_008_0	9	2	Preferred Brand			
H5426	008	0	1	02	01	H5426_008_0	9	1	Generic			
H5426	013	0	1	01	01	H5426_013_0	6	1	Generic			
H5426	013	0	1	01	01	H5426_013_0	6	4	Specialty			
H5426	013	0	1	01	01	H5426_013_0	6	3	Non-Preferred Brand			
H5426	013	0	1	01	01	H5426_013_0	6	2	Preferred Brand			
H5426	014	0	1	01	01	H5426_014_0	6	1	Generic			
H5426	014	0	1	01	01	H5426_014_0	6	2	Preferred Brand			
H5426	014	0	1	01	01	H5426_014_0	6	3	Non-Preferred Brand			
H5426	014	0	1	01	01	H5426_014_0	6	4	Specialty			
H5426	015	0	1	01	01	H5426_015_0	6	1	Generic			
H5426	015	0	1	01	01	H5426_015_0	6	2	Preferred Brand			
H5426	015	0	1	01	01	H5426_015_0	6	3	Non-Preferred Brand			
H5426	015	0	1	01	01	H5426_015_0	6	4	Specialty			
H5427	053	0	1	02	01	H5427_053_0	11	3	Tier 3			
H5427	053	0	1	02	01	H5427_053_0	11	1	Tier 1			
H5427	053	0	1	02	01	H5427_053_0	11	2	Tier 2			
H5427	053	0	1	02	01	H5427_053_0	11	4	Tier 4			
H5427	054	0	1	02	01	H5427_054_0	11	3	Tier 3			
H5427	054	0	1	02	01	H5427_054_0	11	4	Tier 4			
H5427	054	0	1	02	01	H5427_054_0	11	2	Tier 2			
H5427	054	0	1	02	01	H5427_054_0	11	1	Tier 1			
H5427	056	0	1	02	01	H5427_056_0	11	1	Tier 1			
H5427	056	0	1	02	01	H5427_056_0	11	2	Tier 2			
H5427	056	0	1	02	01	H5427_056_0	11	3	Tier 3			
H5427	056	0	1	02	01	H5427_056_0	11	1	Tier 1	1		1
H5427	056	0	1	02	01	H5427_056_0	11	2	Tier 2	2		
H5427	056	0	1	02	01	H5427_056_0	11	3	Tier 3	2		
H5427	056	0	1	02	01	H5427_056_0	11	4	Tier 4	2		
H5427	056	0	1	02	01	H5427_056_0	11	4	Tier 4			
H5427	059	0	1	02	01	H5427_059_0	9	2	Tier 2			
H5427	059	0	1	02	01	H5427_059_0	9	3	Tier 3			
H5427	059	0	1	02	01	H5427_059_0	9	4	Tier 4			
H5427	059	0	1	02	01	H5427_059_0	9	1	Tier 1			
H5427	060	0	1	02	01	H5427_060_0	9	4	Tier 4	2		
H5427	060	0	1	02	01	H5427_060_0	9	2	Tier 2	2		
H5427	060	0	1	02	01	H5427_060_0	9	3	Tier 3	2		
H5427	060	0	1	02	01	H5427_060_0	9	1	Tier 1	1		1
H5427	060	0	1	02	01	H5427_060_0	9	4	Tier 4			
H5427	060	0	1	02	01	H5427_060_0	9	3	Tier 3			
H5427	060	0	1	02	01	H5427_060_0	9	2	Tier 2			
H5427	060	0	1	02	01	H5427_060_0	9	1	Tier 1			
H5427	062	0	1	02	01	H5427_062_0	8	3	Tier 3			
H5427	062	0	1	02	01	H5427_062_0	8	4	Tier 4			
H5427	062	0	1	02	01	H5427_062_0	8	1	Tier 1	1		1
H5427	062	0	1	02	01	H5427_062_0	8	2	Tier 2	2		
H5427	062	0	1	02	01	H5427_062_0	8	3	Tier 3	2		
H5427	062	0	1	02	01	H5427_062_0	8	4	Tier 4	2		
H5427	062	0	1	02	01	H5427_062_0	8	1	Tier 1			
H5427	062	0	1	02	01	H5427_062_0	8	2	Tier 2			
H5427	070	0	1	01	01	H5427_070_0	8	1	Tier 1			
H5427	070	0	1	01	01	H5427_070_0	8	2	Tier 2			
H5427	070	0	1	01	01	H5427_070_0	8	3	Tier 3			
H5427	070	0	1	01	01	H5427_070_0	8	4	Tier 4			
H5427	070	0	1	01	01	H5427_070_0	8	1	Tier 1	1		1
H5427	070	0	1	01	01	H5427_070_0	8	2	Tier 2	2		
H5427	070	0	1	01	01	H5427_070_0	8	3	Tier 3	2		
H5427	070	0	1	01	01	H5427_070_0	8	4	Tier 4	2		
H5427	072	0	1	01	01	H5427_072_0	11	1	Tier 1			
H5427	072	0	1	01	01	H5427_072_0	11	2	Tier 2			
H5427	072	0	1	01	01	H5427_072_0	11	3	Tier 3			
H5427	072	0	1	01	01	H5427_072_0	11	4	Tier 4			
H5427	075	0	1	02	01	H5427_075_0	11	4	Tier 4			
H5427	075	0	1	02	01	H5427_075_0	11	3	Tier 3			
H5427	075	0	1	02	01	H5427_075_0	11	2	Tier 2			
H5427	075	0	1	02	01	H5427_075_0	11	1	Tier 1			
H5428	001	0	1	01	01	H5428_001_0	3	2	Brand			
H5428	001	0	1	01	01	H5428_001_0	3	1	Generic			
H5429	001	0	1	04	01	H5429_001_0	11	3	Non-Preferred Brand			
H5429	001	0	1	04	01	H5429_001_0	11	2	Preferred Brand			
H5429	001	0	1	04	01	H5429_001_0	11	1	Generic			
H5429	001	0	1	04	01	H5429_001_0	11	4	Specialty			
H5429	005	0	1	04	01	H5429_005_0	10	3	Non-Preferred Brand			
H5429	005	0	1	04	01	H5429_005_0	10	2	Preferred Brand			
H5429	005	0	1	04	01	H5429_005_0	10	1	Generic			
H5429	005	0	1	04	01	H5429_005_0	10	4	Specialty			
H5429	015	0	1	04	01	H5429_015_0	10	1	Generic			
H5429	015	0	1	04	01	H5429_015_0	10	2	Preferred Brand			
H5429	015	0	1	04	01	H5429_015_0	10	3	Non-Preferred Brand			
H5429	015	0	1	04	01	H5429_015_0	10	4	Specialty			
H5429	020	0	1	04	01	H5429_020_0	11	1	Generic			
H5429	020	0	1	04	01	H5429_020_0	11	2	Preferred Brand			
H5429	020	0	1	04	01	H5429_020_0	11	3	Non-Preferred Brand			
H5429	020	0	1	04	01	H5429_020_0	11	4	Specialty			
H5431	001	0	1	01	01	H5431_001_0	7	5	Specialty	2		
H5431	001	0	1	01	01	H5431_001_0	7	4	Non-Preferred Brand	2		
H5431	001	0	1	01	01	H5431_001_0	7	3	Preferred Brand	2		
H5431	001	0	1	01	01	H5431_001_0	7	2	Non-Preferred Generic	1		1
H5431	001	0	1	01	01	H5431_001_0	7	1	Preferred Generic			
H5431	001	0	1	01	01	H5431_001_0	7	5	Specialty			
H5431	001	0	1	01	01	H5431_001_0	7	4	Non-Preferred Brand			
H5431	001	0	1	01	01	H5431_001_0	7	3	Preferred Brand			
H5431	001	0	1	01	01	H5431_001_0	7	2	Non-Preferred Generic			
H5431	001	0	1	01	01	H5431_001_0	7	1	Preferred Generic	1		1
H5431	002	0	1	01	01	H5431_002_0	6	3	Preferred Brand	2		
H5431	002	0	1	01	01	H5431_002_0	6	4	Non-Preferred Brand	2		
H5431	002	0	1	01	01	H5431_002_0	6	2	Non-Preferred Generic	1		1
H5431	002	0	1	01	01	H5431_002_0	6	1	Preferred Generic	1		1
H5431	002	0	1	01	01	H5431_002_0	6	5	Specialty			
H5431	002	0	1	01	01	H5431_002_0	6	4	Non-Preferred Brand			
H5431	002	0	1	01	01	H5431_002_0	6	3	Preferred Brand			
H5431	002	0	1	01	01	H5431_002_0	6	2	Non-Preferred Generic			
H5431	002	0	1	01	01	H5431_002_0	6	1	Preferred Generic			
H5431	002	0	1	01	01	H5431_002_0	6	5	Specialty	2		
H5431	005	0	1	01	01	H5431_005_0	8	3	Preferred Brand	2		
H5431	005	0	1	01	01	H5431_005_0	8	3	Preferred Brand			
H5431	005	0	1	01	01	H5431_005_0	8	2	Non-Preferred Generic			
H5431	005	0	1	01	01	H5431_005_0	8	1	Preferred Generic			
H5431	005	0	1	01	01	H5431_005_0	8	4	Non-Preferred Brand	2		
H5431	005	0	1	01	01	H5431_005_0	8	5	Specialty			
H5431	005	0	1	01	01	H5431_005_0	8	5	Specialty	2		
H5431	005	0	1	01	01	H5431_005_0	8	4	Non-Preferred Brand			
H5431	005	0	1	01	01	H5431_005_0	8	2	Non-Preferred Generic	1		1
H5431	005	0	1	01	01	H5431_005_0	8	1	Preferred Generic	1		1
H5433	001	0	1	01	01	H5433_001_0	5	1	Generics	1		1
H5433	001	0	1	01	01	H5433_001_0	5	2	Brand	2		
H5434	001	0	1	04	01	H5434_001_0	7	4	Tier S - Covered Specialty			
H5434	001	0	1	04	01	H5434_001_0	7	3	Tier 3 - Covered Brand			
H5434	001	0	1	04	01	H5434_001_0	7	2	Tier 2 - Covered Preferred Brand			
H5434	001	0	1	04	01	H5434_001_0	7	1	Tier 1 - Covered Generic			
H5434	002	0	1	04	01	H5434_002_0	5	4	Tier S - Covered Specialty			
H5434	002	0	1	04	01	H5434_002_0	5	3	Tier 3 - Covered Brand			
H5434	002	0	1	04	01	H5434_002_0	5	2	Tier 2 - Covered Preferred Brand			
H5434	002	0	1	04	01	H5434_002_0	5	1	Tier 1 - Covered Generic			
H5434	014	0	1	04	01	H5434_014_0	6	2	Tier 2 - Covered Preferred Brand			
H5434	014	0	1	04	01	H5434_014_0	6	3	Tier 3 - Covered Brand			
H5434	014	0	1	04	01	H5434_014_0	6	4	Tier S - Covered Specialty			
H5434	014	0	1	04	01	H5434_014_0	6	1	Tier 1 - Covered Generic			
H5434	015	0	1	04	01	H5434_015_0	5	4	Tier S - Covered Specialty			
H5434	015	0	1	04	01	H5434_015_0	5	3	Tier 3 - Covered Brand			
H5434	015	0	1	04	01	H5434_015_0	5	2	Tier 2 - Covered Preferred Brand			
H5434	015	0	1	04	01	H5434_015_0	5	1	Tier 1 - Covered Generic			
H5434	016	0	1	04	01	H5434_016_0	5	1	Tier 1 - Covered Generic			
H5434	016	0	1	04	01	H5434_016_0	5	2	Tier 2 - Covered Preferred Brand			
H5434	016	0	1	04	01	H5434_016_0	5	4	Tier S - Covered Specialty			
H5434	016	0	1	04	01	H5434_016_0	5	3	Tier 3 - Covered Brand			
H5434	018	0	1	04	01	H5434_018_0	5	1	Tier 1 - Covered Generic			
H5434	018	0	1	04	01	H5434_018_0	5	2	Tier 2 - Covered Preferred Brand			
H5434	018	0	1	04	01	H5434_018_0	5	3	Tier 3 - Covered Brand			
H5434	018	0	1	04	01	H5434_018_0	5	4	Tier S - Covered Specialty			
H5435	013	0	1	09	04	H5435_013_0	6	1	Preferred Generic			
H5435	013	0	1	09	04	H5435_013_0	6	2	Preferred Brand			
H5435	013	0	1	09	04	H5435_013_0	6	3	Non-Preferred			
H5435	013	0	1	09	04	H5435_013_0	6	4	Specialty			
H5435	014	0	1	09	04	H5435_014_0	6	1	Preferred Generic			
H5435	014	0	1	09	04	H5435_014_0	6	2	Preferred Brand			
H5435	014	0	1	09	04	H5435_014_0	6	3	Non-Preferred			
H5435	014	0	1	09	04	H5435_014_0	6	4	Specialty			
H5435	022	0	1	09	04	H5435_022_0	6	4	Specialty			
H5435	022	0	1	09	04	H5435_022_0	6	3	Non-Preferred			
H5435	022	0	1	09	04	H5435_022_0	6	1	Preferred Generic			
H5435	022	0	1	09	04	H5435_022_0	6	2	Preferred Brand			
H5435	023	0	1	09	04	H5435_023_0	7	3	Non-Preferred			
H5435	023	0	1	09	04	H5435_023_0	7	2	Preferred Brand			
H5435	023	0	1	09	04	H5435_023_0	7	1	Preferred Generic			
H5435	023	0	1	09	04	H5435_023_0	7	4	Specialty			
H5435	024	0	1	09	04	H5435_024_0	7	4	Specialty			
H5435	024	0	1	09	04	H5435_024_0	7	3	Non-Preferred			
H5435	024	0	1	09	04	H5435_024_0	7	1	Preferred Generic			
H5435	024	0	1	09	04	H5435_024_0	7	2	Preferred Brand			
H5435	025	0	1	09	04	H5435_025_0	6	1	Preferred Generic			
H5435	025	0	1	09	04	H5435_025_0	6	2	Preferred Brand			
H5435	025	0	1	09	04	H5435_025_0	6	3	Non-Preferred			
H5435	025	0	1	09	04	H5435_025_0	6	4	Specialty			
H5435	027	0	1	09	04	H5435_027_0	6	4	Specialty			
H5435	027	0	1	09	04	H5435_027_0	6	1	Preferred Generic			
H5435	027	0	1	09	04	H5435_027_0	6	2	Preferred Brand			
H5435	027	0	1	09	04	H5435_027_0	6	3	Non-Preferred			
H5435	030	0	1	09	04	H5435_030_0	6	4	Specialty			
H5435	030	0	1	09	04	H5435_030_0	6	3	Non-Preferred			
H5435	030	0	1	09	04	H5435_030_0	6	1	Preferred Generic			
H5435	030	0	1	09	04	H5435_030_0	6	2	Preferred Brand			
H5436	001	0	1	04	01	H5436_001_0	8	1	Generic			
H5436	001	0	1	04	01	H5436_001_0	8	2	Preferred Brand Name			
H5436	001	0	1	04	01	H5436_001_0	8	3	Non-Preferred Brand Name			
H5436	001	0	1	04	01	H5436_001_0	8	4	Specialty			
H5436	002	0	1	04	01	H5436_002_0	8	1	Generic			
H5436	002	0	1	04	01	H5436_002_0	8	2	Preferred Brand Name			
H5436	002	0	1	04	01	H5436_002_0	8	3	Non-Preferred Brand Name			
H5436	002	0	1	04	01	H5436_002_0	8	4	Specialty			
H5437	001	0	1	04	01	H5437_001_0	7	5	Tier 5 - Specialty			
H5437	001	0	1	04	01	H5437_001_0	7	4	Tier 4 - Non-Preferred Brand			
H5437	001	0	1	04	01	H5437_001_0	7	3	Tier 3 - Preferred Brand			
H5437	001	0	1	04	01	H5437_001_0	7	2	Tier 2 - Non-Preferred Generic			
H5437	001	0	1	04	01	H5437_001_0	7	1	Tier 1 - Preferred Generic			
H5437	003	0	1	04	01	H5437_003_0	6	1	Tier 1 - Preferred Generic			
H5437	003	0	1	04	01	H5437_003_0	6	5	Tier 5 - Specialty			
H5437	003	0	1	04	01	H5437_003_0	6	4	Tier 4 - Non-Preferred Brand			
H5437	003	0	1	04	01	H5437_003_0	6	3	Tier 3 - Preferred Brand			
H5437	003	0	1	04	01	H5437_003_0	6	2	Tier 2 - Non-Preferred Generic			
H5437	004	0	1	04	01	H5437_004_0	7	1	Tier 1 - Preferred Generic	1		1
H5437	004	0	1	04	01	H5437_004_0	7	2	Tier 2 - Non-Preferred Generic	1		1
H5437	004	0	1	04	01	H5437_004_0	7	3	Tier 3 - Preferred Brand	2		
H5437	004	0	1	04	01	H5437_004_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5437	004	0	1	04	01	H5437_004_0	7	5	Tier 5 - Specialty	2		
H5437	004	0	1	04	01	H5437_004_0	7	5	Tier 5 - Specialty			
H5437	004	0	1	04	01	H5437_004_0	7	3	Tier 3 - Preferred Brand			
H5437	004	0	1	04	01	H5437_004_0	7	4	Tier 4 - Non-Preferred Brand			
H5437	004	0	1	04	01	H5437_004_0	7	2	Tier 2 - Non-Preferred Generic			
H5437	004	0	1	04	01	H5437_004_0	7	1	Tier 1 - Preferred Generic			
H5437	005	0	1	04	01	H5437_005_0	6	5	Tier 5 - Specialty			
H5437	005	0	1	04	01	H5437_005_0	6	4	Tier 4 - Non-Preferred Brand			
H5437	005	0	1	04	01	H5437_005_0	6	3	Tier 3 - Preferred Brand			
H5437	005	0	1	04	01	H5437_005_0	6	2	Tier 2 - Non-Preferred Generic			
H5437	005	0	1	04	01	H5437_005_0	6	1	Tier 1 - Preferred Generic			
H5437	006	0	1	04	01	H5437_006_0	7	5	Tier 5 - Specialty			
H5437	006	0	1	04	01	H5437_006_0	7	3	Tier 3 - Preferred Brand			
H5437	006	0	1	04	01	H5437_006_0	7	4	Tier 4 - Non-Preferred Brand			
H5437	006	0	1	04	01	H5437_006_0	7	2	Tier 2 - Non-Preferred Generic			
H5437	006	0	1	04	01	H5437_006_0	7	1	Tier 1 - Preferred Generic			
H5437	007	0	1	04	01	H5437_007_0	6	1	Tier 1 - Preferred Generic	1		1
H5437	007	0	1	04	01	H5437_007_0	6	5	Tier 5 - Specialty			
H5437	007	0	1	04	01	H5437_007_0	6	4	Tier 4 - Non-Preferred Brand			
H5437	007	0	1	04	01	H5437_007_0	6	3	Tier 3 - Preferred Brand			
H5437	007	0	1	04	01	H5437_007_0	6	5	Tier 5 - Specialty	2		
H5437	007	0	1	04	01	H5437_007_0	6	1	Tier 1 - Preferred Generic			
H5437	007	0	1	04	01	H5437_007_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5437	007	0	1	04	01	H5437_007_0	6	3	Tier 3 - Preferred Brand	2		
H5437	007	0	1	04	01	H5437_007_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5437	007	0	1	04	01	H5437_007_0	6	2	Tier 2 - Non-Preferred Generic			
H5439	001	0	1	04	01	H5439_001_0	5	1	Preferred Generic			
H5439	001	0	1	04	01	H5439_001_0	5	2	Preferred Brand			
H5439	001	0	1	04	01	H5439_001_0	5	5	Specialty			
H5439	001	0	1	04	01	H5439_001_0	5	4	Injectable			
H5439	001	0	1	04	01	H5439_001_0	5	3	Non-Preferred			
H5449	001	0	1	04	01	H5449_001_0	6	1	Generic			
H5449	001	0	1	04	01	H5449_001_0	6	4	Specialty			
H5449	001	0	1	04	01	H5449_001_0	6	3	Non-Preferred Brand			
H5449	001	0	1	04	01	H5449_001_0	6	2	Preferred Brand			
H5470	002	0	1	04	01	H5470_002_0	4	1	Preferred Generic			
H5470	002	0	1	04	01	H5470_002_0	4	2	Preferred Brand			
H5470	002	0	1	04	01	H5470_002_0	4	3	Non-Preferred Brand			
H5470	002	0	1	04	01	H5470_002_0	4	4	Specialty	1	10001000	2
H5470	002	0	1	04	01	H5470_002_0	4	1	Preferred Generic	1	00001000	2
H5470	002	0	1	04	01	H5470_002_0	4	2	Preferred Brand	1	10000000	2
H5470	002	0	1	04	01	H5470_002_0	4	3	Non-Preferred Brand	1	10000000	2
H5470	002	0	1	04	01	H5470_002_0	4	4	Specialty			
H5485	001	0	1	09	04	H5485_001_0	11	1	Generic			
H5485	001	0	1	09	04	H5485_001_0	11	4	Specialty			
H5485	001	0	1	09	04	H5485_001_0	11	3	Non-Preferred Brand			
H5485	001	0	1	09	04	H5485_001_0	11	2	Preferred Brand			
H5501	001	0	1	04	01	H5501_001_0	11	1	Generic			
H5501	001	0	1	04	01	H5501_001_0	11	3	Non-Preferred Brand			
H5501	001	0	1	04	01	H5501_001_0	11	4	Specialty	2		
H5501	001	0	1	04	01	H5501_001_0	11	3	Non-Preferred Brand	2		
H5501	001	0	1	04	01	H5501_001_0	11	2	Preferred Brand	1		1
H5501	001	0	1	04	01	H5501_001_0	11	1	Generic	1		1
H5501	001	0	1	04	01	H5501_001_0	11	4	Specialty			
H5501	001	0	1	04	01	H5501_001_0	11	2	Preferred Brand			
H5507	001	0	1	04	01	H5507_001_0	4	2	Preferred Brand			
H5507	001	0	1	04	01	H5507_001_0	4	1	Preferred Generic			
H5507	001	0	1	04	01	H5507_001_0	4	3	Non-Preferred			
H5507	001	0	1	04	01	H5507_001_0	4	4	Specialty			
H5508	001	0	1	04	01	H5508_001_0	4	3	Preferred Brand			
H5508	001	0	1	04	01	H5508_001_0	4	2	Generic			
H5508	001	0	1	04	01	H5508_001_0	4	5	Specialty	2		
H5508	001	0	1	04	01	H5508_001_0	4	4	Non-Preferred Brand	2		
H5508	001	0	1	04	01	H5508_001_0	4	3	Preferred Brand	2		
H5508	001	0	1	04	01	H5508_001_0	4	2	Generic	1		1
H5508	001	0	1	04	01	H5508_001_0	4	1	Preferred Generic			
H5508	001	0	1	04	01	H5508_001_0	4	4	Non-Preferred Brand			
H5508	001	0	1	04	01	H5508_001_0	4	5	Specialty			
H5508	001	0	1	04	01	H5508_001_0	4	1	Preferred Generic	1		1
H5508	003	0	1	04	01	H5508_003_0	4	3	Preferred Brand			
H5508	003	0	1	04	01	H5508_003_0	4	4	Non-Preferred Brand			
H5508	003	0	1	04	01	H5508_003_0	4	5	Specialty			
H5508	003	0	1	04	01	H5508_003_0	4	2	Generic			
H5508	003	0	1	04	01	H5508_003_0	4	1	Preferred Generic			
H5509	001	0	1	04	01	H5509_001_0	7	4	SPECIALTY			
H5509	001	0	1	04	01	H5509_001_0	7	1	PREFERRED GENERIC	1		1
H5509	001	0	1	04	01	H5509_001_0	7	1	PREFERRED GENERIC			
H5509	001	0	1	04	01	H5509_001_0	7	2	PREFERRED BRAND			
H5509	001	0	1	04	01	H5509_001_0	7	4	SPECIALTY	2		
H5509	001	0	1	04	01	H5509_001_0	7	3	NON-PREFERRED BRAND			
H5509	001	0	1	04	01	H5509_001_0	7	2	PREFERRED BRAND	2		
H5509	001	0	1	04	01	H5509_001_0	7	3	NON-PREFERRED BRAND	2		
H5509	003	0	1	04	01	H5509_003_0	6	2	PREFERRED BRAND			
H5509	003	0	1	04	01	H5509_003_0	6	1	PREFERRED GENERIC			
H5509	003	0	1	04	01	H5509_003_0	6	4	SPECIALTY	2		
H5509	003	0	1	04	01	H5509_003_0	6	3	NON-PREFERRED BRAND	2		
H5509	003	0	1	04	01	H5509_003_0	6	2	PREFERRED BRAND	2		
H5509	003	0	1	04	01	H5509_003_0	6	1	PREFERRED GENERIC	1		1
H5509	003	0	1	04	01	H5509_003_0	6	3	NON-PREFERRED BRAND			
H5509	003	0	1	04	01	H5509_003_0	6	4	SPECIALTY			
H5509	004	0	1	04	01	H5509_004_0	7	5	OTHER - SPECIAL NEEDS	1		1
H5509	004	0	1	04	01	H5509_004_0	7	2	PREFERRED BRAND			
H5509	004	0	1	04	01	H5509_004_0	7	3	NON-PREFERRED BRAND			
H5509	004	0	1	04	01	H5509_004_0	7	4	SPECIALTY			
H5509	004	0	1	04	01	H5509_004_0	7	1	PREFERRED GENERIC			
H5509	004	0	1	04	01	H5509_004_0	7	1	PREFERRED GENERIC	2		
H5509	004	0	1	04	01	H5509_004_0	7	2	PREFERRED BRAND	2		
H5509	004	0	1	04	01	H5509_004_0	7	3	NON-PREFERRED BRAND	2		
H5509	004	0	1	04	01	H5509_004_0	7	4	SPECIALTY	2		
H5509	004	0	1	04	01	H5509_004_0	7	5	OTHER - SPECIAL NEEDS			
H5509	005	0	1	04	01	H5509_005_0	6	2	PREFERRED BRAND			
H5509	005	0	1	04	01	H5509_005_0	6	3	NON-PREFERRED BRAND			
H5509	005	0	1	04	01	H5509_005_0	6	4	SPECIALTY			
H5509	005	0	1	04	01	H5509_005_0	6	5	OTHER - SPECIAL NEEDS			
H5509	005	0	1	04	01	H5509_005_0	6	1	PREFERRED GENERIC	2		
H5509	005	0	1	04	01	H5509_005_0	6	2	PREFERRED BRAND	2		
H5509	005	0	1	04	01	H5509_005_0	6	3	NON-PREFERRED BRAND	2		
H5509	005	0	1	04	01	H5509_005_0	6	4	SPECIALTY	2		
H5509	005	0	1	04	01	H5509_005_0	6	5	OTHER - SPECIAL NEEDS	1		1
H5509	005	0	1	04	01	H5509_005_0	6	1	PREFERRED GENERIC			
H5509	006	0	1	04	01	H5509_006_0	8	2	PREFERRED BRAND	2		
H5509	006	0	1	04	01	H5509_006_0	8	1	PREFERRED GENERIC	2		
H5509	006	0	1	04	01	H5509_006_0	8	5	OTHER - SPECIAL NEEDS	1		1
H5509	006	0	1	04	01	H5509_006_0	8	4	SPECIALTY	2		
H5509	006	0	1	04	01	H5509_006_0	8	3	NON-PREFERRED BRAND	2		
H5509	006	0	1	04	01	H5509_006_0	8	1	PREFERRED GENERIC			
H5509	006	0	1	04	01	H5509_006_0	8	2	PREFERRED BRAND			
H5509	006	0	1	04	01	H5509_006_0	8	3	NON-PREFERRED BRAND			
H5509	006	0	1	04	01	H5509_006_0	8	4	SPECIALTY			
H5509	006	0	1	04	01	H5509_006_0	8	5	OTHER - SPECIAL NEEDS			
H5509	007	0	1	04	01	H5509_007_0	7	1	PREFERRED GENERIC			
H5509	007	0	1	04	01	H5509_007_0	7	4	SPECIALTY	2		
H5509	007	0	1	04	01	H5509_007_0	7	3	NON-PREFERRED BRAND	2		
H5509	007	0	1	04	01	H5509_007_0	7	2	PREFERRED BRAND	2		
H5509	007	0	1	04	01	H5509_007_0	7	5	OTHER - SPECIAL NEEDS	1		1
H5509	007	0	1	04	01	H5509_007_0	7	5	OTHER - SPECIAL NEEDS			
H5509	007	0	1	04	01	H5509_007_0	7	4	SPECIALTY			
H5509	007	0	1	04	01	H5509_007_0	7	3	NON-PREFERRED BRAND			
H5509	007	0	1	04	01	H5509_007_0	7	2	PREFERRED BRAND			
H5509	007	0	1	04	01	H5509_007_0	7	1	PREFERRED GENERIC	2		
H5509	008	0	1	04	01	H5509_008_0	7	2	PREFERRED BRAND	2		
H5509	008	0	1	04	01	H5509_008_0	7	1	PREFERRED GENERIC	2		
H5509	008	0	1	04	01	H5509_008_0	7	5	OTHER - SPECIAL NEEDS			
H5509	008	0	1	04	01	H5509_008_0	7	4	SPECIALTY			
H5509	008	0	1	04	01	H5509_008_0	7	3	NON-PREFERRED BRAND			
H5509	008	0	1	04	01	H5509_008_0	7	2	PREFERRED BRAND			
H5509	008	0	1	04	01	H5509_008_0	7	1	PREFERRED GENERIC			
H5509	008	0	1	04	01	H5509_008_0	7	3	NON-PREFERRED BRAND	2		
H5509	008	0	1	04	01	H5509_008_0	7	5	OTHER - SPECIAL NEEDS	1		1
H5509	008	0	1	04	01	H5509_008_0	7	4	SPECIALTY	2		
H5509	009	0	1	04	01	H5509_009_0	9	2	PREFERRED BRAND			
H5509	009	0	1	04	01	H5509_009_0	9	1	PREFERRED GENERIC			
H5509	009	0	1	04	01	H5509_009_0	9	3	NON-PREFERRED BRAND			
H5509	009	0	1	04	01	H5509_009_0	9	4	SPECIALTY			
H5509	009	0	1	04	01	H5509_009_0	9	5	OTHER - SPECIAL NEEDS	1		1
H5509	009	0	1	04	01	H5509_009_0	9	1	PREFERRED GENERIC	2		
H5509	009	0	1	04	01	H5509_009_0	9	2	PREFERRED BRAND	2		
H5509	009	0	1	04	01	H5509_009_0	9	3	NON-PREFERRED BRAND	2		
H5509	009	0	1	04	01	H5509_009_0	9	4	SPECIALTY	2		
H5509	009	0	1	04	01	H5509_009_0	9	5	OTHER - SPECIAL NEEDS			
H5509	010	0	1	04	01	H5509_010_0	7	2	PREFERRED BRAND			
H5509	010	0	1	04	01	H5509_010_0	7	1	PREFERRED GENERIC			
H5509	010	0	1	04	01	H5509_010_0	7	3	NON-PREFERRED BRAND			
H5509	010	0	1	04	01	H5509_010_0	7	4	SPECIALTY	2		
H5509	010	0	1	04	01	H5509_010_0	7	3	NON-PREFERRED BRAND	2		
H5509	010	0	1	04	01	H5509_010_0	7	2	PREFERRED BRAND	2		
H5509	010	0	1	04	01	H5509_010_0	7	1	PREFERRED GENERIC	1		1
H5509	010	0	1	04	01	H5509_010_0	7	4	SPECIALTY			
H5509	011	0	1	04	01	H5509_011_0	7	1	PREFERRED GENERIC			
H5509	011	0	1	04	01	H5509_011_0	7	2	PREFERRED BRAND			
H5509	011	0	1	04	01	H5509_011_0	7	2	PREFERRED BRAND	2		
H5509	011	0	1	04	01	H5509_011_0	7	3	NON-PREFERRED BRAND	2		
H5509	011	0	1	04	01	H5509_011_0	7	1	PREFERRED GENERIC	1		1
H5509	011	0	1	04	01	H5509_011_0	7	4	SPECIALTY			
H5509	011	0	1	04	01	H5509_011_0	7	3	NON-PREFERRED BRAND			
H5509	011	0	1	04	01	H5509_011_0	7	4	SPECIALTY	2		
H5509	012	0	1	04	01	H5509_012_0	7	1	PREFERRED GENERIC			
H5509	012	0	1	04	01	H5509_012_0	7	2	PREFERRED BRAND			
H5509	012	0	1	04	01	H5509_012_0	7	3	NON-PREFERRED BRAND			
H5509	012	0	1	04	01	H5509_012_0	7	4	SPECIALTY			
H5509	012	0	1	04	01	H5509_012_0	7	1	PREFERRED GENERIC	1		1
H5509	012	0	1	04	01	H5509_012_0	7	2	PREFERRED BRAND	2		
H5509	012	0	1	04	01	H5509_012_0	7	3	NON-PREFERRED BRAND	2		
H5509	012	0	1	04	01	H5509_012_0	7	4	SPECIALTY	2		
H5509	013	0	1	04	01	H5509_013_0	6	1	PREFERRED GENERIC			
H5509	013	0	1	04	01	H5509_013_0	6	2	PREFERRED BRAND			
H5509	013	0	1	04	01	H5509_013_0	6	3	NON-PREFERRED BRAND			
H5509	013	0	1	04	01	H5509_013_0	6	4	SPECIALTY	2		
H5509	013	0	1	04	01	H5509_013_0	6	1	PREFERRED GENERIC	1		1
H5509	013	0	1	04	01	H5509_013_0	6	2	PREFERRED BRAND	2		
H5509	013	0	1	04	01	H5509_013_0	6	3	NON-PREFERRED BRAND	2		
H5509	013	0	1	04	01	H5509_013_0	6	4	SPECIALTY			
H5510	002	0	1	04	01	H5510_002_0	6	1	Tier 1 - Preferred Generic			
H5510	002	0	1	04	01	H5510_002_0	6	2	Tier 2 - Non-Preferred Generic			
H5510	002	0	1	04	01	H5510_002_0	6	5	Tier 5 - Specialty	2		
H5510	002	0	1	04	01	H5510_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5510	002	0	1	04	01	H5510_002_0	6	3	Tier 3 - Preferred Brand	2		
H5510	002	0	1	04	01	H5510_002_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5510	002	0	1	04	01	H5510_002_0	6	1	Tier 1 - Preferred Generic	1		1
H5510	002	0	1	04	01	H5510_002_0	6	5	Tier 5 - Specialty			
H5510	002	0	1	04	01	H5510_002_0	6	4	Tier 4 - Non-Preferred Brand			
H5510	002	0	1	04	01	H5510_002_0	6	3	Tier 3 - Preferred Brand			
H5510	003	0	1	04	01	H5510_003_0	8	2	Tier 2 - Non-Preferred Generic			
H5510	003	0	1	04	01	H5510_003_0	8	3	Tier 3 - Preferred Brand			
H5510	003	0	1	04	01	H5510_003_0	8	4	Tier 4 - Non-Preferred Brand			
H5510	003	0	1	04	01	H5510_003_0	8	5	Tier 5 - Specialty			
H5510	003	0	1	04	01	H5510_003_0	8	1	Tier 1 - Preferred Generic			
H5510	005	0	1	04	01	H5510_005_0	8	5	Tier 5 - Specialty			
H5510	005	0	1	04	01	H5510_005_0	8	2	Tier 2 - Non-Preferred Generic			
H5510	005	0	1	04	01	H5510_005_0	8	3	Tier 3 - Preferred Brand			
H5510	005	0	1	04	01	H5510_005_0	8	4	Tier 4 - Non-Preferred Brand			
H5510	005	0	1	04	01	H5510_005_0	8	1	Tier 1 - Preferred Generic			
H5510	006	0	1	04	01	H5510_006_0	7	2	Tier 2 - Non-Preferred Generic			
H5510	006	0	1	04	01	H5510_006_0	7	3	Tier 3 - Preferred Brand			
H5510	006	0	1	04	01	H5510_006_0	7	4	Tier 4 - Non-Preferred Brand			
H5510	006	0	1	04	01	H5510_006_0	7	5	Tier 5 - Specialty			
H5510	006	0	1	04	01	H5510_006_0	7	1	Tier 1 - Preferred Generic	1		1
H5510	006	0	1	04	01	H5510_006_0	7	2	Tier 2 - Non-Preferred Generic	1		1
H5510	006	0	1	04	01	H5510_006_0	7	3	Tier 3 - Preferred Brand	2		
H5510	006	0	1	04	01	H5510_006_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5510	006	0	1	04	01	H5510_006_0	7	5	Tier 5 - Specialty	2		
H5510	006	0	1	04	01	H5510_006_0	7	1	Tier 1 - Preferred Generic			
H5512	001	0	1	04	01	H5512_001_0	7	5	Tier 5 - Specialty			
H5512	001	0	1	04	01	H5512_001_0	7	4	Tier 4 - Non-Preferred Brand			
H5512	001	0	1	04	01	H5512_001_0	7	3	Tier 3 - Preferred Brand			
H5512	001	0	1	04	01	H5512_001_0	7	2	Tier 2 - Non-Preferred Generic			
H5512	001	0	1	04	01	H5512_001_0	7	1	Tier 1 - Preferred Generic			
H5512	002	0	1	04	01	H5512_002_0	6	3	Tier 3 - Preferred Brand	2		
H5512	002	0	1	04	01	H5512_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5512	002	0	1	04	01	H5512_002_0	6	5	Tier 5 - Specialty	2		
H5512	002	0	1	04	01	H5512_002_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5512	002	0	1	04	01	H5512_002_0	6	1	Tier 1 - Preferred Generic	1		1
H5512	002	0	1	04	01	H5512_002_0	6	5	Tier 5 - Specialty			
H5512	002	0	1	04	01	H5512_002_0	6	4	Tier 4 - Non-Preferred Brand			
H5512	002	0	1	04	01	H5512_002_0	6	2	Tier 2 - Non-Preferred Generic			
H5512	002	0	1	04	01	H5512_002_0	6	3	Tier 3 - Preferred Brand			
H5512	002	0	1	04	01	H5512_002_0	6	1	Tier 1 - Preferred Generic			
H5512	008	0	1	04	01	H5512_008_0	7	5	Tier 5 - Specialty			
H5512	008	0	1	04	01	H5512_008_0	7	2	Tier 2 - Non-Preferred Generic			
H5512	008	0	1	04	01	H5512_008_0	7	3	Tier 3 - Preferred Brand			
H5512	008	0	1	04	01	H5512_008_0	7	4	Tier 4 - Non-Preferred Brand			
H5512	008	0	1	04	01	H5512_008_0	7	1	Tier 1 - Preferred Generic			
H5512	009	0	1	04	01	H5512_009_0	6	3	Tier 3 - Preferred Brand	2		
H5512	009	0	1	04	01	H5512_009_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5512	009	0	1	04	01	H5512_009_0	6	5	Tier 5 - Specialty	2		
H5512	009	0	1	04	01	H5512_009_0	6	1	Tier 1 - Preferred Generic			
H5512	009	0	1	04	01	H5512_009_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5512	009	0	1	04	01	H5512_009_0	6	1	Tier 1 - Preferred Generic	1		1
H5512	009	0	1	04	01	H5512_009_0	6	5	Tier 5 - Specialty			
H5512	009	0	1	04	01	H5512_009_0	6	4	Tier 4 - Non-Preferred Brand			
H5512	009	0	1	04	01	H5512_009_0	6	2	Tier 2 - Non-Preferred Generic			
H5512	009	0	1	04	01	H5512_009_0	6	3	Tier 3 - Preferred Brand			
H5516	001	0	1	04	01	H5516_001_0	5	3	Non-Preferred			
H5516	001	0	1	04	01	H5516_001_0	5	4	Specialty			
H5516	001	0	1	04	01	H5516_001_0	5	2	Preferred Brand			
H5516	001	0	1	04	01	H5516_001_0	5	1	Preferred Generic			
H5517	002	0	1	04	01	H5517_002_0	6	2	Preferred Brand	2		
H5517	002	0	1	04	01	H5517_002_0	6	3	Non-preferred Generic/Non-Preferred Brand	2		
H5517	002	0	1	04	01	H5517_002_0	6	4	Specialty - Generic and Brand	2		
H5517	002	0	1	04	01	H5517_002_0	6	1	Preferred Generic			
H5517	002	0	1	04	01	H5517_002_0	6	2	Preferred Brand			
H5517	002	0	1	04	01	H5517_002_0	6	3	Non-preferred Generic/Non-Preferred Brand			
H5517	002	0	1	04	01	H5517_002_0	6	4	Specialty - Generic and Brand			
H5517	002	0	1	04	01	H5517_002_0	6	1	Preferred Generic	1		1
H5517	003	0	1	04	01	H5517_003_0	4	3	Non-Preferred Generic/Non-Preferred Brand			
H5517	003	0	1	04	01	H5517_003_0	4	4	Specialty			
H5517	003	0	1	04	01	H5517_003_0	4	1	Preferred Generic			
H5517	003	0	1	04	01	H5517_003_0	4	2	Preferred Brand			
H5517	004	0	1	04	01	H5517_004_0	7	4	Specialty			
H5517	004	0	1	04	01	H5517_004_0	7	1	Preferred Generic			
H5517	004	0	1	04	01	H5517_004_0	7	2	Preferred Brand			
H5517	004	0	1	04	01	H5517_004_0	7	3	Non-Preferred Brand			
H5517	005	0	1	04	01	H5517_005_0	5	1	Preferred Generic			
H5517	005	0	1	04	01	H5517_005_0	5	4	Specialty-Generic and Brand			
H5517	005	0	1	04	01	H5517_005_0	5	1	Preferred Generic	1		1
H5517	005	0	1	04	01	H5517_005_0	5	2	Preferred Brand	2		
H5517	005	0	1	04	01	H5517_005_0	5	2	Preferred Brand			
H5517	005	0	1	04	01	H5517_005_0	5	3	Non-Preferred Generic/Non-Preferred Brand			
H5517	005	0	1	04	01	H5517_005_0	5	4	Specialty-Generic and Brand	2		
H5517	005	0	1	04	01	H5517_005_0	5	3	Non-Preferred Generic/Non-Preferred Brand	2		
H5520	002	0	1	04	01	H5520_002_0	6	4	Injectable			
H5520	002	0	1	04	01	H5520_002_0	6	3	Non-Preferred Brand			
H5520	002	0	1	04	01	H5520_002_0	6	2	Preferred Brand			
H5520	002	0	1	04	01	H5520_002_0	6	1	Preferred Generic			
H5520	002	0	1	04	01	H5520_002_0	6	5	Specialty			
H5520	004	0	1	04	01	H5520_004_0	5	1	Preferred Generic			
H5520	004	0	1	04	01	H5520_004_0	5	2	Preferred Brand			
H5520	004	0	1	04	01	H5520_004_0	5	3	Non-Preferred Brand			
H5520	004	0	1	04	01	H5520_004_0	5	4	Injectable			
H5520	004	0	1	04	01	H5520_004_0	5	5	Specialty			
H5520	005	0	1	04	01	H5520_005_0	5	5	Specialty			
H5520	005	0	1	04	01	H5520_005_0	5	1	Preferred Generic			
H5520	005	0	1	04	01	H5520_005_0	5	2	Preferred Brand			
H5520	005	0	1	04	01	H5520_005_0	5	3	Non-Preferred Brand			
H5520	005	0	1	04	01	H5520_005_0	5	4	Injectable			
H5520	006	0	1	04	01	H5520_006_0	4	5	Specialty			
H5520	006	0	1	04	01	H5520_006_0	4	4	Injectable			
H5520	006	0	1	04	01	H5520_006_0	4	3	Non-Preferred Brand			
H5520	006	0	1	04	01	H5520_006_0	4	1	Preferred Generic			
H5520	006	0	1	04	01	H5520_006_0	4	2	Preferred Brand			
H5520	007	0	1	04	01	H5520_007_0	5	5	Specialty			
H5520	007	0	1	04	01	H5520_007_0	5	1	Preferred Generic			
H5520	007	0	1	04	01	H5520_007_0	5	2	Preferred Brand			
H5520	007	0	1	04	01	H5520_007_0	5	3	Non-Preferred Brand			
H5520	007	0	1	04	01	H5520_007_0	5	4	Injectable			
H5520	008	0	1	04	01	H5520_008_0	5	5	Specialty			
H5520	008	0	1	04	01	H5520_008_0	5	1	Preferred Generic			
H5520	008	0	1	04	01	H5520_008_0	5	2	Preferred Brand			
H5520	008	0	1	04	01	H5520_008_0	5	3	Non-Preferred Brand			
H5520	008	0	1	04	01	H5520_008_0	5	4	Injectable			
H5521	005	0	1	04	01	H5521_005_0	8	1	Tier 1 - Preferred Generic			
H5521	005	0	1	04	01	H5521_005_0	8	2	Tier 2 - Non-Preferred Generic			
H5521	005	0	1	04	01	H5521_005_0	8	3	Tier 3 - Preferred Brand			
H5521	005	0	1	04	01	H5521_005_0	8	4	Tier 4 - Non-Preferred Brand			
H5521	005	0	1	04	01	H5521_005_0	8	5	Tier 5 - Specialty			
H5521	006	0	1	04	01	H5521_006_0	6	5	Tier 5 - Specialty	2		
H5521	006	0	1	04	01	H5521_006_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5521	006	0	1	04	01	H5521_006_0	6	1	Tier 1 - Preferred Generic	1		1
H5521	006	0	1	04	01	H5521_006_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5521	006	0	1	04	01	H5521_006_0	6	3	Tier 3 - Preferred Brand	2		
H5521	006	0	1	04	01	H5521_006_0	6	5	Tier 5 - Specialty			
H5521	006	0	1	04	01	H5521_006_0	6	4	Tier 4 - Non-Preferred Brand			
H5521	006	0	1	04	01	H5521_006_0	6	3	Tier 3 - Preferred Brand			
H5521	006	0	1	04	01	H5521_006_0	6	2	Tier 2 - Non-Preferred Generic			
H5521	006	0	1	04	01	H5521_006_0	6	1	Tier 1 - Preferred Generic			
H5521	008	0	1	04	01	H5521_008_0	7	5	Tier 5 - Specialty			
H5521	008	0	1	04	01	H5521_008_0	7	4	Tier 4 - Non-Preferred Brand			
H5521	008	0	1	04	01	H5521_008_0	7	3	Tier 3 - Preferred Brand			
H5521	008	0	1	04	01	H5521_008_0	7	2	Tier 2 - Non-Preferred Generic			
H5521	008	0	1	04	01	H5521_008_0	7	1	Tier 1 - Preferred Generic			
H5521	009	0	1	04	01	H5521_009_0	8	5	Tier 5 - Specialty	2		
H5521	009	0	1	04	01	H5521_009_0	8	4	Tier 4 - Non-Preferred Brand	2		
H5521	009	0	1	04	01	H5521_009_0	8	1	Tier 1 - Preferred Generic			
H5521	009	0	1	04	01	H5521_009_0	8	2	Tier 2 - Non-Preferred Generic	1		1
H5521	009	0	1	04	01	H5521_009_0	8	3	Tier 3 - Preferred Brand	2		
H5521	009	0	1	04	01	H5521_009_0	8	2	Tier 2 - Non-Preferred Generic			
H5521	009	0	1	04	01	H5521_009_0	8	3	Tier 3 - Preferred Brand			
H5521	009	0	1	04	01	H5521_009_0	8	4	Tier 4 - Non-Preferred Brand			
H5521	009	0	1	04	01	H5521_009_0	8	5	Tier 5 - Specialty			
H5521	009	0	1	04	01	H5521_009_0	8	1	Tier 1 - Preferred Generic	1		1
H5521	011	0	1	04	01	H5521_011_0	9	1	Tier 1 - Preferred Generic			
H5521	011	0	1	04	01	H5521_011_0	9	2	Tier 2 - Non-Preferred Generic			
H5521	011	0	1	04	01	H5521_011_0	9	3	Tier 3 - Preferred Brand			
H5521	011	0	1	04	01	H5521_011_0	9	4	Tier 4 - Non-Preferred Brand			
H5521	011	0	1	04	01	H5521_011_0	9	5	Tier 5 - Specialty			
H5521	012	0	1	04	01	H5521_012_0	8	5	Tier 5 - Specialty			
H5521	012	0	1	04	01	H5521_012_0	8	4	Tier 4 - Non-Preferred Brand			
H5521	012	0	1	04	01	H5521_012_0	8	3	Tier 3 - Preferred Brand			
H5521	012	0	1	04	01	H5521_012_0	8	2	Tier 2 - Non-Preferred Generic			
H5521	012	0	1	04	01	H5521_012_0	8	1	Tier 1 - Preferred Generic	1		1
H5521	012	0	1	04	01	H5521_012_0	8	5	Tier 5 - Specialty	2		
H5521	012	0	1	04	01	H5521_012_0	8	4	Tier 4 - Non-Preferred Brand	2		
H5521	012	0	1	04	01	H5521_012_0	8	1	Tier 1 - Preferred Generic			
H5521	012	0	1	04	01	H5521_012_0	8	2	Tier 2 - Non-Preferred Generic	1		1
H5521	012	0	1	04	01	H5521_012_0	8	3	Tier 3 - Preferred Brand	2		
H5522	001	0	1	04	01	H5522_001_0	8	4	Tier 4- Specialty Drugs			
H5522	001	0	1	04	01	H5522_001_0	8	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand			
H5522	001	0	1	04	01	H5522_001_0	8	2	Tier 2- Preferred Brand	2		
H5522	001	0	1	04	01	H5522_001_0	8	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand	2		
H5522	001	0	1	04	01	H5522_001_0	8	4	Tier 4- Specialty Drugs	2		
H5522	001	0	1	04	01	H5522_001_0	8	1	Tier 1- Preferred Generic	1		1
H5522	001	0	1	04	01	H5522_001_0	8	2	Tier 2- Preferred Brand			
H5522	001	0	1	04	01	H5522_001_0	8	1	Tier 1- Preferred Generic			
H5522	002	0	1	04	01	H5522_002_0	7	4	Tier 4- Specialty Drugs			
H5522	002	0	1	04	01	H5522_002_0	7	1	Tier 1-Preferred Generic			
H5522	002	0	1	04	01	H5522_002_0	7	2	Tier 2- Preferred Brand	2		
H5522	002	0	1	04	01	H5522_002_0	7	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand	2		
H5522	002	0	1	04	01	H5522_002_0	7	4	Tier 4- Specialty Drugs	2		
H5522	002	0	1	04	01	H5522_002_0	7	1	Tier 1-Preferred Generic	1		1
H5522	002	0	1	04	01	H5522_002_0	7	2	Tier 2- Preferred Brand			
H5522	002	0	1	04	01	H5522_002_0	7	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand			
H5522	003	0	1	04	01	H5522_003_0	7	4	Tier 4- Specialty Drugs			
H5522	003	0	1	04	01	H5522_003_0	7	1	Tier 1- Preferred Generic			
H5522	003	0	1	04	01	H5522_003_0	7	2	Tier 2- Preferred Brand	2		
H5522	003	0	1	04	01	H5522_003_0	7	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand	2		
H5522	003	0	1	04	01	H5522_003_0	7	4	Tier 4- Specialty Drugs	2		
H5522	003	0	1	04	01	H5522_003_0	7	1	Tier 1- Preferred Generic	1		1
H5522	003	0	1	04	01	H5522_003_0	7	2	Tier 2- Preferred Brand			
H5522	003	0	1	04	01	H5522_003_0	7	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand			
H5522	004	0	1	04	01	H5522_004_0	5	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand			
H5522	004	0	1	04	01	H5522_004_0	5	2	Tier 2- Preferred Brand			
H5522	004	0	1	04	01	H5522_004_0	5	4	Tier 4- Specialty Tier			
H5522	004	0	1	04	01	H5522_004_0	5	1	Tier 1-Preferred Generic			
H5522	005	0	1	04	01	H5522_005_0	5	4	Tier 4- Specialty Drugs			
H5522	005	0	1	04	01	H5522_005_0	5	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand			
H5522	005	0	1	04	01	H5522_005_0	5	2	Tier 2- Preferred Brand			
H5522	005	0	1	04	01	H5522_005_0	5	1	Tier 1- Preferred Generic			
H5522	006	0	1	04	01	H5522_006_0	7	4	Tier 4- Specialty Drugs			
H5522	006	0	1	04	01	H5522_006_0	7	1	Tier 1-Preferred Generic	1		1
H5522	006	0	1	04	01	H5522_006_0	7	2	Tier 2- Preferred Brand	2		
H5522	006	0	1	04	01	H5522_006_0	7	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand	2		
H5522	006	0	1	04	01	H5522_006_0	7	4	Tier 4- Specialty Drugs	2		
H5522	006	0	1	04	01	H5522_006_0	7	2	Tier 2- Preferred Brand			
H5522	006	0	1	04	01	H5522_006_0	7	1	Tier 1-Preferred Generic			
H5522	006	0	1	04	01	H5522_006_0	7	3	Tier 3- Non-Preferred Generic/Non-Preferred Brand			
H5523	001	0	1	04	01	H5523_001_0	20	1	Generic			
H5523	001	0	1	04	01	H5523_001_0	20	4	Specialty			
H5523	001	0	1	04	01	H5523_001_0	20	3	Non-Preferred Brand			
H5523	001	0	1	04	01	H5523_001_0	20	2	Preferred Brand			
H5525	001	0	1	04	01	H5525_001_0	4	1	Preferred Generic			
H5525	001	0	1	04	01	H5525_001_0	4	2	Preferred Brand			
H5525	001	0	1	04	01	H5525_001_0	4	4	Specialty	1	10001000	2
H5525	001	0	1	04	01	H5525_001_0	4	3	Non-Preferred Brand	1	10000000	2
H5525	001	0	1	04	01	H5525_001_0	4	2	Preferred Brand	1	10000000	2
H5525	001	0	1	04	01	H5525_001_0	4	1	Preferred Generic	1		1
H5525	001	0	1	04	01	H5525_001_0	4	4	Specialty			
H5525	001	0	1	04	01	H5525_001_0	4	3	Non-Preferred Brand			
H5525	004	0	1	04	01	H5525_004_0	5	1	Preferred Generic			
H5525	004	0	1	04	01	H5525_004_0	5	3	Non-Preferred Brand	1	10000000	2
H5525	004	0	1	04	01	H5525_004_0	5	2	Preferred Brand	1	10000000	2
H5525	004	0	1	04	01	H5525_004_0	5	1	Preferred Generic	1	00001000	2
H5525	004	0	1	04	01	H5525_004_0	5	4	Specialty			
H5525	004	0	1	04	01	H5525_004_0	5	3	Non-Preferred Brand			
H5525	004	0	1	04	01	H5525_004_0	5	2	Preferred Brand			
H5525	004	0	1	04	01	H5525_004_0	5	4	Specialty	1	10001000	2
H5526	003	0	1	04	01	H5526_003_0	10	1	Formulary Generic			
H5526	003	0	1	04	01	H5526_003_0	10	4	Specialty Injectables			
H5526	003	0	1	04	01	H5526_003_0	10	3	Non-Preferred Brand/Generic			
H5526	003	0	1	04	01	H5526_003_0	10	2	Preferred Brand			
H5526	004	0	1	04	01	H5526_004_0	9	2	Preferred Brand			
H5526	004	0	1	04	01	H5526_004_0	9	3	Non-Preferred Brand/Generic			
H5526	004	0	1	04	01	H5526_004_0	9	4	Specialty Injectables			
H5526	004	0	1	04	01	H5526_004_0	9	1	Formulary Generic			
H5526	007	0	1	04	01	H5526_007_0	7	3	Non-Preferred Brand/Generic			
H5526	007	0	1	04	01	H5526_007_0	7	2	Preferred Brand			
H5526	007	0	1	04	01	H5526_007_0	7	1	Formulary Generic			
H5526	007	0	1	04	01	H5526_007_0	7	4	Specialty Injectables			
H5526	007	0	1	04	01	H5526_007_0	7	1	Formulary Generic	1		1
H5526	007	0	1	04	01	H5526_007_0	7	2	Preferred Brand	1	10000000	2
H5526	007	0	1	04	01	H5526_007_0	7	3	Non-Preferred Brand/Generic	2		
H5526	007	0	1	04	01	H5526_007_0	7	4	Specialty Injectables	2		
H5526	008	0	1	04	01	H5526_008_0	9	3	Non-Preferred Brand/Generic			
H5526	008	0	1	04	01	H5526_008_0	9	2	Preferred Brand			
H5526	008	0	1	04	01	H5526_008_0	9	1	Formulary Generic			
H5526	008	0	1	04	01	H5526_008_0	9	4	Specialty Injectables			
H5526	008	0	1	04	01	H5526_008_0	9	4	Specialty Injectables	2		
H5526	008	0	1	04	01	H5526_008_0	9	3	Non-Preferred Brand/Generic	2		
H5526	008	0	1	04	01	H5526_008_0	9	2	Preferred Brand	2		
H5526	008	0	1	04	01	H5526_008_0	9	1	Formulary Generic	1		1
H5526	010	0	1	04	01	H5526_010_0	7	1	Formulary Generic			
H5526	010	0	1	04	01	H5526_010_0	7	2	Preferred Brand			
H5526	010	0	1	04	01	H5526_010_0	7	3	Non-Preferred Brand/Generic			
H5526	010	0	1	04	01	H5526_010_0	7	3	Non-Preferred Brand/Generic	1		1
H5526	010	0	1	04	01	H5526_010_0	7	2	Preferred Brand	1		1
H5526	010	0	1	04	01	H5526_010_0	7	1	Formulary Generic	1		1
H5526	010	0	1	04	01	H5526_010_0	7	4	Specialty Injectables			
H5526	010	0	1	04	01	H5526_010_0	7	4	Specialty Injectables	1		1
H5528	002	0	1	04	01	H5528_002_0	4	4	Tier 4			
H5528	002	0	1	04	01	H5528_002_0	4	2	Tier 2			
H5528	002	0	1	04	01	H5528_002_0	4	1	Tier 1			
H5528	002	0	1	04	01	H5528_002_0	4	3	Tier 3			
H5528	003	0	1	04	01	H5528_003_0	4	2	Tier 2	2		
H5528	003	0	1	04	01	H5528_003_0	4	3	Tier 3			
H5528	003	0	1	04	01	H5528_003_0	4	2	Tier 2			
H5528	003	0	1	04	01	H5528_003_0	4	4	Tier 4			
H5528	003	0	1	04	01	H5528_003_0	4	4	Tier 4	2		
H5528	003	0	1	04	01	H5528_003_0	4	3	Tier 3	2		
H5528	003	0	1	04	01	H5528_003_0	4	1	Tier 1			
H5528	003	0	1	04	01	H5528_003_0	4	1	Tier 1	1		1
H5528	005	0	1	04	01	H5528_005_0	3	4	Tier 4			
H5528	005	0	1	04	01	H5528_005_0	3	1	Tier 1			
H5528	005	0	1	04	01	H5528_005_0	3	2	Tier 2			
H5528	005	0	1	04	01	H5528_005_0	3	3	Tier 3			
H5528	008	0	1	04	01	H5528_008_0	4	4	Tier 4			
H5528	008	0	1	04	01	H5528_008_0	4	4	Tier 4	2		
H5528	008	0	1	04	01	H5528_008_0	4	3	Tier 3	2		
H5528	008	0	1	04	01	H5528_008_0	4	2	Tier 2	2		
H5528	008	0	1	04	01	H5528_008_0	4	1	Tier 1	1		1
H5528	008	0	1	04	01	H5528_008_0	4	3	Tier 3			
H5528	008	0	1	04	01	H5528_008_0	4	2	Tier 2			
H5528	008	0	1	04	01	H5528_008_0	4	1	Tier 1			
H5528	010	0	1	04	01	H5528_010_0	3	4	Tier 4			
H5528	010	0	1	04	01	H5528_010_0	3	1	Tier 1			
H5528	010	0	1	04	01	H5528_010_0	3	3	Tier 3			
H5528	010	0	1	04	01	H5528_010_0	3	2	Tier 2			
H5528	011	0	1	04	01	H5528_011_0	4	1	Tier 1			
H5528	011	0	1	04	01	H5528_011_0	4	4	Tier 4	2		
H5528	011	0	1	04	01	H5528_011_0	4	3	Tier 3	2		
H5528	011	0	1	04	01	H5528_011_0	4	2	Tier 2	2		
H5528	011	0	1	04	01	H5528_011_0	4	2	Tier 2			
H5528	011	0	1	04	01	H5528_011_0	4	3	Tier 3			
H5528	011	0	1	04	01	H5528_011_0	4	4	Tier 4			
H5528	011	0	1	04	01	H5528_011_0	4	1	Tier 1	1		1
H5528	015	0	1	04	01	H5528_015_0	4	4	Tier 4	2		
H5528	015	0	1	04	01	H5528_015_0	4	3	Tier 3	2		
H5528	015	0	1	04	01	H5528_015_0	4	2	Tier 2	2		
H5528	015	0	1	04	01	H5528_015_0	4	1	Tier 1			
H5528	015	0	1	04	01	H5528_015_0	4	2	Tier 2			
H5528	015	0	1	04	01	H5528_015_0	4	3	Tier 3			
H5528	015	0	1	04	01	H5528_015_0	4	1	Tier 1	1		1
H5528	015	0	1	04	01	H5528_015_0	4	4	Tier 4			
H5528	016	0	1	04	01	H5528_016_0	4	4	Tier 4			
H5528	016	0	1	04	01	H5528_016_0	4	1	Tier 1	1		1
H5528	016	0	1	04	01	H5528_016_0	4	3	Tier 3			
H5528	016	0	1	04	01	H5528_016_0	4	2	Tier 2			
H5528	016	0	1	04	01	H5528_016_0	4	2	Tier 2	2		
H5528	016	0	1	04	01	H5528_016_0	4	1	Tier 1			
H5528	016	0	1	04	01	H5528_016_0	4	4	Tier 4	2		
H5528	016	0	1	04	01	H5528_016_0	4	3	Tier 3	2		
H5528	017	0	1	04	01	H5528_017_0	4	1	Tier 1			
H5528	017	0	1	04	01	H5528_017_0	4	2	Tier 2			
H5528	017	0	1	04	01	H5528_017_0	4	3	Tier 3			
H5528	017	0	1	04	01	H5528_017_0	4	4	Tier 4			
H5528	017	0	1	04	01	H5528_017_0	4	1	Tier 1	1		1
H5528	017	0	1	04	01	H5528_017_0	4	2	Tier 2	2		
H5528	017	0	1	04	01	H5528_017_0	4	3	Tier 3	2		
H5528	017	0	1	04	01	H5528_017_0	4	4	Tier 4	2		
H5529	001	0	1	04	01	H5529_001_0	7	1	Tier One Preferred Generics			
H5529	001	0	1	04	01	H5529_001_0	7	2	Tier 2 Preferred Brand			
H5529	001	0	1	04	01	H5529_001_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H5529	001	0	1	04	01	H5529_001_0	7	4	Tier 4 Non-Specialty Injectibles			
H5529	001	0	1	04	01	H5529_001_0	7	5	Tier 5 Speciality	2		
H5529	001	0	1	04	01	H5529_001_0	7	1	Tier One Preferred Generics	1		1
H5529	001	0	1	04	01	H5529_001_0	7	2	Tier 2 Preferred Brand	2		
H5529	001	0	1	04	01	H5529_001_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H5529	001	0	1	04	01	H5529_001_0	7	4	Tier 4 Non-Specialty Injectibles	2		
H5529	001	0	1	04	01	H5529_001_0	7	5	Tier 5 Speciality			
H5530	001	0	1	04	01	H5530_001_0	9	1	Tier One Preferred Generics			
H5530	001	0	1	04	01	H5530_001_0	9	2	Tier 2 Preferred Brand			
H5530	001	0	1	04	01	H5530_001_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H5530	001	0	1	04	01	H5530_001_0	9	4	Tier 4 Non-Specialty Injectibles			
H5530	001	0	1	04	01	H5530_001_0	9	5	Tier 5 Speciality			
H5530	001	0	1	04	01	H5530_001_0	9	1	Tier One Preferred Generics	1		1
H5530	001	0	1	04	01	H5530_001_0	9	2	Tier 2 Preferred Brand	2		
H5530	001	0	1	04	01	H5530_001_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H5530	001	0	1	04	01	H5530_001_0	9	4	Tier 4 Non-Specialty Injectibles	2		
H5530	001	0	1	04	01	H5530_001_0	9	5	Tier 5 Speciality	2		
H5531	001	0	1	04	01	H5531_001_0	6	4	Tier 4 - Non-Preferred Brand			
H5531	001	0	1	04	01	H5531_001_0	6	3	Tier 3 - Preferred Brand			
H5531	001	0	1	04	01	H5531_001_0	6	2	Tier 2 - Non-Preferred Generic			
H5531	001	0	1	04	01	H5531_001_0	6	1	Tier 1 - Preferred Generic			
H5531	001	0	1	04	01	H5531_001_0	6	5	Tier 5 - Specialty			
H5531	002	0	1	04	01	H5531_002_0	6	1	Tier 1 - Preferred Generic	1		1
H5531	002	0	1	04	01	H5531_002_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5531	002	0	1	04	01	H5531_002_0	6	3	Tier 3 - Preferred Brand	2		
H5531	002	0	1	04	01	H5531_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5531	002	0	1	04	01	H5531_002_0	6	5	Tier 5 - Specialty			
H5531	002	0	1	04	01	H5531_002_0	6	4	Tier 4 - Non-Preferred Brand			
H5531	002	0	1	04	01	H5531_002_0	6	3	Tier 3 - Preferred Brand			
H5531	002	0	1	04	01	H5531_002_0	6	2	Tier 2 - Non-Preferred Generic			
H5531	002	0	1	04	01	H5531_002_0	6	1	Tier 1 - Preferred Generic			
H5531	002	0	1	04	01	H5531_002_0	6	5	Tier 5 - Specialty	2		
H5531	003	0	1	04	01	H5531_003_0	6	4	Tier 4 - Non-Preferred Brand			
H5531	003	0	1	04	01	H5531_003_0	6	3	Tier 3 - Preferred Brand			
H5531	003	0	1	04	01	H5531_003_0	6	2	Tier 2 - Non-Preferred Generic			
H5531	003	0	1	04	01	H5531_003_0	6	1	Tier 1 - Preferred Generic			
H5531	003	0	1	04	01	H5531_003_0	6	5	Tier 5 - Specialty			
H5531	004	0	1	04	01	H5531_004_0	5	1	Tier 1 - Preferred Generic	1		1
H5531	004	0	1	04	01	H5531_004_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H5531	004	0	1	04	01	H5531_004_0	5	3	Tier 3 - Preferred Brand	2		
H5531	004	0	1	04	01	H5531_004_0	5	4	Tier 4 - Non-Preferred Brand	2		
H5531	004	0	1	04	01	H5531_004_0	5	5	Tier 5 - Specialty			
H5531	004	0	1	04	01	H5531_004_0	5	4	Tier 4 - Non-Preferred Brand			
H5531	004	0	1	04	01	H5531_004_0	5	5	Tier 5 - Specialty	2		
H5531	004	0	1	04	01	H5531_004_0	5	2	Tier 2 - Non-Preferred Generic			
H5531	004	0	1	04	01	H5531_004_0	5	1	Tier 1 - Preferred Generic			
H5531	004	0	1	04	01	H5531_004_0	5	3	Tier 3 - Preferred Brand			
H5531	005	0	1	04	01	H5531_005_0	5	1	Tier1 - Preferred Generic			
H5531	005	0	1	04	01	H5531_005_0	5	2	Tier 2 - Non-Preferred Generic			
H5531	005	0	1	04	01	H5531_005_0	5	3	Tier 3 - Preferred Brand			
H5531	005	0	1	04	01	H5531_005_0	5	4	Tier 4 - Non-Preferred Brand			
H5531	005	0	1	04	01	H5531_005_0	5	5	Tier 5 - Specialty			
H5531	006	0	1	04	01	H5531_006_0	5	5	Tier 5 - Specialty	2		
H5531	006	0	1	04	01	H5531_006_0	5	3	Tier 3 - Preferred Brand			
H5531	006	0	1	04	01	H5531_006_0	5	3	Tier 3 - Preferred Brand	2		
H5531	006	0	1	04	01	H5531_006_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H5531	006	0	1	04	01	H5531_006_0	5	1	Tier 1 - Preferred Generic	1		1
H5531	006	0	1	04	01	H5531_006_0	5	5	Tier 5 - Specialty			
H5531	006	0	1	04	01	H5531_006_0	5	4	Tier 4 - Non-Preferred Brand			
H5531	006	0	1	04	01	H5531_006_0	5	4	Tier 4 - Non-Preferred Brand	2		
H5531	006	0	1	04	01	H5531_006_0	5	2	Tier 2 - Non-Preferred Generic			
H5531	006	0	1	04	01	H5531_006_0	5	1	Tier 1 - Preferred Generic			
H5531	007	0	1	04	01	H5531_007_0	6	5	Tier 5 - Specialty			
H5531	007	0	1	04	01	H5531_007_0	6	4	Tier 4 - Non-Preferred Brand			
H5531	007	0	1	04	01	H5531_007_0	6	1	Tier 1 - Preferred Generic			
H5531	007	0	1	04	01	H5531_007_0	6	2	Tier 2 - Non-Preferred Generic			
H5531	007	0	1	04	01	H5531_007_0	6	3	Tier 3 - Preferred Brand			
H5531	008	0	1	04	01	H5531_008_0	5	4	Tier 4 - Non-Preferred Brand			
H5531	008	0	1	04	01	H5531_008_0	5	5	Tier 5 - Specialty			
H5531	008	0	1	04	01	H5531_008_0	5	1	Tier 1 - Preferred Generic	1		1
H5531	008	0	1	04	01	H5531_008_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H5531	008	0	1	04	01	H5531_008_0	5	3	Tier 3 - Preferred Brand	2		
H5531	008	0	1	04	01	H5531_008_0	5	4	Tier 4 - Non-Preferred Brand	2		
H5531	008	0	1	04	01	H5531_008_0	5	5	Tier 5 - Specialty	2		
H5531	008	0	1	04	01	H5531_008_0	5	2	Tier 2 - Non-Preferred Generic			
H5531	008	0	1	04	01	H5531_008_0	5	3	Tier 3 - Preferred Brand			
H5531	008	0	1	04	01	H5531_008_0	5	1	Tier 1 - Preferred Generic			
H5531	009	0	1	04	01	H5531_009_0	6	4	Tier 4 - Non-Preferred Brand			
H5531	009	0	1	04	01	H5531_009_0	6	5	Tier 5 - Specialty			
H5531	009	0	1	04	01	H5531_009_0	6	3	Tier 3 - Preferred Brand			
H5531	009	0	1	04	01	H5531_009_0	6	2	Tier 2 - Non-Preferred Generic			
H5531	009	0	1	04	01	H5531_009_0	6	1	Tier 1 - Preferred Generic			
H5531	010	0	1	04	01	H5531_010_0	5	4	Tier 4 - Non-Preferred Brand	2		
H5531	010	0	1	04	01	H5531_010_0	5	5	Tier 5 - Specialty	2		
H5531	010	0	1	04	01	H5531_010_0	5	3	Tier 3 - Preferred Brand	2		
H5531	010	0	1	04	01	H5531_010_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H5531	010	0	1	04	01	H5531_010_0	5	1	Tier 1 - Preferred Generic	1		1
H5531	010	0	1	04	01	H5531_010_0	5	5	Tier 5 - Specialty			
H5531	010	0	1	04	01	H5531_010_0	5	4	Tier 4 - Non-Preferred Brand			
H5531	010	0	1	04	01	H5531_010_0	5	3	Tier 3 - Preferred Brand			
H5531	010	0	1	04	01	H5531_010_0	5	2	Tier 2 - Non-Preferred Generic			
H5531	010	0	1	04	01	H5531_010_0	5	1	Tier 1 - Preferred Generic			
H5532	001	0	1	04	01	H5532_001_0	5	3	Non-Preferred			
H5532	001	0	1	04	01	H5532_001_0	5	2	Preferred Brand			
H5532	001	0	1	04	01	H5532_001_0	5	1	Preferred Generic			
H5532	001	0	1	04	01	H5532_001_0	5	4	Specialty			
H5533	002	0	1	04	01	H5533_002_0	5	1	Generic	1		1
H5533	002	0	1	04	01	H5533_002_0	5	3	Non-Preferred Brand	2		
H5533	002	0	1	04	01	H5533_002_0	5	4	Specialty	2		
H5533	002	0	1	04	01	H5533_002_0	5	4	Specialty			
H5533	002	0	1	04	01	H5533_002_0	5	3	Non-Preferred Brand			
H5533	002	0	1	04	01	H5533_002_0	5	1	Generic			
H5533	002	0	1	04	01	H5533_002_0	5	2	Preferred Brand			
H5533	002	0	1	04	01	H5533_002_0	5	2	Preferred Brand	2		
H5549	001	0	1	01	01	H5549_001_0	6	1	Generic			
H5549	001	0	1	01	01	H5549_001_0	6	2	Preferred Brand			
H5549	001	0	1	01	01	H5549_001_0	6	3	Non-Preferred Brand			
H5549	001	0	1	01	01	H5549_001_0	6	4	Specialty	2		
H5549	001	0	1	01	01	H5549_001_0	6	1	Generic	1		1
H5549	001	0	1	01	01	H5549_001_0	6	2	Preferred Brand	2		
H5549	001	0	1	01	01	H5549_001_0	6	3	Non-Preferred Brand	2		
H5549	001	0	1	01	01	H5549_001_0	6	4	Specialty			
H5554	001	0	1	01	01	H5554_001_0	5	1	Generics			
H5554	001	0	1	01	01	H5554_001_0	5	2	Brand	2		
H5554	001	0	1	01	01	H5554_001_0	5	1	Generics	1		1
H5554	001	0	1	01	01	H5554_001_0	5	2	Brand			
H5575	006	0	1	01	01	H5575_006_0	5	1	Generic			
H5575	006	0	1	01	01	H5575_006_0	5	2	Preferred Brand			
H5575	006	0	1	01	01	H5575_006_0	5	3	Non-Preferred Brand			
H5575	007	0	1	01	01	H5575_007_0	6	3	Non-Preferred Brand			
H5575	007	0	1	01	01	H5575_007_0	6	2	Preferred Brand			
H5575	007	0	1	01	01	H5575_007_0	6	1	Generic			
H5576	005	0	1	02	01	H5576_005_0	5	3	Tier 3			
H5576	005	0	1	02	01	H5576_005_0	5	4	Tier 4			
H5576	005	0	1	02	01	H5576_005_0	5	2	Tier 2			
H5576	005	0	1	02	01	H5576_005_0	5	1	Tier 1			
H5576	006	0	1	02	01	H5576_006_0	5	4	Tier 4	2		
H5576	006	0	1	02	01	H5576_006_0	5	3	Tier 3	2		
H5576	006	0	1	02	01	H5576_006_0	5	2	Tier 2	2		
H5576	006	0	1	02	01	H5576_006_0	5	1	Tier 1	1		1
H5576	006	0	1	02	01	H5576_006_0	5	4	Tier 4			
H5576	006	0	1	02	01	H5576_006_0	5	3	Tier 3			
H5576	006	0	1	02	01	H5576_006_0	5	1	Tier 1			
H5576	006	0	1	02	01	H5576_006_0	5	2	Tier 2			
H5576	007	0	1	02	01	H5576_007_0	7	2	Tier 2			
H5576	007	0	1	02	01	H5576_007_0	7	3	Tier 3			
H5576	007	0	1	02	01	H5576_007_0	7	4	Tier 4			
H5576	007	0	1	02	01	H5576_007_0	7	1	Tier 1			
H5576	009	0	1	02	01	H5576_009_0	5	4	Tier 4			
H5576	009	0	1	02	01	H5576_009_0	5	3	Tier 3			
H5576	009	0	1	02	01	H5576_009_0	5	1	Tier 1			
H5576	009	0	1	02	01	H5576_009_0	5	2	Tier 2			
H5577	002	0	1	01	01	H5577_002_0	7	4	Specialty			
H5577	002	0	1	01	01	H5577_002_0	7	1	Generic			
H5577	002	0	1	01	01	H5577_002_0	7	2	Preferred Brand			
H5577	002	0	1	01	01	H5577_002_0	7	3	Non-Preferred Brand			
H5578	002	0	1	01	01	H5578_002_0	19	1	Tier 1 - Generic	1		1
H5578	002	0	1	01	01	H5578_002_0	19	4	Tier 4 - Specialty			
H5578	002	0	1	01	01	H5578_002_0	19	3	Tier 3 - Non-Preferred Brand			
H5578	002	0	1	01	01	H5578_002_0	19	2	Tier 2 - Prefered Brand			
H5578	002	0	1	01	01	H5578_002_0	19	1	Tier 1 - Generic			
H5578	002	0	1	01	01	H5578_002_0	19	2	Tier 2 - Prefered Brand	2		
H5578	002	0	1	01	01	H5578_002_0	19	4	Tier 4 - Specialty	2		
H5578	002	0	1	01	01	H5578_002_0	19	3	Tier 3 - Non-Preferred Brand	2		
H5578	006	0	1	01	01	H5578_006_0	19	1	Tier 1 - Generic			
H5578	006	0	1	01	01	H5578_006_0	19	2	Tier 2 - Prefered Brand			
H5578	006	0	1	01	01	H5578_006_0	19	3	Tier 3 - Non-Preferred Brand			
H5578	006	0	1	01	01	H5578_006_0	19	4	Tier 4 - Specialty			
H5578	006	0	1	01	01	H5578_006_0	19	1	Tier 1 - Generic	1		1
H5578	006	0	1	01	01	H5578_006_0	19	3	Tier 3 - Non-Preferred Brand	2		
H5578	006	0	1	01	01	H5578_006_0	19	2	Tier 2 - Prefered Brand	2		
H5578	006	0	1	01	01	H5578_006_0	19	4	Tier 4 - Specialty	2		
H5588	002	0	1	01	01	H5588_002_0	7	1	Generic			
H5588	002	0	1	01	01	H5588_002_0	7	4	Specialty Drugs			
H5588	002	0	1	01	01	H5588_002_0	7	3	Non-Preferred Brand			
H5588	002	0	1	01	01	H5588_002_0	7	2	Preferred Brand			
H5590	001	0	1	01	01	H5590_001_0	7	1	Generic			
H5590	001	0	1	01	01	H5590_001_0	7	2	Brand			
H5590	001	0	1	01	01	H5590_001_0	7	3	Non-Preferred Brand			
H5590	001	0	1	01	01	H5590_001_0	7	4	Injectable			
H5591	001	0	1	02	01	H5591_001_0	11	4	Tier 4	2		
H5591	001	0	1	02	01	H5591_001_0	11	3	Tier 3	2		
H5591	001	0	1	02	01	H5591_001_0	11	1	Tier 1	1		1
H5591	001	0	1	02	01	H5591_001_0	11	2	Tier 2	2		
H5591	001	0	1	02	01	H5591_001_0	11	4	Tier 4			
H5591	001	0	1	02	01	H5591_001_0	11	3	Tier 3			
H5591	001	0	1	02	01	H5591_001_0	11	2	Tier 2			
H5591	001	0	1	02	01	H5591_001_0	11	1	Tier 1			
H5591	002	0	1	01	01	H5591_002_0	8	1	Tier 1			
H5591	002	0	1	01	01	H5591_002_0	8	3	Tier 3			
H5591	002	0	1	01	01	H5591_002_0	8	2	Tier 2			
H5591	002	0	1	01	01	H5591_002_0	8	4	Tier 4	2		
H5591	002	0	1	01	01	H5591_002_0	8	3	Tier 3	2		
H5591	002	0	1	01	01	H5591_002_0	8	2	Tier 2	2		
H5591	002	0	1	01	01	H5591_002_0	8	1	Tier 1	1		1
H5591	002	0	1	01	01	H5591_002_0	8	4	Tier 4			
H5594	001	0	1	02	01	H5594_001_0	8	4	Tier 4	2		
H5594	001	0	1	02	01	H5594_001_0	8	3	Tier 3	2		
H5594	001	0	1	02	01	H5594_001_0	8	2	Tier 2	2		
H5594	001	0	1	02	01	H5594_001_0	8	1	Tier 1	1		1
H5594	001	0	1	02	01	H5594_001_0	8	4	Tier 4			
H5594	001	0	1	02	01	H5594_001_0	8	3	Tier 3			
H5594	001	0	1	02	01	H5594_001_0	8	1	Tier 1			
H5594	001	0	1	02	01	H5594_001_0	8	2	Tier 2			
H5594	002	0	1	02	01	H5594_002_0	8	3	Tier 3	2		
H5594	002	0	1	02	01	H5594_002_0	8	2	Tier 2	2		
H5594	002	0	1	02	01	H5594_002_0	8	1	Tier 1	1		1
H5594	002	0	1	02	01	H5594_002_0	8	4	Tier 4	2		
H5594	002	0	1	02	01	H5594_002_0	8	1	Tier 1			
H5594	002	0	1	02	01	H5594_002_0	8	2	Tier 2			
H5594	002	0	1	02	01	H5594_002_0	8	3	Tier 3			
H5594	002	0	1	02	01	H5594_002_0	8	4	Tier 4			
H5594	005	0	1	02	01	H5594_005_0	8	4	Tier 4			
H5594	005	0	1	02	01	H5594_005_0	8	3	Tier 3			
H5594	005	0	1	02	01	H5594_005_0	8	1	Tier 1			
H5594	005	0	1	02	01	H5594_005_0	8	2	Tier 2			
H5594	006	0	1	02	01	H5594_006_0	8	3	Tier 3	2		
H5594	006	0	1	02	01	H5594_006_0	8	2	Tier 2	2		
H5594	006	0	1	02	01	H5594_006_0	8	1	Tier 1	1		1
H5594	006	0	1	02	01	H5594_006_0	8	4	Tier 4	2		
H5594	006	0	1	02	01	H5594_006_0	8	1	Tier 1			
H5594	006	0	1	02	01	H5594_006_0	8	2	Tier 2			
H5594	006	0	1	02	01	H5594_006_0	8	3	Tier 3			
H5594	006	0	1	02	01	H5594_006_0	8	4	Tier 4			
H5594	007	0	1	02	01	H5594_007_0	9	4	Tier 4			
H5594	007	0	1	02	01	H5594_007_0	9	3	Tier 3			
H5594	007	0	1	02	01	H5594_007_0	9	1	Tier 1			
H5594	007	0	1	02	01	H5594_007_0	9	2	Tier 2			
H5594	008	0	1	02	01	H5594_008_0	9	2	Tier 2	2		
H5594	008	0	1	02	01	H5594_008_0	9	1	Tier 1			
H5594	008	0	1	02	01	H5594_008_0	9	2	Tier 2			
H5594	008	0	1	02	01	H5594_008_0	9	3	Tier 3			
H5594	008	0	1	02	01	H5594_008_0	9	3	Tier 3	2		
H5594	008	0	1	02	01	H5594_008_0	9	4	Tier 4	2		
H5594	008	0	1	02	01	H5594_008_0	9	1	Tier 1	1		1
H5594	008	0	1	02	01	H5594_008_0	9	4	Tier 4			
H5594	009	0	1	02	01	H5594_009_0	10	4	Tier 4			
H5594	009	0	1	02	01	H5594_009_0	10	3	Tier 3			
H5594	009	0	1	02	01	H5594_009_0	10	2	Tier 2			
H5594	009	0	1	02	01	H5594_009_0	10	1	Tier 1			
H5608	003	0	1	01	01	H5608_003_0	7	1	1	1		1
H5608	003	0	1	01	01	H5608_003_0	7	2	2			
H5608	003	0	1	01	01	H5608_003_0	7	1	1			
H5608	003	0	1	01	01	H5608_003_0	7	2	2	2		
H5609	001	0	1	01	01	H5609_001_0	11	5	Specialty			
H5609	001	0	1	01	01	H5609_001_0	11	1	Generic	1		1
H5609	001	0	1	01	01	H5609_001_0	11	3	Non-Preferred Brand	2		
H5609	001	0	1	01	01	H5609_001_0	11	4	Injectible	2		
H5609	001	0	1	01	01	H5609_001_0	11	5	Specialty	2		
H5609	001	0	1	01	01	H5609_001_0	11	4	Injectible			
H5609	001	0	1	01	01	H5609_001_0	11	3	Non-Preferred Brand			
H5609	001	0	1	01	01	H5609_001_0	11	2	Preferred Brand			
H5609	001	0	1	01	01	H5609_001_0	11	1	Generic			
H5609	001	0	1	01	01	H5609_001_0	11	2	Preferred Brand	2		
H5619	001	0	1	01	01	H5619_001_0	8	1	Tier 1 - Generic			
H5619	001	0	1	01	01	H5619_001_0	8	2	Tier 2 - Preferred Brand			
H5619	001	0	1	01	01	H5619_001_0	8	3	Tier 3 - Non-Preferred Brand			
H5619	001	0	1	01	01	H5619_001_0	8	4	Tier 4 - Specialty Drug			
H5619	001	0	1	01	01	H5619_001_0	8	1	Tier 1 - Generic	1		1
H5619	001	0	1	01	01	H5619_001_0	8	2	Tier 2 - Preferred Brand	2		
H5619	001	0	1	01	01	H5619_001_0	8	3	Tier 3 - Non-Preferred Brand	2		
H5619	001	0	1	01	01	H5619_001_0	8	4	Tier 4 - Specialty Drug	2		
H5619	004	0	1	01	01	H5619_004_0	8	4	Tier 4 - Specialty Drug	2		
H5619	004	0	1	01	01	H5619_004_0	8	3	Tier 3 - Non-Preferred Brand	2		
H5619	004	0	1	01	01	H5619_004_0	8	2	Tier 2 - Preferred Brand	2		
H5619	004	0	1	01	01	H5619_004_0	8	1	Tier 1 - Generic	1		1
H5619	004	0	1	01	01	H5619_004_0	8	4	Tier 4 - Specialty Drug			
H5619	004	0	1	01	01	H5619_004_0	8	3	Tier 3 - Non-Preferred Brand			
H5619	004	0	1	01	01	H5619_004_0	8	1	Tier 1 - Generic			
H5619	004	0	1	01	01	H5619_004_0	8	2	Tier 2 - Preferred Brand			
H5619	007	0	1	01	01	H5619_007_0	8	1	Tier 1 - Generic			
H5619	007	0	1	01	01	H5619_007_0	8	2	Tier 2 - Preferred Brand			
H5619	007	0	1	01	01	H5619_007_0	8	3	Tier 3 - Non-Preferred Brand			
H5619	007	0	1	01	01	H5619_007_0	8	4	Tier 4 - Specialty Drug			
H5619	007	0	1	01	01	H5619_007_0	8	1	Tier 1 - Generic	1		1
H5619	007	0	1	01	01	H5619_007_0	8	2	Tier 2 - Preferred Brand	2		
H5619	007	0	1	01	01	H5619_007_0	8	3	Tier 3 - Non-Preferred Brand	2		
H5619	007	0	1	01	01	H5619_007_0	8	4	Tier 4 - Specialty Drug	2		
H5619	008	0	1	01	01	H5619_008_0	9	4	Tier 4 - Specialty Drug	2		
H5619	008	0	1	01	01	H5619_008_0	9	3	Tier 3 - Non-Preferred Brand	2		
H5619	008	0	1	01	01	H5619_008_0	9	2	Tier 2 - Preferred Brand	2		
H5619	008	0	1	01	01	H5619_008_0	9	1	Tier 1 - Generic	1		1
H5619	008	0	1	01	01	H5619_008_0	9	4	Tier 4 - Specialty Drug			
H5619	008	0	1	01	01	H5619_008_0	9	3	Tier 3 - Non-Preferred Brand			
H5619	008	0	1	01	01	H5619_008_0	9	1	Tier 1 - Generic			
H5619	008	0	1	01	01	H5619_008_0	9	2	Tier 2 - Preferred Brand			
H5628	001	0	1	01	01	H5628_001_0	6	1	Generic			
H5628	001	0	1	01	01	H5628_001_0	6	2	Preferred Brand			
H5628	001	0	1	01	01	H5628_001_0	6	3	Non-Preferred Brand			
H5628	001	0	1	01	01	H5628_001_0	6	4	Specialty Drugs			
H5628	002	0	1	01	01	H5628_002_0	8	1	Generic			
H5628	002	0	1	01	01	H5628_002_0	8	2	Preferred Brand			
H5628	002	0	1	01	01	H5628_002_0	8	4	Specialty Drugs			
H5628	002	0	1	01	01	H5628_002_0	8	3	Non-Preferred Brand			
H5628	006	0	1	01	01	H5628_006_0	5	1	Generic			
H5628	006	0	1	01	01	H5628_006_0	5	3	Non-Preferred Brand			
H5628	006	0	1	01	01	H5628_006_0	5	2	Preferred Brand			
H5628	006	0	1	01	01	H5628_006_0	5	4	Specialty Drugs			
H5640	001	0	1	01	01	H5640_001_0	7	1	Generic			
H5640	001	0	1	01	01	H5640_001_0	7	2	Brand			
H5640	001	0	1	01	01	H5640_001_0	7	1	Generic	1		1
H5640	001	0	1	01	01	H5640_001_0	7	2	Brand	2		
H5649	001	0	1	01	01	H5649_001_0	7	4	Specialty Drugs			
H5649	001	0	1	01	01	H5649_001_0	7	1	Generic			
H5649	001	0	1	01	01	H5649_001_0	7	2	Preferred Brand			
H5649	001	0	1	01	01	H5649_001_0	7	3	Brand			
H5652	001	0	1	37	05	H5652_001_0	4	3	Non Preferred			
H5652	001	0	1	37	05	H5652_001_0	4	2	Preferred Brand			
H5652	001	0	1	37	05	H5652_001_0	4	1	Preferred Generic			
H5652	001	0	1	37	05	H5652_001_0	4	4	Specialty			
H5652	003	0	1	37	05	H5652_003_0	4	4	Specialty			
H5652	003	0	1	37	05	H5652_003_0	4	1	Preferred Generic			
H5652	003	0	1	37	05	H5652_003_0	4	2	Preferred Brand			
H5652	003	0	1	37	05	H5652_003_0	4	3	Non Preferred			
H5652	004	0	1	37	05	H5652_004_0	3	4	Specialty			
H5652	004	0	1	37	05	H5652_004_0	3	2	Preferred Brand			
H5652	004	0	1	37	05	H5652_004_0	3	3	Non Preferred			
H5652	004	0	1	37	05	H5652_004_0	3	1	Preferred Generic			
H5656	001	0	1	01	01	H5656_001_0	5	2	Preferred  Brand			
H5656	001	0	1	01	01	H5656_001_0	5	1	Generic	1		1
H5656	001	0	1	01	01	H5656_001_0	5	2	Preferred  Brand	2		
H5656	001	0	1	01	01	H5656_001_0	5	3	Non-Preferred Brand	2		
H5656	001	0	1	01	01	H5656_001_0	5	4	Speciality	2		
H5656	001	0	1	01	01	H5656_001_0	5	1	Generic			
H5656	001	0	1	01	01	H5656_001_0	5	3	Non-Preferred Brand			
H5656	001	0	1	01	01	H5656_001_0	5	4	Speciality			
H5656	004	0	1	01	01	H5656_004_0	6	1	Generic			
H5656	004	0	1	01	01	H5656_004_0	6	4	Speciality			
H5656	004	0	1	01	01	H5656_004_0	6	3	Non-Preferred Brand			
H5656	004	0	1	01	01	H5656_004_0	6	2	Preferred  Brand			
H5656	009	0	1	01	01	H5656_009_0	6	4	Speciality	2		
H5656	009	0	1	01	01	H5656_009_0	6	3	Non-Preferred Brand	2		
H5656	009	0	1	01	01	H5656_009_0	6	2	Preferred  Brand	2		
H5656	009	0	1	01	01	H5656_009_0	6	1	Generic	1		1
H5656	009	0	1	01	01	H5656_009_0	6	3	Non-Preferred Brand			
H5656	009	0	1	01	01	H5656_009_0	6	2	Preferred  Brand			
H5656	009	0	1	01	01	H5656_009_0	6	1	Generic			
H5656	009	0	1	01	01	H5656_009_0	6	4	Speciality			
H5657	004	0	1	09	04	H5657_004_0	3	3	Non-Preferred Brand			
H5657	004	0	1	09	04	H5657_004_0	3	4	Specialty			
H5657	004	0	1	09	04	H5657_004_0	3	1	Preferred Generic	1	00001000	2
H5657	004	0	1	09	04	H5657_004_0	3	2	Preferred Brand	1	10000000	2
H5657	004	0	1	09	04	H5657_004_0	3	3	Non-Preferred Brand	1	10000000	2
H5657	004	0	1	09	04	H5657_004_0	3	4	Specialty	1	10001000	2
H5657	004	0	1	09	04	H5657_004_0	3	1	Preferred Generic			
H5657	004	0	1	09	04	H5657_004_0	3	2	Preferred Brand			
H5657	005	0	1	09	04	H5657_005_0	4	1	Preferred Generic			
H5657	005	0	1	09	04	H5657_005_0	4	2	Preferred Brand			
H5657	005	0	1	09	04	H5657_005_0	4	3	Non-Preferred Brand			
H5657	005	0	1	09	04	H5657_005_0	4	4	Specialty			
H5657	005	0	1	09	04	H5657_005_0	4	1	Preferred Generic	1	00001000	2
H5657	005	0	1	09	04	H5657_005_0	4	2	Preferred Brand	1	10000000	2
H5657	005	0	1	09	04	H5657_005_0	4	3	Non-Preferred Brand	1	10000000	2
H5657	005	0	1	09	04	H5657_005_0	4	4	Specialty	1	10001000	2
H5665	002	0	1	01	01	H5665_002_0	9	1	Formulary Generic			
H5665	002	0	1	01	01	H5665_002_0	9	4	Formulary Specialty			
H5665	002	0	1	01	01	H5665_002_0	9	3	Formulary Non-Preferred Brand			
H5665	002	0	1	01	01	H5665_002_0	9	2	Formulary Preferred Brand			
H5678	001	0	1	37	05	H5678_001_0	4	3	Non Preferred			
H5678	001	0	1	37	05	H5678_001_0	4	2	Preferred Brand			
H5678	001	0	1	37	05	H5678_001_0	4	1	Preferred Generic			
H5678	001	0	1	37	05	H5678_001_0	4	4	Specialty			
H5678	003	0	1	37	05	H5678_003_0	4	1	Preferred Generic			
H5678	003	0	1	37	05	H5678_003_0	4	2	Preferred Brand			
H5678	003	0	1	37	05	H5678_003_0	4	4	Specialty			
H5678	003	0	1	37	05	H5678_003_0	4	3	Non Preferred			
H5678	004	0	1	37	05	H5678_004_0	3	1	Preferred Generic			
H5678	004	0	1	37	05	H5678_004_0	3	3	Non Preferred			
H5678	004	0	1	37	05	H5678_004_0	3	2	Preferred Brand			
H5678	004	0	1	37	05	H5678_004_0	3	4	Specialty			
H5679	001	0	1	01	01	H5679_001_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H5679	001	0	1	01	01	H5679_001_0	8	2	Tier 2 Preferred Brand			
H5679	001	0	1	01	01	H5679_001_0	8	1	Tier 1 Preferred Generic			
H5679	001	0	1	01	01	H5679_001_0	8	4	Tier 4 Non-Specialty Injectable			
H5679	001	0	1	01	01	H5679_001_0	8	5	Tier 5 Specialty	2		
H5679	001	0	1	01	01	H5679_001_0	8	4	Tier 4 Non-Specialty Injectable	2		
H5679	001	0	1	01	01	H5679_001_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H5679	001	0	1	01	01	H5679_001_0	8	2	Tier 2 Preferred Brand	2		
H5679	001	0	1	01	01	H5679_001_0	8	1	Tier 1 Preferred Generic	1		1
H5679	001	0	1	01	01	H5679_001_0	8	5	Tier 5 Specialty			
H5679	002	0	1	01	01	H5679_002_0	8	1	Tier 1 Preferred Generic			
H5679	002	0	1	01	01	H5679_002_0	8	2	Tier 2 Preferred Brand			
H5679	002	0	1	01	01	H5679_002_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H5679	002	0	1	01	01	H5679_002_0	8	4	Tier 4 Non-Specialty Injectable	2		
H5679	002	0	1	01	01	H5679_002_0	8	5	Tier 5 Specialty	2		
H5679	002	0	1	01	01	H5679_002_0	8	2	Tier 2 Preferred Brand	2		
H5679	002	0	1	01	01	H5679_002_0	8	1	Tier 1 Preferred Generic	1		1
H5679	002	0	1	01	01	H5679_002_0	8	5	Tier 5 Specialty			
H5679	002	0	1	01	01	H5679_002_0	8	4	Tier 4 Non-Specialty Injectable			
H5679	002	0	1	01	01	H5679_002_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H5696	001	0	1	01	01	H5696_001_0	9	1	Generic	1		1
H5696	001	0	1	01	01	H5696_001_0	9	2	Preferred Brand	2		
H5696	001	0	1	01	01	H5696_001_0	9	3	Non-Preferred Brand	2		
H5696	001	0	1	01	01	H5696_001_0	9	3	Non-Preferred Brand			
H5696	001	0	1	01	01	H5696_001_0	9	1	Generic			
H5696	001	0	1	01	01	H5696_001_0	9	4	Injectable  Specialty			
H5696	001	0	1	01	01	H5696_001_0	9	2	Preferred Brand			
H5696	001	0	1	01	01	H5696_001_0	9	4	Injectable  Specialty	2		
H5696	002	0	1	01	01	H5696_002_0	10	1	Generic			
H5696	002	0	1	01	01	H5696_002_0	10	3	Non-Preferred Brand			
H5696	002	0	1	01	01	H5696_002_0	10	4	Injectable  Specialty			
H5696	002	0	1	01	01	H5696_002_0	10	2	Preferred Brand			
H5696	003	0	1	01	01	H5696_003_0	8	3	Non-Preferred Brand	2		
H5696	003	0	1	01	01	H5696_003_0	8	4	Injectable  Specialty	2		
H5696	003	0	1	01	01	H5696_003_0	8	2	Preferred Brand	2		
H5696	003	0	1	01	01	H5696_003_0	8	1	Generic	1		1
H5696	003	0	1	01	01	H5696_003_0	8	4	Injectable  Specialty			
H5696	003	0	1	01	01	H5696_003_0	8	3	Non-Preferred Brand			
H5696	003	0	1	01	01	H5696_003_0	8	2	Preferred Brand			
H5696	003	0	1	01	01	H5696_003_0	8	1	Generic			
H5696	004	0	1	01	01	H5696_004_0	9	4	Injectable  Specialty			
H5696	004	0	1	01	01	H5696_004_0	9	1	Generic			
H5696	004	0	1	01	01	H5696_004_0	9	2	Preferred Brand			
H5696	004	0	1	01	01	H5696_004_0	9	3	Non-Preferred Brand			
H5696	022	0	1	01	01	H5696_022_0	12	2	Preferred Brand	2		
H5696	022	0	1	01	01	H5696_022_0	12	3	Non-Preferred Brand	2		
H5696	022	0	1	01	01	H5696_022_0	12	4	Injectable and Specialty	2		
H5696	022	0	1	01	01	H5696_022_0	12	1	Generic	1		1
H5696	022	0	1	01	01	H5696_022_0	12	1	Generic			
H5696	022	0	1	01	01	H5696_022_0	12	2	Preferred Brand			
H5696	022	0	1	01	01	H5696_022_0	12	3	Non-Preferred Brand			
H5696	022	0	1	01	01	H5696_022_0	12	4	Injectable and Specialty			
H5697	001	0	1	37	05	H5697_001_0	5	4	Specialty			
H5697	001	0	1	37	05	H5697_001_0	5	3	Non Preferred			
H5697	001	0	1	37	05	H5697_001_0	5	1	Preferred Generic			
H5697	001	0	1	37	05	H5697_001_0	5	2	Preferred Brand			
H5697	003	0	1	37	05	H5697_003_0	3	3	Non Preferred			
H5697	003	0	1	37	05	H5697_003_0	3	2	Preferred Brand			
H5697	003	0	1	37	05	H5697_003_0	3	4	Specialty			
H5697	003	0	1	37	05	H5697_003_0	3	1	Preferred Generic			
H5697	004	0	1	37	05	H5697_004_0	3	2	Preferred Brand			
H5697	004	0	1	37	05	H5697_004_0	3	3	Non Preferred			
H5697	004	0	1	37	05	H5697_004_0	3	4	Specialty			
H5697	004	0	1	37	05	H5697_004_0	3	1	Preferred Generic			
H5698	002	0	1	01	01	H5698_002_0	4	3	Tier 3 - Preferred Brand	2		
H5698	002	0	1	01	01	H5698_002_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	002	0	1	01	01	H5698_002_0	4	5	Tier - Specialty (Brand or Generic)	2		
H5698	002	0	1	01	01	H5698_002_0	4	2	Tier 2 - Generic			
H5698	002	0	1	01	01	H5698_002_0	4	5	Tier - Specialty (Brand or Generic)			
H5698	002	0	1	01	01	H5698_002_0	4	1	Tier 1- Preferred Generics	1		1
H5698	002	0	1	01	01	H5698_002_0	4	2	Tier 2 - Generic	1		1
H5698	002	0	1	01	01	H5698_002_0	4	3	Tier 3 - Preferred Brand			
H5698	002	0	1	01	01	H5698_002_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	002	0	1	01	01	H5698_002_0	4	1	Tier 1- Preferred Generics			
H5698	005	0	1	01	01	H5698_005_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	005	0	1	01	01	H5698_005_0	5	3	Tier 3 - Preferred Brand	2		
H5698	005	0	1	01	01	H5698_005_0	5	2	Tier 2 - Generic	1		1
H5698	005	0	1	01	01	H5698_005_0	5	2	Tier 2 - Generic			
H5698	005	0	1	01	01	H5698_005_0	5	1	Tier 1- Preferred Generics			
H5698	005	0	1	01	01	H5698_005_0	5	3	Tier 3 - Preferred Brand			
H5698	005	0	1	01	01	H5698_005_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	005	0	1	01	01	H5698_005_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	005	0	1	01	01	H5698_005_0	5	1	Tier 1- Preferred Generics	1		1
H5698	005	0	1	01	01	H5698_005_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	017	0	1	01	01	H5698_017_0	6	1	Tier 1- Preferred Generics			
H5698	017	0	1	01	01	H5698_017_0	6	2	Tier 2 - Generic			
H5698	017	0	1	01	01	H5698_017_0	6	3	Tier 3 - Preferred Brand			
H5698	017	0	1	01	01	H5698_017_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	017	0	1	01	01	H5698_017_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	017	0	1	01	01	H5698_017_0	6	1	Tier 1- Preferred Generics	1		1
H5698	017	0	1	01	01	H5698_017_0	6	2	Tier 2 - Generic	1		1
H5698	017	0	1	01	01	H5698_017_0	6	3	Tier 3 - Preferred Brand	2		
H5698	017	0	1	01	01	H5698_017_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	017	0	1	01	01	H5698_017_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	018	0	1	01	01	H5698_018_0	7	1	Tier 1- Preferred Generics			
H5698	018	0	1	01	01	H5698_018_0	7	2	Tier 2 - Generic			
H5698	018	0	1	01	01	H5698_018_0	7	3	Tier 3 - Preferred Brand			
H5698	018	0	1	01	01	H5698_018_0	7	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	018	0	1	01	01	H5698_018_0	7	5	Tier - Specialty (Brand or Generic)	2		
H5698	018	0	1	01	01	H5698_018_0	7	1	Tier 1- Preferred Generics	1		1
H5698	018	0	1	01	01	H5698_018_0	7	2	Tier 2 - Generic	1		1
H5698	018	0	1	01	01	H5698_018_0	7	3	Tier 3 - Preferred Brand	2		
H5698	018	0	1	01	01	H5698_018_0	7	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	018	0	1	01	01	H5698_018_0	7	5	Tier - Specialty (Brand or Generic)			
H5698	020	0	1	01	01	H5698_020_0	6	1	Tier 1- Preferred Generics			
H5698	020	0	1	01	01	H5698_020_0	6	2	Tier 2 - Generic			
H5698	020	0	1	01	01	H5698_020_0	6	3	Tier 3 - Preferred Brand			
H5698	020	0	1	01	01	H5698_020_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	020	0	1	01	01	H5698_020_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	020	0	1	01	01	H5698_020_0	6	3	Tier 3 - Preferred Brand	2		
H5698	020	0	1	01	01	H5698_020_0	6	2	Tier 2 - Generic	1		1
H5698	020	0	1	01	01	H5698_020_0	6	1	Tier 1- Preferred Generics	1		1
H5698	020	0	1	01	01	H5698_020_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	020	0	1	01	01	H5698_020_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	021	0	1	01	01	H5698_021_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	021	0	1	01	01	H5698_021_0	6	2	Tier 2 - Generic	1		1
H5698	021	0	1	01	01	H5698_021_0	6	3	Tier 3 - Preferred Brand	2		
H5698	021	0	1	01	01	H5698_021_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	021	0	1	01	01	H5698_021_0	6	1	Tier 1- Preferred Generics	1		1
H5698	021	0	1	01	01	H5698_021_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	021	0	1	01	01	H5698_021_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	021	0	1	01	01	H5698_021_0	6	3	Tier 3 - Preferred Brand			
H5698	021	0	1	01	01	H5698_021_0	6	2	Tier 2 - Generic			
H5698	021	0	1	01	01	H5698_021_0	6	1	Tier 1- Preferred Generics			
H5698	028	0	1	01	01	H5698_028_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	028	0	1	01	01	H5698_028_0	5	1	Tier 1- Preferred Generics	1		1
H5698	028	0	1	01	01	H5698_028_0	5	2	Tier 2 - Generic	1		1
H5698	028	0	1	01	01	H5698_028_0	5	3	Tier 3 - Preferred Brand	2		
H5698	028	0	1	01	01	H5698_028_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	028	0	1	01	01	H5698_028_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	028	0	1	01	01	H5698_028_0	5	1	Tier 1- Preferred Generics			
H5698	028	0	1	01	01	H5698_028_0	5	2	Tier 2 - Generic			
H5698	028	0	1	01	01	H5698_028_0	5	3	Tier 3 - Preferred Brand			
H5698	028	0	1	01	01	H5698_028_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	029	0	1	01	01	H5698_029_0	7	2	Tier 2 - Generic			
H5698	029	0	1	01	01	H5698_029_0	7	3	Tier 3 - Preferred Brand			
H5698	029	0	1	01	01	H5698_029_0	7	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	029	0	1	01	01	H5698_029_0	7	5	Tier - Specialty (Brand or Generic)			
H5698	029	0	1	01	01	H5698_029_0	7	1	Tier 1- Preferred Generics	1		1
H5698	029	0	1	01	01	H5698_029_0	7	2	Tier 2 - Generic	1		1
H5698	029	0	1	01	01	H5698_029_0	7	5	Tier - Specialty (Brand or Generic)	2		
H5698	029	0	1	01	01	H5698_029_0	7	1	Tier 1- Preferred Generics			
H5698	029	0	1	01	01	H5698_029_0	7	3	Tier 3 - Preferred Brand	2		
H5698	029	0	1	01	01	H5698_029_0	7	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	036	0	1	01	01	H5698_036_0	4	3	Tier 3 - Preferred Brand			
H5698	036	0	1	01	01	H5698_036_0	4	2	Tier 2 - Generic			
H5698	036	0	1	01	01	H5698_036_0	4	5	Tier - Specialty (Brand or Generic)	2		
H5698	036	0	1	01	01	H5698_036_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	036	0	1	01	01	H5698_036_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	036	0	1	01	01	H5698_036_0	4	2	Tier 2 - Generic	1		1
H5698	036	0	1	01	01	H5698_036_0	4	1	Tier 1- Preferred Generics			
H5698	036	0	1	01	01	H5698_036_0	4	1	Tier 1- Preferred Generics	1		1
H5698	036	0	1	01	01	H5698_036_0	4	5	Tier - Specialty (Brand or Generic)			
H5698	036	0	1	01	01	H5698_036_0	4	3	Tier 3 - Preferred Brand	2		
H5698	037	0	1	01	01	H5698_037_0	6	2	Tier 2 - Generic			
H5698	037	0	1	01	01	H5698_037_0	6	1	Tier 1- Preferred Generics			
H5698	037	0	1	01	01	H5698_037_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	037	0	1	01	01	H5698_037_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	037	0	1	01	01	H5698_037_0	6	3	Tier 3 - Preferred Brand	2		
H5698	037	0	1	01	01	H5698_037_0	6	3	Tier 3 - Preferred Brand			
H5698	037	0	1	01	01	H5698_037_0	6	1	Tier 1- Preferred Generics	1		1
H5698	037	0	1	01	01	H5698_037_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	037	0	1	01	01	H5698_037_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	037	0	1	01	01	H5698_037_0	6	2	Tier 2 - Generic	1		1
H5698	056	0	1	01	01	H5698_056_0	4	1	Tier 1- Preferred Generics			
H5698	056	0	1	01	01	H5698_056_0	4	2	Tier 2 - Generic			
H5698	056	0	1	01	01	H5698_056_0	4	3	Tier 3 - Preferred Brand			
H5698	056	0	1	01	01	H5698_056_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	056	0	1	01	01	H5698_056_0	4	5	Tier - Specialty (Brand or Generic)			
H5698	056	0	1	01	01	H5698_056_0	4	1	Tier 1- Preferred Generics	1		1
H5698	056	0	1	01	01	H5698_056_0	4	2	Tier 2 - Generic	1		1
H5698	056	0	1	01	01	H5698_056_0	4	3	Tier 3 - Preferred Brand	2		
H5698	056	0	1	01	01	H5698_056_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	056	0	1	01	01	H5698_056_0	4	5	Tier - Specialty (Brand or Generic)	2		
H5698	057	0	1	01	01	H5698_057_0	6	1	Tier 1- Preferred Generics			
H5698	057	0	1	01	01	H5698_057_0	6	2	Tier 2 - Generic			
H5698	057	0	1	01	01	H5698_057_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	057	0	1	01	01	H5698_057_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	057	0	1	01	01	H5698_057_0	6	3	Tier 3 - Preferred Brand	2		
H5698	057	0	1	01	01	H5698_057_0	6	2	Tier 2 - Generic	1		1
H5698	057	0	1	01	01	H5698_057_0	6	1	Tier 1- Preferred Generics	1		1
H5698	057	0	1	01	01	H5698_057_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	057	0	1	01	01	H5698_057_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	057	0	1	01	01	H5698_057_0	6	3	Tier 3 - Preferred Brand			
H5698	059	0	1	01	01	H5698_059_0	6	1	Tier 1- Preferred Generics			
H5698	059	0	1	01	01	H5698_059_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	059	0	1	01	01	H5698_059_0	6	3	Tier 3 - Preferred Brand	2		
H5698	059	0	1	01	01	H5698_059_0	6	2	Tier 2 - Generic	1		1
H5698	059	0	1	01	01	H5698_059_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	059	0	1	01	01	H5698_059_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	059	0	1	01	01	H5698_059_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	059	0	1	01	01	H5698_059_0	6	3	Tier 3 - Preferred Brand			
H5698	059	0	1	01	01	H5698_059_0	6	2	Tier 2 - Generic			
H5698	059	0	1	01	01	H5698_059_0	6	1	Tier 1- Preferred Generics	1		1
H5698	060	0	1	01	01	H5698_060_0	5	1	Tier 1- Preferred Generics			
H5698	060	0	1	01	01	H5698_060_0	5	2	Tier 2 - Generic			
H5698	060	0	1	01	01	H5698_060_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	060	0	1	01	01	H5698_060_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	060	0	1	01	01	H5698_060_0	5	3	Tier 3 - Preferred Brand	2		
H5698	060	0	1	01	01	H5698_060_0	5	2	Tier 2 - Generic	1		1
H5698	060	0	1	01	01	H5698_060_0	5	1	Tier 1- Preferred Generics	1		1
H5698	060	0	1	01	01	H5698_060_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	060	0	1	01	01	H5698_060_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	060	0	1	01	01	H5698_060_0	5	3	Tier 3 - Preferred Brand			
H5698	061	0	1	01	01	H5698_061_0	6	1	Tier 1- Preferred Generics			
H5698	061	0	1	01	01	H5698_061_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	061	0	1	01	01	H5698_061_0	6	3	Tier 3 - Preferred Brand	2		
H5698	061	0	1	01	01	H5698_061_0	6	2	Tier 2 - Generic	1		1
H5698	061	0	1	01	01	H5698_061_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	061	0	1	01	01	H5698_061_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	061	0	1	01	01	H5698_061_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	061	0	1	01	01	H5698_061_0	6	3	Tier 3 - Preferred Brand			
H5698	061	0	1	01	01	H5698_061_0	6	2	Tier 2 - Generic			
H5698	061	0	1	01	01	H5698_061_0	6	1	Tier 1- Preferred Generics	1		1
H5698	062	0	1	01	01	H5698_062_0	5	2	Tier 2 - Generic			
H5698	062	0	1	01	01	H5698_062_0	5	3	Tier 3 - Preferred Brand			
H5698	062	0	1	01	01	H5698_062_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	062	0	1	01	01	H5698_062_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	062	0	1	01	01	H5698_062_0	5	1	Tier 1- Preferred Generics	1		1
H5698	062	0	1	01	01	H5698_062_0	5	2	Tier 2 - Generic	1		1
H5698	062	0	1	01	01	H5698_062_0	5	3	Tier 3 - Preferred Brand	2		
H5698	062	0	1	01	01	H5698_062_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	062	0	1	01	01	H5698_062_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	062	0	1	01	01	H5698_062_0	5	1	Tier 1- Preferred Generics			
H5698	063	0	1	01	01	H5698_063_0	5	1	Tier 1- Preferred Generics			
H5698	063	0	1	01	01	H5698_063_0	5	2	Tier 2 - Generic			
H5698	063	0	1	01	01	H5698_063_0	5	3	Tier 3 - Preferred Brand			
H5698	063	0	1	01	01	H5698_063_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	063	0	1	01	01	H5698_063_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	063	0	1	01	01	H5698_063_0	5	1	Tier 1- Preferred Generics	1		1
H5698	063	0	1	01	01	H5698_063_0	5	2	Tier 2 - Generic	1		1
H5698	063	0	1	01	01	H5698_063_0	5	3	Tier 3 - Preferred Brand	2		
H5698	063	0	1	01	01	H5698_063_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	063	0	1	01	01	H5698_063_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	064	0	1	01	01	H5698_064_0	5	1	Tier 1- Preferred Generics			
H5698	064	0	1	01	01	H5698_064_0	5	2	Tier 2 - Generic			
H5698	064	0	1	01	01	H5698_064_0	5	3	Tier 3 - Preferred Brand			
H5698	064	0	1	01	01	H5698_064_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	064	0	1	01	01	H5698_064_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	064	0	1	01	01	H5698_064_0	5	1	Tier 1- Preferred Generics	1		1
H5698	064	0	1	01	01	H5698_064_0	5	2	Tier 2 - Generic	1		1
H5698	064	0	1	01	01	H5698_064_0	5	3	Tier 3 - Preferred Brand	2		
H5698	064	0	1	01	01	H5698_064_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	064	0	1	01	01	H5698_064_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	065	0	1	01	01	H5698_065_0	5	1	Tier 1- Preferred Generics			
H5698	065	0	1	01	01	H5698_065_0	5	2	Tier 2 - Generic			
H5698	065	0	1	01	01	H5698_065_0	5	3	Tier 3 - Preferred Brand			
H5698	065	0	1	01	01	H5698_065_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	065	0	1	01	01	H5698_065_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	065	0	1	01	01	H5698_065_0	5	1	Tier 1- Preferred Generics	1		1
H5698	065	0	1	01	01	H5698_065_0	5	2	Tier 2 - Generic	1		1
H5698	065	0	1	01	01	H5698_065_0	5	3	Tier 3 - Preferred Brand	2		
H5698	065	0	1	01	01	H5698_065_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	065	0	1	01	01	H5698_065_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	066	0	1	01	01	H5698_066_0	4	1	Tier 1- Preferred Generics			
H5698	066	0	1	01	01	H5698_066_0	4	2	Tier 2 - Generic			
H5698	066	0	1	01	01	H5698_066_0	4	3	Tier 3 - Preferred Brand			
H5698	066	0	1	01	01	H5698_066_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	066	0	1	01	01	H5698_066_0	4	5	Tier - Specialty (Brand or Generic)	2		
H5698	066	0	1	01	01	H5698_066_0	4	1	Tier 1- Preferred Generics	1		1
H5698	066	0	1	01	01	H5698_066_0	4	2	Tier 2 - Generic	1		1
H5698	066	0	1	01	01	H5698_066_0	4	3	Tier 3 - Preferred Brand	2		
H5698	066	0	1	01	01	H5698_066_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	066	0	1	01	01	H5698_066_0	4	5	Tier - Specialty (Brand or Generic)			
H5698	067	0	1	01	01	H5698_067_0	5	1	Tier 1- Preferred Generics			
H5698	067	0	1	01	01	H5698_067_0	5	2	Tier 2 - Generic			
H5698	067	0	1	01	01	H5698_067_0	5	3	Tier 3 - Preferred Brand			
H5698	067	0	1	01	01	H5698_067_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	067	0	1	01	01	H5698_067_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	067	0	1	01	01	H5698_067_0	5	1	Tier 1- Preferred Generics	1		1
H5698	067	0	1	01	01	H5698_067_0	5	2	Tier 2 - Generic	1		1
H5698	067	0	1	01	01	H5698_067_0	5	3	Tier 3 - Preferred Brand	2		
H5698	067	0	1	01	01	H5698_067_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	067	0	1	01	01	H5698_067_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	068	0	1	01	01	H5698_068_0	4	5	Tier - Specialty (Brand or Generic)			
H5698	068	0	1	01	01	H5698_068_0	4	1	Tier 1- Preferred Generics	1		1
H5698	068	0	1	01	01	H5698_068_0	4	2	Tier 2 - Generic	1		1
H5698	068	0	1	01	01	H5698_068_0	4	3	Tier 3 - Preferred Brand	2		
H5698	068	0	1	01	01	H5698_068_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	068	0	1	01	01	H5698_068_0	4	5	Tier - Specialty (Brand or Generic)	2		
H5698	068	0	1	01	01	H5698_068_0	4	1	Tier 1- Preferred Generics			
H5698	068	0	1	01	01	H5698_068_0	4	2	Tier 2 - Generic			
H5698	068	0	1	01	01	H5698_068_0	4	3	Tier 3 - Preferred Brand			
H5698	068	0	1	01	01	H5698_068_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	069	0	1	01	01	H5698_069_0	4	1	Tier 1- Preferred Generics			
H5698	069	0	1	01	01	H5698_069_0	4	5	Tier - Specialty (Brand or Generic)			
H5698	069	0	1	01	01	H5698_069_0	4	1	Tier 1- Preferred Generics	1		1
H5698	069	0	1	01	01	H5698_069_0	4	2	Tier 2 - Generic	1		1
H5698	069	0	1	01	01	H5698_069_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	069	0	1	01	01	H5698_069_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	069	0	1	01	01	H5698_069_0	4	5	Tier - Specialty (Brand or Generic)	2		
H5698	069	0	1	01	01	H5698_069_0	4	2	Tier 2 - Generic			
H5698	069	0	1	01	01	H5698_069_0	4	3	Tier 3 - Preferred Brand			
H5698	069	0	1	01	01	H5698_069_0	4	3	Tier 3 - Preferred Brand	2		
H5698	070	0	1	01	01	H5698_070_0	4	1	Tier 1- Preferred Generics			
H5698	070	0	1	01	01	H5698_070_0	4	2	Tier 2 - Generic			
H5698	070	0	1	01	01	H5698_070_0	4	5	Tier - Specialty (Brand or Generic)	2		
H5698	070	0	1	01	01	H5698_070_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	070	0	1	01	01	H5698_070_0	4	3	Tier 3 - Preferred Brand	2		
H5698	070	0	1	01	01	H5698_070_0	4	2	Tier 2 - Generic	1		1
H5698	070	0	1	01	01	H5698_070_0	4	1	Tier 1- Preferred Generics	1		1
H5698	070	0	1	01	01	H5698_070_0	4	5	Tier - Specialty (Brand or Generic)			
H5698	070	0	1	01	01	H5698_070_0	4	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	070	0	1	01	01	H5698_070_0	4	3	Tier 3 - Preferred Brand			
H5698	071	0	1	01	01	H5698_071_0	6	1	Tier 1- Preferred Generics			
H5698	071	0	1	01	01	H5698_071_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	071	0	1	01	01	H5698_071_0	6	3	Tier 3 - Preferred Brand	2		
H5698	071	0	1	01	01	H5698_071_0	6	2	Tier 2 - Generic	1		1
H5698	071	0	1	01	01	H5698_071_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	071	0	1	01	01	H5698_071_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	071	0	1	01	01	H5698_071_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	071	0	1	01	01	H5698_071_0	6	3	Tier 3 - Preferred Brand			
H5698	071	0	1	01	01	H5698_071_0	6	2	Tier 2 - Generic			
H5698	071	0	1	01	01	H5698_071_0	6	1	Tier 1- Preferred Generics	1		1
H5698	072	0	1	01	01	H5698_072_0	6	1	Tier 1- Preferred Generics			
H5698	072	0	1	01	01	H5698_072_0	6	2	Tier 2 - Generic			
H5698	072	0	1	01	01	H5698_072_0	6	3	Tier 3 - Preferred Brand			
H5698	072	0	1	01	01	H5698_072_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	072	0	1	01	01	H5698_072_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	072	0	1	01	01	H5698_072_0	6	1	Tier 1- Preferred Generics	1		1
H5698	072	0	1	01	01	H5698_072_0	6	2	Tier 2 - Generic	1		1
H5698	072	0	1	01	01	H5698_072_0	6	3	Tier 3 - Preferred Brand	2		
H5698	072	0	1	01	01	H5698_072_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	072	0	1	01	01	H5698_072_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	073	0	1	01	01	H5698_073_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	073	0	1	01	01	H5698_073_0	6	3	Tier 3 - Preferred Brand	2		
H5698	073	0	1	01	01	H5698_073_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	073	0	1	01	01	H5698_073_0	6	2	Tier 2 - Generic	1		1
H5698	073	0	1	01	01	H5698_073_0	6	1	Tier 1- Preferred Generics	1		1
H5698	073	0	1	01	01	H5698_073_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	073	0	1	01	01	H5698_073_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	073	0	1	01	01	H5698_073_0	6	3	Tier 3 - Preferred Brand			
H5698	073	0	1	01	01	H5698_073_0	6	2	Tier 2 - Generic			
H5698	073	0	1	01	01	H5698_073_0	6	1	Tier 1- Preferred Generics			
H5698	074	0	1	01	01	H5698_074_0	6	2	Tier 2 - Generic			
H5698	074	0	1	01	01	H5698_074_0	6	1	Tier 1- Preferred Generics			
H5698	074	0	1	01	01	H5698_074_0	6	3	Tier 3 - Preferred Brand			
H5698	074	0	1	01	01	H5698_074_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	074	0	1	01	01	H5698_074_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	074	0	1	01	01	H5698_074_0	6	1	Tier 1- Preferred Generics	1		1
H5698	074	0	1	01	01	H5698_074_0	6	2	Tier 2 - Generic	1		1
H5698	074	0	1	01	01	H5698_074_0	6	3	Tier 3 - Preferred Brand	2		
H5698	074	0	1	01	01	H5698_074_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	074	0	1	01	01	H5698_074_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	075	0	1	01	01	H5698_075_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	075	0	1	01	01	H5698_075_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	075	0	1	01	01	H5698_075_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	075	0	1	01	01	H5698_075_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	075	0	1	01	01	H5698_075_0	6	3	Tier 3 - Preferred Brand			
H5698	075	0	1	01	01	H5698_075_0	6	2	Tier 2 - Generic			
H5698	075	0	1	01	01	H5698_075_0	6	1	Tier 1- Preferred Generics			
H5698	075	0	1	01	01	H5698_075_0	6	3	Tier 3 - Preferred Brand	2		
H5698	075	0	1	01	01	H5698_075_0	6	2	Tier 2 - Generic	1		1
H5698	075	0	1	01	01	H5698_075_0	6	1	Tier 1- Preferred Generics	1		1
H5698	076	0	1	01	01	H5698_076_0	6	1	Tier 1- Preferred Generics			
H5698	076	0	1	01	01	H5698_076_0	6	2	Tier 2 - Generic			
H5698	076	0	1	01	01	H5698_076_0	6	3	Tier 3 - Preferred Brand			
H5698	076	0	1	01	01	H5698_076_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	076	0	1	01	01	H5698_076_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	076	0	1	01	01	H5698_076_0	6	1	Tier 1- Preferred Generics	1		1
H5698	076	0	1	01	01	H5698_076_0	6	2	Tier 2 - Generic	1		1
H5698	076	0	1	01	01	H5698_076_0	6	3	Tier 3 - Preferred Brand	2		
H5698	076	0	1	01	01	H5698_076_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	076	0	1	01	01	H5698_076_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	086	0	1	01	01	H5698_086_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	086	0	1	01	01	H5698_086_0	6	3	Tier 3 - Preferred Brand	2		
H5698	086	0	1	01	01	H5698_086_0	6	2	Tier 2 - Generic	1		1
H5698	086	0	1	01	01	H5698_086_0	6	1	Tier 1- Preferred Generics	1		1
H5698	086	0	1	01	01	H5698_086_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	086	0	1	01	01	H5698_086_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	086	0	1	01	01	H5698_086_0	6	3	Tier 3 - Preferred Brand			
H5698	086	0	1	01	01	H5698_086_0	6	2	Tier 2 - Generic			
H5698	086	0	1	01	01	H5698_086_0	6	1	Tier 1- Preferred Generics			
H5698	086	0	1	01	01	H5698_086_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	087	0	1	01	01	H5698_087_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	087	0	1	01	01	H5698_087_0	6	3	Tier 3 - Preferred Brand	2		
H5698	087	0	1	01	01	H5698_087_0	6	2	Tier 2 - Generic	1		1
H5698	087	0	1	01	01	H5698_087_0	6	1	Tier 1- Preferred Generics	1		1
H5698	087	0	1	01	01	H5698_087_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	087	0	1	01	01	H5698_087_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	087	0	1	01	01	H5698_087_0	6	3	Tier 3 - Preferred Brand			
H5698	087	0	1	01	01	H5698_087_0	6	2	Tier 2 - Generic			
H5698	087	0	1	01	01	H5698_087_0	6	1	Tier 1- Preferred Generics			
H5698	087	0	1	01	01	H5698_087_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	088	0	1	01	01	H5698_088_0	6	1	Tier 1- Preferred Generics			
H5698	088	0	1	01	01	H5698_088_0	6	2	Tier 2 - Generic			
H5698	088	0	1	01	01	H5698_088_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	088	0	1	01	01	H5698_088_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	088	0	1	01	01	H5698_088_0	6	3	Tier 3 - Preferred Brand	2		
H5698	088	0	1	01	01	H5698_088_0	6	2	Tier 2 - Generic	1		1
H5698	088	0	1	01	01	H5698_088_0	6	1	Tier 1- Preferred Generics	1		1
H5698	088	0	1	01	01	H5698_088_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	088	0	1	01	01	H5698_088_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	088	0	1	01	01	H5698_088_0	6	3	Tier 3 - Preferred Brand			
H5698	089	0	1	01	01	H5698_089_0	6	1	Tier 1- Preferred Generics			
H5698	089	0	1	01	01	H5698_089_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	089	0	1	01	01	H5698_089_0	6	3	Tier 3 - Preferred Brand	2		
H5698	089	0	1	01	01	H5698_089_0	6	2	Tier 2 - Generic	1		1
H5698	089	0	1	01	01	H5698_089_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	089	0	1	01	01	H5698_089_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	089	0	1	01	01	H5698_089_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	089	0	1	01	01	H5698_089_0	6	3	Tier 3 - Preferred Brand			
H5698	089	0	1	01	01	H5698_089_0	6	2	Tier 2 - Generic			
H5698	089	0	1	01	01	H5698_089_0	6	1	Tier 1- Preferred Generics	1		1
H5698	090	0	1	01	01	H5698_090_0	6	3	Tier 3 - Preferred Brand			
H5698	090	0	1	01	01	H5698_090_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	090	0	1	01	01	H5698_090_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	090	0	1	01	01	H5698_090_0	6	1	Tier 1- Preferred Generics	1		1
H5698	090	0	1	01	01	H5698_090_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	090	0	1	01	01	H5698_090_0	6	3	Tier 3 - Preferred Brand	2		
H5698	090	0	1	01	01	H5698_090_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	090	0	1	01	01	H5698_090_0	6	1	Tier 1- Preferred Generics			
H5698	090	0	1	01	01	H5698_090_0	6	2	Tier 2 - Generic			
H5698	090	0	1	01	01	H5698_090_0	6	2	Tier 2 - Generic	1		1
H5698	091	0	1	01	01	H5698_091_0	6	3	Tier 3 - Preferred Brand	2		
H5698	091	0	1	01	01	H5698_091_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	091	0	1	01	01	H5698_091_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	091	0	1	01	01	H5698_091_0	6	1	Tier 1- Preferred Generics			
H5698	091	0	1	01	01	H5698_091_0	6	2	Tier 2 - Generic			
H5698	091	0	1	01	01	H5698_091_0	6	3	Tier 3 - Preferred Brand			
H5698	091	0	1	01	01	H5698_091_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	091	0	1	01	01	H5698_091_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	091	0	1	01	01	H5698_091_0	6	1	Tier 1- Preferred Generics	1		1
H5698	091	0	1	01	01	H5698_091_0	6	2	Tier 2 - Generic	1		1
H5698	092	0	1	01	01	H5698_092_0	6	2	Tier 2 - Generic			
H5698	092	0	1	01	01	H5698_092_0	6	1	Tier 1- Preferred Generics			
H5698	092	0	1	01	01	H5698_092_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	092	0	1	01	01	H5698_092_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	092	0	1	01	01	H5698_092_0	6	3	Tier 3 - Preferred Brand	2		
H5698	092	0	1	01	01	H5698_092_0	6	2	Tier 2 - Generic	1		1
H5698	092	0	1	01	01	H5698_092_0	6	1	Tier 1- Preferred Generics	1		1
H5698	092	0	1	01	01	H5698_092_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	092	0	1	01	01	H5698_092_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	092	0	1	01	01	H5698_092_0	6	3	Tier 3 - Preferred Brand			
H5698	093	0	1	01	01	H5698_093_0	6	1	Tier 1- Preferred Generics	1		1
H5698	093	0	1	01	01	H5698_093_0	6	2	Tier 2 - Generic	1		1
H5698	093	0	1	01	01	H5698_093_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	093	0	1	01	01	H5698_093_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	093	0	1	01	01	H5698_093_0	6	3	Tier 3 - Preferred Brand			
H5698	093	0	1	01	01	H5698_093_0	6	2	Tier 2 - Generic			
H5698	093	0	1	01	01	H5698_093_0	6	1	Tier 1- Preferred Generics			
H5698	093	0	1	01	01	H5698_093_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	093	0	1	01	01	H5698_093_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	093	0	1	01	01	H5698_093_0	6	3	Tier 3 - Preferred Brand	2		
H5698	094	0	1	01	01	H5698_094_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	094	0	1	01	01	H5698_094_0	6	3	Tier 3 - Preferred Brand	2		
H5698	094	0	1	01	01	H5698_094_0	6	2	Tier 2 - Generic	1		1
H5698	094	0	1	01	01	H5698_094_0	6	1	Tier 1- Preferred Generics	1		1
H5698	094	0	1	01	01	H5698_094_0	6	3	Tier 3 - Preferred Brand			
H5698	094	0	1	01	01	H5698_094_0	6	1	Tier 1- Preferred Generics			
H5698	094	0	1	01	01	H5698_094_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	094	0	1	01	01	H5698_094_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	094	0	1	01	01	H5698_094_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	094	0	1	01	01	H5698_094_0	6	2	Tier 2 - Generic			
H5698	095	0	1	01	01	H5698_095_0	6	2	Tier 2 - Generic			
H5698	095	0	1	01	01	H5698_095_0	6	1	Tier 1- Preferred Generics			
H5698	095	0	1	01	01	H5698_095_0	6	2	Tier 2 - Generic	1		1
H5698	095	0	1	01	01	H5698_095_0	6	3	Tier 3 - Preferred Brand	2		
H5698	095	0	1	01	01	H5698_095_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	095	0	1	01	01	H5698_095_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	095	0	1	01	01	H5698_095_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	095	0	1	01	01	H5698_095_0	6	3	Tier 3 - Preferred Brand			
H5698	095	0	1	01	01	H5698_095_0	6	1	Tier 1- Preferred Generics	1		1
H5698	095	0	1	01	01	H5698_095_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	096	0	1	01	01	H5698_096_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	096	0	1	01	01	H5698_096_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	096	0	1	01	01	H5698_096_0	6	2	Tier 2 - Generic	1		1
H5698	096	0	1	01	01	H5698_096_0	6	3	Tier 3 - Preferred Brand	2		
H5698	096	0	1	01	01	H5698_096_0	6	1	Tier 1- Preferred Generics	1		1
H5698	096	0	1	01	01	H5698_096_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	096	0	1	01	01	H5698_096_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	096	0	1	01	01	H5698_096_0	6	3	Tier 3 - Preferred Brand			
H5698	096	0	1	01	01	H5698_096_0	6	2	Tier 2 - Generic			
H5698	096	0	1	01	01	H5698_096_0	6	1	Tier 1- Preferred Generics			
H5698	097	0	1	01	01	H5698_097_0	6	2	Tier 2 - Generic	1		1
H5698	097	0	1	01	01	H5698_097_0	6	3	Tier 3 - Preferred Brand	2		
H5698	097	0	1	01	01	H5698_097_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	097	0	1	01	01	H5698_097_0	6	1	Tier 1- Preferred Generics	1		1
H5698	097	0	1	01	01	H5698_097_0	6	3	Tier 3 - Preferred Brand			
H5698	097	0	1	01	01	H5698_097_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	097	0	1	01	01	H5698_097_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	097	0	1	01	01	H5698_097_0	6	1	Tier 1- Preferred Generics			
H5698	097	0	1	01	01	H5698_097_0	6	2	Tier 2 - Generic			
H5698	097	0	1	01	01	H5698_097_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	111	0	1	02	01	H5698_111_0	6	2	Tier 2 - Generic			
H5698	111	0	1	02	01	H5698_111_0	6	1	Tier 1- Preferred Generics			
H5698	111	0	1	02	01	H5698_111_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	111	0	1	02	01	H5698_111_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	111	0	1	02	01	H5698_111_0	6	3	Tier 3 - Preferred Brand	2		
H5698	111	0	1	02	01	H5698_111_0	6	2	Tier 2 - Generic	1		1
H5698	111	0	1	02	01	H5698_111_0	6	1	Tier 1- Preferred Generics	1		1
H5698	111	0	1	02	01	H5698_111_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	111	0	1	02	01	H5698_111_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	111	0	1	02	01	H5698_111_0	6	3	Tier 3 - Preferred Brand			
H5698	112	0	1	02	01	H5698_112_0	6	1	Tier 1- Preferred Generics	1		1
H5698	112	0	1	02	01	H5698_112_0	6	2	Tier 2 - Generic	1		1
H5698	112	0	1	02	01	H5698_112_0	6	5	Tier - Specialty (Brand or Generic)			
H5698	112	0	1	02	01	H5698_112_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	112	0	1	02	01	H5698_112_0	6	3	Tier 3 - Preferred Brand			
H5698	112	0	1	02	01	H5698_112_0	6	2	Tier 2 - Generic			
H5698	112	0	1	02	01	H5698_112_0	6	1	Tier 1- Preferred Generics			
H5698	112	0	1	02	01	H5698_112_0	6	5	Tier - Specialty (Brand or Generic)	2		
H5698	112	0	1	02	01	H5698_112_0	6	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	112	0	1	02	01	H5698_112_0	6	3	Tier 3 - Preferred Brand	2		
H5698	113	0	1	02	01	H5698_113_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	113	0	1	02	01	H5698_113_0	5	3	Tier 3 - Preferred Brand	2		
H5698	113	0	1	02	01	H5698_113_0	5	2	Tier 2 - Generic	1		1
H5698	113	0	1	02	01	H5698_113_0	5	1	Tier 1- Preferred Generics	1		1
H5698	113	0	1	02	01	H5698_113_0	5	3	Tier 3 - Preferred Brand			
H5698	113	0	1	02	01	H5698_113_0	5	1	Tier 1- Preferred Generics			
H5698	113	0	1	02	01	H5698_113_0	5	5	Tier - Specialty (Brand or Generic)			
H5698	113	0	1	02	01	H5698_113_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	113	0	1	02	01	H5698_113_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	113	0	1	02	01	H5698_113_0	5	2	Tier 2 - Generic			
H5698	114	0	1	02	01	H5698_114_0	5	2	Tier 2 - Generic			
H5698	114	0	1	02	01	H5698_114_0	5	1	Tier 1- Preferred Generics			
H5698	114	0	1	02	01	H5698_114_0	5	5	Tier - Specialty (Brand or Generic)	2		
H5698	114	0	1	02	01	H5698_114_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic	2		
H5698	114	0	1	02	01	H5698_114_0	5	3	Tier 3 - Preferred Brand	2		
H5698	114	0	1	02	01	H5698_114_0	5	2	Tier 2 - Generic	1		1
H5698	114	0	1	02	01	H5698_114_0	5	1	Tier 1- Preferred Generics	1		1
H5698	114	0	1	02	01	H5698_114_0	5	3	Tier 3 - Preferred Brand			
H5698	114	0	1	02	01	H5698_114_0	5	4	Tier 4 -Non-Preferred Brand, Non-Preferred Generic			
H5698	114	0	1	02	01	H5698_114_0	5	5	Tier - Specialty (Brand or Generic)			
H5700	002	0	1	01	01	H5700_002_0	19	3	Tier 3 - Non-Preferred Brand			
H5700	002	0	1	01	01	H5700_002_0	19	2	Tier 2 - Prefered Brand			
H5700	002	0	1	01	01	H5700_002_0	19	4	Tier 4 - Specialty	2		
H5700	002	0	1	01	01	H5700_002_0	19	3	Tier 3 - Non-Preferred Brand	2		
H5700	002	0	1	01	01	H5700_002_0	19	2	Tier 2 - Prefered Brand	2		
H5700	002	0	1	01	01	H5700_002_0	19	1	Tier 1 - Generic	1		1
H5700	002	0	1	01	01	H5700_002_0	19	4	Tier 4 - Specialty			
H5700	002	0	1	01	01	H5700_002_0	19	1	Tier 1 - Generic			
H5700	005	0	1	01	01	H5700_005_0	9	1	Tier 1 - Generic			
H5700	005	0	1	01	01	H5700_005_0	9	3	Tier 3 - Non - Preferred Brand	2		
H5700	005	0	1	01	01	H5700_005_0	9	2	Tier 2 - Preferred Brand	2		
H5700	005	0	1	01	01	H5700_005_0	9	1	Tier 1 - Generic	1		1
H5700	005	0	1	01	01	H5700_005_0	9	4	Tier 4 - Specialty Drugs			
H5700	005	0	1	01	01	H5700_005_0	9	3	Tier 3 - Non - Preferred Brand			
H5700	005	0	1	01	01	H5700_005_0	9	2	Tier 2 - Preferred Brand			
H5700	005	0	1	01	01	H5700_005_0	9	4	Tier 4 - Specialty Drugs	2		
H5700	009	0	1	01	01	H5700_009_0	20	3	Tier 3 - Non-Preferred Brand			
H5700	009	0	1	01	01	H5700_009_0	20	2	Tier 2 - Prefered Brand			
H5700	009	0	1	01	01	H5700_009_0	20	1	Tier 1 - Generic			
H5700	009	0	1	01	01	H5700_009_0	20	4	Tier 4 - Specialty			
H5700	009	0	1	01	01	H5700_009_0	20	4	Tier 4 - Specialty	2		
H5700	009	0	1	01	01	H5700_009_0	20	3	Tier 3 - Non-Preferred Brand	2		
H5700	009	0	1	01	01	H5700_009_0	20	2	Tier 2 - Prefered Brand	2		
H5700	009	0	1	01	01	H5700_009_0	20	1	Tier 1 - Generic	1		1
H5700	020	0	1	01	01	H5700_020_0	18	1	Tier 1 - Generic			
H5700	020	0	1	01	01	H5700_020_0	18	2	Tier 2 - Prefered Brand			
H5700	020	0	1	01	01	H5700_020_0	18	4	Tier 4 - Specialty	2		
H5700	020	0	1	01	01	H5700_020_0	18	3	Tier 3 - Non-Preferred Brand	2		
H5700	020	0	1	01	01	H5700_020_0	18	2	Tier 2 - Prefered Brand	2		
H5700	020	0	1	01	01	H5700_020_0	18	1	Tier 1 - Generic	1		1
H5700	020	0	1	01	01	H5700_020_0	18	4	Tier 4 - Specialty			
H5700	020	0	1	01	01	H5700_020_0	18	3	Tier 3 - Non-Preferred Brand			
H5700	025	0	1	02	01	H5700_025_0	21	1	Tier 1 - Generic			
H5700	025	0	1	02	01	H5700_025_0	21	4	Tier 4 - Specialty			
H5700	025	0	1	02	01	H5700_025_0	21	1	Tier 1 - Generic	1		1
H5700	025	0	1	02	01	H5700_025_0	21	2	Tier 2 - Prefered Brand	2		
H5700	025	0	1	02	01	H5700_025_0	21	3	Tier 3 - Non-Preferred Brand	2		
H5700	025	0	1	02	01	H5700_025_0	21	3	Tier 3 - Non-Preferred Brand			
H5700	025	0	1	02	01	H5700_025_0	21	2	Tier 2 - Prefered Brand			
H5700	025	0	1	02	01	H5700_025_0	21	4	Tier 4 - Specialty	2		
H5721	004	0	1	09	04	H5721_004_0	4	1	Preferred Generic			
H5721	004	0	1	09	04	H5721_004_0	4	2	Preferred Brand			
H5721	004	0	1	09	04	H5721_004_0	4	5	Specialty			
H5721	004	0	1	09	04	H5721_004_0	4	4	Injectable			
H5721	004	0	1	09	04	H5721_004_0	4	3	Non-Preferred Brand			
H5732	001	0	1	01	01	H5732_001_0	4	5	Tier 5/Nivel 5			
H5732	001	0	1	01	01	H5732_001_0	4	1	Tier 1/Nivel 1	1		1
H5732	001	0	1	01	01	H5732_001_0	4	2	Tier 2/Nivel 2	2		
H5732	001	0	1	01	01	H5732_001_0	4	3	Tier 3/Nivel 3	2		
H5732	001	0	1	01	01	H5732_001_0	4	4	Tier 4/Nivel 4	2		
H5732	001	0	1	01	01	H5732_001_0	4	5	Tier 5/Nivel 5	2		
H5732	001	0	1	01	01	H5732_001_0	4	1	Tier 1/Nivel 1			
H5732	001	0	1	01	01	H5732_001_0	4	2	Tier 2/Nivel 2			
H5732	001	0	1	01	01	H5732_001_0	4	3	Tier 3/Nivel 3			
H5732	001	0	1	01	01	H5732_001_0	4	4	Tier 4/Nivel 4			
H5732	002	0	1	01	01	H5732_002_0	5	1	Tier 1/Nivel 1			
H5732	002	0	1	01	01	H5732_002_0	5	2	Tier 2/Nivel 2			
H5732	002	0	1	01	01	H5732_002_0	5	3	Tier 3/Nivel 3			
H5732	002	0	1	01	01	H5732_002_0	5	4	Tier 4/Nivel 4			
H5732	002	0	1	01	01	H5732_002_0	5	5	Tier 5/Nivel 5	2		
H5732	002	0	1	01	01	H5732_002_0	5	1	Tier 1/Nivel 1	1		1
H5732	002	0	1	01	01	H5732_002_0	5	2	Tier 2/Nivel 2	1		1
H5732	002	0	1	01	01	H5732_002_0	5	3	Tier 3/Nivel 3	2		
H5732	002	0	1	01	01	H5732_002_0	5	4	Tier 4/Nivel 4	2		
H5732	002	0	1	01	01	H5732_002_0	5	5	Tier 5/Nivel 5			
H5736	002	0	1	09	04	H5736_002_0	6	4	Tier 4 - Non-Preferred Brand			
H5736	002	0	1	09	04	H5736_002_0	6	5	Tier 5 - Specialty			
H5736	002	0	1	09	04	H5736_002_0	6	2	Tier 2 - Non-Preferred Generic			
H5736	002	0	1	09	04	H5736_002_0	6	1	Tier 1 - Preferred Generic			
H5736	002	0	1	09	04	H5736_002_0	6	3	Tier 3 - Preferred Brand			
H5736	003	0	1	09	04	H5736_003_0	5	1	Tier1 - Preferred Generic			
H5736	003	0	1	09	04	H5736_003_0	5	2	Tier 2 - Non-Preferred Generic			
H5736	003	0	1	09	04	H5736_003_0	5	4	Tier 4 - Non-Preferred Brand			
H5736	003	0	1	09	04	H5736_003_0	5	5	Tier 5 - Specialty			
H5736	003	0	1	09	04	H5736_003_0	5	3	Tier 3 - Preferred Brand			
H5736	007	0	1	09	04	H5736_007_0	6	3	Tier 3 - Preferred Brand			
H5736	007	0	1	09	04	H5736_007_0	6	4	Tier 4 - Non-Preferred Brand			
H5736	007	0	1	09	04	H5736_007_0	6	5	Tier 5 - Specialty			
H5736	007	0	1	09	04	H5736_007_0	6	2	Tier 2 - Non-Preferred Generic			
H5736	007	0	1	09	04	H5736_007_0	6	1	Tier 1 - Preferred Generic			
H5736	012	0	1	09	04	H5736_012_0	6	5	Tier 5 - Specialty			
H5736	012	0	1	09	04	H5736_012_0	6	4	Tier 4 - Non-Preferred Brand			
H5736	012	0	1	09	04	H5736_012_0	6	1	Tier 1 - Preferred Generic			
H5736	012	0	1	09	04	H5736_012_0	6	2	Tier 2 - Non-Preferred Generic			
H5736	012	0	1	09	04	H5736_012_0	6	3	Tier 3 - Preferred Brand			
H5736	014	0	1	09	04	H5736_014_0	6	1	Tier 1 - Preferred Generic	1		1
H5736	014	0	1	09	04	H5736_014_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5736	014	0	1	09	04	H5736_014_0	6	5	Tier 5 - Specialty	2		
H5736	014	0	1	09	04	H5736_014_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5736	014	0	1	09	04	H5736_014_0	6	3	Tier 3 - Preferred Brand	2		
H5736	014	0	1	09	04	H5736_014_0	6	1	Tier 1 - Preferred Generic			
H5736	014	0	1	09	04	H5736_014_0	6	2	Tier 2 - Non-Preferred Generic			
H5736	014	0	1	09	04	H5736_014_0	6	3	Tier 3 - Preferred Brand			
H5736	014	0	1	09	04	H5736_014_0	6	4	Tier 4 - Non-Preferred Brand			
H5736	014	0	1	09	04	H5736_014_0	6	5	Tier 5 - Specialty			
H5736	017	0	1	09	04	H5736_017_0	6	5	Tier 5 - Specialty			
H5736	017	0	1	09	04	H5736_017_0	6	1	Tier 1 - Preferred Generic	1		1
H5736	017	0	1	09	04	H5736_017_0	6	2	Tier 2 - Non-Preferred Generic	1		1
H5736	017	0	1	09	04	H5736_017_0	6	3	Tier 3 - Preferred Brand	2		
H5736	017	0	1	09	04	H5736_017_0	6	4	Tier 4 - Non-Preferred Brand			
H5736	017	0	1	09	04	H5736_017_0	6	5	Tier 5 - Specialty	2		
H5736	017	0	1	09	04	H5736_017_0	6	1	Tier 1 - Preferred Generic			
H5736	017	0	1	09	04	H5736_017_0	6	2	Tier 2 - Non-Preferred Generic			
H5736	017	0	1	09	04	H5736_017_0	6	3	Tier 3 - Preferred Brand			
H5736	017	0	1	09	04	H5736_017_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5736	024	0	1	09	04	H5736_024_0	5	4	Tier 4 - Non-Preferred Brand			
H5736	024	0	1	09	04	H5736_024_0	5	5	Tier 5 - Specialty			
H5736	024	0	1	09	04	H5736_024_0	5	1	Tier 1 - Preferred Generic			
H5736	024	0	1	09	04	H5736_024_0	5	2	Tier 2 - Non-Preferred Generic			
H5736	024	0	1	09	04	H5736_024_0	5	3	Tier 3 - Preferred Brand			
H5736	025	0	1	09	04	H5736_025_0	5	2	Tier 2 - Non-Preferred Generic			
H5736	025	0	1	09	04	H5736_025_0	5	3	Tier 3 - Preferred Brand			
H5736	025	0	1	09	04	H5736_025_0	5	5	Tier 5 - Specialty			
H5736	025	0	1	09	04	H5736_025_0	5	4	Tier 4 - Non-Preferred Brand			
H5736	025	0	1	09	04	H5736_025_0	5	1	Tier1 - Preferred Generic			
H5736	026	0	1	09	04	H5736_026_0	5	1	Tier 1 - Preferred Generic			
H5736	026	0	1	09	04	H5736_026_0	5	5	Tier 5 - Specialty			
H5736	026	0	1	09	04	H5736_026_0	5	4	Tier 4 - Non-Preferred Brand			
H5736	026	0	1	09	04	H5736_026_0	5	3	Tier 3 - Preferred Brand			
H5736	026	0	1	09	04	H5736_026_0	5	2	Tier 2 - Non-Preferred Generic			
H5736	027	0	1	09	04	H5736_027_0	6	1	Tier 1 - Preferred Generic			
H5736	027	0	1	09	04	H5736_027_0	6	2	Tier 2 - Non-Preferred Generic			
H5736	027	0	1	09	04	H5736_027_0	6	3	Tier 3 - Preferred Brand			
H5736	027	0	1	09	04	H5736_027_0	6	4	Tier 4 - Non-Preferred Brand			
H5736	027	0	1	09	04	H5736_027_0	6	5	Tier 5 - Specialty			
H5746	006	0	1	01	01	H5746_006_0	4	3	Non-Preferred Brand Name Drugs			
H5746	006	0	1	01	01	H5746_006_0	4	2	Preferred Brand Name Drugs			
H5746	006	0	1	01	01	H5746_006_0	4	1	Generic Drugs			
H5746	006	0	1	01	01	H5746_006_0	4	4	Specialty Drugs			
H5746	007	0	1	01	01	H5746_007_0	4	1	Generic Drugs	1		1
H5746	007	0	1	01	01	H5746_007_0	4	2	Preferred Brand Name Drugs	2		
H5746	007	0	1	01	01	H5746_007_0	4	3	Non-Preferred Brand Name Drugs	2		
H5746	007	0	1	01	01	H5746_007_0	4	4	Specialty Drugs			
H5746	007	0	1	01	01	H5746_007_0	4	3	Non-Preferred Brand Name Drugs			
H5746	007	0	1	01	01	H5746_007_0	4	4	Specialty Drugs	2		
H5746	007	0	1	01	01	H5746_007_0	4	1	Generic Drugs			
H5746	007	0	1	01	01	H5746_007_0	4	2	Preferred Brand Name Drugs			
H5746	011	0	1	01	01	H5746_011_0	4	1	Generic Drugs			
H5746	011	0	1	01	01	H5746_011_0	4	2	Preferred Brand Name Drugs			
H5746	011	0	1	01	01	H5746_011_0	4	4	Specialty Drugs	2		
H5746	011	0	1	01	01	H5746_011_0	4	3	Non-Preferred Brand Name Drugs	2		
H5746	011	0	1	01	01	H5746_011_0	4	2	Preferred Brand Name Drugs	2		
H5746	011	0	1	01	01	H5746_011_0	4	1	Generic Drugs	1		1
H5746	011	0	1	01	01	H5746_011_0	4	4	Specialty Drugs			
H5746	011	0	1	01	01	H5746_011_0	4	3	Non-Preferred Brand Name Drugs			
H5746	012	0	1	02	01	H5746_012_0	7	1	Generic Drugs			
H5746	012	0	1	02	01	H5746_012_0	7	3	Non-Preferred Brand Name Drugs	2		
H5746	012	0	1	02	01	H5746_012_0	7	2	Preferred Brand Name Drugs	2		
H5746	012	0	1	02	01	H5746_012_0	7	1	Generic Drugs	1		1
H5746	012	0	1	02	01	H5746_012_0	7	4	Specialty Drugs			
H5746	012	0	1	02	01	H5746_012_0	7	3	Non-Preferred Brand Name Drugs			
H5746	012	0	1	02	01	H5746_012_0	7	2	Preferred Brand Name Drugs			
H5746	012	0	1	02	01	H5746_012_0	7	4	Specialty Drugs	2		
H5749	001	0	1	02	01	H5749_001_0	3	1	Preferred Generic			
H5749	001	0	1	02	01	H5749_001_0	3	2	Preferred Brand			
H5749	001	0	1	02	01	H5749_001_0	3	3	Non-Preferred			
H5749	001	0	1	02	01	H5749_001_0	3	4	Specialty			
H5750	001	0	1	02	01	H5750_001_0	6	2	Brand	1		1
H5750	001	0	1	02	01	H5750_001_0	6	1	Generic	1		1
H5750	001	0	1	02	01	H5750_001_0	6	3	Specialty			
H5750	001	0	1	02	01	H5750_001_0	6	2	Brand			
H5750	001	0	1	02	01	H5750_001_0	6	1	Generic			
H5750	001	0	1	02	01	H5750_001_0	6	3	Specialty	2		
H5750	003	0	1	02	01	H5750_003_0	6	2	Brand	2		
H5750	003	0	1	02	01	H5750_003_0	6	1	Generic	1		1
H5750	003	0	1	02	01	H5750_003_0	6	3	Specialty			
H5750	003	0	1	02	01	H5750_003_0	6	2	Brand			
H5750	003	0	1	02	01	H5750_003_0	6	1	Generic			
H5750	003	0	1	02	01	H5750_003_0	6	3	Specialty	2		
H5754	001	0	1	37	05	H5754_001_0	4	1	Preferred Generic			
H5754	001	0	1	37	05	H5754_001_0	4	2	Preferred Brand			
H5754	001	0	1	37	05	H5754_001_0	4	3	Non Preferred			
H5754	001	0	1	37	05	H5754_001_0	4	4	Specialty			
H5754	003	0	1	37	05	H5754_003_0	6	1	Preferred Generic			
H5754	003	0	1	37	05	H5754_003_0	6	2	Preferred Brand			
H5754	003	0	1	37	05	H5754_003_0	6	4	Specialty			
H5754	003	0	1	37	05	H5754_003_0	6	3	Non Preferred			
H5754	004	0	1	37	05	H5754_004_0	3	1	Preferred Generic			
H5754	004	0	1	37	05	H5754_004_0	3	3	Non Preferred			
H5754	004	0	1	37	05	H5754_004_0	3	2	Preferred Brand			
H5754	004	0	1	37	05	H5754_004_0	3	4	Specialty			
H5760	003	0	1	02	01	H5760_003_0	11	1	Generic	1		1
H5760	003	0	1	02	01	H5760_003_0	11	4	Non-Preferred Brand			
H5760	003	0	1	02	01	H5760_003_0	11	3	Non-Preferred Brand	2		
H5760	003	0	1	02	01	H5760_003_0	11	4	Non-Preferred Brand	2		
H5760	003	0	1	02	01	H5760_003_0	11	2	Preferred Brand	2		
H5760	003	0	1	02	01	H5760_003_0	11	3	Non-Preferred Brand			
H5760	003	0	1	02	01	H5760_003_0	11	2	Preferred Brand			
H5760	003	0	1	02	01	H5760_003_0	11	1	Generic			
H5760	004	0	1	02	01	H5760_004_0	8	1	Generic	1		1
H5760	004	0	1	02	01	H5760_004_0	8	1	Generic			
H5760	004	0	1	02	01	H5760_004_0	8	3	Non-Preferred Brand	2		
H5760	004	0	1	02	01	H5760_004_0	8	4	Non-Preferred Brand and Specialty	2		
H5760	004	0	1	02	01	H5760_004_0	8	2	Brand	2		
H5760	004	0	1	02	01	H5760_004_0	8	2	Brand			
H5760	004	0	1	02	01	H5760_004_0	8	3	Non-Preferred Brand			
H5760	004	0	1	02	01	H5760_004_0	8	4	Non-Preferred Brand and Specialty			
H5760	007	0	1	02	01	H5760_007_0	6	1	Generic	1		1
H5760	007	0	1	02	01	H5760_007_0	6	2	Preferred Brand	2		
H5760	007	0	1	02	01	H5760_007_0	6	3	Non-Preferred Brand	2		
H5760	007	0	1	02	01	H5760_007_0	6	4	Non-Preferred Brand	2		
H5760	007	0	1	02	01	H5760_007_0	6	4	Non-Preferred Brand			
H5760	007	0	1	02	01	H5760_007_0	6	3	Non-Preferred Brand			
H5760	007	0	1	02	01	H5760_007_0	6	2	Preferred Brand			
H5760	007	0	1	02	01	H5760_007_0	6	1	Generic			
H5774	005	0	1	01	01	H5774_005_0	9	3	Non-Preferred Brand			
H5774	005	0	1	01	01	H5774_005_0	9	4	Specialty			
H5774	005	0	1	01	01	H5774_005_0	9	1	Generic	1		1
H5774	005	0	1	01	01	H5774_005_0	9	2	Preferred Brand			
H5774	005	0	1	01	01	H5774_005_0	9	1	Generic			
H5774	005	0	1	01	01	H5774_005_0	9	2	Preferred Brand	2		
H5774	005	0	1	01	01	H5774_005_0	9	3	Non-Preferred Brand	2		
H5774	005	0	1	01	01	H5774_005_0	9	4	Specialty	2		
H5774	006	0	1	01	01	H5774_006_0	9	3	Non-Preferred Brand			
H5774	006	0	1	01	01	H5774_006_0	9	2	Preferred Brand			
H5774	006	0	1	01	01	H5774_006_0	9	1	Generic			
H5774	006	0	1	01	01	H5774_006_0	9	4	Specialty			
H5774	006	0	1	01	01	H5774_006_0	9	4	Specialty	2		
H5774	006	0	1	01	01	H5774_006_0	9	3	Non-Preferred Brand	2		
H5774	006	0	1	01	01	H5774_006_0	9	2	Preferred Brand	2		
H5774	006	0	1	01	01	H5774_006_0	9	1	Generic	1		1
H5774	008	0	1	01	01	H5774_008_0	8	1	Generic			
H5774	008	0	1	01	01	H5774_008_0	8	2	Preferred Brand			
H5774	008	0	1	01	01	H5774_008_0	8	3	Non-Preferred Brand			
H5774	008	0	1	01	01	H5774_008_0	8	3	Non-Preferred Brand	2		
H5774	008	0	1	01	01	H5774_008_0	8	2	Preferred Brand	2		
H5774	008	0	1	01	01	H5774_008_0	8	1	Generic	1		1
H5774	008	0	1	01	01	H5774_008_0	8	4	Specialty			
H5774	008	0	1	01	01	H5774_008_0	8	4	Specialty	2		
H5774	009	0	1	01	01	H5774_009_0	9	1	Generic	1		1
H5774	009	0	1	01	01	H5774_009_0	9	4	Specialty			
H5774	009	0	1	01	01	H5774_009_0	9	3	Non-Preferred Brand			
H5774	009	0	1	01	01	H5774_009_0	9	2	Preferred Brand			
H5774	009	0	1	01	01	H5774_009_0	9	1	Generic			
H5774	009	0	1	01	01	H5774_009_0	9	2	Preferred Brand	2		
H5774	009	0	1	01	01	H5774_009_0	9	4	Specialty	2		
H5774	009	0	1	01	01	H5774_009_0	9	3	Non-Preferred Brand	2		
H5774	014	0	1	01	01	H5774_014_0	9	1	Generic			
H5774	014	0	1	01	01	H5774_014_0	9	2	Preferred Brand			
H5774	014	0	1	01	01	H5774_014_0	9	3	Non-Preferred Brand			
H5774	014	0	1	01	01	H5774_014_0	9	4	Specialty			
H5774	014	0	1	01	01	H5774_014_0	9	1	Generic	1		1
H5774	014	0	1	01	01	H5774_014_0	9	2	Preferred Brand	2		
H5774	014	0	1	01	01	H5774_014_0	9	4	Specialty	2		
H5774	014	0	1	01	01	H5774_014_0	9	3	Non-Preferred Brand	2		
H5774	016	0	1	01	01	H5774_016_0	10	1	Generic			
H5774	016	0	1	01	01	H5774_016_0	10	1	Generic	1		1
H5774	016	0	1	01	01	H5774_016_0	10	2	Brand			
H5774	016	0	1	01	01	H5774_016_0	10	2	Brand	2		
H5774	019	0	1	01	01	H5774_019_0	10	1	Generic			
H5774	019	0	1	01	01	H5774_019_0	10	2	Brand			
H5774	019	0	1	01	01	H5774_019_0	10	2	Brand	2		
H5774	019	0	1	01	01	H5774_019_0	10	1	Generic	1		1
H5774	020	0	1	01	01	H5774_020_0	10	1	Generic	1		1
H5774	020	0	1	01	01	H5774_020_0	10	2	Brand			
H5774	020	0	1	01	01	H5774_020_0	10	1	Generic			
H5774	020	0	1	01	01	H5774_020_0	10	2	Brand	2		
H5774	021	0	1	01	01	H5774_021_0	10	1	Generic	1		1
H5774	021	0	1	01	01	H5774_021_0	10	2	Preferred Brand	2		
H5774	021	0	1	01	01	H5774_021_0	10	3	Non-Preferred Brand	2		
H5774	021	0	1	01	01	H5774_021_0	10	4	Specialty			
H5774	021	0	1	01	01	H5774_021_0	10	3	Non-Preferred Brand			
H5774	021	0	1	01	01	H5774_021_0	10	4	Specialty	2		
H5774	021	0	1	01	01	H5774_021_0	10	1	Generic			
H5774	021	0	1	01	01	H5774_021_0	10	2	Preferred Brand			
H5783	002	0	1	01	01	H5783_002_0	8	2	Tier 2 - Preferred Brand	2		
H5783	002	0	1	01	01	H5783_002_0	8	1	Tier 1 - Generic	1		1
H5783	002	0	1	01	01	H5783_002_0	8	4	Tier 4 - Specialty Drug	2		
H5783	002	0	1	01	01	H5783_002_0	8	3	Tier 3 - Non-Preferred Brand	2		
H5783	002	0	1	01	01	H5783_002_0	8	4	Tier 4 - Specialty Drug			
H5783	002	0	1	01	01	H5783_002_0	8	3	Tier 3 - Non-Preferred Brand			
H5783	002	0	1	01	01	H5783_002_0	8	2	Tier 2 - Preferred Brand			
H5783	002	0	1	01	01	H5783_002_0	8	1	Tier 1 - Generic			
H5783	006	0	1	01	01	H5783_006_0	20	2	Tier 2 - Prefered Brand	2		
H5783	006	0	1	01	01	H5783_006_0	20	1	Tier 1 - Generic			
H5783	006	0	1	01	01	H5783_006_0	20	4	Tier 4 - Specialty	2		
H5783	006	0	1	01	01	H5783_006_0	20	3	Tier 3 - Non-Preferred Brand	2		
H5783	006	0	1	01	01	H5783_006_0	20	2	Tier 2 - Prefered Brand			
H5783	006	0	1	01	01	H5783_006_0	20	3	Tier 3 - Non-Preferred Brand			
H5783	006	0	1	01	01	H5783_006_0	20	4	Tier 4 - Specialty			
H5783	006	0	1	01	01	H5783_006_0	20	1	Tier 1 - Generic	1		1
H5783	009	0	1	01	01	H5783_009_0	16	2	Tier 2 - Prefered Brand	2		
H5783	009	0	1	01	01	H5783_009_0	16	3	Tier 3 - Non-Preferred Brand	2		
H5783	009	0	1	01	01	H5783_009_0	16	4	Tier 4 - Specialty	2		
H5783	009	0	1	01	01	H5783_009_0	16	1	Tier 1 - Generic	1		1
H5783	009	0	1	01	01	H5783_009_0	16	4	Tier 4 - Specialty			
H5783	009	0	1	01	01	H5783_009_0	16	3	Tier 3 - Non-Preferred Brand			
H5783	009	0	1	01	01	H5783_009_0	16	2	Tier 2 - Prefered Brand			
H5783	009	0	1	01	01	H5783_009_0	16	1	Tier 1 - Generic			
H5793	001	0	1	01	01	H5793_001_0	5	4	Tier 4 - Non-Preferred Brand			
H5793	001	0	1	01	01	H5793_001_0	5	3	Tier 3 - Preferred Brand			
H5793	001	0	1	01	01	H5793_001_0	5	2	Tier 2 - Non-Preferred Generic			
H5793	001	0	1	01	01	H5793_001_0	5	1	Tier 1 - Preferred Generic			
H5793	001	0	1	01	01	H5793_001_0	5	5	Tier 5 - Specialty			
H5793	003	0	1	01	01	H5793_003_0	4	4	Tier 4 - Non-Preferred Brand			
H5793	003	0	1	01	01	H5793_003_0	4	3	Tier 3 - Preferred Brand			
H5793	003	0	1	01	01	H5793_003_0	4	2	Tier 2 - Non-Preferred Generic			
H5793	003	0	1	01	01	H5793_003_0	4	1	Tier 1 - Preferred Generic			
H5793	003	0	1	01	01	H5793_003_0	4	5	Tier 5 - Specialty			
H5793	003	0	1	01	01	H5793_003_0	4	5	Tier 5 - Specialty	2		
H5793	003	0	1	01	01	H5793_003_0	4	4	Tier 4 - Non-Preferred Brand	2		
H5793	003	0	1	01	01	H5793_003_0	4	3	Tier 3 - Preferred Brand	2		
H5793	003	0	1	01	01	H5793_003_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H5793	003	0	1	01	01	H5793_003_0	4	1	Tier 1 - Preferred Generic	1		1
H5793	008	0	1	01	01	H5793_008_0	4	3	Tier 3 - Preferred Brand			
H5793	008	0	1	01	01	H5793_008_0	4	2	Tier 2 - Non-Preferred Generic			
H5793	008	0	1	01	01	H5793_008_0	4	1	Tier 1 - Preferred Generic			
H5793	008	0	1	01	01	H5793_008_0	4	4	Tier 4 - Non-Preferred Brand			
H5793	008	0	1	01	01	H5793_008_0	4	5	Tier 5 - Specialty			
H5810	001	0	1	01	01	H5810_001_0	6	4	Specialty Drugs			
H5810	001	0	1	01	01	H5810_001_0	6	3	Non-Preferred Brand			
H5810	001	0	1	01	01	H5810_001_0	6	1	Generic			
H5810	001	0	1	01	01	H5810_001_0	6	2	Preferred Brand			
H5810	002	0	1	01	01	H5810_002_0	7	3	Non-Preferred Brand			
H5810	002	0	1	01	01	H5810_002_0	7	2	Preferred Brand			
H5810	002	0	1	01	01	H5810_002_0	7	1	Generic			
H5810	002	0	1	01	01	H5810_002_0	7	4	Specialty Drugs			
H5811	001	0	1	01	01	H5811_001_0	6	3	Specialty	2		
H5811	001	0	1	01	01	H5811_001_0	6	2	Brand	2		
H5811	001	0	1	01	01	H5811_001_0	6	1	Generic	1		1
H5811	001	0	1	01	01	H5811_001_0	6	3	Specialty			
H5811	001	0	1	01	01	H5811_001_0	6	1	Generic			
H5811	001	0	1	01	01	H5811_001_0	6	2	Brand			
H5812	012	0	1	09	04	H5812_012_0	3	1	Tier 1			
H5812	012	0	1	09	04	H5812_012_0	3	2	Tier 2			
H5812	012	0	1	09	04	H5812_012_0	3	3	Tier 3			
H5812	012	0	1	09	04	H5812_012_0	3	4	Tier 4			
H5812	030	0	1	09	04	H5812_030_0	3	1	Tier 1			
H5812	030	0	1	09	04	H5812_030_0	3	4	Tier 4			
H5812	030	0	1	09	04	H5812_030_0	3	3	Tier 3			
H5812	030	0	1	09	04	H5812_030_0	3	2	Tier 2			
H5812	044	0	1	09	04	H5812_044_0	5	3	Tier 3			
H5812	044	0	1	09	04	H5812_044_0	5	2	Tier 2			
H5812	044	0	1	09	04	H5812_044_0	5	1	Tier 1			
H5812	044	0	1	09	04	H5812_044_0	5	4	Tier 4			
H5812	054	0	1	09	04	H5812_054_0	5	3	Tier 3			
H5812	054	0	1	09	04	H5812_054_0	5	2	Tier 2			
H5812	054	0	1	09	04	H5812_054_0	5	1	Tier 1			
H5812	054	0	1	09	04	H5812_054_0	5	4	Tier 4			
H5812	055	0	1	09	04	H5812_055_0	5	1	Tier 1			
H5812	055	0	1	09	04	H5812_055_0	5	2	Tier 2			
H5812	055	0	1	09	04	H5812_055_0	5	3	Tier 3			
H5812	055	0	1	09	04	H5812_055_0	5	4	Tier 4			
H5812	056	0	1	09	04	H5812_056_0	5	3	Tier 3			
H5812	056	0	1	09	04	H5812_056_0	5	2	Tier 2			
H5812	056	0	1	09	04	H5812_056_0	5	1	Tier 1			
H5812	056	0	1	09	04	H5812_056_0	5	4	Tier 4			
H5812	061	0	1	09	04	H5812_061_0	3	3	Tier 3			
H5812	061	0	1	09	04	H5812_061_0	3	4	Tier 4			
H5812	061	0	1	09	04	H5812_061_0	3	1	Tier 1			
H5812	061	0	1	09	04	H5812_061_0	3	2	Tier 2			
H5812	062	0	1	09	04	H5812_062_0	3	1	Tier 1			
H5812	062	0	1	09	04	H5812_062_0	3	2	Tier 2			
H5812	062	0	1	09	04	H5812_062_0	3	3	Tier 3			
H5812	062	0	1	09	04	H5812_062_0	3	4	Tier 4			
H5812	063	0	1	09	04	H5812_063_0	3	1	Tier 1			
H5812	063	0	1	09	04	H5812_063_0	3	2	Tier 2			
H5812	063	0	1	09	04	H5812_063_0	3	3	Tier 3			
H5812	063	0	1	09	04	H5812_063_0	3	4	Tier 4			
H5813	003	0	1	01	01	H5813_003_0	6	1	Tier 1 - Preferred Generic			
H5813	003	0	1	01	01	H5813_003_0	6	2	Tier 2 - Non-Preferred Generic			
H5813	003	0	1	01	01	H5813_003_0	6	3	Tier 3 - Preferred Brand			
H5813	003	0	1	01	01	H5813_003_0	6	4	Tier 4 - Non-Preferred Brand			
H5813	003	0	1	01	01	H5813_003_0	6	5	Tier 5 - Specialty			
H5813	004	0	1	01	01	H5813_004_0	7	2	Tier 2 - Non-Preferred Generic	1		1
H5813	004	0	1	01	01	H5813_004_0	7	3	Tier 3 - Preferred Brand	2		
H5813	004	0	1	01	01	H5813_004_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5813	004	0	1	01	01	H5813_004_0	7	5	Tier 5 - Specialty	2		
H5813	004	0	1	01	01	H5813_004_0	7	1	Tier 1 - Preferred Generic	1		1
H5813	004	0	1	01	01	H5813_004_0	7	5	Tier 5 - Specialty			
H5813	004	0	1	01	01	H5813_004_0	7	4	Tier 4 - Non-Preferred Brand			
H5813	004	0	1	01	01	H5813_004_0	7	3	Tier 3 - Preferred Brand			
H5813	004	0	1	01	01	H5813_004_0	7	1	Tier 1 - Preferred Generic			
H5813	004	0	1	01	01	H5813_004_0	7	2	Tier 2 - Non-Preferred Generic			
H5813	005	0	1	01	01	H5813_005_0	7	1	Tier 1 - Preferred Generic			
H5813	005	0	1	01	01	H5813_005_0	7	2	Tier 2 - Non-Preferred Generic			
H5813	005	0	1	01	01	H5813_005_0	7	3	Tier 3 - Preferred Brand			
H5813	005	0	1	01	01	H5813_005_0	7	4	Tier 4 - Non-Preferred Brand			
H5813	005	0	1	01	01	H5813_005_0	7	5	Tier 5 - Specialty			
H5813	006	0	1	01	01	H5813_006_0	7	4	Tier 4 - Non-Preferred Brand			
H5813	006	0	1	01	01	H5813_006_0	7	3	Tier 3 - Preferred Brand			
H5813	006	0	1	01	01	H5813_006_0	7	2	Tier 2 - Non-Preferred Generic			
H5813	006	0	1	01	01	H5813_006_0	7	1	Tier 1 - Preferred Generic			
H5813	006	0	1	01	01	H5813_006_0	7	5	Tier 5 - Specialty			
H5817	009	0	1	01	01	H5817_009_0	3	3	Non-Preferred Brand Name Drugs			
H5817	009	0	1	01	01	H5817_009_0	3	2	Preferred Brand Name Drugs			
H5817	009	0	1	01	01	H5817_009_0	3	4	Specialty Drugs	2		
H5817	009	0	1	01	01	H5817_009_0	3	3	Non-Preferred Brand Name Drugs	2		
H5817	009	0	1	01	01	H5817_009_0	3	2	Preferred Brand Name Drugs	2		
H5817	009	0	1	01	01	H5817_009_0	3	1	Generic Drugs	1		1
H5817	009	0	1	01	01	H5817_009_0	3	4	Specialty Drugs			
H5817	009	0	1	01	01	H5817_009_0	3	1	Generic Drugs			
H5817	010	0	1	01	01	H5817_010_0	4	3	Non-Preferred Brand Name Drugs			
H5817	010	0	1	01	01	H5817_010_0	4	2	Preferred Brand Name Drugs			
H5817	010	0	1	01	01	H5817_010_0	4	1	Generic Drugs	1		1
H5817	010	0	1	01	01	H5817_010_0	4	2	Preferred Brand Name Drugs	2		
H5817	010	0	1	01	01	H5817_010_0	4	3	Non-Preferred Brand Name Drugs	2		
H5817	010	0	1	01	01	H5817_010_0	4	4	Specialty Drugs	2		
H5817	010	0	1	01	01	H5817_010_0	4	1	Generic Drugs			
H5817	010	0	1	01	01	H5817_010_0	4	4	Specialty Drugs			
H5817	011	0	1	01	01	H5817_011_0	7	2	Preferred Brand Name Drugs			
H5817	011	0	1	01	01	H5817_011_0	7	4	Specialty Drugs	2		
H5817	011	0	1	01	01	H5817_011_0	7	3	Non-Preferred Brand Name Drugs	2		
H5817	011	0	1	01	01	H5817_011_0	7	2	Preferred Brand Name Drugs	2		
H5817	011	0	1	01	01	H5817_011_0	7	1	Generic Drugs	1		1
H5817	011	0	1	01	01	H5817_011_0	7	4	Specialty Drugs			
H5817	011	0	1	01	01	H5817_011_0	7	3	Non-Preferred Brand Name Drugs			
H5817	011	0	1	01	01	H5817_011_0	7	1	Generic Drugs			
H5817	014	0	1	01	01	H5817_014_0	4	3	Non-Preferred Brand Name Drugs	2		
H5817	014	0	1	01	01	H5817_014_0	4	2	Preferred Brand Name Drugs	2		
H5817	014	0	1	01	01	H5817_014_0	4	1	Generic Drugs	1		1
H5817	014	0	1	01	01	H5817_014_0	4	3	Non-Preferred Brand Name Drugs			
H5817	014	0	1	01	01	H5817_014_0	4	2	Preferred Brand Name Drugs			
H5817	014	0	1	01	01	H5817_014_0	4	4	Specialty Drugs	2		
H5817	014	0	1	01	01	H5817_014_0	4	1	Generic Drugs			
H5817	014	0	1	01	01	H5817_014_0	4	4	Specialty Drugs			
H5817	015	0	1	01	01	H5817_015_0	5	3	Non-Preferred Brand Name Drugs			
H5817	015	0	1	01	01	H5817_015_0	5	4	Specialty Drugs			
H5817	015	0	1	01	01	H5817_015_0	5	1	Generic Drugs			
H5817	015	0	1	01	01	H5817_015_0	5	2	Preferred Brand Name Drugs			
H5817	016	0	1	02	01	H5817_016_0	3	2	Preferred Brand Name Drugs	2		
H5817	016	0	1	02	01	H5817_016_0	3	3	Non-Preferred Brand Name Drugs	2		
H5817	016	0	1	02	01	H5817_016_0	3	4	Specialty Drugs	2		
H5817	016	0	1	02	01	H5817_016_0	3	4	Specialty Drugs			
H5817	016	0	1	02	01	H5817_016_0	3	3	Non-Preferred Brand Name Drugs			
H5817	016	0	1	02	01	H5817_016_0	3	2	Preferred Brand Name Drugs			
H5817	016	0	1	02	01	H5817_016_0	3	1	Generic Drugs	1		1
H5817	016	0	1	02	01	H5817_016_0	3	1	Generic Drugs			
H5817	017	0	1	02	01	H5817_017_0	3	3	Non-Preferred Brand Name Drugs			
H5817	017	0	1	02	01	H5817_017_0	3	2	Preferred Brand Name Drugs			
H5817	017	0	1	02	01	H5817_017_0	3	1	Generic Drugs			
H5817	017	0	1	02	01	H5817_017_0	3	4	Specialty Drugs	2		
H5817	017	0	1	02	01	H5817_017_0	3	3	Non-Preferred Brand Name Drugs	2		
H5817	017	0	1	02	01	H5817_017_0	3	4	Specialty Drugs			
H5817	017	0	1	02	01	H5817_017_0	3	1	Generic Drugs	1		1
H5817	017	0	1	02	01	H5817_017_0	3	2	Preferred Brand Name Drugs	2		
H5820	002	0	1	09	04	H5820_002_0	7	1	Generic			
H5820	002	0	1	09	04	H5820_002_0	7	2	Preferred Brand			
H5820	002	0	1	09	04	H5820_002_0	7	3	Non-Preferred Brand			
H5820	002	0	1	09	04	H5820_002_0	7	4	Specialty			
H5820	003	0	1	09	04	H5820_003_0	7	1	Generic			
H5820	003	0	1	09	04	H5820_003_0	7	2	Preferred Brand			
H5820	003	0	1	09	04	H5820_003_0	7	4	Specialty			
H5820	003	0	1	09	04	H5820_003_0	7	3	Non-Preferred Brand			
H5820	004	0	1	09	04	H5820_004_0	7	1	Generic			
H5820	004	0	1	09	04	H5820_004_0	7	3	Non-Preferred Brand			
H5820	004	0	1	09	04	H5820_004_0	7	2	Preferred Brand			
H5820	004	0	1	09	04	H5820_004_0	7	4	Specialty			
H5820	008	0	1	09	04	H5820_008_0	7	1	Generic			
H5820	008	0	1	09	04	H5820_008_0	7	2	Preferred Brand			
H5820	008	0	1	09	04	H5820_008_0	7	4	Specialty			
H5820	008	0	1	09	04	H5820_008_0	7	3	Non-Preferred Brand			
H5820	009	0	1	09	04	H5820_009_0	7	1	Generic			
H5820	009	0	1	09	04	H5820_009_0	7	2	Preferred Brand			
H5820	009	0	1	09	04	H5820_009_0	7	3	Non-Preferred Brand			
H5820	009	0	1	09	04	H5820_009_0	7	4	Specialty			
H5820	010	0	1	09	04	H5820_010_0	8	1	Generic			
H5820	010	0	1	09	04	H5820_010_0	8	2	Preferred Brand			
H5820	010	0	1	09	04	H5820_010_0	8	4	Specialty			
H5820	010	0	1	09	04	H5820_010_0	8	3	Non-Preferred Brand			
H5820	011	0	1	09	04	H5820_011_0	7	1	Generic			
H5820	011	0	1	09	04	H5820_011_0	7	2	Preferred Brand			
H5820	011	0	1	09	04	H5820_011_0	7	3	Non-Preferred Brand			
H5820	011	0	1	09	04	H5820_011_0	7	4	Specialty			
H5820	013	0	1	09	04	H5820_013_0	7	1	Generic			
H5820	013	0	1	09	04	H5820_013_0	7	2	Preferred Brand			
H5820	013	0	1	09	04	H5820_013_0	7	3	Non-Preferred Brand			
H5820	013	0	1	09	04	H5820_013_0	7	4	Specialty			
H5821	001	0	1	02	01	H5821_001_0	5	1	Generic Drugs			
H5821	001	0	1	02	01	H5821_001_0	5	2	Preferred Brand Drugs			
H5821	001	0	1	02	01	H5821_001_0	5	3	Non-Preferred Brand Drugs			
H5821	001	0	1	02	01	H5821_001_0	5	4	Specialty Drugs			
H5821	001	0	1	02	01	H5821_001_0	5	4	Specialty Drugs	2		
H5821	001	0	1	02	01	H5821_001_0	5	3	Non-Preferred Brand Drugs	2		
H5821	001	0	1	02	01	H5821_001_0	5	2	Preferred Brand Drugs	2		
H5821	001	0	1	02	01	H5821_001_0	5	1	Generic Drugs	1		1
H5821	004	0	1	02	01	H5821_004_0	5	1	Generic Drugs	1		1
H5821	004	0	1	02	01	H5821_004_0	5	2	Preferred Brand Drugs			
H5821	004	0	1	02	01	H5821_004_0	5	1	Generic Drugs			
H5821	004	0	1	02	01	H5821_004_0	5	4	Specialty Drugs			
H5821	004	0	1	02	01	H5821_004_0	5	3	Non-Preferred Brand Drugs			
H5821	004	0	1	02	01	H5821_004_0	5	2	Preferred Brand Drugs	2		
H5821	004	0	1	02	01	H5821_004_0	5	3	Non-Preferred Brand Drugs	2		
H5821	004	0	1	02	01	H5821_004_0	5	4	Specialty Drugs	2		
H5821	013	0	1	02	01	H5821_013_0	5	2	Preferred Brand Drugs			
H5821	013	0	1	02	01	H5821_013_0	5	3	Non-Preferred Brand Drugs			
H5821	013	0	1	02	01	H5821_013_0	5	4	Specialty Drugs			
H5821	013	0	1	02	01	H5821_013_0	5	1	Generic Drugs	1		1
H5821	013	0	1	02	01	H5821_013_0	5	2	Preferred Brand Drugs	2		
H5821	013	0	1	02	01	H5821_013_0	5	3	Non-Preferred Brand Drugs	2		
H5821	013	0	1	02	01	H5821_013_0	5	4	Specialty Drugs	2		
H5821	013	0	1	02	01	H5821_013_0	5	1	Generic Drugs			
H5821	015	0	1	02	01	H5821_015_0	6	3	Non-Preferred Brand Drugs			
H5821	015	0	1	02	01	H5821_015_0	6	4	Specialty Drugs			
H5821	015	0	1	02	01	H5821_015_0	6	1	Generic Drugs	1		1
H5821	015	0	1	02	01	H5821_015_0	6	1	Generic Drugs			
H5821	015	0	1	02	01	H5821_015_0	6	4	Specialty Drugs	2		
H5821	015	0	1	02	01	H5821_015_0	6	2	Preferred Brand Drugs			
H5821	015	0	1	02	01	H5821_015_0	6	2	Preferred Brand Drugs	2		
H5821	015	0	1	02	01	H5821_015_0	6	3	Non-Preferred Brand Drugs	2		
H5821	017	0	1	02	01	H5821_017_0	7	4	Specialty Drugs			
H5821	017	0	1	02	01	H5821_017_0	7	3	Non-Preferred Brand Drugs			
H5821	017	0	1	02	01	H5821_017_0	7	2	Preferred Brand Drugs			
H5821	017	0	1	02	01	H5821_017_0	7	1	Generic Drugs			
H5823	002	0	1	01	01	H5823_002_0	7	3	Non-Preferred Brand			
H5823	002	0	1	01	01	H5823_002_0	7	2	Preferred Brand			
H5823	002	0	1	01	01	H5823_002_0	7	1	Generic			
H5823	002	0	1	01	01	H5823_002_0	7	4	Specialty Drugs			
H5826	008	0	1	01	01	H5826_008_0	11	2	Tier 2 - Brand			
H5826	008	0	1	01	01	H5826_008_0	11	3	Tier 3 - Specialty			
H5826	008	0	1	01	01	H5826_008_0	11	1	Tier 1 - Generic			
H5826	009	0	1	01	01	H5826_009_0	14	2	Tier 2 - Brand			
H5826	009	0	1	01	01	H5826_009_0	14	1	Tier 1 - Generic			
H5826	009	0	1	01	01	H5826_009_0	14	3	Tier 3 - Specialty			
H5826	010	0	1	01	01	H5826_010_0	9	1	Tier 1 - Generic	1		1
H5826	010	0	1	01	01	H5826_010_0	9	2	Tier 2 - Brand	2		
H5826	010	0	1	01	01	H5826_010_0	9	3	Tier 3 - Specialty			
H5826	010	0	1	01	01	H5826_010_0	9	3	Tier 3 - Specialty	2		
H5826	010	0	1	01	01	H5826_010_0	9	1	Tier 1 - Generic			
H5826	010	0	1	01	01	H5826_010_0	9	2	Tier 2 - Brand			
H5832	001	0	1	01	01	H5832_001_0	6	1	Tier 1 - Preferred Generic			
H5832	001	0	1	01	01	H5832_001_0	6	2	Tier 2 - Non-Preferred Generic			
H5832	001	0	1	01	01	H5832_001_0	6	3	Tier 3 - Preferred Brand			
H5832	001	0	1	01	01	H5832_001_0	6	4	Tier 4 - Non-Preferred Brand			
H5832	001	0	1	01	01	H5832_001_0	6	5	Tier 5 - Specialty			
H5832	002	0	1	01	01	H5832_002_0	8	1	Tier 1 - Preferred Generic			
H5832	002	0	1	01	01	H5832_002_0	8	2	Tier 2 - Non-Preferred Generic			
H5832	002	0	1	01	01	H5832_002_0	8	5	Tier 5 - Specialty			
H5832	002	0	1	01	01	H5832_002_0	8	4	Tier 4 - Non-Preferred Brand			
H5832	002	0	1	01	01	H5832_002_0	8	3	Tier 3 - Preferred Brand			
H5839	001	0	1	09	04	H5839_001_0	4	3	Non-Preferred Brand			
H5839	001	0	1	09	04	H5839_001_0	4	2	Preferred Brand			
H5839	001	0	1	09	04	H5839_001_0	4	1	Generic			
H5839	001	0	1	09	04	H5839_001_0	4	4	Specialty			
H5849	005	0	1	09	04	H5849_005_0	5	1	Generic			
H5849	005	0	1	09	04	H5849_005_0	5	2	Preferred Brand			
H5849	005	0	1	09	04	H5849_005_0	5	3	Non-Preferred Brand			
H5849	005	0	1	09	04	H5849_005_0	5	4	Specialty			
H5849	006	0	1	09	04	H5849_006_0	5	1	Generic			
H5849	006	0	1	09	04	H5849_006_0	5	2	Preferred Brand			
H5849	006	0	1	09	04	H5849_006_0	5	4	Specialty			
H5849	006	0	1	09	04	H5849_006_0	5	3	Non-Preferred Brand			
H5849	007	0	1	09	04	H5849_007_0	5	1	Generic			
H5849	007	0	1	09	04	H5849_007_0	5	3	Non-Preferred Brand			
H5849	007	0	1	09	04	H5849_007_0	5	2	Preferred Brand			
H5849	007	0	1	09	04	H5849_007_0	5	4	Specialty			
H5850	001	0	1	01	01	H5850_001_0	5	1	Preferred Generic and Select Brand			
H5850	001	0	1	01	01	H5850_001_0	5	2	Preferred Brand			
H5850	001	0	1	01	01	H5850_001_0	5	3	Non-Preferred Brand			
H5850	001	0	1	01	01	H5850_001_0	5	1	Preferred Generic and Select Brand	1		1
H5850	001	0	1	01	01	H5850_001_0	5	4	Specialty Drugs	2		
H5850	001	0	1	01	01	H5850_001_0	5	3	Non-Preferred Brand	2		
H5850	001	0	1	01	01	H5850_001_0	5	2	Preferred Brand	2		
H5850	001	0	1	01	01	H5850_001_0	5	4	Specialty Drugs			
H5850	002	0	1	01	01	H5850_002_0	5	1	Preferred Generic and Select Brand			
H5850	002	0	1	01	01	H5850_002_0	5	2	Preferred Brand			
H5850	002	0	1	01	01	H5850_002_0	5	4	Specialty Drugs			
H5850	002	0	1	01	01	H5850_002_0	5	3	Non-Preferred Brand			
H5850	002	0	1	01	01	H5850_002_0	5	1	Preferred Generic and Select Brand	1		1
H5850	002	0	1	01	01	H5850_002_0	5	2	Preferred Brand	2		
H5850	002	0	1	01	01	H5850_002_0	5	3	Non-Preferred Brand	2		
H5850	002	0	1	01	01	H5850_002_0	5	4	Specialty Drugs	2		
H5850	003	0	1	01	01	H5850_003_0	5	4	Specialty Drugs			
H5850	003	0	1	01	01	H5850_003_0	5	4	Specialty Drugs	2		
H5850	003	0	1	01	01	H5850_003_0	5	3	Non-Preferred Brand			
H5850	003	0	1	01	01	H5850_003_0	5	2	Preferred Brand	2		
H5850	003	0	1	01	01	H5850_003_0	5	1	Preferred Generic and Select Brand	1		1
H5850	003	0	1	01	01	H5850_003_0	5	3	Non-Preferred Brand	2		
H5850	003	0	1	01	01	H5850_003_0	5	1	Preferred Generic and Select Brand			
H5850	003	0	1	01	01	H5850_003_0	5	2	Preferred Brand			
H5850	004	0	1	01	01	H5850_004_0	6	3	Non-Preferred Brand			
H5850	004	0	1	01	01	H5850_004_0	6	2	Preferred Brand			
H5850	004	0	1	01	01	H5850_004_0	6	4	Specialty Drugs	2		
H5850	004	0	1	01	01	H5850_004_0	6	1	Preferred Generic and Select Brand			
H5850	004	0	1	01	01	H5850_004_0	6	4	Specialty Drugs			
H5850	004	0	1	01	01	H5850_004_0	6	1	Preferred Generic and Select Brand	1		1
H5850	004	0	1	01	01	H5850_004_0	6	2	Preferred Brand	2		
H5850	004	0	1	01	01	H5850_004_0	6	3	Non-Preferred Brand	2		
H5850	005	0	1	01	01	H5850_005_0	5	1	Preferred Generic and Select Brand			
H5850	005	0	1	01	01	H5850_005_0	5	2	Preferred Brand			
H5850	005	0	1	01	01	H5850_005_0	5	3	Non-Preferred Brand			
H5850	005	0	1	01	01	H5850_005_0	5	4	Specialty Drugs			
H5850	006	0	1	01	01	H5850_006_0	5	4	Specialty Drugs	2		
H5850	006	0	1	01	01	H5850_006_0	5	3	Non-Preferred Brand	2		
H5850	006	0	1	01	01	H5850_006_0	5	2	Preferred Brand	2		
H5850	006	0	1	01	01	H5850_006_0	5	4	Specialty Drugs			
H5850	006	0	1	01	01	H5850_006_0	5	3	Non-Preferred Brand			
H5850	006	0	1	01	01	H5850_006_0	5	2	Preferred Brand			
H5850	006	0	1	01	01	H5850_006_0	5	1	Preferred Generic and Select Brand			
H5850	006	0	1	01	01	H5850_006_0	5	1	Preferred Generic and Select Brand	1		1
H5850	007	0	1	01	01	H5850_007_0	5	1	Preferred Generic and Select Brand			
H5850	007	0	1	01	01	H5850_007_0	5	4	Specialty Drugs	2		
H5850	007	0	1	01	01	H5850_007_0	5	3	Non-Preferred Brand			
H5850	007	0	1	01	01	H5850_007_0	5	4	Specialty Drugs			
H5850	007	0	1	01	01	H5850_007_0	5	1	Preferred Generic and Select Brand	1		1
H5850	007	0	1	01	01	H5850_007_0	5	2	Preferred Brand	2		
H5850	007	0	1	01	01	H5850_007_0	5	3	Non-Preferred Brand	2		
H5850	007	0	1	01	01	H5850_007_0	5	2	Preferred Brand			
H5850	010	0	1	01	01	H5850_010_0	7	3	Non-Preferred Brand			
H5850	010	0	1	01	01	H5850_010_0	7	4	Specialty Drugs			
H5850	010	0	1	01	01	H5850_010_0	7	1	Preferred Generic and Select Brand			
H5850	010	0	1	01	01	H5850_010_0	7	2	Preferred Brand			
H5850	012	0	1	01	01	H5850_012_0	5	1	Preferred Generic and Select Brand	1		1
H5850	012	0	1	01	01	H5850_012_0	5	2	Preferred Brand	1		1
H5850	012	0	1	01	01	H5850_012_0	5	3	Non-Preferred Brand	2		
H5850	012	0	1	01	01	H5850_012_0	5	4	Specialty Drugs			
H5850	012	0	1	01	01	H5850_012_0	5	3	Non-Preferred Brand			
H5850	012	0	1	01	01	H5850_012_0	5	4	Specialty Drugs	2		
H5850	012	0	1	01	01	H5850_012_0	5	1	Preferred Generic and Select Brand			
H5850	012	0	1	01	01	H5850_012_0	5	2	Preferred Brand			
H5850	013	0	1	01	01	H5850_013_0	5	1	Preferred Generic and Select Brand	1		1
H5850	013	0	1	01	01	H5850_013_0	5	4	Specialty Drugs			
H5850	013	0	1	01	01	H5850_013_0	5	3	Non-Preferred Brand			
H5850	013	0	1	01	01	H5850_013_0	5	2	Preferred Brand			
H5850	013	0	1	01	01	H5850_013_0	5	1	Preferred Generic and Select Brand			
H5850	013	0	1	01	01	H5850_013_0	5	2	Preferred Brand	2		
H5850	013	0	1	01	01	H5850_013_0	5	4	Specialty Drugs	2		
H5850	013	0	1	01	01	H5850_013_0	5	3	Non-Preferred Brand	2		
H5850	015	0	1	01	01	H5850_015_0	5	1	Preferred Generic and Select Brand			
H5850	015	0	1	01	01	H5850_015_0	5	2	Preferred Brand			
H5850	015	0	1	01	01	H5850_015_0	5	4	Specialty Drugs	2		
H5850	015	0	1	01	01	H5850_015_0	5	3	Non-Preferred Brand	2		
H5850	015	0	1	01	01	H5850_015_0	5	2	Preferred Brand	2		
H5850	015	0	1	01	01	H5850_015_0	5	1	Preferred Generic and Select Brand	1		1
H5850	015	0	1	01	01	H5850_015_0	5	4	Specialty Drugs			
H5850	015	0	1	01	01	H5850_015_0	5	3	Non-Preferred Brand			
H5850	016	0	1	01	01	H5850_016_0	5	1	Preferred Generic and Select Brand			
H5850	016	0	1	01	01	H5850_016_0	5	2	Preferred Brand	2		
H5850	016	0	1	01	01	H5850_016_0	5	3	Non-Preferred Brand	2		
H5850	016	0	1	01	01	H5850_016_0	5	1	Preferred Generic and Select Brand	1		1
H5850	016	0	1	01	01	H5850_016_0	5	4	Specialty Drugs			
H5850	016	0	1	01	01	H5850_016_0	5	3	Non-Preferred Brand			
H5850	016	0	1	01	01	H5850_016_0	5	2	Preferred Brand			
H5850	016	0	1	01	01	H5850_016_0	5	4	Specialty Drugs	2		
H5850	017	0	1	01	01	H5850_017_0	5	4	Specialty Drugs			
H5850	017	0	1	01	01	H5850_017_0	5	1	Preferred Generic and Select Brand	1		1
H5850	017	0	1	01	01	H5850_017_0	5	2	Preferred Brand	2		
H5850	017	0	1	01	01	H5850_017_0	5	3	Non-Preferred Brand	2		
H5850	017	0	1	01	01	H5850_017_0	5	4	Specialty Drugs	2		
H5850	017	0	1	01	01	H5850_017_0	5	1	Preferred Generic and Select Brand			
H5850	017	0	1	01	01	H5850_017_0	5	2	Preferred Brand			
H5850	017	0	1	01	01	H5850_017_0	5	3	Non-Preferred Brand			
H5850	018	0	1	02	01	H5850_018_0	6	3	Non-Preferred Brand	2		
H5850	018	0	1	02	01	H5850_018_0	6	2	Preferred Brand	2		
H5850	018	0	1	02	01	H5850_018_0	6	1	Preferred Generic and Select Brand	1		1
H5850	018	0	1	02	01	H5850_018_0	6	4	Specialty Drugs			
H5850	018	0	1	02	01	H5850_018_0	6	3	Non-Preferred Brand			
H5850	018	0	1	02	01	H5850_018_0	6	2	Preferred Brand			
H5850	018	0	1	02	01	H5850_018_0	6	4	Specialty Drugs	2		
H5850	018	0	1	02	01	H5850_018_0	6	1	Preferred Generic and Select Brand			
H5850	019	0	1	01	01	H5850_019_0	5	2	Preferred Brand			
H5850	019	0	1	01	01	H5850_019_0	5	1	Preferred Generic and Select Brand			
H5850	019	0	1	01	01	H5850_019_0	5	4	Specialty Drugs			
H5850	019	0	1	01	01	H5850_019_0	5	3	Non-Preferred Brand			
H5854	002	0	1	01	01	H5854_002_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H5854	002	0	1	01	01	H5854_002_0	7	2	Tier 2 Preferred Brand	2		
H5854	002	0	1	01	01	H5854_002_0	7	1	Tier 1 Preferred Generic	1		1
H5854	002	0	1	01	01	H5854_002_0	7	5	Tier 5 Specialty			
H5854	002	0	1	01	01	H5854_002_0	7	4	Tier 4 Non-Specialty Injectable			
H5854	002	0	1	01	01	H5854_002_0	7	4	Tier 4 Non-Specialty Injectable	2		
H5854	002	0	1	01	01	H5854_002_0	7	5	Tier 5 Specialty	2		
H5854	002	0	1	01	01	H5854_002_0	7	1	Tier 1 Preferred Generic			
H5854	002	0	1	01	01	H5854_002_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H5854	002	0	1	01	01	H5854_002_0	7	2	Tier 2 Preferred Brand			
H5854	003	0	1	01	01	H5854_003_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H5854	003	0	1	01	01	H5854_003_0	7	2	Tier 2 Preferred Brand			
H5854	003	0	1	01	01	H5854_003_0	7	1	Tier 1 Preferred Generic			
H5854	003	0	1	01	01	H5854_003_0	7	5	Tier 5 Specialty	2		
H5854	003	0	1	01	01	H5854_003_0	7	5	Tier 5 Specialty			
H5854	003	0	1	01	01	H5854_003_0	7	1	Tier 1 Preferred Generic	1		1
H5854	003	0	1	01	01	H5854_003_0	7	2	Tier 2 Preferred Brand	2		
H5854	003	0	1	01	01	H5854_003_0	7	4	Tier 4 Non-Specialty Injectable			
H5854	003	0	1	01	01	H5854_003_0	7	4	Tier 4 Non-Specialty Injectable	2		
H5854	003	0	1	01	01	H5854_003_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H5854	005	0	1	01	01	H5854_005_0	7	5	Tier 5 Specialty	2		
H5854	005	0	1	01	01	H5854_005_0	7	4	Tier 4 Non-Specialty Injectable	2		
H5854	005	0	1	01	01	H5854_005_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
H5854	005	0	1	01	01	H5854_005_0	7	2	Tier 2 Preferred Brand	2		
H5854	005	0	1	01	01	H5854_005_0	7	5	Tier 5 Specialty			
H5854	005	0	1	01	01	H5854_005_0	7	1	Tier 1 Preferred Generic	1		1
H5854	005	0	1	01	01	H5854_005_0	7	4	Tier 4 Non-Specialty Injectable			
H5854	005	0	1	01	01	H5854_005_0	7	3	Tier 3 Non-Preferred Brand or Generic			
H5854	005	0	1	01	01	H5854_005_0	7	2	Tier 2 Preferred Brand			
H5854	005	0	1	01	01	H5854_005_0	7	1	Tier 1 Preferred Generic			
H5859	003	0	1	01	01	H5859_003_0	5	2	2			
H5859	003	0	1	01	01	H5859_003_0	5	1	1			
H5859	003	0	1	01	01	H5859_003_0	5	1	1	1		1
H5859	003	0	1	01	01	H5859_003_0	5	2	2	2		
H5862	001	0	1	09	04	H5862_001_0	15	1	Tier 1 - Generic			
H5862	001	0	1	09	04	H5862_001_0	15	2	Tier 2 - Preferred Brand			
H5862	001	0	1	09	04	H5862_001_0	15	3	Tier 3 - Non Preferred Brand			
H5862	001	0	1	09	04	H5862_001_0	15	4	Tier 4 - Injectable Drugs			
H5862	001	0	1	09	04	H5862_001_0	15	5	Tier 5 - Specialty Drugs			
H5868	001	0	1	04	01	H5868_001_0	4	4	Specialty	1	10001000	2
H5868	001	0	1	04	01	H5868_001_0	4	3	Non-Preferred Brand	1	10000000	2
H5868	001	0	1	04	01	H5868_001_0	4	2	Preferred Brand	1	10000000	2
H5868	001	0	1	04	01	H5868_001_0	4	1	Preferred Generic	1	00001000	2
H5868	001	0	1	04	01	H5868_001_0	4	2	Preferred Brand			
H5868	001	0	1	04	01	H5868_001_0	4	3	Non-Preferred Brand			
H5868	001	0	1	04	01	H5868_001_0	4	4	Specialty			
H5868	001	0	1	04	01	H5868_001_0	4	1	Preferred Generic			
H5868	003	0	1	04	01	H5868_003_0	3	4	Specialty	1	10001000	2
H5868	003	0	1	04	01	H5868_003_0	3	1	Preferred Generic	1	00001000	2
H5868	003	0	1	04	01	H5868_003_0	3	4	Specialty			
H5868	003	0	1	04	01	H5868_003_0	3	3	Non-Preferred Brand			
H5868	003	0	1	04	01	H5868_003_0	3	2	Preferred Brand			
H5868	003	0	1	04	01	H5868_003_0	3	1	Preferred Generic			
H5868	003	0	1	04	01	H5868_003_0	3	3	Non-Preferred Brand	1	10000000	2
H5868	003	0	1	04	01	H5868_003_0	3	2	Preferred Brand	1	10000000	2
H5883	002	1	1	01	01	H5883_002_1	9	2	Preferred Brand			
H5883	002	1	1	01	01	H5883_002_1	9	1	Preferred Generic			
H5883	002	1	1	01	01	H5883_002_1	9	3	Non-Preferred Brand			
H5883	002	1	1	01	01	H5883_002_1	9	4	Specialty			
H5883	002	1	1	01	01	H5883_002_1	9	5	Injectable			
H5883	002	2	1	01	01	H5883_002_2	9	1	Preferred Generic			
H5883	002	2	1	01	01	H5883_002_2	9	2	Preferred Brand			
H5883	002	2	1	01	01	H5883_002_2	9	3	Non-Preferred Brand			
H5883	002	2	1	01	01	H5883_002_2	9	4	Specialty			
H5883	002	2	1	01	01	H5883_002_2	9	5	Injectable			
H5883	002	3	1	01	01	H5883_002_3	9	2	Preferred Brand			
H5883	002	3	1	01	01	H5883_002_3	9	1	Preferred Generic			
H5883	002	3	1	01	01	H5883_002_3	9	3	Non-Preferred Brand			
H5883	002	3	1	01	01	H5883_002_3	9	5	Injectable			
H5883	002	3	1	01	01	H5883_002_3	9	4	Specialty			
H5883	002	4	1	01	01	H5883_002_4	9	1	Preferred Generic			
H5883	002	4	1	01	01	H5883_002_4	9	2	Preferred Brand			
H5883	002	4	1	01	01	H5883_002_4	9	3	Non-Preferred Brand			
H5883	002	4	1	01	01	H5883_002_4	9	4	Specialty			
H5883	002	4	1	01	01	H5883_002_4	9	5	Injectable			
H5883	002	7	1	01	01	H5883_002_7	8	1	Preferred Generic			
H5883	002	7	1	01	01	H5883_002_7	8	2	Preferred Brand			
H5883	002	7	1	01	01	H5883_002_7	8	4	Specialty			
H5883	002	7	1	01	01	H5883_002_7	8	3	Non-Preferred Brand			
H5883	002	7	1	01	01	H5883_002_7	8	5	Injectable			
H5883	003	1	1	01	01	H5883_003_1	9	4	Specialty	2		
H5883	003	1	1	01	01	H5883_003_1	9	3	Non-Preferred Brand	2		
H5883	003	1	1	01	01	H5883_003_1	9	2	Preferred Brand	2		
H5883	003	1	1	01	01	H5883_003_1	9	1	Preferred Generic	1		1
H5883	003	1	1	01	01	H5883_003_1	9	5	Injectable	2		
H5883	003	1	1	01	01	H5883_003_1	9	4	Specialty			
H5883	003	1	1	01	01	H5883_003_1	9	3	Non-Preferred Brand			
H5883	003	1	1	01	01	H5883_003_1	9	2	Preferred Brand			
H5883	003	1	1	01	01	H5883_003_1	9	1	Preferred Generic			
H5883	003	1	1	01	01	H5883_003_1	9	5	Injectable			
H5883	003	2	1	01	01	H5883_003_2	9	4	Specialty	2		
H5883	003	2	1	01	01	H5883_003_2	9	3	Non-Preferred Brand	2		
H5883	003	2	1	01	01	H5883_003_2	9	2	Preferred Brand	2		
H5883	003	2	1	01	01	H5883_003_2	9	1	Preferred Generic	1		1
H5883	003	2	1	01	01	H5883_003_2	9	5	Injectable			
H5883	003	2	1	01	01	H5883_003_2	9	4	Specialty			
H5883	003	2	1	01	01	H5883_003_2	9	3	Non-Preferred Brand			
H5883	003	2	1	01	01	H5883_003_2	9	2	Preferred Brand			
H5883	003	2	1	01	01	H5883_003_2	9	1	Preferred Generic			
H5883	003	2	1	01	01	H5883_003_2	9	5	Injectable	2		
H5883	003	3	1	01	01	H5883_003_3	9	1	Preferred Generic			
H5883	003	3	1	01	01	H5883_003_3	9	2	Preferred Brand			
H5883	003	3	1	01	01	H5883_003_3	9	5	Injectable	2		
H5883	003	3	1	01	01	H5883_003_3	9	4	Specialty	2		
H5883	003	3	1	01	01	H5883_003_3	9	3	Non-Preferred Brand	2		
H5883	003	3	1	01	01	H5883_003_3	9	2	Preferred Brand	2		
H5883	003	3	1	01	01	H5883_003_3	9	1	Preferred Generic	1		1
H5883	003	3	1	01	01	H5883_003_3	9	5	Injectable			
H5883	003	3	1	01	01	H5883_003_3	9	4	Specialty			
H5883	003	3	1	01	01	H5883_003_3	9	3	Non-Preferred Brand			
H5883	003	4	1	01	01	H5883_003_4	9	1	Preferred Generic			
H5883	003	4	1	01	01	H5883_003_4	9	4	Specialty	2		
H5883	003	4	1	01	01	H5883_003_4	9	3	Non-Preferred Brand	2		
H5883	003	4	1	01	01	H5883_003_4	9	2	Preferred Brand	2		
H5883	003	4	1	01	01	H5883_003_4	9	5	Injectable	2		
H5883	003	4	1	01	01	H5883_003_4	9	5	Injectable			
H5883	003	4	1	01	01	H5883_003_4	9	4	Specialty			
H5883	003	4	1	01	01	H5883_003_4	9	3	Non-Preferred Brand			
H5883	003	4	1	01	01	H5883_003_4	9	2	Preferred Brand			
H5883	003	4	1	01	01	H5883_003_4	9	1	Preferred Generic	1		1
H5883	003	5	1	01	01	H5883_003_5	9	2	Preferred Brand			
H5883	003	5	1	01	01	H5883_003_5	9	3	Non-Preferred Brand			
H5883	003	5	1	01	01	H5883_003_5	9	4	Specialty			
H5883	003	5	1	01	01	H5883_003_5	9	5	Injectable			
H5883	003	5	1	01	01	H5883_003_5	9	1	Preferred Generic	1		1
H5883	003	5	1	01	01	H5883_003_5	9	2	Preferred Brand	2		
H5883	003	5	1	01	01	H5883_003_5	9	3	Non-Preferred Brand	2		
H5883	003	5	1	01	01	H5883_003_5	9	4	Specialty	2		
H5883	003	5	1	01	01	H5883_003_5	9	5	Injectable	2		
H5883	003	5	1	01	01	H5883_003_5	9	1	Preferred Generic			
H5884	002	1	1	09	04	H5884_002_1	6	3	Tier 3			
H5884	002	1	1	09	04	H5884_002_1	6	4	Tier 4			
H5884	002	1	1	09	04	H5884_002_1	6	2	Tier 2			
H5884	002	1	1	09	04	H5884_002_1	6	1	Tier 1			
H5884	002	2	1	09	04	H5884_002_2	6	1	Tier 1			
H5884	002	2	1	09	04	H5884_002_2	6	3	Tier 3			
H5884	002	2	1	09	04	H5884_002_2	6	4	Tier 4			
H5884	002	2	1	09	04	H5884_002_2	6	2	Tier 2			
H5884	003	1	1	09	04	H5884_003_1	6	4	Tier 4			
H5884	003	1	1	09	04	H5884_003_1	6	3	Tier 3			
H5884	003	1	1	09	04	H5884_003_1	6	1	Tier 1			
H5884	003	1	1	09	04	H5884_003_1	6	2	Tier 2			
H5884	003	2	1	09	04	H5884_003_2	6	4	Tier 4			
H5884	003	2	1	09	04	H5884_003_2	6	2	Tier 2			
H5884	003	2	1	09	04	H5884_003_2	6	3	Tier 3			
H5884	003	2	1	09	04	H5884_003_2	6	1	Tier 1			
H5884	004	1	1	09	04	H5884_004_1	6	2	Tier 2			
H5884	004	1	1	09	04	H5884_004_1	6	1	Tier 1			
H5884	004	1	1	09	04	H5884_004_1	6	3	Tier 3			
H5884	004	1	1	09	04	H5884_004_1	6	4	Tier 4			
H5884	004	2	1	09	04	H5884_004_2	6	3	Tier 3			
H5884	004	2	1	09	04	H5884_004_2	6	4	Tier 4			
H5884	004	2	1	09	04	H5884_004_2	6	2	Tier 2			
H5884	004	2	1	09	04	H5884_004_2	6	1	Tier 1			
H5887	001	0	1	01	01	H5887_001_0	10	4	Specialty Tier Brand			
H5887	001	0	1	01	01	H5887_001_0	10	3	Non-Preferred Brand			
H5887	001	0	1	01	01	H5887_001_0	10	1	Generic			
H5887	001	0	1	01	01	H5887_001_0	10	2	Preferred Brand			
H5887	006	0	1	01	01	H5887_006_0	10	3	Non-Preferred Brand			
H5887	006	0	1	01	01	H5887_006_0	10	1	Generic			
H5887	006	0	1	01	01	H5887_006_0	10	2	Preferred Brand			
H5887	006	0	1	01	01	H5887_006_0	10	4	Specialty Tier Brand			
H5887	007	0	1	01	01	H5887_007_0	10	4	Specialty Tier Brand	2		
H5887	007	0	1	01	01	H5887_007_0	10	1	Generic	1		1
H5887	007	0	1	01	01	H5887_007_0	10	2	Preferred Brand	2		
H5887	007	0	1	01	01	H5887_007_0	10	3	Non-Preferred Brand	2		
H5887	007	0	1	01	01	H5887_007_0	10	1	Generic			
H5887	007	0	1	01	01	H5887_007_0	10	2	Preferred Brand			
H5887	007	0	1	01	01	H5887_007_0	10	3	Non-Preferred Brand			
H5887	007	0	1	01	01	H5887_007_0	10	4	Specialty Tier Brand			
H5896	007	0	1	01	01	H5896_007_0	6	1	Generic Drugs			
H5896	007	0	1	01	01	H5896_007_0	6	2	Preferred Brand Name Drugs			
H5896	007	0	1	01	01	H5896_007_0	6	3	Non-Preferred Brand Name Drugs			
H5896	007	0	1	01	01	H5896_007_0	6	4	Specialty Drugs			
H5896	008	0	1	01	01	H5896_008_0	4	4	Specialty Drugs			
H5896	008	0	1	01	01	H5896_008_0	4	3	Non-Preferred Brand Name Drugs			
H5896	008	0	1	01	01	H5896_008_0	4	2	Preferred Brand Name Drugs			
H5896	008	0	1	01	01	H5896_008_0	4	1	Generic Drugs			
H5896	009	0	1	01	01	H5896_009_0	4	4	Specialty Drugs	2		
H5896	009	0	1	01	01	H5896_009_0	4	3	Non-Preferred Brand Name Drugs	2		
H5896	009	0	1	01	01	H5896_009_0	4	2	Preferred Brand Name Drugs	2		
H5896	009	0	1	01	01	H5896_009_0	4	1	Generic Drugs	1		1
H5896	009	0	1	01	01	H5896_009_0	4	1	Generic Drugs			
H5896	009	0	1	01	01	H5896_009_0	4	2	Preferred Brand Name Drugs			
H5896	009	0	1	01	01	H5896_009_0	4	3	Non-Preferred Brand Name Drugs			
H5896	009	0	1	01	01	H5896_009_0	4	4	Specialty Drugs			
H5896	012	0	1	02	01	H5896_012_0	3	1	Generic Drugs			
H5896	012	0	1	02	01	H5896_012_0	3	2	Preferred Brand Name Drugs			
H5896	012	0	1	02	01	H5896_012_0	3	3	Non-Preferred Brand Name Drugs			
H5896	012	0	1	02	01	H5896_012_0	3	4	Specialty Drugs			
H5908	003	0	1	09	04	H5908_003_0	6	1	Value Generics			
H5908	003	0	1	09	04	H5908_003_0	6	2	Generic			
H5908	003	0	1	09	04	H5908_003_0	6	3	Preferred Brand			
H5908	003	0	1	09	04	H5908_003_0	6	4	Non-Preferred Brand			
H5908	003	0	1	09	04	H5908_003_0	6	5	Specialty	2		
H5908	003	0	1	09	04	H5908_003_0	6	1	Value Generics	1		1
H5908	003	0	1	09	04	H5908_003_0	6	2	Generic	1		1
H5908	003	0	1	09	04	H5908_003_0	6	3	Preferred Brand	2		
H5908	003	0	1	09	04	H5908_003_0	6	4	Non-Preferred Brand	2		
H5908	003	0	1	09	04	H5908_003_0	6	5	Specialty			
H5918	001	0	1	37	05	H5918_001_0	5	1	Preferred Generic			
H5918	001	0	1	37	05	H5918_001_0	5	2	Preferred Brand			
H5918	001	0	1	37	05	H5918_001_0	5	3	Non Preferred			
H5918	001	0	1	37	05	H5918_001_0	5	4	Specialty			
H5918	003	0	1	37	05	H5918_003_0	4	1	Preferred Generic			
H5918	003	0	1	37	05	H5918_003_0	4	2	Preferred Brand			
H5918	003	0	1	37	05	H5918_003_0	4	4	Specialty			
H5918	003	0	1	37	05	H5918_003_0	4	3	Non Preferred			
H5918	004	0	1	37	05	H5918_004_0	3	1	Preferred Generic			
H5918	004	0	1	37	05	H5918_004_0	3	3	Non Preferred			
H5918	004	0	1	37	05	H5918_004_0	3	2	Preferred Brand			
H5918	004	0	1	37	05	H5918_004_0	3	4	Specialty			
H5926	001	0	1	01	01	H5926_001_0	5	1	Generic			
H5926	001	0	1	01	01	H5926_001_0	5	2	Preferred Brand			
H5926	001	0	1	01	01	H5926_001_0	5	3	Non-Preferred Brand			
H5926	001	0	1	01	01	H5926_001_0	5	4	Specialty Drugs			
H5926	002	0	1	01	01	H5926_002_0	8	1	Generic			
H5926	002	0	1	01	01	H5926_002_0	8	2	Preferred Brand			
H5926	002	0	1	01	01	H5926_002_0	8	3	Non-Preferred Brand			
H5926	002	0	1	01	01	H5926_002_0	8	4	Specialty Drugs			
H5928	002	0	1	01	01	H5928_002_0	4	1	Generic			
H5928	002	0	1	01	01	H5928_002_0	4	2	Brand			
H5928	002	0	1	01	01	H5928_002_0	4	3	Other Non-Preferred			
H5928	002	0	1	01	01	H5928_002_0	4	4	Specialty			
H5928	002	0	1	01	01	H5928_002_0	4	1	Generic	1		1
H5928	002	0	1	01	01	H5928_002_0	4	2	Brand	2		
H5928	002	0	1	01	01	H5928_002_0	4	3	Other Non-Preferred	2		
H5928	002	0	1	01	01	H5928_002_0	4	4	Specialty	2		
H5928	004	0	1	01	01	H5928_004_0	6	4	Specialty	2		
H5928	004	0	1	01	01	H5928_004_0	6	1	Generic			
H5928	004	0	1	01	01	H5928_004_0	6	2	Brand			
H5928	004	0	1	01	01	H5928_004_0	6	3	Other Non-Preferred			
H5928	004	0	1	01	01	H5928_004_0	6	4	Specialty			
H5928	004	0	1	01	01	H5928_004_0	6	1	Generic	1		1
H5928	004	0	1	01	01	H5928_004_0	6	2	Brand	2		
H5928	004	0	1	01	01	H5928_004_0	6	3	Other Non-Preferred	2		
H5928	006	0	1	01	01	H5928_006_0	5	4	Specialty	2		
H5928	006	0	1	01	01	H5928_006_0	5	3	Other Non-Preferred	2		
H5928	006	0	1	01	01	H5928_006_0	5	2	Brand	2		
H5928	006	0	1	01	01	H5928_006_0	5	1	Generic	1		1
H5928	006	0	1	01	01	H5928_006_0	5	4	Specialty			
H5928	006	0	1	01	01	H5928_006_0	5	1	Generic			
H5928	006	0	1	01	01	H5928_006_0	5	2	Brand			
H5928	006	0	1	01	01	H5928_006_0	5	3	Other Non-Preferred			
H5928	008	0	1	01	01	H5928_008_0	6	1	Generic			
H5928	008	0	1	01	01	H5928_008_0	6	2	Brand			
H5928	008	0	1	01	01	H5928_008_0	6	3	Other Non-Preferred			
H5928	008	0	1	01	01	H5928_008_0	6	4	Specialty			
H5928	008	0	1	01	01	H5928_008_0	6	1	Generic	1		1
H5928	008	0	1	01	01	H5928_008_0	6	2	Brand	2		
H5928	008	0	1	01	01	H5928_008_0	6	3	Other Non-Preferred	2		
H5928	008	0	1	01	01	H5928_008_0	6	4	Specialty	2		
H5928	010	0	1	01	01	H5928_010_0	5	4	Specialty	2		
H5928	010	0	1	01	01	H5928_010_0	5	1	Generic			
H5928	010	0	1	01	01	H5928_010_0	5	2	Brand			
H5928	010	0	1	01	01	H5928_010_0	5	3	Other Non-Preferred			
H5928	010	0	1	01	01	H5928_010_0	5	4	Specialty			
H5928	010	0	1	01	01	H5928_010_0	5	1	Generic	1		1
H5928	010	0	1	01	01	H5928_010_0	5	2	Brand	2		
H5928	010	0	1	01	01	H5928_010_0	5	3	Other Non-Preferred	2		
H5928	011	0	1	01	01	H5928_011_0	5	4	Specialty	2		
H5928	011	0	1	01	01	H5928_011_0	5	2	Brand	2		
H5928	011	0	1	01	01	H5928_011_0	5	1	Generic	1		1
H5928	011	0	1	01	01	H5928_011_0	5	4	Specialty			
H5928	011	0	1	01	01	H5928_011_0	5	3	Other Non-Preferred			
H5928	011	0	1	01	01	H5928_011_0	5	2	Brand			
H5928	011	0	1	01	01	H5928_011_0	5	1	Generic			
H5928	011	0	1	01	01	H5928_011_0	5	3	Other Non-Preferred	2		
H5928	012	0	1	01	01	H5928_012_0	4	1	Generic			
H5928	012	0	1	01	01	H5928_012_0	4	2	Brand			
H5928	012	0	1	01	01	H5928_012_0	4	3	Other Non-Preferred			
H5928	012	0	1	01	01	H5928_012_0	4	4	Specialty			
H5928	012	0	1	01	01	H5928_012_0	4	1	Generic	1		1
H5928	012	0	1	01	01	H5928_012_0	4	2	Brand	2		
H5928	012	0	1	01	01	H5928_012_0	4	3	Other Non-Preferred	2		
H5928	012	0	1	01	01	H5928_012_0	4	4	Specialty	2		
H5932	001	0	1	01	01	H5932_001_0	4	3	Tier 3			
H5932	001	0	1	01	01	H5932_001_0	4	2	Tier 2			
H5932	001	0	1	01	01	H5932_001_0	4	1	Tier 1			
H5932	001	0	1	01	01	H5932_001_0	4	4	Tier 4			
H5938	001	0	1	01	01	H5938_001_0	7	3	Non-Preferred Brand			
H5938	001	0	1	01	01	H5938_001_0	7	2	Preferred Brand			
H5938	001	0	1	01	01	H5938_001_0	7	1	Generic			
H5938	001	0	1	01	01	H5938_001_0	7	4	Specialty Brand/Generic			
H5938	006	0	1	01	01	H5938_006_0	7	1	Generic			
H5938	006	0	1	01	01	H5938_006_0	7	2	Preferred Brand			
H5938	006	0	1	01	01	H5938_006_0	7	3	Non-Preferred Brand			
H5938	006	0	1	01	01	H5938_006_0	7	4	Specialty Brand/Generic			
H5938	006	0	1	01	01	H5938_006_0	7	1	Generic	1		1
H5938	006	0	1	01	01	H5938_006_0	7	2	Preferred Brand	2		
H5938	006	0	1	01	01	H5938_006_0	7	3	Non-Preferred Brand	2		
H5938	006	0	1	01	01	H5938_006_0	7	4	Specialty Brand/Generic	2		
H5943	001	0	1	39	05	H5943_001_0	6	1	Generic			
H5943	001	0	1	39	05	H5943_001_0	6	4	Specialty			
H5943	001	0	1	39	05	H5943_001_0	6	3	Additional Brand			
H5943	001	0	1	39	05	H5943_001_0	6	2	Brand			
H5948	001	0	1	01	01	H5948_001_0	4	1	Generic			
H5948	001	0	1	01	01	H5948_001_0	4	2	Preferred Brand			
H5948	001	0	1	01	01	H5948_001_0	4	3	Non Preferred Brand			
H5948	001	0	1	01	01	H5948_001_0	4	4	Specialty			
H5948	001	0	1	01	01	H5948_001_0	4	5	Lifestyle Enhancement			
H5948	001	0	1	01	01	H5948_001_0	4	1	Generic	1		1
H5948	001	0	1	01	01	H5948_001_0	4	2	Preferred Brand	2		
H5948	001	0	1	01	01	H5948_001_0	4	3	Non Preferred Brand	2		
H5948	001	0	1	01	01	H5948_001_0	4	4	Specialty	2		
H5948	001	0	1	01	01	H5948_001_0	4	5	Lifestyle Enhancement	1		1
H5948	002	0	1	01	01	H5948_002_0	4	4	Specialty			
H5948	002	0	1	01	01	H5948_002_0	4	3	Non Preferred Brand			
H5948	002	0	1	01	01	H5948_002_0	4	2	Preferred Brand			
H5948	002	0	1	01	01	H5948_002_0	4	1	Generic			
H5948	002	0	1	01	01	H5948_002_0	4	5	Lifestyle Enhancement			
H5948	003	0	1	01	01	H5948_003_0	4	1	Generic	1		1
H5948	003	0	1	01	01	H5948_003_0	4	2	Preferred Brand	2		
H5948	003	0	1	01	01	H5948_003_0	4	3	Non Preferred Brand	2		
H5948	003	0	1	01	01	H5948_003_0	4	4	Specialty	2		
H5948	003	0	1	01	01	H5948_003_0	4	5	Lifestyle Enhancement			
H5948	003	0	1	01	01	H5948_003_0	4	4	Specialty			
H5948	003	0	1	01	01	H5948_003_0	4	5	Lifestyle Enhancement	1		1
H5948	003	0	1	01	01	H5948_003_0	4	2	Preferred Brand			
H5948	003	0	1	01	01	H5948_003_0	4	1	Generic			
H5948	003	0	1	01	01	H5948_003_0	4	3	Non Preferred Brand			
H5950	001	0	1	01	01	H5950_001_0	5	1	Tier 1 - Preferred Generic			
H5950	001	0	1	01	01	H5950_001_0	5	5	Tier 5 - Specialty			
H5950	001	0	1	01	01	H5950_001_0	5	4	Tier 4 - Non-Preferred Brand			
H5950	001	0	1	01	01	H5950_001_0	5	3	Tier 3 - Preferred Brand			
H5950	001	0	1	01	01	H5950_001_0	5	2	Tier 2 - Non-Preferred Generic			
H5950	002	0	1	01	01	H5950_002_0	4	1	Tier 1 - Preferred Generic			
H5950	002	0	1	01	01	H5950_002_0	4	2	Tier 2 - Non-Preferred Generic			
H5950	002	0	1	01	01	H5950_002_0	4	3	Tier 3 - Preferred Brand			
H5950	002	0	1	01	01	H5950_002_0	4	4	Tier 4 - Non-Preferred Brand			
H5950	002	0	1	01	01	H5950_002_0	4	5	Tier 5 - Specialty			
H5950	003	0	1	01	01	H5950_003_0	5	4	Tier 4 - Non-Preferred Brand	2		
H5950	003	0	1	01	01	H5950_003_0	5	5	Tier 5 - Specialty	2		
H5950	003	0	1	01	01	H5950_003_0	5	3	Tier 3 - Preferred Brand	2		
H5950	003	0	1	01	01	H5950_003_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H5950	003	0	1	01	01	H5950_003_0	5	1	Tier 1 - Preferred Generic			
H5950	003	0	1	01	01	H5950_003_0	5	2	Tier 2 - Non-Preferred Generic			
H5950	003	0	1	01	01	H5950_003_0	5	3	Tier 3 - Preferred Brand			
H5950	003	0	1	01	01	H5950_003_0	5	4	Tier 4 - Non-Preferred Brand			
H5950	003	0	1	01	01	H5950_003_0	5	5	Tier 5 - Specialty			
H5950	003	0	1	01	01	H5950_003_0	5	1	Tier 1 - Preferred Generic	1		1
H5952	001	0	1	09	04	H5952_001_0	8	1	Preferred Generic			
H5952	001	0	1	09	04	H5952_001_0	8	2	Preferred Brand			
H5952	001	0	1	09	04	H5952_001_0	8	3	Non Preferred Generic/Non Preferred Brand			
H5952	001	0	1	09	04	H5952_001_0	8	4	Specialty-Generic and Brand			
H5969	001	0	1	01	01	H5969_001_0	6	1	Generic			
H5969	001	0	1	01	01	H5969_001_0	6	3	Specialty			
H5969	001	0	1	01	01	H5969_001_0	6	2	Brand			
H5980	006	0	1	01	01	H5980_006_0	5	3	Non-Preferred Brand			
H5980	006	0	1	01	01	H5980_006_0	5	2	Preferred Brand			
H5980	006	0	1	01	01	H5980_006_0	5	1	Generic			
H5980	007	0	1	01	01	H5980_007_0	7	3	Non-Preferred Brand			
H5980	007	0	1	01	01	H5980_007_0	7	2	Preferred Brand			
H5980	007	0	1	01	01	H5980_007_0	7	1	Generic			
H5985	001	0	1	01	01	H5985_001_0	5	3	Brand	2		
H5985	001	0	1	01	01	H5985_001_0	5	4	Specialty	2		
H5985	001	0	1	01	01	H5985_001_0	5	2	Preferred Brand	2		
H5985	001	0	1	01	01	H5985_001_0	5	1	Generic	1		1
H5985	001	0	1	01	01	H5985_001_0	5	4	Specialty			
H5985	001	0	1	01	01	H5985_001_0	5	3	Brand			
H5985	001	0	1	01	01	H5985_001_0	5	2	Preferred Brand			
H5985	001	0	1	01	01	H5985_001_0	5	1	Generic			
H5989	003	0	1	01	01	H5989_003_0	6	1	Generic			
H5989	003	0	1	01	01	H5989_003_0	6	2	Preferred Brand			
H5989	003	0	1	01	01	H5989_003_0	6	3	Non-Preferred Brand			
H5989	003	0	1	01	01	H5989_003_0	6	4	Specialty			
H5989	004	0	1	01	01	H5989_004_0	9	1	Generic			
H5989	004	0	1	01	01	H5989_004_0	9	2	Preferred Brand			
H5989	004	0	1	01	01	H5989_004_0	9	4	Specialty			
H5989	004	0	1	01	01	H5989_004_0	9	3	Non-Preferred Brand			
H5992	001	0	1	01	01	H5992_001_0	8	1	enhanced alternative-generic			
H5992	001	0	1	01	01	H5992_001_0	8	2	enhanced alternative-brand			
H5992	002	0	1	01	01	H5992_002_0	7	1	enhanced alternative-generic			
H5992	002	0	1	01	01	H5992_002_0	7	2	enhanced alternative-brand			
H5992	003	0	1	01	01	H5992_003_0	5	1	enhanced alternative-generic			
H5992	003	0	1	01	01	H5992_003_0	5	2	enhanced alternative-brand			
H5995	002	0	1	01	01	H5995_002_0	4	1	Tier 1 - Generics			
H5995	002	0	1	01	01	H5995_002_0	4	3	Tier 3 - Specialty			
H5995	002	0	1	01	01	H5995_002_0	4	2	Tier 2 - Brands			
H5996	011	0	1	09	04	H5996_011_0	6	4	Injectable			
H5996	011	0	1	09	04	H5996_011_0	6	1	Preferred Generic			
H5996	011	0	1	09	04	H5996_011_0	6	2	Preferred Brand			
H5996	011	0	1	09	04	H5996_011_0	6	3	Non-Preferred Brand			
H5996	011	0	1	09	04	H5996_011_0	6	5	Specialty			
H5996	012	0	1	09	04	H5996_012_0	6	1	Preferred Generic			
H5996	012	0	1	09	04	H5996_012_0	6	2	Preferred Brand			
H5996	012	0	1	09	04	H5996_012_0	6	3	Non-Preferred Brand			
H5996	012	0	1	09	04	H5996_012_0	6	4	Injectable			
H5996	012	0	1	09	04	H5996_012_0	6	5	Specialty			
H5996	013	0	1	09	04	H5996_013_0	6	4	Injectable			
H5996	013	0	1	09	04	H5996_013_0	6	3	Non-Preferred Brand			
H5996	013	0	1	09	04	H5996_013_0	6	2	Preferred Brand			
H5996	013	0	1	09	04	H5996_013_0	6	1	Preferred Generic			
H5996	013	0	1	09	04	H5996_013_0	6	5	Specialty			
H5996	015	0	1	09	04	H5996_015_0	6	4	Injectable			
H5996	015	0	1	09	04	H5996_015_0	6	5	Specialty			
H5996	015	0	1	09	04	H5996_015_0	6	2	Preferred Brand			
H5996	015	0	1	09	04	H5996_015_0	6	3	Non-Preferred Brand			
H5996	015	0	1	09	04	H5996_015_0	6	1	Preferred Generic			
H5996	018	0	1	09	04	H5996_018_0	9	1	Preferred Generic			
H5996	018	0	1	09	04	H5996_018_0	9	3	Non-Preferred			
H5996	018	0	1	09	04	H5996_018_0	9	4	Injectable			
H5996	018	0	1	09	04	H5996_018_0	9	5	Specialty			
H5996	018	0	1	09	04	H5996_018_0	9	2	Preferred Brand			
H5996	019	0	1	09	04	H5996_019_0	6	1	Preferred Generic			
H5996	019	0	1	09	04	H5996_019_0	6	5	Specialty			
H5996	019	0	1	09	04	H5996_019_0	6	2	Preferred Brand			
H5996	019	0	1	09	04	H5996_019_0	6	3	Non-Preferred Brand			
H5996	019	0	1	09	04	H5996_019_0	6	4	Injectable			
H5996	020	0	1	09	04	H5996_020_0	6	4	Injectable			
H5996	020	0	1	09	04	H5996_020_0	6	5	Specialty			
H5996	020	0	1	09	04	H5996_020_0	6	1	Preferred Generic			
H5996	020	0	1	09	04	H5996_020_0	6	3	Non-Preferred Brand			
H5996	020	0	1	09	04	H5996_020_0	6	2	Preferred Brand			
H5996	026	0	1	09	04	H5996_026_0	11	5	Speciality			
H5996	026	0	1	09	04	H5996_026_0	11	1	Preferred Generic			
H5996	026	0	1	09	04	H5996_026_0	11	2	Preferred Brand			
H5996	026	0	1	09	04	H5996_026_0	11	3	Non-Preferred			
H5996	026	0	1	09	04	H5996_026_0	11	4	Injectable			
H5996	027	0	1	09	04	H5996_027_0	9	5	Specialty			
H5996	027	0	1	09	04	H5996_027_0	9	1	Preferred Generic			
H5996	027	0	1	09	04	H5996_027_0	9	2	Preferred Brand			
H5996	027	0	1	09	04	H5996_027_0	9	3	Non-Preferred			
H5996	027	0	1	09	04	H5996_027_0	9	4	Injectable			
H5996	029	0	1	09	04	H5996_029_0	9	5	Specialty			
H5996	029	0	1	09	04	H5996_029_0	9	3	Non-Preferred			
H5996	029	0	1	09	04	H5996_029_0	9	2	Preferred Brand			
H5996	029	0	1	09	04	H5996_029_0	9	1	Preferred Generic			
H5996	029	0	1	09	04	H5996_029_0	9	4	Injectable			
H5996	031	0	1	09	04	H5996_031_0	6	5	Specialty			
H5996	031	0	1	09	04	H5996_031_0	6	1	Preferred Generic			
H5996	031	0	1	09	04	H5996_031_0	6	4	Injectable			
H5996	031	0	1	09	04	H5996_031_0	6	3	Non Preferred Brand			
H5996	031	0	1	09	04	H5996_031_0	6	2	Preferred Brand			
H5996	035	0	1	09	04	H5996_035_0	6	4	Injectable			
H5996	035	0	1	09	04	H5996_035_0	6	3	Non-Preferred Brand			
H5996	035	0	1	09	04	H5996_035_0	6	2	Preferred Brand			
H5996	035	0	1	09	04	H5996_035_0	6	1	Preferred Generic			
H5996	035	0	1	09	04	H5996_035_0	6	5	Specialty			
H5996	036	0	1	09	04	H5996_036_0	6	5	Specialty			
H5996	036	0	1	09	04	H5996_036_0	6	1	Preferred Generic			
H5996	036	0	1	09	04	H5996_036_0	6	2	Preferred Brand			
H5996	036	0	1	09	04	H5996_036_0	6	3	Non-Preferred Brand			
H5996	036	0	1	09	04	H5996_036_0	6	4	Injectable			
H5996	037	0	1	09	04	H5996_037_0	6	4	Injectable			
H5996	037	0	1	09	04	H5996_037_0	6	3	Non-Preferred Brand			
H5996	037	0	1	09	04	H5996_037_0	6	2	Preferred Brand			
H5996	037	0	1	09	04	H5996_037_0	6	1	Preferred Generic			
H5996	037	0	1	09	04	H5996_037_0	6	5	Specialty			
H5996	041	0	1	09	04	H5996_041_0	6	1	Preferred Generic			
H5996	041	0	1	09	04	H5996_041_0	6	2	Preferred Brand			
H5996	041	0	1	09	04	H5996_041_0	6	3	Non-Preferred Brand			
H5996	041	0	1	09	04	H5996_041_0	6	4	Injectable			
H5996	041	0	1	09	04	H5996_041_0	6	5	Specialty			
H5996	042	0	1	09	04	H5996_042_0	6	4	Injectable			
H5996	042	0	1	09	04	H5996_042_0	6	3	Non-Preferred Brand			
H5996	042	0	1	09	04	H5996_042_0	6	2	Preferred Brand			
H5996	042	0	1	09	04	H5996_042_0	6	1	Preferred Generic			
H5996	042	0	1	09	04	H5996_042_0	6	5	Specialty			
H5996	043	0	1	09	04	H5996_043_0	6	2	Preferred Brand			
H5996	043	0	1	09	04	H5996_043_0	6	1	Preferred Generic			
H5996	043	0	1	09	04	H5996_043_0	6	3	Non-Preferred Brand			
H5996	043	0	1	09	04	H5996_043_0	6	4	Injectable			
H5996	043	0	1	09	04	H5996_043_0	6	5	Specialty			
H5996	049	0	1	09	04	H5996_049_0	7	2	Preferred Brand			
H5996	049	0	1	09	04	H5996_049_0	7	1	Preferred Generic			
H5996	049	0	1	09	04	H5996_049_0	7	3	Non-Preferred Brand			
H5996	049	0	1	09	04	H5996_049_0	7	5	Specialty			
H5996	049	0	1	09	04	H5996_049_0	7	4	Injectable			
H5996	050	0	1	09	04	H5996_050_0	7	1	Preferred Generic			
H5996	050	0	1	09	04	H5996_050_0	7	2	Preferred Brand			
H5996	050	0	1	09	04	H5996_050_0	7	4	Injectable			
H5996	050	0	1	09	04	H5996_050_0	7	3	Non-Preferred Brand			
H5996	050	0	1	09	04	H5996_050_0	7	5	Specialty			
H5996	051	0	1	09	04	H5996_051_0	7	2	Preferred Brand			
H5996	051	0	1	09	04	H5996_051_0	7	3	Non-Preferred Brand			
H5996	051	0	1	09	04	H5996_051_0	7	4	Injectable			
H5996	051	0	1	09	04	H5996_051_0	7	5	Specialty			
H5996	051	0	1	09	04	H5996_051_0	7	1	Preferred Generic			
H5996	069	0	1	09	04	H5996_069_0	9	4	Injectable			
H5996	069	0	1	09	04	H5996_069_0	9	2	Preferred Brand			
H5996	069	0	1	09	04	H5996_069_0	9	3	Non-Preferred			
H5996	069	0	1	09	04	H5996_069_0	9	1	Preferred Generic			
H5996	069	0	1	09	04	H5996_069_0	9	5	Specialty			
H5998	001	0	1	01	01	H5998_001_0	8	4	Non-Preferred			
H5998	001	0	1	01	01	H5998_001_0	8	1	Preferred Generic			
H5998	001	0	1	01	01	H5998_001_0	8	2	Preferred Brand			
H5998	001	0	1	01	01	H5998_001_0	8	3	Specialty			
H5998	002	0	1	01	01	H5998_002_0	6	4	Non-Preferred	2		
H5998	002	0	1	01	01	H5998_002_0	6	3	Specialty	2		
H5998	002	0	1	01	01	H5998_002_0	6	2	Preferred Brand	2		
H5998	002	0	1	01	01	H5998_002_0	6	1	Preferred Generic	1		1
H5998	002	0	1	01	01	H5998_002_0	6	4	Non-Preferred			
H5998	002	0	1	01	01	H5998_002_0	6	3	Specialty			
H5998	002	0	1	01	01	H5998_002_0	6	2	Preferred Brand			
H5998	002	0	1	01	01	H5998_002_0	6	1	Preferred Generic			
H6120	002	0	1	01	01	H6120_002_0	6	1	Generic			
H6120	002	0	1	01	01	H6120_002_0	6	2	Preferred Brand			
H6120	002	0	1	01	01	H6120_002_0	6	3	Non Preferred Brand			
H6120	002	0	1	01	01	H6120_002_0	6	4	Specialty Drugs			
H6120	002	0	1	01	01	H6120_002_0	6	1	Generic	1		1
H6120	002	0	1	01	01	H6120_002_0	6	4	Specialty Drugs	2		
H6120	002	0	1	01	01	H6120_002_0	6	3	Non Preferred Brand	2		
H6120	002	0	1	01	01	H6120_002_0	6	2	Preferred Brand	2		
H6120	003	0	1	01	01	H6120_003_0	6	4	Specialty Drugs	2		
H6120	003	0	1	01	01	H6120_003_0	6	3	Non Preferred Brand	2		
H6120	003	0	1	01	01	H6120_003_0	6	2	Preferred Brand	2		
H6120	003	0	1	01	01	H6120_003_0	6	1	Generic	1		1
H6120	003	0	1	01	01	H6120_003_0	6	3	Non Preferred Brand			
H6120	003	0	1	01	01	H6120_003_0	6	4	Specialty Drugs			
H6120	003	0	1	01	01	H6120_003_0	6	2	Preferred Brand			
H6120	003	0	1	01	01	H6120_003_0	6	1	Generic			
H6145	001	0	1	04	01	H6145_001_0	6	3	Non-Preferred Brand			
H6145	001	0	1	04	01	H6145_001_0	6	1	Generic			
H6145	001	0	1	04	01	H6145_001_0	6	2	Preferred Brand			
H6145	001	0	1	04	01	H6145_001_0	6	4	Specialty			
H6178	001	0	1	01	01	H6178_001_0	6	2	Tier 2			
H6178	001	0	1	01	01	H6178_001_0	6	1	Tier 1			
H6178	001	0	1	01	01	H6178_001_0	6	3	Tier 3			
H6178	001	0	1	01	01	H6178_001_0	6	4	Tier 4			
H6181	007	0	1	01	01	H6181_007_0	5	2	Preferred Brand Name Drugs			
H6181	007	0	1	01	01	H6181_007_0	5	4	Specialty Drugs			
H6181	007	0	1	01	01	H6181_007_0	5	1	Generic Drugs			
H6181	007	0	1	01	01	H6181_007_0	5	3	Non-Preferred Brand Name Drugs			
H6181	008	0	1	01	01	H6181_008_0	4	1	Generic Drugs			
H6181	008	0	1	01	01	H6181_008_0	4	2	Preferred Brand Name Drugs			
H6181	008	0	1	01	01	H6181_008_0	4	4	Specialty Drugs			
H6181	008	0	1	01	01	H6181_008_0	4	3	Non-Preferred Brand Name Drugs			
H6181	008	0	1	01	01	H6181_008_0	4	1	Generic Drugs	1		1
H6181	008	0	1	01	01	H6181_008_0	4	2	Preferred Brand Name Drugs	2		
H6181	008	0	1	01	01	H6181_008_0	4	3	Non-Preferred Brand Name Drugs	2		
H6181	008	0	1	01	01	H6181_008_0	4	4	Specialty Drugs	2		
H6181	009	0	1	01	01	H6181_009_0	4	2	Preferred Brand Name Drugs	2		
H6181	009	0	1	01	01	H6181_009_0	4	3	Non-Preferred Brand Name Drugs	2		
H6181	009	0	1	01	01	H6181_009_0	4	1	Generic Drugs	1		1
H6181	009	0	1	01	01	H6181_009_0	4	4	Specialty Drugs	2		
H6181	009	0	1	01	01	H6181_009_0	4	4	Specialty Drugs			
H6181	009	0	1	01	01	H6181_009_0	4	3	Non-Preferred Brand Name Drugs			
H6181	009	0	1	01	01	H6181_009_0	4	1	Generic Drugs			
H6181	009	0	1	01	01	H6181_009_0	4	2	Preferred Brand Name Drugs			
H6181	013	0	1	02	01	H6181_013_0	3	4	Specialty Drugs	2		
H6181	013	0	1	02	01	H6181_013_0	3	3	Non-Preferred Brand Name Drugs	2		
H6181	013	0	1	02	01	H6181_013_0	3	2	Preferred Brand Name Drugs	2		
H6181	013	0	1	02	01	H6181_013_0	3	1	Generic Drugs	1		1
H6181	013	0	1	02	01	H6181_013_0	3	4	Specialty Drugs			
H6181	013	0	1	02	01	H6181_013_0	3	3	Non-Preferred Brand Name Drugs			
H6181	013	0	1	02	01	H6181_013_0	3	2	Preferred Brand Name Drugs			
H6181	013	0	1	02	01	H6181_013_0	3	1	Generic Drugs			
H6184	001	0	1	01	01	H6184_001_0	9	1	Tier 1 Preferred Generic			
H6184	001	0	1	01	01	H6184_001_0	9	2	Tier 2 Preferred Brand			
H6184	001	0	1	01	01	H6184_001_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H6184	001	0	1	01	01	H6184_001_0	9	4	Tier 4 Non-Specialty Injectable			
H6184	001	0	1	01	01	H6184_001_0	9	4	Tier 4 Non-Specialty Injectable	2		
H6184	001	0	1	01	01	H6184_001_0	9	1	Tier 1 Preferred Generic	1		1
H6184	001	0	1	01	01	H6184_001_0	9	2	Tier 2 Preferred Brand	2		
H6184	001	0	1	01	01	H6184_001_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H6184	001	0	1	01	01	H6184_001_0	9	5	Tier 5 Specialty	2		
H6184	001	0	1	01	01	H6184_001_0	9	5	Tier 5 Specialty			
H6228	001	0	1	37	05	H6228_001_0	4	1	Preferred Generic			
H6228	001	0	1	37	05	H6228_001_0	4	2	Preferred Brand			
H6228	001	0	1	37	05	H6228_001_0	4	3	Non Preferred			
H6228	001	0	1	37	05	H6228_001_0	4	4	Specialty			
H6228	003	0	1	37	05	H6228_003_0	3	1	Preferred Generic			
H6228	003	0	1	37	05	H6228_003_0	3	2	Preferred Brand			
H6228	003	0	1	37	05	H6228_003_0	3	3	Non Preferred			
H6228	003	0	1	37	05	H6228_003_0	3	4	Specialty			
H6328	001	0	1	04	01	H6328_001_0	10	4	Specialty	2		
H6328	001	0	1	04	01	H6328_001_0	10	3	Non-Preferred Drugs	2		
H6328	001	0	1	04	01	H6328_001_0	10	2	Preferred Brand	2		
H6328	001	0	1	04	01	H6328_001_0	10	1	Preferred Generic	1		1
H6328	001	0	1	04	01	H6328_001_0	10	4	Specialty			
H6328	001	0	1	04	01	H6328_001_0	10	3	Non-Preferred Drugs			
H6328	001	0	1	04	01	H6328_001_0	10	2	Preferred Brand			
H6328	001	0	1	04	01	H6328_001_0	10	1	Preferred Generic			
H6328	002	0	1	04	01	H6328_002_0	8	3	Non-Preferred Drugs	2		
H6328	002	0	1	04	01	H6328_002_0	8	4	Specialty	2		
H6328	002	0	1	04	01	H6328_002_0	8	2	Preferred Brand	2		
H6328	002	0	1	04	01	H6328_002_0	8	1	Preferred Generic	1		1
H6328	002	0	1	04	01	H6328_002_0	8	4	Specialty			
H6328	002	0	1	04	01	H6328_002_0	8	3	Non-Preferred Drugs			
H6328	002	0	1	04	01	H6328_002_0	8	2	Preferred Brand			
H6328	002	0	1	04	01	H6328_002_0	8	1	Preferred Generic			
H6360	001	0	1	18	06	H6360_001_0	7	1	Generic	1		1
H6360	001	0	1	18	06	H6360_001_0	7	3	Specialty			
H6360	001	0	1	18	06	H6360_001_0	7	2	Brand-Name			
H6360	001	0	1	18	06	H6360_001_0	7	1	Generic			
H6360	001	0	1	18	06	H6360_001_0	7	2	Brand-Name	2		
H6360	001	0	1	18	06	H6360_001_0	7	3	Specialty	2		
H6360	002	0	1	18	06	H6360_002_0	6	1	Generic			
H6360	002	0	1	18	06	H6360_002_0	6	2	Brand-Name			
H6360	002	0	1	18	06	H6360_002_0	6	3	Specialty	2		
H6360	002	0	1	18	06	H6360_002_0	6	2	Brand-Name	2		
H6360	002	0	1	18	06	H6360_002_0	6	1	Generic	1		1
H6360	002	0	1	18	06	H6360_002_0	6	3	Specialty			
H6360	006	0	1	18	06	H6360_006_0	7	1	Generic			
H6360	006	0	1	18	06	H6360_006_0	7	2	Brand-Name			
H6360	006	0	1	18	06	H6360_006_0	7	3	Specialty			
H6360	009	0	2	18	06	H6360_009_0	5	1	Generic			
H6360	009	0	2	18	06	H6360_009_0	5	2	Brand-Name			
H6360	009	0	2	18	06	H6360_009_0	5	3	Specialty	2		
H6360	009	0	2	18	06	H6360_009_0	5	1	Generic	1		1
H6360	009	0	2	18	06	H6360_009_0	5	2	Brand-Name	2		
H6360	009	0	2	18	06	H6360_009_0	5	3	Specialty			
H6411	002	0	1	04	01	H6411_002_0	4	3	Non-Preferred Brand	1	10000000	2
H6411	002	0	1	04	01	H6411_002_0	4	2	Preferred Brand	1	10000000	2
H6411	002	0	1	04	01	H6411_002_0	4	1	Preferred Generic	1	00001000	2
H6411	002	0	1	04	01	H6411_002_0	4	4	Specialty			
H6411	002	0	1	04	01	H6411_002_0	4	3	Non-Preferred Brand			
H6411	002	0	1	04	01	H6411_002_0	4	2	Preferred Brand			
H6411	002	0	1	04	01	H6411_002_0	4	1	Preferred Generic			
H6411	002	0	1	04	01	H6411_002_0	4	4	Specialty	1	10001000	2
H6421	007	0	1	09	04	H6421_007_0	3	2	Preferred Brand			
H6421	007	0	1	09	04	H6421_007_0	3	4	Specialty			
H6421	007	0	1	09	04	H6421_007_0	3	3	Non-Preferred Brand			
H6421	007	0	1	09	04	H6421_007_0	3	1	Generic			
H6421	011	0	1	09	04	H6421_011_0	3	3	Non-Preferred Brand			
H6421	011	0	1	09	04	H6421_011_0	3	2	Preferred Brand			
H6421	011	0	1	09	04	H6421_011_0	3	1	Generic			
H6421	011	0	1	09	04	H6421_011_0	3	4	Specialty			
H6421	012	0	1	09	04	H6421_012_0	3	1	Generic			
H6421	012	0	1	09	04	H6421_012_0	3	3	Non-Preferred Brand			
H6421	012	0	1	09	04	H6421_012_0	3	2	Preferred Brand			
H6421	012	0	1	09	04	H6421_012_0	3	4	Specialty			
H6499	014	0	1	09	04	H6499_014_0	7	2	Tier 2			
H6499	014	0	1	09	04	H6499_014_0	7	3	Tier 3			
H6499	014	0	1	09	04	H6499_014_0	7	4	Tier 4			
H6499	014	0	1	09	04	H6499_014_0	7	1	Tier 1			
H6499	015	0	1	09	04	H6499_015_0	8	3	Tier 3			
H6499	015	0	1	09	04	H6499_015_0	8	2	Tier 2			
H6499	015	0	1	09	04	H6499_015_0	8	1	Tier 1			
H6499	015	0	1	09	04	H6499_015_0	8	4	Tier 4			
H6499	030	0	1	09	04	H6499_030_0	8	2	Tier 2			
H6499	030	0	1	09	04	H6499_030_0	8	1	Tier 1			
H6499	030	0	1	09	04	H6499_030_0	8	3	Tier 3			
H6499	030	0	1	09	04	H6499_030_0	8	4	Tier 4			
H6499	032	0	1	09	04	H6499_032_0	7	1	Tier 1			
H6499	032	0	1	09	04	H6499_032_0	7	2	Tier 2			
H6499	032	0	1	09	04	H6499_032_0	7	3	Tier 3			
H6499	032	0	1	09	04	H6499_032_0	7	4	Tier 4			
H6528	001	0	1	04	01	H6528_001_0	8	1	Formulary Generic			
H6528	001	0	1	04	01	H6528_001_0	8	4	Formulary Specialty			
H6528	001	0	1	04	01	H6528_001_0	8	3	Formulary Non-Preferred Brand			
H6528	001	0	1	04	01	H6528_001_0	8	2	Formulary Preferred Brand			
H6621	001	0	1	09	04	H6621_001_0	5	3	Non-Preferred Brand			
H6621	001	0	1	09	04	H6621_001_0	5	4	Specialty			
H6621	001	0	1	09	04	H6621_001_0	5	1	Generic	1		1
H6621	001	0	1	09	04	H6621_001_0	5	2	Preferred Brand			
H6621	001	0	1	09	04	H6621_001_0	5	3	Non-Preferred Brand	2		
H6621	001	0	1	09	04	H6621_001_0	5	4	Specialty	2		
H6621	001	0	1	09	04	H6621_001_0	5	1	Generic			
H6621	001	0	1	09	04	H6621_001_0	5	2	Preferred Brand	2		
H6793	001	0	1	37	05	H6793_001_0	4	1	Preferred Generic			
H6793	001	0	1	37	05	H6793_001_0	4	2	Preferred Brand			
H6793	001	0	1	37	05	H6793_001_0	4	3	Non Preferred			
H6793	001	0	1	37	05	H6793_001_0	4	4	Specialty			
H6793	003	0	1	37	05	H6793_003_0	3	1	Preferred Generic			
H6793	003	0	1	37	05	H6793_003_0	3	2	Preferred Brand			
H6793	003	0	1	37	05	H6793_003_0	3	3	Non Preferred			
H6793	003	0	1	37	05	H6793_003_0	3	4	Specialty			
H6900	001	0	1	04	01	H6900_001_0	6	1	Preferred Generic			
H6900	001	0	1	04	01	H6900_001_0	6	1	Preferred Generic	1	00001000	2
H6900	001	0	1	04	01	H6900_001_0	6	3	Non-Preferred Brand			
H6900	001	0	1	04	01	H6900_001_0	6	4	Specialty			
H6900	001	0	1	04	01	H6900_001_0	6	2	Preferred Brand			
H6900	001	0	1	04	01	H6900_001_0	6	2	Preferred Brand	1	10000000	2
H6900	001	0	1	04	01	H6900_001_0	6	3	Non-Preferred Brand	1	10000000	2
H6900	001	0	1	04	01	H6900_001_0	6	4	Specialty	1	10001000	2
H6900	002	0	1	04	01	H6900_002_0	6	4	Specialty			
H6900	002	0	1	04	01	H6900_002_0	6	3	Non-Preferred Brand			
H6900	002	0	1	04	01	H6900_002_0	6	2	Preferred Brand			
H6900	002	0	1	04	01	H6900_002_0	6	1	Preferred Generic			
H6900	002	0	1	04	01	H6900_002_0	6	1	Preferred Generic	1	00001000	2
H6900	002	0	1	04	01	H6900_002_0	6	2	Preferred Brand	1	10000000	2
H6900	002	0	1	04	01	H6900_002_0	6	3	Non-Preferred Brand	1	10000000	2
H6900	002	0	1	04	01	H6900_002_0	6	4	Specialty	1	10001000	2
H6923	001	0	1	01	01	H6923_001_0	6	5	Tier 5 - Specialty			
H6923	001	0	1	01	01	H6923_001_0	6	4	Tier 4 - Non-Preferred Brand			
H6923	001	0	1	01	01	H6923_001_0	6	3	Tier 3 - Preferred Brand			
H6923	001	0	1	01	01	H6923_001_0	6	1	Tier 1 - Preferred Generic			
H6923	001	0	1	01	01	H6923_001_0	6	2	Tier 2 - Non-Preferred Generic			
H6923	002	0	1	01	01	H6923_002_0	5	1	Tier 1 - Preferred Generic			
H6923	002	0	1	01	01	H6923_002_0	5	2	Tier 2 - Non-Preferred Generic			
H6923	002	0	1	01	01	H6923_002_0	5	3	Tier 3 - Preferred Brand			
H6923	002	0	1	01	01	H6923_002_0	5	4	Tier 4 - Non-Preferred Brand			
H6923	002	0	1	01	01	H6923_002_0	5	5	Tier 5 - Specialty			
H6923	003	0	1	01	01	H6923_003_0	5	4	Tier 4 - Non-Preferred Brand			
H6923	003	0	1	01	01	H6923_003_0	5	1	Tier 1 - Preferred Generic			
H6923	003	0	1	01	01	H6923_003_0	5	2	Tier 2 - Non-Preferred Generic			
H6923	003	0	1	01	01	H6923_003_0	5	3	Tier 3 - Preferred Brand			
H6923	003	0	1	01	01	H6923_003_0	5	5	Tier 5 - Specialty			
H6934	001	0	1	01	01	H6934_001_0	6	3	Non Preferred Brand			
H6934	001	0	1	01	01	H6934_001_0	6	4	Specialty			
H6934	001	0	1	01	01	H6934_001_0	6	1	Generic			
H6934	001	0	1	01	01	H6934_001_0	6	2	preferred Brand			
H6934	002	0	1	01	01	H6934_002_0	9	4	Specialty			
H6934	002	0	1	01	01	H6934_002_0	9	3	Non-Preferred Brand			
H6934	002	0	1	01	01	H6934_002_0	9	1	Generic			
H6934	002	0	1	01	01	H6934_002_0	9	2	Preferred Brand			
H7002	001	0	1	04	01	H7002_001_0	5	1	Preferred Generic			
H7002	001	0	1	04	01	H7002_001_0	5	3	Non-Preferred Brand	1	10000000	2
H7002	001	0	1	04	01	H7002_001_0	5	2	Preferred Brand	1	10000000	2
H7002	001	0	1	04	01	H7002_001_0	5	1	Preferred Generic	1		1
H7002	001	0	1	04	01	H7002_001_0	5	4	Specialty			
H7002	001	0	1	04	01	H7002_001_0	5	3	Non-Preferred Brand			
H7002	001	0	1	04	01	H7002_001_0	5	4	Specialty	1	10001000	2
H7002	001	0	1	04	01	H7002_001_0	5	2	Preferred Brand			
H7015	001	0	1	01	01	H7015_001_0	10	4	Tier 4			
H7015	001	0	1	01	01	H7015_001_0	10	3	Tier 3			
H7015	001	0	1	01	01	H7015_001_0	10	2	Tier 2			
H7015	001	0	1	01	01	H7015_001_0	10	1	Tier 1			
H7086	001	0	1	01	01	H7086_001_0	3	2	Brand			
H7086	001	0	1	01	01	H7086_001_0	3	1	Generic			
H7146	001	0	1	01	01	H7146_001_0	3	3	Tier 3 - Brand			
H7146	001	0	1	01	01	H7146_001_0	3	2	Tier 2 - Preferred Brand			
H7146	001	0	1	01	01	H7146_001_0	3	1	Tier 1 - Generics			
H7146	001	0	1	01	01	H7146_001_0	3	4	Tier 4 - Specialty			
H7149	001	0	1	01	01	H7149_001_0	10	1	Preferred Generic	1		1
H7149	001	0	1	01	01	H7149_001_0	10	2	Preferred Brand	2		
H7149	001	0	1	01	01	H7149_001_0	10	3	Non-Preferred Generic/Non-Preferred Brand	2		
H7149	001	0	1	01	01	H7149_001_0	10	4	Specialty - Generic and Brand			
H7149	001	0	1	01	01	H7149_001_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H7149	001	0	1	01	01	H7149_001_0	10	4	Specialty - Generic and Brand	2		
H7149	001	0	1	01	01	H7149_001_0	10	1	Preferred Generic			
H7149	001	0	1	01	01	H7149_001_0	10	2	Preferred Brand			
H7149	002	0	1	01	01	H7149_002_0	10	2	Preferred Brand	2		
H7149	002	0	1	01	01	H7149_002_0	10	3	Non-Preferred Generic/Non-Preferred Brand	2		
H7149	002	0	1	01	01	H7149_002_0	10	4	Specialty - Generic and Brand	2		
H7149	002	0	1	01	01	H7149_002_0	10	1	Preferred Generic			
H7149	002	0	1	01	01	H7149_002_0	10	2	Preferred Brand			
H7149	002	0	1	01	01	H7149_002_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H7149	002	0	1	01	01	H7149_002_0	10	4	Specialty - Generic and Brand			
H7149	002	0	1	01	01	H7149_002_0	10	1	Preferred Generic	1		1
H7179	001	0	1	01	01	H7179_001_0	9	3	Tier 3 - Non-Preferred Brand	2		
H7179	001	0	1	01	01	H7179_001_0	9	2	Tier 2 - Preferred Brand	2		
H7179	001	0	1	01	01	H7179_001_0	9	1	Tier 1 - Generic	1		1
H7179	001	0	1	01	01	H7179_001_0	9	4	Tier 4 - Specialty Drug			
H7179	001	0	1	01	01	H7179_001_0	9	3	Tier 3 - Non-Preferred Brand			
H7179	001	0	1	01	01	H7179_001_0	9	2	Tier 2 - Preferred Brand			
H7179	001	0	1	01	01	H7179_001_0	9	1	Tier 1 - Generic			
H7179	001	0	1	01	01	H7179_001_0	9	4	Tier 4 - Specialty Drug	2		
H7179	002	0	1	01	01	H7179_002_0	7	3	Tier 3 - Non-Preferred Brand	2		
H7179	002	0	1	01	01	H7179_002_0	7	2	Tier 2 - Preferred Brand	2		
H7179	002	0	1	01	01	H7179_002_0	7	1	Tier 1 - Generic	1		1
H7179	002	0	1	01	01	H7179_002_0	7	4	Tier 4 - Specialty Drug			
H7179	002	0	1	01	01	H7179_002_0	7	3	Tier 3 - Non-Preferred Brand			
H7179	002	0	1	01	01	H7179_002_0	7	2	Tier 2 - Preferred Brand			
H7179	002	0	1	01	01	H7179_002_0	7	1	Tier 1 - Generic			
H7179	002	0	1	01	01	H7179_002_0	7	4	Tier 4 - Specialty Drug	2		
H7179	007	0	1	01	01	H7179_007_0	7	1	Tier 1 - Generic			
H7179	007	0	1	01	01	H7179_007_0	7	2	Tier 2 - Preferred Brand			
H7179	007	0	1	01	01	H7179_007_0	7	4	Tier 4 - Specialty Drug	2		
H7179	007	0	1	01	01	H7179_007_0	7	3	Tier 3 - Non-Preferred Brand	2		
H7179	007	0	1	01	01	H7179_007_0	7	2	Tier 2 - Preferred Brand	2		
H7179	007	0	1	01	01	H7179_007_0	7	1	Tier 1 - Generic	1		1
H7179	007	0	1	01	01	H7179_007_0	7	4	Tier 4 - Specialty Drug			
H7179	007	0	1	01	01	H7179_007_0	7	3	Tier 3 - Non-Preferred Brand			
H7179	009	0	1	02	01	H7179_009_0	9	1	Tier 1 - Generic			
H7179	009	0	1	02	01	H7179_009_0	9	3	Tier 3 - Non-Preferred Brand	2		
H7179	009	0	1	02	01	H7179_009_0	9	2	Tier 2 - Preferred Brand	2		
H7179	009	0	1	02	01	H7179_009_0	9	1	Tier 1 - Generic	1		1
H7179	009	0	1	02	01	H7179_009_0	9	4	Tier 4 - Specialty Drug			
H7179	009	0	1	02	01	H7179_009_0	9	3	Tier 3 - Non-Preferred Brand			
H7179	009	0	1	02	01	H7179_009_0	9	2	Tier 2 - Preferred Brand			
H7179	009	0	1	02	01	H7179_009_0	9	4	Tier 4 - Specialty Drug	2		
H7187	001	0	1	02	01	H7187_001_0	4	1	Preferred Generic			
H7187	001	0	1	02	01	H7187_001_0	4	2	Preferred Brand			
H7187	001	0	1	02	01	H7187_001_0	4	3	Non Preferred			
H7187	001	0	1	02	01	H7187_001_0	4	4	Specialty			
H7187	003	0	1	02	01	H7187_003_0	10	1	Preferred Generic			
H7187	003	0	1	02	01	H7187_003_0	10	3	Non-Preferred			
H7187	003	0	1	02	01	H7187_003_0	10	2	Preferred Brand			
H7187	003	0	1	02	01	H7187_003_0	10	4	Specialty			
H7187	006	0	1	02	01	H7187_006_0	3	4	Specialty			
H7187	006	0	1	02	01	H7187_006_0	3	1	Preferred Generic			
H7187	006	0	1	02	01	H7187_006_0	3	2	Preferred Brand			
H7187	006	0	1	02	01	H7187_006_0	3	3	Non Preferred			
H7187	007	0	1	02	01	H7187_007_0	4	1	Preferred Generic			
H7187	007	0	1	02	01	H7187_007_0	4	2	Preferred Brand			
H7187	007	0	1	02	01	H7187_007_0	4	3	Non Preferred			
H7187	007	0	1	02	01	H7187_007_0	4	4	Specialty			
H7187	008	0	1	02	01	H7187_008_0	3	4	Specialty			
H7187	008	0	1	02	01	H7187_008_0	3	3	Non Preferred			
H7187	008	0	1	02	01	H7187_008_0	3	2	Preferred Brand			
H7187	008	0	1	02	01	H7187_008_0	3	1	Preferred Generic			
H7187	009	0	1	02	01	H7187_009_0	5	3	Non-Preferred			
H7187	009	0	1	02	01	H7187_009_0	5	4	Specialty			
H7187	009	0	1	02	01	H7187_009_0	5	2	Preferred Brand			
H7187	009	0	1	02	01	H7187_009_0	5	1	Preferred Generic			
H7188	001	0	1	04	01	H7188_001_0	3	2	Preferred Brand	1	10000000	2
H7188	001	0	1	04	01	H7188_001_0	3	3	Non-Preferred Brand	1	10000000	2
H7188	001	0	1	04	01	H7188_001_0	3	4	Specialty	1	10001000	2
H7188	001	0	1	04	01	H7188_001_0	3	1	Preferred Generic			
H7188	001	0	1	04	01	H7188_001_0	3	2	Preferred Brand			
H7188	001	0	1	04	01	H7188_001_0	3	3	Non-Preferred Brand			
H7188	001	0	1	04	01	H7188_001_0	3	4	Specialty			
H7188	001	0	1	04	01	H7188_001_0	3	1	Preferred Generic	1	00001000	2
H7188	003	0	1	04	01	H7188_003_0	3	3	Non-Preferred Brand	1	10000000	2
H7188	003	0	1	04	01	H7188_003_0	3	2	Preferred Brand	1	10000000	2
H7188	003	0	1	04	01	H7188_003_0	3	1	Preferred Generic	1	00001000	2
H7188	003	0	1	04	01	H7188_003_0	3	1	Preferred Generic			
H7188	003	0	1	04	01	H7188_003_0	3	2	Preferred Brand			
H7188	003	0	1	04	01	H7188_003_0	3	4	Specialty	1	10001000	2
H7188	003	0	1	04	01	H7188_003_0	3	4	Specialty			
H7188	003	0	1	04	01	H7188_003_0	3	3	Non-Preferred Brand			
H7200	006	0	1	01	01	H7200_006_0	4	1	Generic Drugs			
H7200	006	0	1	01	01	H7200_006_0	4	2	Preferred Brand Name Drugs			
H7200	006	0	1	01	01	H7200_006_0	4	3	Non-Preferred Brand Name Drugs			
H7200	006	0	1	01	01	H7200_006_0	4	4	Specialty Drugs			
H7200	007	0	1	01	01	H7200_007_0	8	1	Generic Drugs			
H7200	007	0	1	01	01	H7200_007_0	8	2	Preferred Brand Name Drugs			
H7200	007	0	1	01	01	H7200_007_0	8	3	Non-Preferred Brand Name Drugs			
H7200	007	0	1	01	01	H7200_007_0	8	4	Specialty Drugs			
H7200	011	0	1	02	01	H7200_011_0	4	1	Generic Drugs			
H7200	011	0	1	02	01	H7200_011_0	4	2	Preferred Brand Name Drugs			
H7200	011	0	1	02	01	H7200_011_0	4	3	Non-Preferred Brand Name Drugs			
H7200	011	0	1	02	01	H7200_011_0	4	4	Specialty Drugs			
H7220	003	0	1	01	01	H7220_003_0	9	3	Non-Preferred Brand			
H7220	003	0	1	01	01	H7220_003_0	9	2	Preferred Brand			
H7220	003	0	1	01	01	H7220_003_0	9	1	Generic			
H7220	003	0	1	01	01	H7220_003_0	9	4	Specialty			
H7220	004	0	1	02	01	H7220_004_0	11	1	Generic	1		1
H7220	004	0	1	02	01	H7220_004_0	11	2	Preferred Brand	2		
H7220	004	0	1	02	01	H7220_004_0	11	3	Non-Preferred Brand	2		
H7220	004	0	1	02	01	H7220_004_0	11	4	Specialty			
H7220	004	0	1	02	01	H7220_004_0	11	3	Non-Preferred Brand			
H7220	004	0	1	02	01	H7220_004_0	11	4	Specialty	2		
H7220	004	0	1	02	01	H7220_004_0	11	1	Generic			
H7220	004	0	1	02	01	H7220_004_0	11	2	Preferred Brand			
H7226	001	0	1	09	04	H7226_001_0	5	1	Tier 1			
H7226	001	0	1	09	04	H7226_001_0	5	2	Tier 2			
H7226	001	0	1	09	04	H7226_001_0	5	3	Tier 3			
H7226	001	0	1	09	04	H7226_001_0	5	1	Tier 1	1		1
H7226	001	0	1	09	04	H7226_001_0	5	2	Tier 2	2		
H7226	001	0	1	09	04	H7226_001_0	5	3	Tier 3	2		
H7226	002	0	1	09	04	H7226_002_0	8	1	Tier 1			
H7226	002	0	1	09	04	H7226_002_0	8	2	Tier 2			
H7226	002	0	1	09	04	H7226_002_0	8	3	Tier 3			
H7226	007	0	1	09	04	H7226_007_0	6	3	Tier 3	2		
H7226	007	0	1	09	04	H7226_007_0	6	1	Tier 1	1		1
H7226	007	0	1	09	04	H7226_007_0	6	2	Tier 2			
H7226	007	0	1	09	04	H7226_007_0	6	1	Tier 1			
H7226	007	0	1	09	04	H7226_007_0	6	3	Tier 3			
H7226	007	0	1	09	04	H7226_007_0	6	2	Tier 2	2		
H7226	008	0	1	09	04	H7226_008_0	7	3	Tier 3			
H7226	008	0	1	09	04	H7226_008_0	7	2	Tier 2			
H7226	008	0	1	09	04	H7226_008_0	7	1	Tier 1			
H7226	011	0	1	09	04	H7226_011_0	4	3	Tier 3	2		
H7226	011	0	1	09	04	H7226_011_0	4	2	Tier 2	2		
H7226	011	0	1	09	04	H7226_011_0	4	3	Tier 3			
H7226	011	0	1	09	04	H7226_011_0	4	1	Tier 1	1		1
H7226	011	0	1	09	04	H7226_011_0	4	2	Tier 2			
H7226	011	0	1	09	04	H7226_011_0	4	1	Tier 1			
H7226	013	0	1	09	04	H7226_013_0	7	3	Tier 3			
H7226	013	0	1	09	04	H7226_013_0	7	1	Tier 1			
H7226	013	0	1	09	04	H7226_013_0	7	2	Tier 2			
H7252	002	0	1	01	01	H7252_002_0	6	1	Generic	1		1
H7252	002	0	1	01	01	H7252_002_0	6	2	Preferred Brand	2		
H7252	002	0	1	01	01	H7252_002_0	6	4	Specialty Drugs	2		
H7252	002	0	1	01	01	H7252_002_0	6	1	Generic			
H7252	002	0	1	01	01	H7252_002_0	6	4	Specialty Drugs			
H7252	002	0	1	01	01	H7252_002_0	6	3	Non Preferred Brand			
H7252	002	0	1	01	01	H7252_002_0	6	2	Preferred Brand			
H7252	002	0	1	01	01	H7252_002_0	6	3	Non Preferred Brand	2		
H7252	003	0	1	01	01	H7252_003_0	6	2	Preferred Brand			
H7252	003	0	1	01	01	H7252_003_0	6	3	Non Preferred Brand			
H7252	003	0	1	01	01	H7252_003_0	6	4	Specialty Drugs			
H7252	003	0	1	01	01	H7252_003_0	6	1	Generic	1		1
H7252	003	0	1	01	01	H7252_003_0	6	2	Preferred Brand	2		
H7252	003	0	1	01	01	H7252_003_0	6	3	Non Preferred Brand	2		
H7252	003	0	1	01	01	H7252_003_0	6	4	Specialty Drugs	2		
H7252	003	0	1	01	01	H7252_003_0	6	1	Generic			
H7292	001	0	1	01	01	H7292_001_0	5	2	Brand			
H7292	001	0	1	01	01	H7292_001_0	5	1	Generic			
H7292	001	0	1	01	01	H7292_001_0	5	3	Specialty			
H7301	001	0	1	04	01	H7301_001_0	4	1	Preferred Generic			
H7301	001	0	1	04	01	H7301_001_0	4	2	Preferred Brand			
H7301	001	0	1	04	01	H7301_001_0	4	3	Non-Preferred Generic/Non-Preferred Brand			
H7301	001	0	1	04	01	H7301_001_0	4	4	Specialty - Generic and Brand			
H7301	001	0	1	04	01	H7301_001_0	4	4	Specialty - Generic and Brand	2		
H7301	001	0	1	04	01	H7301_001_0	4	1	Preferred Generic	1		1
H7301	001	0	1	04	01	H7301_001_0	4	2	Preferred Brand	2		
H7301	001	0	1	04	01	H7301_001_0	4	3	Non-Preferred Generic/Non-Preferred Brand	2		
H7301	002	0	1	04	01	H7301_002_0	3	1	Preferred Generic	1		1
H7301	002	0	1	04	01	H7301_002_0	3	2	Preferred Brand	2		
H7301	002	0	1	04	01	H7301_002_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
H7301	002	0	1	04	01	H7301_002_0	3	4	Specialty - Generic and Brand	2		
H7301	002	0	1	04	01	H7301_002_0	3	1	Preferred Generic			
H7301	002	0	1	04	01	H7301_002_0	3	2	Preferred Brand			
H7301	002	0	1	04	01	H7301_002_0	3	4	Specialty - Generic and Brand			
H7301	002	0	1	04	01	H7301_002_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
H7306	001	0	1	04	01	H7306_001_0	9	1	Preferred Generic	1		1
H7306	001	0	1	04	01	H7306_001_0	9	4	Specialty-Generic and Brand			
H7306	001	0	1	04	01	H7306_001_0	9	3	Non-Preferred Generic/Non-Preferred Brand			
H7306	001	0	1	04	01	H7306_001_0	9	2	Preferred Brand			
H7306	001	0	1	04	01	H7306_001_0	9	1	Preferred Generic			
H7306	001	0	1	04	01	H7306_001_0	9	4	Specialty-Generic and Brand	2		
H7306	001	0	1	04	01	H7306_001_0	9	2	Preferred Brand	2		
H7306	001	0	1	04	01	H7306_001_0	9	3	Non-Preferred Generic/Non-Preferred Brand	2		
H7306	002	0	1	04	01	H7306_002_0	9	3	Non-Preferred Generic/Non-Preferred Brand	2		
H7306	002	0	1	04	01	H7306_002_0	9	2	Preferred Brand	2		
H7306	002	0	1	04	01	H7306_002_0	9	1	Preferred Generic	1		1
H7306	002	0	1	04	01	H7306_002_0	9	4	Specialty-Generic and Brand			
H7306	002	0	1	04	01	H7306_002_0	9	3	Non-Preferred Generic/Non-Preferred Brand			
H7306	002	0	1	04	01	H7306_002_0	9	2	Preferred Brand			
H7306	002	0	1	04	01	H7306_002_0	9	1	Preferred Generic			
H7306	002	0	1	04	01	H7306_002_0	9	4	Specialty-Generic and Brand	2		
H7406	001	0	1	09	04	H7406_001_0	3	1	Generic			
H7406	001	0	1	09	04	H7406_001_0	3	2	Preferred Brand			
H7406	001	0	1	09	04	H7406_001_0	3	3	Non-Preferred Brand			
H7406	001	0	1	09	04	H7406_001_0	3	4	Specialty			
H7406	004	0	1	09	04	H7406_004_0	3	1	Generic			
H7406	004	0	1	09	04	H7406_004_0	3	2	Preferred Brand			
H7406	004	0	1	09	04	H7406_004_0	3	3	Non-Preferred Brand			
H7406	004	0	1	09	04	H7406_004_0	3	4	Specialty			
H7406	007	0	1	09	04	H7406_007_0	3	1	Generic			
H7406	007	0	1	09	04	H7406_007_0	3	2	Preferred Brand			
H7406	007	0	1	09	04	H7406_007_0	3	4	Specialty			
H7406	007	0	1	09	04	H7406_007_0	3	3	Non-Preferred Brand			
H7406	009	0	1	09	04	H7406_009_0	3	1	Generic			
H7406	009	0	1	09	04	H7406_009_0	3	2	Preferred Brand			
H7406	009	0	1	09	04	H7406_009_0	3	3	Non-Preferred Brand			
H7406	009	0	1	09	04	H7406_009_0	3	4	Specialty			
H7406	010	0	1	09	04	H7406_010_0	3	1	Generic			
H7406	010	0	1	09	04	H7406_010_0	3	3	Non-Preferred Brand			
H7406	010	0	1	09	04	H7406_010_0	3	2	Preferred Brand			
H7406	010	0	1	09	04	H7406_010_0	3	4	Specialty			
H7526	001	0	1	01	01	H7526_001_0	11	2	Preferred Brand			
H7526	001	0	1	01	01	H7526_001_0	11	3	Non-Preferred Brand			
H7526	001	0	1	01	01	H7526_001_0	11	4	Specialty			
H7526	001	0	1	01	01	H7526_001_0	11	1	Generic			
H7568	001	0	1	04	01	H7568_001_0	6	1	Generic			
H7568	001	0	1	04	01	H7568_001_0	6	2	Preferred Brand			
H7568	001	0	1	04	01	H7568_001_0	6	3	Non-Preferred Brand			
H7568	001	0	1	04	01	H7568_001_0	6	4	Specialty			
H7678	001	0	1	01	01	H7678_001_0	5	2	Preferred Brand			
H7678	001	0	1	01	01	H7678_001_0	5	4	Specialty Drugs			
H7678	001	0	1	01	01	H7678_001_0	5	3	Non-Preferred Brand			
H7678	001	0	1	01	01	H7678_001_0	5	1	Generic			
H7678	002	0	1	01	01	H7678_002_0	6	1	Generic			
H7678	002	0	1	01	01	H7678_002_0	6	4	Specialty Drugs			
H7678	002	0	1	01	01	H7678_002_0	6	2	Preferred Brand			
H7678	002	0	1	01	01	H7678_002_0	6	3	Non-Preferred Brand			
H7692	001	0	1	04	01	H7692_001_0	9	4	Specialty-Generic and Brand			
H7692	001	0	1	04	01	H7692_001_0	9	3	Non-Preferred Generic/Non-preferred brand			
H7692	001	0	1	04	01	H7692_001_0	9	2	Preferred Brand			
H7692	001	0	1	04	01	H7692_001_0	9	1	Preferred Generic			
H7731	001	0	1	01	01	H7731_001_0	7	1	Tier 1			
H7731	001	0	1	01	01	H7731_001_0	7	2	Tier 2			
H7731	001	0	1	01	01	H7731_001_0	7	3	Tier 3			
H7731	001	0	1	01	01	H7731_001_0	7	4	Tier 4			
H7731	001	0	1	01	01	H7731_001_0	7	1	Tier 1	1		1
H7731	001	0	1	01	01	H7731_001_0	7	2	Tier 2	1		1
H7731	001	0	1	01	01	H7731_001_0	7	3	Tier 3	1		1
H7731	001	0	1	01	01	H7731_001_0	7	4	Tier 4	1		1
H7787	001	0	1	04	01	H7787_001_0	3	5	Specialty	2		
H7787	001	0	1	04	01	H7787_001_0	3	4	Non-Preferred Brand	2		
H7787	001	0	1	04	01	H7787_001_0	3	3	Preferred Brand	2		
H7787	001	0	1	04	01	H7787_001_0	3	2	Generic	1		1
H7787	001	0	1	04	01	H7787_001_0	3	1	Preferred Generic	1		1
H7787	001	0	1	04	01	H7787_001_0	3	5	Specialty			
H7787	001	0	1	04	01	H7787_001_0	3	4	Non-Preferred Brand			
H7787	001	0	1	04	01	H7787_001_0	3	3	Preferred Brand			
H7787	001	0	1	04	01	H7787_001_0	3	1	Preferred Generic			
H7787	001	0	1	04	01	H7787_001_0	3	2	Generic			
H7787	003	0	1	04	01	H7787_003_0	4	4	Non-Preferred Brand	2		
H7787	003	0	1	04	01	H7787_003_0	4	5	Specialty	2		
H7787	003	0	1	04	01	H7787_003_0	4	2	Generic	1		1
H7787	003	0	1	04	01	H7787_003_0	4	1	Preferred Generic	1		1
H7787	003	0	1	04	01	H7787_003_0	4	3	Preferred Brand	2		
H7787	003	0	1	04	01	H7787_003_0	4	4	Non-Preferred Brand			
H7787	003	0	1	04	01	H7787_003_0	4	3	Preferred Brand			
H7787	003	0	1	04	01	H7787_003_0	4	2	Generic			
H7787	003	0	1	04	01	H7787_003_0	4	1	Preferred Generic			
H7787	003	0	1	04	01	H7787_003_0	4	5	Specialty			
H7908	001	0	1	01	01	H7908_001_0	5	1	Tier 1 - Preferred Generic			
H7908	001	0	1	01	01	H7908_001_0	5	3	Tier 3 - Preferred Brand			
H7908	001	0	1	01	01	H7908_001_0	5	2	Tier 2 - Non-Preferred Generic			
H7908	001	0	1	01	01	H7908_001_0	5	4	Tier 4 - Non-Preferred Brand			
H7908	001	0	1	01	01	H7908_001_0	5	5	Tier 5 - Specialty			
H7908	002	0	1	01	01	H7908_002_0	4	2	Tier 2 - Non-Preferred Generic	1		1
H7908	002	0	1	01	01	H7908_002_0	4	1	Tier 1 - Preferred Generic	1		1
H7908	002	0	1	01	01	H7908_002_0	4	5	Tier 5 - Specialty			
H7908	002	0	1	01	01	H7908_002_0	4	4	Tier 4 - Non-Preferred Brand			
H7908	002	0	1	01	01	H7908_002_0	4	5	Tier 5 - Specialty	2		
H7908	002	0	1	01	01	H7908_002_0	4	2	Tier 2 - Non-Preferred Generic			
H7908	002	0	1	01	01	H7908_002_0	4	1	Tier 1 - Preferred Generic			
H7908	002	0	1	01	01	H7908_002_0	4	3	Tier 3 - Preferred Brand	2		
H7908	002	0	1	01	01	H7908_002_0	4	4	Tier 4 - Non-Preferred Brand	2		
H7908	002	0	1	01	01	H7908_002_0	4	3	Tier 3 - Preferred Brand			
H7917	004	0	1	04	01	H7917_004_0	7	4	Tier 4			
H7917	004	0	1	04	01	H7917_004_0	7	2	Tier 2			
H7917	004	0	1	04	01	H7917_004_0	7	3	Tier 3			
H7917	004	0	1	04	01	H7917_004_0	7	1	Tier 1			
H7917	005	0	1	04	01	H7917_005_0	7	4	Tier 4			
H7917	005	0	1	04	01	H7917_005_0	7	1	Tier 1			
H7917	005	0	1	04	01	H7917_005_0	7	3	Tier 3			
H7917	005	0	1	04	01	H7917_005_0	7	2	Tier 2			
H7917	006	0	1	04	01	H7917_006_0	7	4	Tier 4			
H7917	006	0	1	04	01	H7917_006_0	7	2	Tier 2			
H7917	006	0	1	04	01	H7917_006_0	7	1	Tier 1			
H7917	006	0	1	04	01	H7917_006_0	7	3	Tier 3			
H7917	007	0	1	04	01	H7917_007_0	6	2	Tier 2			
H7917	007	0	1	04	01	H7917_007_0	6	3	Tier 3			
H7917	007	0	1	04	01	H7917_007_0	6	4	Tier 4			
H7917	007	0	1	04	01	H7917_007_0	6	1	Tier 1			
H7917	008	0	1	04	01	H7917_008_0	7	2	Tier 2			
H7917	008	0	1	04	01	H7917_008_0	7	4	Tier 4			
H7917	008	0	1	04	01	H7917_008_0	7	1	Tier 1			
H7917	008	0	1	04	01	H7917_008_0	7	3	Tier 3			
H7917	009	0	1	04	01	H7917_009_0	7	4	Tier 4			
H7917	009	0	1	04	01	H7917_009_0	7	3	Tier 3			
H7917	009	0	1	04	01	H7917_009_0	7	2	Tier 2			
H7917	009	0	1	04	01	H7917_009_0	7	1	Tier 1			
H7917	010	0	1	04	01	H7917_010_0	7	2	Tier 2			
H7917	010	0	1	04	01	H7917_010_0	7	3	Tier 3			
H7917	010	0	1	04	01	H7917_010_0	7	4	Tier 4			
H7917	010	0	1	04	01	H7917_010_0	7	1	Tier 1			
H7917	011	0	1	04	01	H7917_011_0	7	3	Tier 3			
H7917	011	0	1	04	01	H7917_011_0	7	1	Tier 1			
H7917	011	0	1	04	01	H7917_011_0	7	2	Tier 2			
H7917	011	0	1	04	01	H7917_011_0	7	4	Tier 4			
H8031	001	0	1	01	01	H8031_001_0	4	1	Tier 1			
H8031	001	0	1	01	01	H8031_001_0	4	4	Tier 4			
H8031	001	0	1	01	01	H8031_001_0	4	3	Tier 3			
H8031	001	0	1	01	01	H8031_001_0	4	2	Tier 2			
H8172	003	0	1	04	01	H8172_003_0	3	4	Specialty			
H8172	003	0	1	04	01	H8172_003_0	3	3	Non-Preferred Brand			
H8172	003	0	1	04	01	H8172_003_0	3	4	Specialty	2		
H8172	003	0	1	04	01	H8172_003_0	3	3	Non-Preferred Brand	2		
H8172	003	0	1	04	01	H8172_003_0	3	2	Preferred Brand	2		
H8172	003	0	1	04	01	H8172_003_0	3	1	Generic	1		1
H8172	003	0	1	04	01	H8172_003_0	3	1	Generic			
H8172	003	0	1	04	01	H8172_003_0	3	2	Preferred Brand			
H8172	004	0	1	04	01	H8172_004_0	3	2	Preferred Brand	2		
H8172	004	0	1	04	01	H8172_004_0	3	3	Non-Preferred Brand	2		
H8172	004	0	1	04	01	H8172_004_0	3	4	Specialty	2		
H8172	004	0	1	04	01	H8172_004_0	3	1	Generic	1		1
H8172	004	0	1	04	01	H8172_004_0	3	4	Specialty			
H8172	004	0	1	04	01	H8172_004_0	3	3	Non-Preferred Brand			
H8172	004	0	1	04	01	H8172_004_0	3	1	Generic			
H8172	004	0	1	04	01	H8172_004_0	3	2	Preferred Brand			
H8189	001	0	1	01	01	H8189_001_0	6	1	Generic			
H8189	001	0	1	01	01	H8189_001_0	6	2	Brand			
H8189	001	0	1	01	01	H8189_001_0	6	3	Non-Preferred Brand			
H8189	001	0	1	01	01	H8189_001_0	6	4	Injectable			
H8239	001	0	1	04	01	H8239_001_0	11	1	Preferred Generic			
H8239	001	0	1	04	01	H8239_001_0	11	4	Specialty- Generic and Brand			
H8239	001	0	1	04	01	H8239_001_0	11	3	Non-Preferred Generic/ Non-preferred brand			
H8239	001	0	1	04	01	H8239_001_0	11	2	Preferred Brand			
H8393	001	0	1	04	01	H8393_001_0	10	1	Preferred Generic			
H8393	001	0	1	04	01	H8393_001_0	10	2	Preferred Brand			
H8393	001	0	1	04	01	H8393_001_0	10	3	Non-Preferred Generic/Non-Preferred Brand			
H8393	001	0	1	04	01	H8393_001_0	10	4	Specialty - Generic and Brand	2		
H8393	001	0	1	04	01	H8393_001_0	10	1	Preferred Generic	1		1
H8393	001	0	1	04	01	H8393_001_0	10	2	Preferred Brand	2		
H8393	001	0	1	04	01	H8393_001_0	10	3	Non-Preferred Generic/Non-Preferred Brand	2		
H8393	001	0	1	04	01	H8393_001_0	10	4	Specialty - Generic and Brand			
H8578	001	0	1	01	01	H8578_001_0	7	1	Generic	1		1
H8578	001	0	1	01	01	H8578_001_0	7	4	Specialty			
H8578	001	0	1	01	01	H8578_001_0	7	3	Non-Preferred Brand			
H8578	001	0	1	01	01	H8578_001_0	7	2	Brand			
H8578	001	0	1	01	01	H8578_001_0	7	1	Generic			
H8578	001	0	1	01	01	H8578_001_0	7	2	Brand	2		
H8578	001	0	1	01	01	H8578_001_0	7	4	Specialty	2		
H8578	001	0	1	01	01	H8578_001_0	7	3	Non-Preferred Brand	2		
H8578	002	0	1	01	01	H8578_002_0	7	1	Generic			
H8578	002	0	1	01	01	H8578_002_0	7	3	Non-Preferred Brand			
H8578	002	0	1	01	01	H8578_002_0	7	2	Brand			
H8578	002	0	1	01	01	H8578_002_0	7	4	Specialty			
H8578	004	0	1	01	01	H8578_004_0	7	1	Generic	1		1
H8578	004	0	1	01	01	H8578_004_0	7	4	Specialty			
H8578	004	0	1	01	01	H8578_004_0	7	3	Non-Preferred Brand			
H8578	004	0	1	01	01	H8578_004_0	7	2	Brand			
H8578	004	0	1	01	01	H8578_004_0	7	1	Generic			
H8578	004	0	1	01	01	H8578_004_0	7	2	Brand	2		
H8578	004	0	1	01	01	H8578_004_0	7	4	Specialty	2		
H8578	004	0	1	01	01	H8578_004_0	7	3	Non-Preferred Brand	2		
H8578	005	0	1	01	01	H8578_005_0	7	3	Non-Preferred Brand			
H8578	005	0	1	01	01	H8578_005_0	7	2	Brand			
H8578	005	0	1	01	01	H8578_005_0	7	1	Generic			
H8578	005	0	1	01	01	H8578_005_0	7	4	Specialty			
H8578	007	0	1	01	01	H8578_007_0	7	3	Non-Preferred Brand			
H8578	007	0	1	01	01	H8578_007_0	7	2	Brand			
H8578	007	0	1	01	01	H8578_007_0	7	1	Generic			
H8578	007	0	1	01	01	H8578_007_0	7	4	Specialty			
H8578	007	0	1	01	01	H8578_007_0	7	4	Specialty	2		
H8578	007	0	1	01	01	H8578_007_0	7	3	Non-Preferred Brand	2		
H8578	007	0	1	01	01	H8578_007_0	7	2	Brand	2		
H8578	007	0	1	01	01	H8578_007_0	7	1	Generic	1		1
H8578	008	0	1	01	01	H8578_008_0	6	3	Non-Preferred Brand			
H8578	008	0	1	01	01	H8578_008_0	6	1	Generic			
H8578	008	0	1	01	01	H8578_008_0	6	2	Brand			
H8578	008	0	1	01	01	H8578_008_0	6	4	Specialty			
H8604	001	0	1	04	01	H8604_001_0	7	1	Generic			
H8604	001	0	1	04	01	H8604_001_0	7	2	Preferred Brand			
H8604	001	0	1	04	01	H8604_001_0	7	3	Non-Preferred Brand			
H8604	001	0	1	04	01	H8604_001_0	7	4	Specialty			
H8604	001	0	1	04	01	H8604_001_0	7	1	Generic	1		1
H8604	001	0	1	04	01	H8604_001_0	7	2	Preferred Brand	2		
H8604	001	0	1	04	01	H8604_001_0	7	3	Non-Preferred Brand	2		
H8604	001	0	1	04	01	H8604_001_0	7	4	Specialty	2		
H8604	003	0	1	04	01	H8604_003_0	7	4	Specialty	2		
H8604	003	0	1	04	01	H8604_003_0	7	3	Non-Preferred Brand	2		
H8604	003	0	1	04	01	H8604_003_0	7	1	Generic			
H8604	003	0	1	04	01	H8604_003_0	7	2	Preferred Brand			
H8604	003	0	1	04	01	H8604_003_0	7	3	Non-Preferred Brand			
H8604	003	0	1	04	01	H8604_003_0	7	4	Specialty			
H8604	003	0	1	04	01	H8604_003_0	7	1	Generic	1		1
H8604	003	0	1	04	01	H8604_003_0	7	2	Preferred Brand	2		
H8644	001	0	1	04	01	H8644_001_0	3	3	Non-Preferred Brand			
H8644	001	0	1	04	01	H8644_001_0	3	1	Preferred Generic			
H8644	001	0	1	04	01	H8644_001_0	3	2	Preferred Brand			
H8644	001	0	1	04	01	H8644_001_0	3	4	Specialty			
H8644	001	0	1	04	01	H8644_001_0	3	1	Preferred Generic	1	00001000	2
H8644	001	0	1	04	01	H8644_001_0	3	2	Preferred Brand	1	10000000	2
H8644	001	0	1	04	01	H8644_001_0	3	3	Non-Preferred Brand	1	10000000	2
H8644	001	0	1	04	01	H8644_001_0	3	4	Specialty	1	10001000	2
H8644	003	0	1	04	01	H8644_003_0	3	3	Non-Preferred Brand			
H8644	003	0	1	04	01	H8644_003_0	3	4	Specialty	1	10001000	2
H8644	003	0	1	04	01	H8644_003_0	3	1	Preferred Generic			
H8644	003	0	1	04	01	H8644_003_0	3	2	Preferred Brand			
H8644	003	0	1	04	01	H8644_003_0	3	3	Non-Preferred Brand	1	10000000	2
H8644	003	0	1	04	01	H8644_003_0	3	4	Specialty			
H8644	003	0	1	04	01	H8644_003_0	3	1	Preferred Generic	1	00001000	2
H8644	003	0	1	04	01	H8644_003_0	3	2	Preferred Brand	1	10000000	2
H8649	001	0	1	02	01	H8649_001_0	4	2	Preferred Brand	2		
H8649	001	0	1	02	01	H8649_001_0	4	1	Preferred Generic	1		1
H8649	001	0	1	02	01	H8649_001_0	4	4	Specialty - Generic and Brand	2		
H8649	001	0	1	02	01	H8649_001_0	4	3	Non-Preferred Generic/Non-Preferred Brand	2		
H8649	001	0	1	02	01	H8649_001_0	4	1	Preferred Generic			
H8649	001	0	1	02	01	H8649_001_0	4	2	Preferred Brand			
H8649	001	0	1	02	01	H8649_001_0	4	3	Non-Preferred Generic/Non-Preferred Brand			
H8649	001	0	1	02	01	H8649_001_0	4	4	Specialty - Generic and Brand			
H8649	002	0	1	02	01	H8649_002_0	4	4	Specialty - Generic and Brand	2		
H8649	002	0	1	02	01	H8649_002_0	4	3	Non-Preferred Generic/Non-Preferred Brand	2		
H8649	002	0	1	02	01	H8649_002_0	4	1	Preferred Generic	1		1
H8649	002	0	1	02	01	H8649_002_0	4	2	Preferred Brand	2		
H8649	002	0	1	02	01	H8649_002_0	4	4	Specialty - Generic and Brand			
H8649	002	0	1	02	01	H8649_002_0	4	3	Non-Preferred Generic/Non-Preferred Brand			
H8649	002	0	1	02	01	H8649_002_0	4	2	Preferred Brand			
H8649	002	0	1	02	01	H8649_002_0	4	1	Preferred Generic			
H8649	003	0	1	02	01	H8649_003_0	4	2	Preferred Brand			
H8649	003	0	1	02	01	H8649_003_0	4	3	Non-Preferred Generic/Non-Preferred Brand			
H8649	003	0	1	02	01	H8649_003_0	4	4	Specialty - Generic and Brand			
H8649	003	0	1	02	01	H8649_003_0	4	1	Preferred Generic			
H8649	004	0	1	02	01	H8649_004_0	5	2	Preferred Brand			
H8649	004	0	1	02	01	H8649_004_0	5	3	Non-Preferred Generic/Non-Preferred Brand			
H8649	004	0	1	02	01	H8649_004_0	5	4	Specialty - Generic and Brand	2		
H8649	004	0	1	02	01	H8649_004_0	5	3	Non-Preferred Generic/Non-Preferred Brand	2		
H8649	004	0	1	02	01	H8649_004_0	5	2	Preferred Brand	2		
H8649	004	0	1	02	01	H8649_004_0	5	1	Preferred Generic	1		1
H8649	004	0	1	02	01	H8649_004_0	5	4	Specialty - Generic and Brand			
H8649	004	0	1	02	01	H8649_004_0	5	1	Preferred Generic			
H8649	005	0	1	02	01	H8649_005_0	4	1	Preferred Generic			
H8649	005	0	1	02	01	H8649_005_0	4	2	Preferred Brand			
H8649	005	0	1	02	01	H8649_005_0	4	3	Non-Preferred Generic/Non-Preferred Brand			
H8649	005	0	1	02	01	H8649_005_0	4	4	Specialty - Generic and Brand			
H8649	005	0	1	02	01	H8649_005_0	4	2	Preferred Brand	2		
H8649	005	0	1	02	01	H8649_005_0	4	1	Preferred Generic	1		1
H8649	005	0	1	02	01	H8649_005_0	4	4	Specialty - Generic and Brand	2		
H8649	005	0	1	02	01	H8649_005_0	4	3	Non-Preferred Generic/Non-Preferred Brand	2		
H8649	006	0	1	02	01	H8649_006_0	4	1	Preferred Generic			
H8649	006	0	1	02	01	H8649_006_0	4	4	Specialty - Generic and Brand			
H8649	006	0	1	02	01	H8649_006_0	4	2	Preferred Brand			
H8649	006	0	1	02	01	H8649_006_0	4	3	Non-Preferred Generic/Non-Preferred Brand			
H8707	001	0	1	04	01	H8707_001_0	4	1	Preferred Generic			
H8707	001	0	1	04	01	H8707_001_0	4	2	Preferred Brand			
H8707	001	0	1	04	01	H8707_001_0	4	4	Specialty	1	10001000	2
H8707	001	0	1	04	01	H8707_001_0	4	3	Non-Preferred Brand	1	10000000	2
H8707	001	0	1	04	01	H8707_001_0	4	2	Preferred Brand	1	10000000	2
H8707	001	0	1	04	01	H8707_001_0	4	1	Preferred Generic	1	00001000	2
H8707	001	0	1	04	01	H8707_001_0	4	4	Specialty			
H8707	001	0	1	04	01	H8707_001_0	4	3	Non-Preferred Brand			
H8707	003	0	1	04	01	H8707_003_0	4	1	Preferred Generic			
H8707	003	0	1	04	01	H8707_003_0	4	3	Non-Preferred Brand	1	10000000	2
H8707	003	0	1	04	01	H8707_003_0	4	2	Preferred Brand	1	10000000	2
H8707	003	0	1	04	01	H8707_003_0	4	1	Preferred Generic	1		1
H8707	003	0	1	04	01	H8707_003_0	4	4	Specialty			
H8707	003	0	1	04	01	H8707_003_0	4	3	Non-Preferred Brand			
H8707	003	0	1	04	01	H8707_003_0	4	2	Preferred Brand			
H8707	003	0	1	04	01	H8707_003_0	4	4	Specialty	1	10001000	2
H8707	005	0	1	04	01	H8707_005_0	4	1	Preferred Generic	1	00001000	2
H8707	005	0	1	04	01	H8707_005_0	4	2	Preferred Brand	1	10000000	2
H8707	005	0	1	04	01	H8707_005_0	4	3	Non-Preferred Brand	1	10000000	2
H8707	005	0	1	04	01	H8707_005_0	4	4	Specialty	1	10001000	2
H8707	005	0	1	04	01	H8707_005_0	4	1	Preferred Generic			
H8707	005	0	1	04	01	H8707_005_0	4	2	Preferred Brand			
H8707	005	0	1	04	01	H8707_005_0	4	3	Non-Preferred Brand			
H8707	005	0	1	04	01	H8707_005_0	4	4	Specialty			
H8742	001	0	1	01	01	H8742_001_0	6	3	Non-Preferred Brand			
H8742	001	0	1	01	01	H8742_001_0	6	2	Preferred  Brand			
H8742	001	0	1	01	01	H8742_001_0	6	1	Generic			
H8742	001	0	1	01	01	H8742_001_0	6	4	Speciality			
H8742	008	0	1	01	01	H8742_008_0	7	1	Generic			
H8742	008	0	1	01	01	H8742_008_0	7	2	Preferred Brand			
H8742	008	0	1	01	01	H8742_008_0	7	3	Non-Preferred Brand			
H8742	008	0	1	01	01	H8742_008_0	7	4	Specialty			
H8742	008	0	1	01	01	H8742_008_0	7	1	Generic	1		1
H8742	008	0	1	01	01	H8742_008_0	7	2	Preferred Brand	2		
H8742	008	0	1	01	01	H8742_008_0	7	3	Non-Preferred Brand	2		
H8742	008	0	1	01	01	H8742_008_0	7	4	Specialty	2		
H8742	010	0	1	01	01	H8742_010_0	7	4	Speciality	2		
H8742	010	0	1	01	01	H8742_010_0	7	1	Generic			
H8742	010	0	1	01	01	H8742_010_0	7	2	Preferred  Brand			
H8742	010	0	1	01	01	H8742_010_0	7	3	Non-Preferred Brand			
H8742	010	0	1	01	01	H8742_010_0	7	4	Speciality			
H8742	010	0	1	01	01	H8742_010_0	7	1	Generic	1		1
H8742	010	0	1	01	01	H8742_010_0	7	2	Preferred  Brand	2		
H8742	010	0	1	01	01	H8742_010_0	7	3	Non-Preferred Brand	2		
H8748	001	0	1	02	01	H8748_001_0	6	4	Specialty			
H8748	001	0	1	02	01	H8748_001_0	6	3	Non Preferred			
H8748	001	0	1	02	01	H8748_001_0	6	1	Preferred Generic			
H8748	001	0	1	02	01	H8748_001_0	6	2	Preferred Brand			
H8748	002	0	1	02	01	H8748_002_0	4	1	Preferred Generic	1		1
H8748	002	0	1	02	01	H8748_002_0	4	2	Preferred Brand	2		
H8748	002	0	1	02	01	H8748_002_0	4	3	Non Preferred	2		
H8748	002	0	1	02	01	H8748_002_0	4	1	Preferred Generic			
H8748	002	0	1	02	01	H8748_002_0	4	2	Preferred Brand			
H8748	002	0	1	02	01	H8748_002_0	4	4	Specialty			
H8748	002	0	1	02	01	H8748_002_0	4	3	Non Preferred			
H8748	002	0	1	02	01	H8748_002_0	4	4	Specialty	2		
H8748	003	0	1	02	01	H8748_003_0	5	1	Preferred Generic			
H8748	003	0	1	02	01	H8748_003_0	5	3	Non Preferred			
H8748	003	0	1	02	01	H8748_003_0	5	4	Specialty			
H8748	003	0	1	02	01	H8748_003_0	5	2	Preferred Brand			
H8748	004	0	1	02	01	H8748_004_0	5	1	Preferred Generic			
H8748	004	0	1	02	01	H8748_004_0	5	4	Specialty			
H8748	004	0	1	02	01	H8748_004_0	5	3	Non-Preferred			
H8748	004	0	1	02	01	H8748_004_0	5	2	Preferred Brand			
H8778	001	0	1	01	01	H8778_001_0	9	1	Tier 1 Generic			
H8778	001	0	1	01	01	H8778_001_0	9	2	Tier 2 Preferred Brand			
H8778	001	0	1	01	01	H8778_001_0	9	3	Tier 3 Non-Preferred Brand			
H8778	001	0	1	01	01	H8778_001_0	9	4	Tier 4 Specialty			
H8805	001	0	1	04	01	H8805_001_0	9	1	Generic			
H8805	001	0	1	04	01	H8805_001_0	9	2	Preferred			
H8805	001	0	1	04	01	H8805_001_0	9	3	Brand			
H8805	001	0	1	04	01	H8805_001_0	9	4	Specialty			
H8805	001	0	1	04	01	H8805_001_0	9	1	Generic	1		1
H8805	001	0	1	04	01	H8805_001_0	9	2	Preferred	2		
H8805	001	0	1	04	01	H8805_001_0	9	3	Brand	2		
H8805	001	0	1	04	01	H8805_001_0	9	4	Specialty	2		
H8822	001	0	1	01	01	H8822_001_0	8	5	Specialty			
H8822	001	0	1	01	01	H8822_001_0	8	4	Non-Preferred Brand			
H8822	001	0	1	01	01	H8822_001_0	8	3	Preferred Brand			
H8822	001	0	1	01	01	H8822_001_0	8	2	Generic			
H8822	001	0	1	01	01	H8822_001_0	8	1	Preferred Generic			
H8822	002	0	1	01	01	H8822_002_0	5	4	Non-Preferred Brand			
H8822	002	0	1	01	01	H8822_002_0	5	5	Specialty	2		
H8822	002	0	1	01	01	H8822_002_0	5	4	Non-Preferred Brand	2		
H8822	002	0	1	01	01	H8822_002_0	5	3	Preferred Brand	2		
H8822	002	0	1	01	01	H8822_002_0	5	2	Generic	1		1
H8822	002	0	1	01	01	H8822_002_0	5	1	Preferred Generic	1		1
H8822	002	0	1	01	01	H8822_002_0	5	5	Specialty			
H8822	002	0	1	01	01	H8822_002_0	5	3	Preferred Brand			
H8822	002	0	1	01	01	H8822_002_0	5	2	Generic			
H8822	002	0	1	01	01	H8822_002_0	5	1	Preferred Generic			
H8822	003	0	1	01	01	H8822_003_0	6	4	Non-Preferred Brand			
H8822	003	0	1	01	01	H8822_003_0	6	3	Preferred Brand			
H8822	003	0	1	01	01	H8822_003_0	6	2	Generic			
H8822	003	0	1	01	01	H8822_003_0	6	5	Specialty			
H8822	003	0	1	01	01	H8822_003_0	6	1	Preferred Generic			
H8822	004	0	1	01	01	H8822_004_0	6	4	Non-Preferred Brand	2		
H8822	004	0	1	01	01	H8822_004_0	6	3	Preferred Brand	2		
H8822	004	0	1	01	01	H8822_004_0	6	1	Preferred Generic	1		1
H8822	004	0	1	01	01	H8822_004_0	6	2	Generic	1		1
H8822	004	0	1	01	01	H8822_004_0	6	1	Preferred Generic			
H8822	004	0	1	01	01	H8822_004_0	6	2	Generic			
H8822	004	0	1	01	01	H8822_004_0	6	3	Preferred Brand			
H8822	004	0	1	01	01	H8822_004_0	6	5	Specialty			
H8822	004	0	1	01	01	H8822_004_0	6	4	Non-Preferred Brand			
H8822	004	0	1	01	01	H8822_004_0	6	5	Specialty	2		
H8836	001	0	1	08	03	H8836_001_0	7	3	Non-Preferred Brand			
H8836	001	0	1	08	03	H8836_001_0	7	2	Preferred Brand			
H8836	001	0	1	08	03	H8836_001_0	7	1	Generic			
H8836	001	0	1	08	03	H8836_001_0	7	4	Specialty			
H8980	001	0	1	04	01	H8980_001_0	7	1	Tier 1 - Preferred Generic			
H8980	001	0	1	04	01	H8980_001_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H8980	001	0	1	04	01	H8980_001_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H8980	001	0	1	04	01	H8980_001_0	7	4	Tier 4 - Specialty Drugs			
H8980	001	0	1	04	01	H8980_001_0	7	1	Tier 1 - Preferred Generic	1		1
H8980	001	0	1	04	01	H8980_001_0	7	2	Tier 2 - Preferred Brand	2		
H8980	001	0	1	04	01	H8980_001_0	7	2	Tier 2 - Preferred Brand			
H8980	001	0	1	04	01	H8980_001_0	7	4	Tier 4 - Specialty Drugs	2		
H8980	002	0	1	04	01	H8980_002_0	6	4	Tier 4 - Specialty Drugs			
H8980	002	0	1	04	01	H8980_002_0	6	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand			
H8980	002	0	1	04	01	H8980_002_0	6	2	Tier 2 - Preferred Brand			
H8980	002	0	1	04	01	H8980_002_0	6	1	Tier 1 - Preferred Generic			
H8991	011	0	1	01	01	H8991_011_0	5	2	Preferred Brand Name Drugs			
H8991	011	0	1	01	01	H8991_011_0	5	1	Generic Drugs			
H8991	011	0	1	01	01	H8991_011_0	5	3	Non-Preferred Brand Name Drugs			
H8991	011	0	1	01	01	H8991_011_0	5	4	Specialty Drugs			
H8991	012	0	1	01	01	H8991_012_0	4	4	Specialty Drugs	2		
H8991	012	0	1	01	01	H8991_012_0	4	3	Non-Preferred Brand Name Drugs	2		
H8991	012	0	1	01	01	H8991_012_0	4	2	Preferred Brand Name Drugs	2		
H8991	012	0	1	01	01	H8991_012_0	4	1	Generic Drugs	1		1
H8991	012	0	1	01	01	H8991_012_0	4	2	Preferred Brand Name Drugs			
H8991	012	0	1	01	01	H8991_012_0	4	3	Non-Preferred Brand Name Drugs			
H8991	012	0	1	01	01	H8991_012_0	4	4	Specialty Drugs			
H8991	012	0	1	01	01	H8991_012_0	4	1	Generic Drugs			
H8991	017	0	1	01	01	H8991_017_0	7	4	Specialty Drugs			
H8991	017	0	1	01	01	H8991_017_0	7	3	Non-Preferred Brand Name Drugs			
H8991	017	0	1	01	01	H8991_017_0	7	1	Generic Drugs			
H8991	017	0	1	01	01	H8991_017_0	7	2	Preferred Brand Name Drugs			
H8991	018	0	1	01	01	H8991_018_0	5	3	Non-Preferred Brand Name Drugs			
H8991	018	0	1	01	01	H8991_018_0	5	1	Generic Drugs			
H8991	018	0	1	01	01	H8991_018_0	5	2	Preferred Brand Name Drugs			
H8991	018	0	1	01	01	H8991_018_0	5	4	Specialty Drugs			
H8991	019	0	1	01	01	H8991_019_0	4	2	Preferred Brand Name Drugs	2		
H8991	019	0	1	01	01	H8991_019_0	4	1	Generic Drugs	1		1
H8991	019	0	1	01	01	H8991_019_0	4	4	Specialty Drugs			
H8991	019	0	1	01	01	H8991_019_0	4	3	Non-Preferred Brand Name Drugs			
H8991	019	0	1	01	01	H8991_019_0	4	2	Preferred Brand Name Drugs			
H8991	019	0	1	01	01	H8991_019_0	4	1	Generic Drugs			
H8991	019	0	1	01	01	H8991_019_0	4	3	Non-Preferred Brand Name Drugs	2		
H8991	019	0	1	01	01	H8991_019_0	4	4	Specialty Drugs	2		
H8991	022	0	1	01	01	H8991_022_0	4	1	Generic Drugs			
H8991	022	0	1	01	01	H8991_022_0	4	3	Non-Preferred Brand Name Drugs			
H8991	022	0	1	01	01	H8991_022_0	4	4	Specialty Drugs			
H8991	022	0	1	01	01	H8991_022_0	4	2	Preferred Brand Name Drugs			
H8991	027	0	1	01	01	H8991_027_0	5	2	Preferred Brand Name Drugs			
H8991	027	0	1	01	01	H8991_027_0	5	1	Generic Drugs			
H8991	027	0	1	01	01	H8991_027_0	5	3	Non-Preferred Brand Name Drugs			
H8991	027	0	1	01	01	H8991_027_0	5	4	Specialty Drugs			
H9001	006	0	1	01	01	H9001_006_0	7	1	Tier 1			
H9001	006	0	1	01	01	H9001_006_0	7	3	Tier 3			
H9001	006	0	1	01	01	H9001_006_0	7	2	Tier 2			
H9001	011	0	1	01	01	H9001_011_0	7	2	Tier 2			
H9001	011	0	1	01	01	H9001_011_0	7	1	Tier 1			
H9001	011	0	1	01	01	H9001_011_0	7	3	Tier 3			
H9001	012	0	1	01	01	H9001_012_0	5	3	Tier 3			
H9001	012	0	1	01	01	H9001_012_0	5	2	Tier 2			
H9001	012	0	1	01	01	H9001_012_0	5	1	Tier 1			
H9001	013	0	1	01	01	H9001_013_0	6	2	Tier 2			
H9001	013	0	1	01	01	H9001_013_0	6	1	Tier 1			
H9001	013	0	1	01	01	H9001_013_0	6	3	Tier 3			
H9001	014	0	1	01	01	H9001_014_0	7	2	Tier 2			
H9001	014	0	1	01	01	H9001_014_0	7	1	Tier 1			
H9001	014	0	1	01	01	H9001_014_0	7	3	Tier 3			
H9001	015	0	1	01	01	H9001_015_0	6	3	Tier 3			
H9001	015	0	1	01	01	H9001_015_0	6	2	Tier 2			
H9001	015	0	1	01	01	H9001_015_0	6	1	Tier 1			
H9001	017	0	1	01	01	H9001_017_0	6	2	Tier 2			
H9001	017	0	1	01	01	H9001_017_0	6	3	Tier 3			
H9001	017	0	1	01	01	H9001_017_0	6	1	Tier 1			
H9001	018	0	1	01	01	H9001_018_0	7	1	Tier 1			
H9001	018	0	1	01	01	H9001_018_0	7	2	Tier 2			
H9001	018	0	1	01	01	H9001_018_0	7	3	Tier 3			
H9003	001	0	1	01	01	H9003_001_0	7	3	Specialty	2		
H9003	001	0	1	01	01	H9003_001_0	7	2	Brand	2		
H9003	001	0	1	01	01	H9003_001_0	7	1	Generic	1		1
H9003	001	0	1	01	01	H9003_001_0	7	3	Specialty			
H9003	001	0	1	01	01	H9003_001_0	7	1	Generic			
H9003	001	0	1	01	01	H9003_001_0	7	2	Brand			
H9003	006	0	1	01	01	H9003_006_0	3	3	Specialty	2		
H9003	006	0	1	01	01	H9003_006_0	3	2	Brand	2		
H9003	006	0	1	01	01	H9003_006_0	3	1	Generic			
H9003	006	0	1	01	01	H9003_006_0	3	2	Brand			
H9003	006	0	1	01	01	H9003_006_0	3	3	Specialty			
H9003	006	0	1	01	01	H9003_006_0	3	1	Generic	1		1
H9011	003	0	1	01	01	H9011_003_0	5	3	Non Preferred	2		
H9011	003	0	1	01	01	H9011_003_0	5	2	Preferred Brand	2		
H9011	003	0	1	01	01	H9011_003_0	5	1	Preferred Generic	1		1
H9011	003	0	1	01	01	H9011_003_0	5	4	Specialty			
H9011	003	0	1	01	01	H9011_003_0	5	3	Non Preferred			
H9011	003	0	1	01	01	H9011_003_0	5	2	Preferred Brand			
H9011	003	0	1	01	01	H9011_003_0	5	4	Specialty	2		
H9011	003	0	1	01	01	H9011_003_0	5	1	Preferred Generic			
H9011	016	0	1	02	01	H9011_016_0	4	1	Preferred Generic			
H9011	016	0	1	02	01	H9011_016_0	4	2	Preferred Brand			
H9011	016	0	1	02	01	H9011_016_0	4	3	Non Preferred			
H9011	016	0	1	02	01	H9011_016_0	4	4	Specialty			
H9047	001	0	1	01	01	H9047_001_0	6	1	Generic			
H9047	001	0	1	01	01	H9047_001_0	6	2	Brand			
H9047	001	0	1	01	01	H9047_001_0	6	3	Speciality			
H9047	013	0	2	01	01	H9047_013_0	6	3	Speciality			
H9047	013	0	2	01	01	H9047_013_0	6	1	Generic			
H9047	013	0	2	01	01	H9047_013_0	6	2	Brand			
H9047	024	0	1	02	01	H9047_024_0	7	2	Brand			
H9047	024	0	1	02	01	H9047_024_0	7	3	Speciality			
H9047	024	0	1	02	01	H9047_024_0	7	1	Generic			
H9082	001	0	1	01	01	H9082_001_0	5	2	Preferred Brand			
H9082	001	0	1	01	01	H9082_001_0	5	3	Non-Preferred Brand			
H9082	001	0	1	01	01	H9082_001_0	5	4	Specialty Drugs			
H9082	001	0	1	01	01	H9082_001_0	5	1	Generic			
H9082	002	0	1	01	01	H9082_002_0	5	3	Non-Preferred Brand			
H9082	002	0	1	01	01	H9082_002_0	5	1	Generic			
H9082	002	0	1	01	01	H9082_002_0	5	4	Specialty Drugs			
H9082	002	0	1	01	01	H9082_002_0	5	2	Preferred Brand			
H9101	007	0	1	01	01	H9101_007_0	7	1	Generic			
H9101	007	0	1	01	01	H9101_007_0	7	2	Preferred			
H9101	007	0	1	01	01	H9101_007_0	7	3	Brand			
H9101	007	0	1	01	01	H9101_007_0	7	4	Specialty	2		
H9101	007	0	1	01	01	H9101_007_0	7	1	Generic	1		1
H9101	007	0	1	01	01	H9101_007_0	7	2	Preferred	1		1
H9101	007	0	1	01	01	H9101_007_0	7	3	Brand	2		
H9101	007	0	1	01	01	H9101_007_0	7	4	Specialty			
H9103	001	0	1	01	01	H9103_001_0	4	1	Generic			
H9103	001	0	1	01	01	H9103_001_0	4	2	Brand			
H9103	001	0	1	01	01	H9103_001_0	4	3	Specialty			
H9103	001	0	1	01	01	H9103_001_0	4	1	Generic	1		1
H9103	001	0	1	01	01	H9103_001_0	4	2	Brand	2		
H9103	001	0	1	01	01	H9103_001_0	4	3	Specialty	2		
H9104	006	0	1	01	01	H9104_006_0	11	5	Specialty			
H9104	006	0	1	01	01	H9104_006_0	11	4	Additional Brand			
H9104	006	0	1	01	01	H9104_006_0	11	3	Brand			
H9104	006	0	1	01	01	H9104_006_0	11	2	Preferred Generic			
H9104	006	0	1	01	01	H9104_006_0	11	1	Select Generic	1		1
H9104	006	0	1	01	01	H9104_006_0	11	5	Specialty	2		
H9104	006	0	1	01	01	H9104_006_0	11	4	Additional Brand	2		
H9104	006	0	1	01	01	H9104_006_0	11	3	Brand	2		
H9104	006	0	1	01	01	H9104_006_0	11	2	Preferred Generic	1		1
H9104	006	0	1	01	01	H9104_006_0	11	1	Select Generic			
H9104	007	0	1	01	01	H9104_007_0	10	1	Select Generic			
H9104	007	0	1	01	01	H9104_007_0	10	5	Specialty	2		
H9104	007	0	1	01	01	H9104_007_0	10	4	Additional Brand	2		
H9104	007	0	1	01	01	H9104_007_0	10	3	Brand	2		
H9104	007	0	1	01	01	H9104_007_0	10	2	Preferred Generic	1		1
H9104	007	0	1	01	01	H9104_007_0	10	1	Select Generic	1		1
H9104	007	0	1	01	01	H9104_007_0	10	5	Specialty			
H9104	007	0	1	01	01	H9104_007_0	10	4	Additional Brand			
H9104	007	0	1	01	01	H9104_007_0	10	3	Brand			
H9104	007	0	1	01	01	H9104_007_0	10	2	Preferred Generic			
H9104	008	0	1	01	01	H9104_008_0	10	1	Select Generic			
H9104	008	0	1	01	01	H9104_008_0	10	5	Specialty			
H9104	008	0	1	01	01	H9104_008_0	10	4	Additional Brand			
H9104	008	0	1	01	01	H9104_008_0	10	3	Brand			
H9104	008	0	1	01	01	H9104_008_0	10	2	Preferred Generic	1		1
H9104	008	0	1	01	01	H9104_008_0	10	1	Select Generic	1		1
H9104	008	0	1	01	01	H9104_008_0	10	5	Specialty	2		
H9104	008	0	1	01	01	H9104_008_0	10	4	Additional Brand	2		
H9104	008	0	1	01	01	H9104_008_0	10	3	Brand	2		
H9104	008	0	1	01	01	H9104_008_0	10	2	Preferred Generic			
H9104	009	0	1	01	01	H9104_009_0	10	5	Specialty			
H9104	009	0	1	01	01	H9104_009_0	10	4	Additional Brand			
H9104	009	0	1	01	01	H9104_009_0	10	3	Brand			
H9104	009	0	1	01	01	H9104_009_0	10	2	Preferred Generic			
H9104	009	0	1	01	01	H9104_009_0	10	1	Select Generic			
H9104	009	0	1	01	01	H9104_009_0	10	2	Preferred Generic	1		1
H9104	009	0	1	01	01	H9104_009_0	10	3	Brand	2		
H9104	009	0	1	01	01	H9104_009_0	10	1	Select Generic	1		1
H9104	009	0	1	01	01	H9104_009_0	10	5	Specialty	2		
H9104	009	0	1	01	01	H9104_009_0	10	4	Additional Brand	2		
H9104	013	0	1	01	01	H9104_013_0	10	5	Specialty			
H9104	013	0	1	01	01	H9104_013_0	10	4	Additional Brand			
H9104	013	0	1	01	01	H9104_013_0	10	3	Preferred Brand			
H9104	013	0	1	01	01	H9104_013_0	10	2	Preferred Generic			
H9104	013	0	1	01	01	H9104_013_0	10	1	Select Generic			
H9104	014	0	1	01	01	H9104_014_0	10	1	Select Generic			
H9104	014	0	1	01	01	H9104_014_0	10	5	Specialty			
H9104	014	0	1	01	01	H9104_014_0	10	4	Additional Brand			
H9104	014	0	1	01	01	H9104_014_0	10	3	Preferred Brand			
H9104	014	0	1	01	01	H9104_014_0	10	2	Preferred Generic			
H9104	015	0	1	01	01	H9104_015_0	10	4	Additional Brand			
H9104	015	0	1	01	01	H9104_015_0	10	5	Specialty			
H9104	015	0	1	01	01	H9104_015_0	10	3	Preferred Brand			
H9104	015	0	1	01	01	H9104_015_0	10	2	Preferred Generic			
H9104	015	0	1	01	01	H9104_015_0	10	1	Select Generic			
H9149	002	0	1	02	01	H9149_002_0	4	4	Specialty			
H9149	002	0	1	02	01	H9149_002_0	4	1	Preferred Generic			
H9149	002	0	1	02	01	H9149_002_0	4	2	Preferred Brand			
H9149	002	0	1	02	01	H9149_002_0	4	3	Non-Preferred			
H9302	001	0	1	01	01	H9302_001_0	5	3	Tier III			
H9302	001	0	1	01	01	H9302_001_0	5	2	Tier II			
H9302	001	0	1	01	01	H9302_001_0	5	1	Tier I			
H9302	001	0	1	01	01	H9302_001_0	5	4	Tier IV			
H9302	001	0	1	01	01	H9302_001_0	5	1	Tier I	1		1
H9302	001	0	1	01	01	H9302_001_0	5	2	Tier II	2		
H9302	001	0	1	01	01	H9302_001_0	5	3	Tier III	2		
H9302	001	0	1	01	01	H9302_001_0	5	4	Tier IV	2		
H9302	003	0	1	01	01	H9302_003_0	5	3	Tier III			
H9302	003	0	1	01	01	H9302_003_0	5	2	Tier II			
H9302	003	0	1	01	01	H9302_003_0	5	1	Tier I			
H9302	003	0	1	01	01	H9302_003_0	5	4	Tier IV			
H9302	005	0	1	01	01	H9302_005_0	5	1	Tier I			
H9302	005	0	1	01	01	H9302_005_0	5	2	Tier II			
H9302	005	0	1	01	01	H9302_005_0	5	3	Tier III			
H9302	005	0	1	01	01	H9302_005_0	5	4	Tier IV			
H9302	005	0	1	01	01	H9302_005_0	5	1	Tier I	1		1
H9302	005	0	1	01	01	H9302_005_0	5	2	Tier II	2		
H9302	005	0	1	01	01	H9302_005_0	5	4	Tier IV	2		
H9302	005	0	1	01	01	H9302_005_0	5	3	Tier III	2		
H9302	007	0	1	01	01	H9302_007_0	5	1	Tier I			
H9302	007	0	1	01	01	H9302_007_0	5	3	Tier III			
H9302	007	0	1	01	01	H9302_007_0	5	2	Tier II			
H9302	007	0	1	01	01	H9302_007_0	5	4	Tier IV			
H9302	008	0	1	02	01	H9302_008_0	7	1	Tier I			
H9302	008	0	1	02	01	H9302_008_0	7	2	Tier II			
H9302	008	0	1	02	01	H9302_008_0	7	3	Tier III			
H9302	008	0	1	02	01	H9302_008_0	7	4	Tier IV			
H9302	008	0	1	02	01	H9302_008_0	7	1	Tier I	1		1
H9302	008	0	1	02	01	H9302_008_0	7	2	Tier II	2		
H9302	008	0	1	02	01	H9302_008_0	7	3	Tier III	2		
H9302	008	0	1	02	01	H9302_008_0	7	4	Tier IV	2		
H9313	007	0	1	02	01	H9313_007_0	4	1	Generic			
H9313	007	0	1	02	01	H9313_007_0	4	2	Preferred Brand			
H9313	007	0	1	02	01	H9313_007_0	4	3	Non-Preferred Brand			
H9313	007	0	1	02	01	H9313_007_0	4	4	Specialty			
H9313	010	1	1	01	01	H9313_010_1	4	4	Specialty			
H9313	010	1	1	01	01	H9313_010_1	4	3	Non-Preferred Brand			
H9313	010	1	1	01	01	H9313_010_1	4	2	Preferred Brand			
H9313	010	1	1	01	01	H9313_010_1	4	1	Generic			
H9313	010	2	1	01	01	H9313_010_2	4	2	Preferred Brand			
H9313	010	2	1	01	01	H9313_010_2	4	1	Generic			
H9313	010	2	1	01	01	H9313_010_2	4	4	Specialty			
H9313	010	2	1	01	01	H9313_010_2	4	3	Non-Preferred Brand			
H9313	011	1	1	02	01	H9313_011_1	4	2	Preferred Brand			
H9313	011	1	1	02	01	H9313_011_1	4	3	Non-Preferred Brand			
H9313	011	1	1	02	01	H9313_011_1	4	4	Specialty			
H9313	011	1	1	02	01	H9313_011_1	4	1	Generic	1		1
H9313	011	1	1	02	01	H9313_011_1	4	2	Preferred Brand	2		
H9313	011	1	1	02	01	H9313_011_1	4	4	Specialty	2		
H9313	011	1	1	02	01	H9313_011_1	4	3	Non-Preferred Brand	2		
H9313	011	1	1	02	01	H9313_011_1	4	1	Generic			
H9313	011	2	1	02	01	H9313_011_2	4	2	Preferred Brand	2		
H9313	011	2	1	02	01	H9313_011_2	4	3	Non-Preferred Brand	2		
H9313	011	2	1	02	01	H9313_011_2	4	4	Specialty	2		
H9313	011	2	1	02	01	H9313_011_2	4	4	Specialty			
H9313	011	2	1	02	01	H9313_011_2	4	1	Generic	1		1
H9313	011	2	1	02	01	H9313_011_2	4	3	Non-Preferred Brand			
H9313	011	2	1	02	01	H9313_011_2	4	2	Preferred Brand			
H9313	011	2	1	02	01	H9313_011_2	4	1	Generic			
H9313	012	1	1	02	01	H9313_012_1	5	4	Specialty	2		
H9313	012	1	1	02	01	H9313_012_1	5	1	Generic			
H9313	012	1	1	02	01	H9313_012_1	5	2	Preferred Brand			
H9313	012	1	1	02	01	H9313_012_1	5	3	Non-Preferred Brand	2		
H9313	012	1	1	02	01	H9313_012_1	5	2	Preferred Brand	2		
H9313	012	1	1	02	01	H9313_012_1	5	1	Generic	1		1
H9313	012	1	1	02	01	H9313_012_1	5	4	Specialty			
H9313	012	1	1	02	01	H9313_012_1	5	3	Non-Preferred Brand			
H9313	012	2	1	02	01	H9313_012_2	5	4	Specialty	2		
H9313	012	2	1	02	01	H9313_012_2	5	3	Non-Preferred Brand	2		
H9313	012	2	1	02	01	H9313_012_2	5	2	Preferred Brand	2		
H9313	012	2	1	02	01	H9313_012_2	5	3	Non-Preferred Brand			
H9313	012	2	1	02	01	H9313_012_2	5	4	Specialty			
H9313	012	2	1	02	01	H9313_012_2	5	1	Generic	1		1
H9313	012	2	1	02	01	H9313_012_2	5	2	Preferred Brand			
H9313	012	2	1	02	01	H9313_012_2	5	1	Generic			
H9385	002	0	1	01	01	H9385_002_0	7	3	Specialty			
H9385	002	0	1	01	01	H9385_002_0	7	2	Brand			
H9385	002	0	1	01	01	H9385_002_0	7	1	Generic			
H9385	002	0	1	01	01	H9385_002_0	7	1	Generic	1		1
H9385	002	0	1	01	01	H9385_002_0	7	2	Brand	2		
H9385	002	0	1	01	01	H9385_002_0	7	3	Specialty	2		
H9452	002	0	1	09	04	H9452_002_0	9	1	Tier 1 Preferred Generic			
H9452	002	0	1	09	04	H9452_002_0	9	2	Tier 2 Preferred Brand			
H9452	002	0	1	09	04	H9452_002_0	9	5	Tier 5 Specialty	2		
H9452	002	0	1	09	04	H9452_002_0	9	4	Tier 4 Non-Specialty Injectable	2		
H9452	002	0	1	09	04	H9452_002_0	9	3	Tier 3 Non-Preferred Brand or Generic	2		
H9452	002	0	1	09	04	H9452_002_0	9	2	Tier 2 Preferred Brand	2		
H9452	002	0	1	09	04	H9452_002_0	9	1	Tier 1 Preferred Generic	1		1
H9452	002	0	1	09	04	H9452_002_0	9	5	Tier 5 Specialty			
H9452	002	0	1	09	04	H9452_002_0	9	4	Tier 4 Non-Specialty Injectable			
H9452	002	0	1	09	04	H9452_002_0	9	3	Tier 3 Non-Preferred Brand or Generic			
H9466	001	0	1	01	01	H9466_001_0	8	1	Tier 1 Preferred Generic			
H9466	001	0	1	01	01	H9466_001_0	8	4	Tier 4 Non-Specialty Injectable	2		
H9466	001	0	1	01	01	H9466_001_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
H9466	001	0	1	01	01	H9466_001_0	8	2	Tier 2 Preferred Brand	2		
H9466	001	0	1	01	01	H9466_001_0	8	5	Tier 5 Specialty	2		
H9466	001	0	1	01	01	H9466_001_0	8	5	Tier 5 Specialty			
H9466	001	0	1	01	01	H9466_001_0	8	4	Tier 4 Non-Specialty Injectable			
H9466	001	0	1	01	01	H9466_001_0	8	3	Tier 3 Non-Preferred Brand or Generic			
H9466	001	0	1	01	01	H9466_001_0	8	2	Tier 2 Preferred Brand			
H9466	001	0	1	01	01	H9466_001_0	8	1	Tier 1 Preferred Generic	1		1
H9503	001	0	1	04	01	H9503_001_0	7	3	Non-Preferred Brand			
H9503	001	0	1	04	01	H9503_001_0	7	2	Preferred Brand			
H9503	001	0	1	04	01	H9503_001_0	7	1	Preferred Generic			
H9503	001	0	1	04	01	H9503_001_0	7	4	Specialty			
H9503	001	0	1	04	01	H9503_001_0	7	1	Preferred Generic	1	00001000	2
H9503	001	0	1	04	01	H9503_001_0	7	2	Preferred Brand	1	10000000	2
H9503	001	0	1	04	01	H9503_001_0	7	3	Non-Preferred Brand	1	10000000	2
H9503	001	0	1	04	01	H9503_001_0	7	4	Specialty	1	10001000	2
H9519	001	0	1	09	04	H9519_001_0	10	3	Tier 3			
H9519	001	0	1	09	04	H9519_001_0	10	2	Tier 2			
H9519	001	0	1	09	04	H9519_001_0	10	1	Tier 1			
H9519	001	0	1	09	04	H9519_001_0	10	4	Specialty Tier 4			
H9519	001	0	1	09	04	H9519_001_0	10	4	Specialty Tier 4	2		
H9519	001	0	1	09	04	H9519_001_0	10	3	Tier 3	2		
H9519	001	0	1	09	04	H9519_001_0	10	2	Tier 2	2		
H9519	001	0	1	09	04	H9519_001_0	10	1	Tier 1	1		1
H9519	003	0	1	09	04	H9519_003_0	10	1	Tier 1			
H9519	003	0	1	09	04	H9519_003_0	10	2	Tier 2			
H9519	003	0	1	09	04	H9519_003_0	10	3	Tier 3			
H9519	003	0	1	09	04	H9519_003_0	10	3	Tier 3	2		
H9519	003	0	1	09	04	H9519_003_0	10	2	Tier 2	2		
H9519	003	0	1	09	04	H9519_003_0	10	1	Tier 1	1	10001000	2
H9519	003	0	1	09	04	H9519_003_0	10	4	Specialty Tier 4			
H9519	003	0	1	09	04	H9519_003_0	10	4	Specialty Tier 4	2		
H9615	002	0	1	04	01	H9615_002_0	8	1	Tier 1			
H9615	002	0	1	04	01	H9615_002_0	8	2	Tier 2			
H9615	002	0	1	04	01	H9615_002_0	8	3	Tier 3			
H9615	002	0	1	04	01	H9615_002_0	8	1	Tier 1	1		1
H9615	002	0	1	04	01	H9615_002_0	8	2	Tier 2	2		
H9615	002	0	1	04	01	H9615_002_0	8	3	Tier 3	2		
H9615	004	0	1	04	01	H9615_004_0	9	1	Tier 1			
H9615	004	0	1	04	01	H9615_004_0	9	2	Tier 2			
H9615	004	0	1	04	01	H9615_004_0	9	3	Tier 3			
H9615	004	0	1	04	01	H9615_004_0	9	1	Tier 1	1		1
H9615	004	0	1	04	01	H9615_004_0	9	2	Tier 2	2		
H9615	004	0	1	04	01	H9615_004_0	9	3	Tier 3	2		
H9663	001	0	1	04	01	H9663_001_0	6	1	Tier 1 - Preferred Generic			
H9663	001	0	1	04	01	H9663_001_0	6	2	Tier 2 - Non-Preferred Generic			
H9663	001	0	1	04	01	H9663_001_0	6	3	Tier 3 - Preferred Brand			
H9663	001	0	1	04	01	H9663_001_0	6	4	Tier 4 - Non-Preferred Brand			
H9663	001	0	1	04	01	H9663_001_0	6	5	Tier 5 - Specialty			
H9663	002	0	1	04	01	H9663_002_0	5	4	Tier 4 - Non-Preferred Brand	2		
H9663	002	0	1	04	01	H9663_002_0	5	2	Tier 2 - Non-Preferred Generic			
H9663	002	0	1	04	01	H9663_002_0	5	2	Tier 2 - Non-Preferred Generic	1		1
H9663	002	0	1	04	01	H9663_002_0	5	1	Tier 1 - Preferred Generic	1		1
H9663	002	0	1	04	01	H9663_002_0	5	5	Tier 5 - Specialty			
H9663	002	0	1	04	01	H9663_002_0	5	4	Tier 4 - Non-Preferred Brand			
H9663	002	0	1	04	01	H9663_002_0	5	3	Tier 3 - Preferred Brand			
H9663	002	0	1	04	01	H9663_002_0	5	3	Tier 3 - Preferred Brand	2		
H9663	002	0	1	04	01	H9663_002_0	5	1	Tier 1 - Preferred Generic			
H9663	002	0	1	04	01	H9663_002_0	5	5	Tier 5 - Specialty	2		
H9670	001	0	1	04	01	H9670_001_0	6	1	Generic	1		1
H9670	001	0	1	04	01	H9670_001_0	6	1	Generic			
H9670	001	0	1	04	01	H9670_001_0	6	2	Preferred Brand			
H9670	001	0	1	04	01	H9670_001_0	6	3	Non-Preferred Brand			
H9670	001	0	1	04	01	H9670_001_0	6	4	Specialty			
H9670	001	0	1	04	01	H9670_001_0	6	4	Specialty	2		
H9670	001	0	1	04	01	H9670_001_0	6	3	Non-Preferred Brand	2		
H9670	001	0	1	04	01	H9670_001_0	6	2	Preferred Brand	2		
H9670	002	0	1	04	01	H9670_002_0	6	2	Preferred Brand	2		
H9670	002	0	1	04	01	H9670_002_0	6	1	Generic	1		1
H9670	002	0	1	04	01	H9670_002_0	6	4	Specialty			
H9670	002	0	1	04	01	H9670_002_0	6	3	Non-Preferred Brand			
H9670	002	0	1	04	01	H9670_002_0	6	2	Preferred Brand			
H9670	002	0	1	04	01	H9670_002_0	6	1	Generic			
H9670	002	0	1	04	01	H9670_002_0	6	3	Non-Preferred Brand	2		
H9670	002	0	1	04	01	H9670_002_0	6	4	Specialty	2		
H9720	009	0	1	09	04	H9720_009_0	11	1	Generic			
H9720	009	0	1	09	04	H9720_009_0	11	2	Preferred Brand			
H9720	009	0	1	09	04	H9720_009_0	11	4	Specialty			
H9720	009	0	1	09	04	H9720_009_0	11	3	Brand			
H9720	011	0	1	09	04	H9720_011_0	9	1	Generic			
H9720	011	0	1	09	04	H9720_011_0	9	2	Preferred Brand			
H9720	011	0	1	09	04	H9720_011_0	9	3	Brand			
H9720	011	0	1	09	04	H9720_011_0	9	4	Specialty			
H9720	026	0	1	09	04	H9720_026_0	11	1	Generic			
H9720	026	0	1	09	04	H9720_026_0	11	3	Brand			
H9720	026	0	1	09	04	H9720_026_0	11	4	Specialty			
H9720	026	0	1	09	04	H9720_026_0	11	2	Preferred Brand			
H9793	001	0	1	09	04	H9793_001_0	9	4	Specialty			
H9793	001	0	1	09	04	H9793_001_0	9	3	Non-Preferred Brand			
H9793	001	0	1	09	04	H9793_001_0	9	1	Generic			
H9793	001	0	1	09	04	H9793_001_0	9	2	Preferred Brand			
H9793	003	0	1	09	04	H9793_003_0	9	3	Non-Preferred Brand			
H9793	003	0	1	09	04	H9793_003_0	9	2	Preferred Brand			
H9793	003	0	1	09	04	H9793_003_0	9	1	Generic			
H9793	003	0	1	09	04	H9793_003_0	9	4	Specialty			
H9793	003	0	1	09	04	H9793_003_0	9	1	Generic	1		1
H9793	003	0	1	09	04	H9793_003_0	9	2	Preferred Brand	2		
H9793	003	0	1	09	04	H9793_003_0	9	3	Non-Preferred Brand	2		
H9793	003	0	1	09	04	H9793_003_0	9	4	Specialty	2		
H9793	004	0	1	09	04	H9793_004_0	8	1	Generic			
H9793	004	0	1	09	04	H9793_004_0	8	4	Specialty			
H9793	004	0	1	09	04	H9793_004_0	8	3	Non-Preferred Brand			
H9793	004	0	1	09	04	H9793_004_0	8	2	Preferred Brand			
H9793	006	0	1	09	04	H9793_006_0	8	3	Non-Preferred Brand	2		
H9793	006	0	1	09	04	H9793_006_0	8	2	Preferred Brand	2		
H9793	006	0	1	09	04	H9793_006_0	8	1	Generic	1		1
H9793	006	0	1	09	04	H9793_006_0	8	4	Specialty			
H9793	006	0	1	09	04	H9793_006_0	8	3	Non-Preferred Brand			
H9793	006	0	1	09	04	H9793_006_0	8	2	Preferred Brand			
H9793	006	0	1	09	04	H9793_006_0	8	1	Generic			
H9793	006	0	1	09	04	H9793_006_0	8	4	Specialty	2		
H9847	001	0	1	04	01	H9847_001_0	5	2	Preferred Brand	2		
H9847	001	0	1	04	01	H9847_001_0	5	2	Preferred Brand			
H9847	001	0	1	04	01	H9847_001_0	5	1	Preferred Generic			
H9847	001	0	1	04	01	H9847_001_0	5	4	Specialty-Generic and Brand	2		
H9847	001	0	1	04	01	H9847_001_0	5	3	Non-preferred Generic/Non-Preferred Brand	2		
H9847	001	0	1	04	01	H9847_001_0	5	3	Non-preferred Generic/Non-Preferred Brand			
H9847	001	0	1	04	01	H9847_001_0	5	1	Preferred Generic	1		1
H9847	001	0	1	04	01	H9847_001_0	5	4	Specialty-Generic and Brand			
H9859	002	0	1	01	01	H9859_002_0	10	1	Tier 1			
H9859	002	0	1	01	01	H9859_002_0	10	2	Tier 2			
H9859	002	0	1	01	01	H9859_002_0	10	3	Tier 3			
H9859	004	0	1	01	01	H9859_004_0	8	2	Tier 2			
H9859	004	0	1	01	01	H9859_004_0	8	3	Tier 3			
H9859	004	0	1	01	01	H9859_004_0	8	1	Tier 1			
H9882	001	0	1	01	01	H9882_001_0	5	4	Specialty			
H9882	001	0	1	01	01	H9882_001_0	5	3	Non-Preferred Brand			
H9882	001	0	1	01	01	H9882_001_0	5	2	Preferred Brand			
H9882	001	0	1	01	01	H9882_001_0	5	1	Generic			
H9882	002	0	1	01	01	H9882_002_0	6	1	Generic			
H9882	002	0	1	01	01	H9882_002_0	6	2	Preferred Brand			
H9882	002	0	1	01	01	H9882_002_0	6	3	Non-Preferred Brand			
H9882	002	0	1	01	01	H9882_002_0	6	4	Specialty			
H9930	003	0	1	04	01	H9930_003_0	3	3	Non-Preferred Brand			
H9930	003	0	1	04	01	H9930_003_0	3	4	Specialty			
H9930	003	0	1	04	01	H9930_003_0	3	1	Generic	1		1
H9930	003	0	1	04	01	H9930_003_0	3	2	Preferred Brand	2		
H9930	003	0	1	04	01	H9930_003_0	3	3	Non-Preferred Brand	2		
H9930	003	0	1	04	01	H9930_003_0	3	4	Specialty	2		
H9930	003	0	1	04	01	H9930_003_0	3	2	Preferred Brand			
H9930	003	0	1	04	01	H9930_003_0	3	1	Generic			
H9931	001	0	1	09	04	H9931_001_0	6	2	Formulary Brand			
H9931	001	0	1	09	04	H9931_001_0	6	1	Formulary Generic			
H9931	001	0	1	09	04	H9931_001_0	6	3	Formulary Specialty			
R3175	001	0	1	31	11	R3175_001_0	6	1	Preferred Generic			
R3175	001	0	1	31	11	R3175_001_0	6	2	Preferred Brand			
R3175	001	0	1	31	11	R3175_001_0	6	3	Non-Preferred			
R3175	001	0	1	31	11	R3175_001_0	6	4	Specialty			
R3175	004	0	1	31	11	R3175_004_0	4	1	Preferred Generic			
R3175	004	0	1	31	11	R3175_004_0	4	2	Preferred Brand			
R3175	004	0	1	31	11	R3175_004_0	4	3	Non Preferred			
R3175	004	0	1	31	11	R3175_004_0	4	4	Specialty			
R3444	001	0	1	31	11	R3444_001_0	11	3	Formulary Non-Preferred Brand			
R3444	001	0	1	31	11	R3444_001_0	11	2	Formulary Preferred Brand			
R3444	001	0	1	31	11	R3444_001_0	11	1	Formulary Generic			
R3444	001	0	1	31	11	R3444_001_0	11	4	Formulary Specialty			
R3444	002	0	1	31	11	R3444_002_0	9	4	Formulary Specialty			
R3444	002	0	1	31	11	R3444_002_0	9	1	Formulary Generic			
R3444	002	0	1	31	11	R3444_002_0	9	2	Formulary Preferred Brand			
R3444	002	0	1	31	11	R3444_002_0	9	3	Formulary Non-Preferred Brand			
R3444	003	0	1	31	11	R3444_003_0	8	4	Formulary Specialty			
R3444	003	0	1	31	11	R3444_003_0	8	3	Formulary Non-Preferred Brand			
R3444	003	0	1	31	11	R3444_003_0	8	1	Formulary Generic			
R3444	003	0	1	31	11	R3444_003_0	8	2	Formulary Preferred Brand			
R3444	004	0	1	31	11	R3444_004_0	8	1	Formulary Generic			
R3444	004	0	1	31	11	R3444_004_0	8	2	Formulary Preferred Brand			
R3444	004	0	1	31	11	R3444_004_0	8	3	Formulary Non-Preferred Brand			
R3444	004	0	1	31	11	R3444_004_0	8	4	Formulary Specialty			
R3444	005	0	1	31	11	R3444_005_0	8	5	Formulary Zero Copay	1		1
R3444	005	0	1	31	11	R3444_005_0	8	1	Formulary Generic			
R3444	005	0	1	31	11	R3444_005_0	8	2	Formulary Preferred Brand			
R3444	005	0	1	31	11	R3444_005_0	8	3	Formulary Non-Preferred Brand			
R3444	005	0	1	31	11	R3444_005_0	8	4	Formulary Specialty			
R3444	005	0	1	31	11	R3444_005_0	8	5	Formulary Zero Copay			
R3444	005	0	1	31	11	R3444_005_0	8	1	Formulary Generic	2		
R3444	005	0	1	31	11	R3444_005_0	8	2	Formulary Preferred Brand	2		
R3444	005	0	1	31	11	R3444_005_0	8	3	Formulary Non-Preferred Brand	2		
R3444	005	0	1	31	11	R3444_005_0	8	4	Formulary Specialty	2		
R3444	006	0	1	31	11	R3444_006_0	8	3	Formulary Non-Preferred Brand	2		
R3444	006	0	1	31	11	R3444_006_0	8	4	Formulary Specialty	2		
R3444	006	0	1	31	11	R3444_006_0	8	5	Formulary Zero Copay	1		1
R3444	006	0	1	31	11	R3444_006_0	8	4	Formulary Specialty			
R3444	006	0	1	31	11	R3444_006_0	8	5	Formulary Zero Copay			
R3444	006	0	1	31	11	R3444_006_0	8	1	Formulary Generic			
R3444	006	0	1	31	11	R3444_006_0	8	2	Formulary Preferred Brand	2		
R3444	006	0	1	31	11	R3444_006_0	8	3	Formulary Non-Preferred Brand			
R3444	006	0	1	31	11	R3444_006_0	8	1	Formulary Generic	2		
R3444	006	0	1	31	11	R3444_006_0	8	2	Formulary Preferred Brand			
R3444	007	0	1	31	11	R3444_007_0	8	1	Formulary Generic			
R3444	007	0	1	31	11	R3444_007_0	8	2	Formulary Preferred Brand			
R3444	007	0	1	31	11	R3444_007_0	8	3	Formulary Non-Preferred Brand			
R3444	007	0	1	31	11	R3444_007_0	8	4	Formulary Specialty			
R5287	001	0	1	31	11	R5287_001_0	6	2	Preferred Brand			
R5287	001	0	1	31	11	R5287_001_0	6	1	Preferred Generic			
R5287	001	0	1	31	11	R5287_001_0	6	4	Specialty			
R5287	001	0	1	31	11	R5287_001_0	6	3	Non-Preferred			
R5342	001	0	1	31	11	R5342_001_0	5	2	Preferred Brand			
R5342	001	0	1	31	11	R5342_001_0	5	4	Specialty			
R5342	001	0	1	31	11	R5342_001_0	5	3	Non-Preferred			
R5342	001	0	1	31	11	R5342_001_0	5	1	Preferred Generic			
R5342	004	0	1	31	11	R5342_004_0	5	1	Preferred Generic			
R5342	004	0	1	31	11	R5342_004_0	5	2	Preferred Brand			
R5342	004	0	1	31	11	R5342_004_0	5	4	Specialty			
R5342	004	0	1	31	11	R5342_004_0	5	3	Non Preferred			
R5566	005	0	1	31	11	R5566_005_0	6	4	Covered Specialty			
R5566	005	0	1	31	11	R5566_005_0	6	2	Level 2: Covered Preferred Brand			
R5566	005	0	1	31	11	R5566_005_0	6	3	Level 3: Covered Brand			
R5566	005	0	1	31	11	R5566_005_0	6	1	Level 1: Covered Generic			
R5595	001	0	1	31	11	R5595_001_0	8	4	Tier 4 - Non-Preferred Brand			
R5595	001	0	1	31	11	R5595_001_0	8	1	Tier 1 - Preferred Generic			
R5595	001	0	1	31	11	R5595_001_0	8	2	Tier 2 - Non-Preferred Generic			
R5595	001	0	1	31	11	R5595_001_0	8	3	Tier 3 - Preferred Brand			
R5595	001	0	1	31	11	R5595_001_0	8	5	Tier 5 - Specialty			
R5595	003	0	1	31	11	R5595_003_0	9	1	Tier 1 - Preferred Generic			
R5595	003	0	1	31	11	R5595_003_0	9	3	Tier 3 - Preferred Brand			
R5595	003	0	1	31	11	R5595_003_0	9	5	Tier 5 - Specialty			
R5595	003	0	1	31	11	R5595_003_0	9	2	Tier 2 - Non-Preferred Generic			
R5595	003	0	1	31	11	R5595_003_0	9	4	Tier 4 - Non-Preferred Brand			
R5595	004	0	1	31	11	R5595_004_0	8	2	Tier 2 - Non-Preferred Generic			
R5595	004	0	1	31	11	R5595_004_0	8	3	Tier 3 - Preferred Brand			
R5595	004	0	1	31	11	R5595_004_0	8	4	Tier 4 - Non-Preferred Brand			
R5595	004	0	1	31	11	R5595_004_0	8	5	Tier 5 - Specialty			
R5595	004	0	1	31	11	R5595_004_0	8	1	Tier 1 - Preferred Generic	1		1
R5595	004	0	1	31	11	R5595_004_0	8	2	Tier 2 - Non-Preferred Generic	1		1
R5595	004	0	1	31	11	R5595_004_0	8	3	Tier 3 - Preferred Brand	2		
R5595	004	0	1	31	11	R5595_004_0	8	1	Tier 1 - Preferred Generic			
R5595	004	0	1	31	11	R5595_004_0	8	5	Tier 5 - Specialty	2		
R5595	004	0	1	31	11	R5595_004_0	8	4	Tier 4 - Non-Preferred Brand	2		
R5595	006	0	1	31	11	R5595_006_0	10	1	Tier 1 - Preferred Generic			
R5595	006	0	1	31	11	R5595_006_0	10	2	Tier 2 - Non-Preferred Generic			
R5595	006	0	1	31	11	R5595_006_0	10	3	Tier 3 - Preferred Brand			
R5595	006	0	1	31	11	R5595_006_0	10	5	Tier 5 - Specialty	2		
R5595	006	0	1	31	11	R5595_006_0	10	4	Tier 4 - Non-Preferred Brand			
R5595	006	0	1	31	11	R5595_006_0	10	3	Tier 3 - Preferred Brand	2		
R5595	006	0	1	31	11	R5595_006_0	10	2	Tier 2 - Non-Preferred Generic	1		1
R5595	006	0	1	31	11	R5595_006_0	10	1	Tier 1 - Preferred Generic	1		1
R5595	006	0	1	31	11	R5595_006_0	10	5	Tier 5 - Specialty			
R5595	006	0	1	31	11	R5595_006_0	10	4	Tier 4 - Non-Preferred Brand	2		
R5595	007	0	1	31	11	R5595_007_0	8	5	Tier 5 - Specialty	2		
R5595	007	0	1	31	11	R5595_007_0	8	4	Tier 4 - Non-Preferred Brand	2		
R5595	007	0	1	31	11	R5595_007_0	8	3	Tier 3 - Preferred Brand	2		
R5595	007	0	1	31	11	R5595_007_0	8	2	Tier 2 - Non-Preferred Generic	1		1
R5595	007	0	1	31	11	R5595_007_0	8	1	Tier 1 - Preferred Generic	1		1
R5595	007	0	1	31	11	R5595_007_0	8	4	Tier 4 - Non-Preferred Brand			
R5595	007	0	1	31	11	R5595_007_0	8	3	Tier 3 - Preferred Brand			
R5595	007	0	1	31	11	R5595_007_0	8	2	Tier 2 - Non-Preferred Generic			
R5595	007	0	1	31	11	R5595_007_0	8	1	Tier 1 - Preferred Generic			
R5595	007	0	1	31	11	R5595_007_0	8	5	Tier 5 - Specialty			
R5674	001	0	1	31	11	R5674_001_0	12	2	Brand			
R5674	001	0	1	31	11	R5674_001_0	12	1	Generic			
R5674	001	0	1	31	11	R5674_001_0	12	3	Specialty			
R5826	001	0	1	31	11	R5826_001_0	5	2	Preferred Brand	1	10000000	2
R5826	001	0	1	31	11	R5826_001_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	001	0	1	31	11	R5826_001_0	5	4	Specialty	1	10001000	2
R5826	001	0	1	31	11	R5826_001_0	5	1	Preferred Generic			
R5826	001	0	1	31	11	R5826_001_0	5	2	Preferred Brand			
R5826	001	0	1	31	11	R5826_001_0	5	3	Non-Preferred Brand			
R5826	001	0	1	31	11	R5826_001_0	5	4	Specialty			
R5826	001	0	1	31	11	R5826_001_0	5	1	Preferred Generic	1	00001000	2
R5826	002	0	1	31	11	R5826_002_0	6	1	Preferred Generic	1	00001000	2
R5826	002	0	1	31	11	R5826_002_0	6	2	Preferred Brand	1	10000000	2
R5826	002	0	1	31	11	R5826_002_0	6	3	Non-Preferred Brand	1	10000000	2
R5826	002	0	1	31	11	R5826_002_0	6	4	Specialty			
R5826	002	0	1	31	11	R5826_002_0	6	3	Non-Preferred Brand			
R5826	002	0	1	31	11	R5826_002_0	6	2	Preferred Brand			
R5826	002	0	1	31	11	R5826_002_0	6	1	Preferred Generic			
R5826	002	0	1	31	11	R5826_002_0	6	4	Specialty	1	10001000	2
R5826	003	0	1	31	11	R5826_003_0	5	3	Non-Preferred Brand			
R5826	003	0	1	31	11	R5826_003_0	5	2	Preferred Brand			
R5826	003	0	1	31	11	R5826_003_0	5	1	Preferred Generic			
R5826	003	0	1	31	11	R5826_003_0	5	4	Specialty			
R5826	003	0	1	31	11	R5826_003_0	5	4	Specialty	1	10001000	2
R5826	003	0	1	31	11	R5826_003_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	003	0	1	31	11	R5826_003_0	5	2	Preferred Brand	1	10000000	2
R5826	003	0	1	31	11	R5826_003_0	5	1	Preferred Generic	1	00001000	2
R5826	004	0	1	31	11	R5826_004_0	5	1	Preferred Generic			
R5826	004	0	1	31	11	R5826_004_0	5	2	Preferred Brand			
R5826	004	0	1	31	11	R5826_004_0	5	3	Non-Preferred Brand			
R5826	004	0	1	31	11	R5826_004_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	004	0	1	31	11	R5826_004_0	5	2	Preferred Brand	1	10000000	2
R5826	004	0	1	31	11	R5826_004_0	5	1	Preferred Generic	1	00001000	2
R5826	004	0	1	31	11	R5826_004_0	5	4	Specialty			
R5826	004	0	1	31	11	R5826_004_0	5	4	Specialty	1	10001000	2
R5826	005	0	1	31	11	R5826_005_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	005	0	1	31	11	R5826_005_0	5	2	Preferred Brand	1	10000000	2
R5826	005	0	1	31	11	R5826_005_0	5	1	Preferred Generic	1	00001000	2
R5826	005	0	1	31	11	R5826_005_0	5	4	Specialty			
R5826	005	0	1	31	11	R5826_005_0	5	3	Non-Preferred Brand			
R5826	005	0	1	31	11	R5826_005_0	5	2	Preferred Brand			
R5826	005	0	1	31	11	R5826_005_0	5	1	Preferred Generic			
R5826	005	0	1	31	11	R5826_005_0	5	4	Specialty	1	10001000	2
R5826	006	0	1	31	11	R5826_006_0	5	2	Preferred Brand	1	10000000	2
R5826	006	0	1	31	11	R5826_006_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	006	0	1	31	11	R5826_006_0	5	4	Specialty	1	10001000	2
R5826	006	0	1	31	11	R5826_006_0	5	1	Preferred Generic			
R5826	006	0	1	31	11	R5826_006_0	5	1	Preferred Generic	1	00001000	2
R5826	006	0	1	31	11	R5826_006_0	5	4	Specialty			
R5826	006	0	1	31	11	R5826_006_0	5	2	Preferred Brand			
R5826	006	0	1	31	11	R5826_006_0	5	3	Non-Preferred Brand			
R5826	007	0	1	31	11	R5826_007_0	5	4	Specialty	1	10001000	2
R5826	007	0	1	31	11	R5826_007_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	007	0	1	31	11	R5826_007_0	5	2	Preferred Brand	1	10000000	2
R5826	007	0	1	31	11	R5826_007_0	5	1	Preferred Generic	1	00001000	2
R5826	007	0	1	31	11	R5826_007_0	5	4	Specialty			
R5826	007	0	1	31	11	R5826_007_0	5	3	Non-Preferred Brand			
R5826	007	0	1	31	11	R5826_007_0	5	1	Preferred Generic			
R5826	007	0	1	31	11	R5826_007_0	5	2	Preferred Brand			
R5826	008	0	1	31	11	R5826_008_0	5	2	Preferred Brand	1	10000000	2
R5826	008	0	1	31	11	R5826_008_0	5	4	Specialty			
R5826	008	0	1	31	11	R5826_008_0	5	4	Specialty	1	10001000	2
R5826	008	0	1	31	11	R5826_008_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	008	0	1	31	11	R5826_008_0	5	1	Preferred Generic	1	00001000	2
R5826	008	0	1	31	11	R5826_008_0	5	1	Preferred Generic			
R5826	008	0	1	31	11	R5826_008_0	5	2	Preferred Brand			
R5826	008	0	1	31	11	R5826_008_0	5	3	Non-Preferred Brand			
R5826	009	0	1	31	11	R5826_009_0	8	2	Preferred Brand	1	10000000	2
R5826	009	0	1	31	11	R5826_009_0	8	3	Non-Preferred Brand	1	10000000	2
R5826	009	0	1	31	11	R5826_009_0	8	4	Specialty	1	10001000	2
R5826	009	0	1	31	11	R5826_009_0	8	1	Preferred Generic	1	00001000	2
R5826	009	0	1	31	11	R5826_009_0	8	4	Specialty			
R5826	009	0	1	31	11	R5826_009_0	8	3	Non-Preferred Brand			
R5826	009	0	1	31	11	R5826_009_0	8	2	Preferred Brand			
R5826	009	0	1	31	11	R5826_009_0	8	1	Preferred Generic			
R5826	010	0	1	31	11	R5826_010_0	5	3	Non-Preferred Brand			
R5826	010	0	1	31	11	R5826_010_0	5	2	Preferred Brand			
R5826	010	0	1	31	11	R5826_010_0	5	4	Specialty	1	10001000	2
R5826	010	0	1	31	11	R5826_010_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	010	0	1	31	11	R5826_010_0	5	2	Preferred Brand	1	10000000	2
R5826	010	0	1	31	11	R5826_010_0	5	1	Preferred Generic	1	00001000	2
R5826	010	0	1	31	11	R5826_010_0	5	4	Specialty			
R5826	010	0	1	31	11	R5826_010_0	5	1	Preferred Generic			
R5826	011	0	1	31	11	R5826_011_0	5	1	Preferred Generic			
R5826	011	0	1	31	11	R5826_011_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	011	0	1	31	11	R5826_011_0	5	2	Preferred Brand	1	10000000	2
R5826	011	0	1	31	11	R5826_011_0	5	1	Preferred Generic	1	00001000	2
R5826	011	0	1	31	11	R5826_011_0	5	4	Specialty			
R5826	011	0	1	31	11	R5826_011_0	5	3	Non-Preferred Brand			
R5826	011	0	1	31	11	R5826_011_0	5	2	Preferred Brand			
R5826	011	0	1	31	11	R5826_011_0	5	4	Specialty	1	10001000	2
R5826	012	0	1	31	11	R5826_012_0	5	3	Non-Preferred Brand			
R5826	012	0	1	31	11	R5826_012_0	5	2	Preferred Brand			
R5826	012	0	1	31	11	R5826_012_0	5	1	Preferred Generic			
R5826	012	0	1	31	11	R5826_012_0	5	4	Specialty			
R5826	012	0	1	31	11	R5826_012_0	5	4	Specialty	1	10001000	2
R5826	012	0	1	31	11	R5826_012_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	012	0	1	31	11	R5826_012_0	5	2	Preferred Brand	1	10000000	2
R5826	012	0	1	31	11	R5826_012_0	5	1	Preferred Generic	1	00001000	2
R5826	013	0	1	31	11	R5826_013_0	5	1	Preferred Generic			
R5826	013	0	1	31	11	R5826_013_0	5	2	Preferred Brand			
R5826	013	0	1	31	11	R5826_013_0	5	4	Specialty	1	10001000	2
R5826	013	0	1	31	11	R5826_013_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	013	0	1	31	11	R5826_013_0	5	2	Preferred Brand	1	10000000	2
R5826	013	0	1	31	11	R5826_013_0	5	1	Preferred Generic	1	00001000	2
R5826	013	0	1	31	11	R5826_013_0	5	4	Specialty			
R5826	013	0	1	31	11	R5826_013_0	5	3	Non-Preferred Brand			
R5826	014	0	1	31	11	R5826_014_0	6	1	Preferred Generic			
R5826	014	0	1	31	11	R5826_014_0	6	4	Specialty			
R5826	014	0	1	31	11	R5826_014_0	6	1	Preferred Generic	1	00001000	2
R5826	014	0	1	31	11	R5826_014_0	6	2	Preferred Brand	1	10000000	2
R5826	014	0	1	31	11	R5826_014_0	6	3	Non-Preferred Brand	1	10000000	2
R5826	014	0	1	31	11	R5826_014_0	6	3	Non-Preferred Brand			
R5826	014	0	1	31	11	R5826_014_0	6	2	Preferred Brand			
R5826	014	0	1	31	11	R5826_014_0	6	4	Specialty	1	10001000	2
R5826	049	0	1	31	11	R5826_049_0	5	1	Preferred Generic			
R5826	049	0	1	31	11	R5826_049_0	5	2	Preferred Brand			
R5826	049	0	1	31	11	R5826_049_0	5	3	Non-Preferred Brand			
R5826	049	0	1	31	11	R5826_049_0	5	4	Specialty			
R5826	049	0	1	31	11	R5826_049_0	5	1	Preferred Generic	1	00001000	2
R5826	049	0	1	31	11	R5826_049_0	5	2	Preferred Brand	1	10000000	2
R5826	049	0	1	31	11	R5826_049_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	049	0	1	31	11	R5826_049_0	5	4	Specialty	1	10001000	2
R5826	051	0	1	31	11	R5826_051_0	5	2	Preferred Brand	1	10000000	2
R5826	051	0	1	31	11	R5826_051_0	5	1	Preferred Generic	1	00001000	2
R5826	051	0	1	31	11	R5826_051_0	5	4	Specialty			
R5826	051	0	1	31	11	R5826_051_0	5	3	Non-Preferred Brand			
R5826	051	0	1	31	11	R5826_051_0	5	2	Preferred Brand			
R5826	051	0	1	31	11	R5826_051_0	5	1	Preferred Generic			
R5826	051	0	1	31	11	R5826_051_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	051	0	1	31	11	R5826_051_0	5	4	Specialty	1	10001000	2
R5826	054	0	1	31	11	R5826_054_0	5	2	Preferred Brand	1	10000000	2
R5826	054	0	1	31	11	R5826_054_0	5	1	Preferred Generic	1	00001000	2
R5826	054	0	1	31	11	R5826_054_0	5	4	Specialty			
R5826	054	0	1	31	11	R5826_054_0	5	3	Non-Preferred Brand			
R5826	054	0	1	31	11	R5826_054_0	5	2	Preferred Brand			
R5826	054	0	1	31	11	R5826_054_0	5	1	Preferred Generic			
R5826	054	0	1	31	11	R5826_054_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	054	0	1	31	11	R5826_054_0	5	4	Specialty	1	10001000	2
R5826	059	0	1	31	11	R5826_059_0	5	1	Preferred Generic			
R5826	059	0	1	31	11	R5826_059_0	5	2	Preferred Brand			
R5826	059	0	1	31	11	R5826_059_0	5	3	Non-Preferred Brand			
R5826	059	0	1	31	11	R5826_059_0	5	4	Specialty			
R5826	059	0	1	31	11	R5826_059_0	5	1	Preferred Generic	1	00001000	2
R5826	059	0	1	31	11	R5826_059_0	5	2	Preferred Brand	1	10000000	2
R5826	059	0	1	31	11	R5826_059_0	5	3	Non-Preferred Brand	1	10000000	2
R5826	059	0	1	31	11	R5826_059_0	5	4	Specialty	1	10001000	2
R5863	001	0	1	31	11	R5863_001_0	11	1	Preferred Generic			
R5863	001	0	1	31	11	R5863_001_0	11	2	Preferrred Brand			
R5863	001	0	1	31	11	R5863_001_0	11	3	Non-Preferred Brand			
R5863	001	0	1	31	11	R5863_001_0	11	4	Injectable			
R5863	001	0	1	31	11	R5863_001_0	11	5	Specialty			
R5941	001	0	1	31	11	R5941_001_0	10	1	Tier One Preferred Generics			
R5941	001	0	1	31	11	R5941_001_0	10	5	Tier 5 Specialty	2		
R5941	001	0	1	31	11	R5941_001_0	10	4	Tier 4 Non-Specialty Injectibles	2		
R5941	001	0	1	31	11	R5941_001_0	10	3	Tier 3 Non-Preferred Brand or Generic	2		
R5941	001	0	1	31	11	R5941_001_0	10	2	Tier 2 Preferred Brand	2		
R5941	001	0	1	31	11	R5941_001_0	10	1	Tier One Preferred Generics	1		1
R5941	001	0	1	31	11	R5941_001_0	10	5	Tier 5 Specialty			
R5941	001	0	1	31	11	R5941_001_0	10	4	Tier 4 Non-Specialty Injectibles			
R5941	001	0	1	31	11	R5941_001_0	10	3	Tier 3 Non-Preferred Brand or Generic			
R5941	001	0	1	31	11	R5941_001_0	10	2	Tier 2 Preferred Brand			
R5941	002	0	1	31	11	R5941_002_0	10	1	Tier One Preferred Generics			
R5941	002	0	1	31	11	R5941_002_0	10	2	Tier 2 Preferred Brand			
R5941	002	0	1	31	11	R5941_002_0	10	5	Tier 5 Specialty	2		
R5941	002	0	1	31	11	R5941_002_0	10	4	Tier 4 Non-Specialty Injectibles	2		
R5941	002	0	1	31	11	R5941_002_0	10	3	Tier 3 Non-Preferred Brand or Generic	2		
R5941	002	0	1	31	11	R5941_002_0	10	2	Tier 2 Preferred Brand	2		
R5941	002	0	1	31	11	R5941_002_0	10	1	Tier One Preferred Generics	1		1
R5941	002	0	1	31	11	R5941_002_0	10	5	Tier 5 Specialty			
R5941	002	0	1	31	11	R5941_002_0	10	4	Tier 4 Non-Specialty Injectibles			
R5941	002	0	1	31	11	R5941_002_0	10	3	Tier 3 Non-Preferred Brand or Generic			
R5941	003	0	1	31	11	R5941_003_0	7	4	Tier 4 Non-Specialty Injectibles	2		
R5941	003	0	1	31	11	R5941_003_0	7	1	Tier One Preferred Generics			
R5941	003	0	1	31	11	R5941_003_0	7	2	Tier 2 Preferred Brand			
R5941	003	0	1	31	11	R5941_003_0	7	3	Tier 3 Non-Preferred Brand or Generic			
R5941	003	0	1	31	11	R5941_003_0	7	5	Tier 5 Specialty	2		
R5941	003	0	1	31	11	R5941_003_0	7	5	Tier 5 Specialty			
R5941	003	0	1	31	11	R5941_003_0	7	1	Tier One Preferred Generics	1		1
R5941	003	0	1	31	11	R5941_003_0	7	2	Tier 2 Preferred Brand	2		
R5941	003	0	1	31	11	R5941_003_0	7	3	Tier 3 Non-Preferred Brand or Generic	2		
R5941	003	0	1	31	11	R5941_003_0	7	4	Tier 4 Non-Specialty Injectibles			
R5941	004	0	1	31	11	R5941_004_0	8	1	Tier One Preferred Generics	1		1
R5941	004	0	1	31	11	R5941_004_0	8	2	Tier 2 Preferred Brand	2		
R5941	004	0	1	31	11	R5941_004_0	8	3	Tier 3 Non-Preferred Brand or Generic	2		
R5941	004	0	1	31	11	R5941_004_0	8	4	Tier 4 Non-Specialty Injectibles	2		
R5941	004	0	1	31	11	R5941_004_0	8	5	Tier 5 Specialty	2		
R5941	004	0	1	31	11	R5941_004_0	8	1	Tier One Preferred Generics			
R5941	004	0	1	31	11	R5941_004_0	8	2	Tier 2 Preferred Brand			
R5941	004	0	1	31	11	R5941_004_0	8	3	Tier 3 Non-Preferred Brand or Generic			
R5941	004	0	1	31	11	R5941_004_0	8	4	Tier 4 Non-Specialty Injectibles			
R5941	004	0	1	31	11	R5941_004_0	8	5	Tier 5 Specialty			
R6801	001	0	1	31	11	R6801_001_0	11	1	Formulary Generic			
R6801	001	0	1	31	11	R6801_001_0	11	2	Formulary Preferred Brand			
R6801	001	0	1	31	11	R6801_001_0	11	3	Formulary Non-Preferred Brand			
R6801	001	0	1	31	11	R6801_001_0	11	4	Formulary Specialty			
R6801	002	0	1	31	11	R6801_002_0	8	3	Formulary Non-Preferred Brand			
R6801	002	0	1	31	11	R6801_002_0	8	2	Formulary Preferred Brand			
R6801	002	0	1	31	11	R6801_002_0	8	1	Formulary Generic			
R6801	002	0	1	31	11	R6801_002_0	8	4	Formulary Specialty			
R6801	003	0	1	31	11	R6801_003_0	9	1	Formulary Generic			
R6801	003	0	1	31	11	R6801_003_0	9	2	Formulary Preferred Brand			
R6801	003	0	1	31	11	R6801_003_0	9	3	Formulary Non-Preferred Brand			
R6801	003	0	1	31	11	R6801_003_0	9	4	Formulary Specialty			
R6801	004	0	1	31	11	R6801_004_0	9	1	Formulary Generic			
R6801	004	0	1	31	11	R6801_004_0	9	2	Formulary Preferred Brand			
R6801	004	0	1	31	11	R6801_004_0	9	3	Formulary Non-Preferred Brand			
R6801	004	0	1	31	11	R6801_004_0	9	4	Formulary Specialty			
R6801	005	0	1	31	11	R6801_005_0	8	3	Formulary Non-Preferred Brand			
R6801	005	0	1	31	11	R6801_005_0	8	2	Formulary Preferred Brand			
R6801	005	0	1	31	11	R6801_005_0	8	1	Formulary Generic			
R6801	005	0	1	31	11	R6801_005_0	8	4	Formulary Specialty			
R6801	005	0	1	31	11	R6801_005_0	8	5	Formulary Zero Copay	1		1
R6801	005	0	1	31	11	R6801_005_0	8	4	Formulary Specialty	2		
R6801	005	0	1	31	11	R6801_005_0	8	3	Formulary Non-Preferred Brand	2		
R6801	005	0	1	31	11	R6801_005_0	8	2	Formulary Preferred Brand	2		
R6801	005	0	1	31	11	R6801_005_0	8	1	Formulary Generic	2		
R6801	005	0	1	31	11	R6801_005_0	8	5	Formulary Zero Copay			
R6801	006	0	1	31	11	R6801_006_0	8	1	Formulary Generic			
R6801	006	0	1	31	11	R6801_006_0	8	2	Formulary Preferred Brand			
R6801	006	0	1	31	11	R6801_006_0	8	3	Formulary Non-Preferred Brand			
R6801	006	0	1	31	11	R6801_006_0	8	4	Formulary Specialty			
R6801	006	0	1	31	11	R6801_006_0	8	5	Formulary Zero Copay			
R6801	006	0	1	31	11	R6801_006_0	8	1	Formulary Generic	2		
R6801	006	0	1	31	11	R6801_006_0	8	2	Formulary Preferred Brand	2		
R6801	006	0	1	31	11	R6801_006_0	8	3	Formulary Non-Preferred Brand	2		
R6801	006	0	1	31	11	R6801_006_0	8	4	Formulary Specialty	2		
R6801	006	0	1	31	11	R6801_006_0	8	5	Formulary Zero Copay	1		1
R6801	007	0	1	31	11	R6801_007_0	8	1	Formulary Generic			
R6801	007	0	1	31	11	R6801_007_0	8	2	Formulary Preferred Brand			
R6801	007	0	1	31	11	R6801_007_0	8	3	Formulary Non-Preferred Brand			
R6801	007	0	1	31	11	R6801_007_0	8	4	Formulary Specialty			
R7444	001	0	1	31	11	R7444_001_0	5	3	Non-Preferred			
R7444	001	0	1	31	11	R7444_001_0	5	2	Preferred Brand			
R7444	001	0	1	31	11	R7444_001_0	5	1	Preferred Generic			
R7444	001	0	1	31	11	R7444_001_0	5	4	Specialty			
R9896	001	0	1	31	11	R9896_001_0	11	3	Formulary Non-Preferred Brand			
R9896	001	0	1	31	11	R9896_001_0	11	4	Formulary Specialty			
R9896	001	0	1	31	11	R9896_001_0	11	1	Formulary Generic			
R9896	001	0	1	31	11	R9896_001_0	11	2	Formulary Preferred Brand			
R9896	002	0	1	31	11	R9896_002_0	8	3	Formulary Non-Preferred Brand			
R9896	002	0	1	31	11	R9896_002_0	8	1	Formulary Generic			
R9896	002	0	1	31	11	R9896_002_0	8	2	Formulary Preferred Brand			
R9896	002	0	1	31	11	R9896_002_0	8	4	Formulary Specialty			
R9896	003	0	1	31	11	R9896_003_0	8	3	Formulary Non-Preferred Brand			
R9896	003	0	1	31	11	R9896_003_0	8	4	Formulary Specialty			
R9896	003	0	1	31	11	R9896_003_0	8	1	Formulary Generic			
R9896	003	0	1	31	11	R9896_003_0	8	2	Formulary Preferred Brand			
R9896	004	0	1	31	11	R9896_004_0	8	1	Formulary Generic			
R9896	004	0	1	31	11	R9896_004_0	8	2	Formulary Preferred Brand			
R9896	004	0	1	31	11	R9896_004_0	8	4	Formulary Specialty			
R9896	004	0	1	31	11	R9896_004_0	8	3	Formulary Non-Preferred Brand			
R9896	005	0	1	31	11	R9896_005_0	9	5	Formulary Zero Copay			
R9896	005	0	1	31	11	R9896_005_0	9	1	Formulary Generic			
R9896	005	0	1	31	11	R9896_005_0	9	2	Formulary Preferred Brand			
R9896	005	0	1	31	11	R9896_005_0	9	3	Formulary Non-Preferred Brand			
R9896	005	0	1	31	11	R9896_005_0	9	4	Formulary Specialty			
R9896	005	0	1	31	11	R9896_005_0	9	5	Formulary Zero Copay	1		1
R9896	005	0	1	31	11	R9896_005_0	9	4	Formulary Specialty	2		
R9896	005	0	1	31	11	R9896_005_0	9	2	Formulary Preferred Brand	2		
R9896	005	0	1	31	11	R9896_005_0	9	1	Formulary Generic	2		
R9896	005	0	1	31	11	R9896_005_0	9	3	Formulary Non-Preferred Brand	2		
R9896	006	0	1	31	11	R9896_006_0	8	4	Formulary Specialty	2		
R9896	006	0	1	31	11	R9896_006_0	8	3	Formulary Non-Preferred Brand	2		
R9896	006	0	1	31	11	R9896_006_0	8	2	Formulary Preferred Brand	2		
R9896	006	0	1	31	11	R9896_006_0	8	1	Formulary Generic	2		
R9896	006	0	1	31	11	R9896_006_0	8	5	Formulary Zero Copay			
R9896	006	0	1	31	11	R9896_006_0	8	4	Formulary Specialty			
R9896	006	0	1	31	11	R9896_006_0	8	3	Formulary Non-Preferred Brand			
R9896	006	0	1	31	11	R9896_006_0	8	2	Formulary Preferred Brand			
R9896	006	0	1	31	11	R9896_006_0	8	1	Formulary Generic			
R9896	006	0	1	31	11	R9896_006_0	8	5	Formulary Zero Copay	1		1
R9896	007	0	1	31	11	R9896_007_0	8	2	Formulary Preferred Brand			
R9896	007	0	1	31	11	R9896_007_0	8	3	Formulary Non-Preferred Brand			
R9896	007	0	1	31	11	R9896_007_0	8	4	Formulary Specialty			
R9896	007	0	1	31	11	R9896_007_0	8	1	Formulary Generic			
R9943	001	0	1	31	11	R9943_001_0	14	5	Tier 5 Specialty			
R9943	001	0	1	31	11	R9943_001_0	14	4	Tier 4 Non-Specialty Injectable			
R9943	001	0	1	31	11	R9943_001_0	14	3	Tier 3 Non-Preferred Brand or Generic			
R9943	001	0	1	31	11	R9943_001_0	14	2	Tier 2 Preferred Brand			
R9943	001	0	1	31	11	R9943_001_0	14	1	Tier 1 Preferred Generic			
R9943	001	0	1	31	11	R9943_001_0	14	1	Tier 1 Preferred Generic	1		1
R9943	001	0	1	31	11	R9943_001_0	14	3	Tier 3 Non-Preferred Brand or Generic	2		
R9943	001	0	1	31	11	R9943_001_0	14	4	Tier 4 Non-Specialty Injectable	2		
R9943	001	0	1	31	11	R9943_001_0	14	5	Tier 5 Specialty	2		
R9943	001	0	1	31	11	R9943_001_0	14	2	Tier 2 Preferred Brand	2		
S0043	009	0		29	10	S0043_009_0	2	3	Non-Preferred Brand			
S0043	009	0		29	10	S0043_009_0	2	2	Brand			
S0043	009	0		29	10	S0043_009_0	2	1	Generic			
S0043	009	0		29	10	S0043_009_0	2	4	Specialty			
S0043	010	0		29	10	S0043_010_0	4	1	Generic			
S0043	010	0		29	10	S0043_010_0	4	2	Brand			
S0043	010	0		29	10	S0043_010_0	4	3	Non-Preferred Brand			
S0043	010	0		29	10	S0043_010_0	4	4	Specialty			
S0043	013	0		29	10	S0043_013_0	5	3	Non-Preferred Brand			
S0043	013	0		29	10	S0043_013_0	5	2	Brand			
S0043	013	0		29	10	S0043_013_0	5	1	Generic			
S0043	013	0		29	10	S0043_013_0	5	4	Specialty	2		
S0043	013	0		29	10	S0043_013_0	5	4	Specialty			
S0043	013	0		29	10	S0043_013_0	5	1	Generic	1		1
S0043	013	0		29	10	S0043_013_0	5	2	Brand	2		
S0043	013	0		29	10	S0043_013_0	5	3	Non-Preferred Brand	2		
S0197	002	0		29	10	S0197_002_0	2	4	Speciality-Generic and Brand			
S0197	002	0		29	10	S0197_002_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S0197	002	0		29	10	S0197_002_0	2	1	Preferred Generic			
S0197	002	0		29	10	S0197_002_0	2	2	Preferred Brand			
S0197	003	0		29	10	S0197_003_0	3	1	Preferred Generic			
S0197	003	0		29	10	S0197_003_0	3	2	Preferred Brand			
S0197	003	0		29	10	S0197_003_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S0197	003	0		29	10	S0197_003_0	3	4	Specialty-Generic and Brand			
S0197	005	0		29	10	S0197_005_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S0197	005	0		29	10	S0197_005_0	3	4	Specialty-Generic and Brand	2		
S0197	005	0		29	10	S0197_005_0	3	1	Preferred Generic			
S0197	005	0		29	10	S0197_005_0	3	4	Specialty-Generic and Brand			
S0197	005	0		29	10	S0197_005_0	3	1	Preferred Generic	1		1
S0197	005	0		29	10	S0197_005_0	3	2	Preferred Brand	2		
S0197	005	0		29	10	S0197_005_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S0197	005	0		29	10	S0197_005_0	3	2	Preferred Brand			
S1030	001	0		29	10	S1030_001_0	5	1	Generic			
S1030	001	0		29	10	S1030_001_0	5	2	Preferred Brand			
S1030	001	0		29	10	S1030_001_0	5	3	Non-Preferred Brand			
S1030	001	0		29	10	S1030_001_0	5	4	Specialty			
S1030	006	0		29	10	S1030_006_0	4	1	Generic			
S1030	006	0		29	10	S1030_006_0	4	2	Preferred Brand			
S1030	006	0		29	10	S1030_006_0	4	3	Non-Preferred Brand			
S1030	006	0		29	10	S1030_006_0	4	4	Specialty			
S2321	002	0		29	10	S2321_002_0	4	2	Preferred Brand			
S2321	002	0		29	10	S2321_002_0	4	1	Generic			
S2321	002	0		29	10	S2321_002_0	4	4	Specialty			
S2321	002	0		29	10	S2321_002_0	4	3	Non-Preferred Brand			
S2468	001	0		29	10	S2468_001_0	4	1	Formulary Generic			
S2468	001	0		29	10	S2468_001_0	4	3	Non-Preferred Brand			
S2468	001	0		29	10	S2468_001_0	4	4	Injectables			
S2468	001	0		29	10	S2468_001_0	4	5	Formulary Specialty (Unique High Cost Drugs)			
S2468	001	0		29	10	S2468_001_0	4	2	Formulary Brand			
S2505	001	0		29	10	S2505_001_0	4	2	Tier 2 - Preferred Brand			
S2505	001	0		29	10	S2505_001_0	4	3	Tier 3 - NonPreferred Brand, NonPreferred Generic			
S2505	001	0		29	10	S2505_001_0	4	4	Tier 4 - Speciality (Brand or Generic)			
S2505	001	0		29	10	S2505_001_0	4	1	Tier 1 - Preferred Generics			
S2505	003	0		29	10	S2505_003_0	4	3	Tier 3 - NonPreferred Brand, NonPreferred Generic			
S2505	003	0		29	10	S2505_003_0	4	4	Tier 4 - Speciality (Brand or Generic)			
S2505	003	0		29	10	S2505_003_0	4	2	Tier 2 - Preferred Brand			
S2505	003	0		29	10	S2505_003_0	4	1	Tier 1 - Preferred Generics			
S2505	005	0		29	10	S2505_005_0	5	4	Tier 4 - Speciality (Brand or Generic)			
S2505	005	0		29	10	S2505_005_0	5	1	Tier 1 - Preferred Generics			
S2505	005	0		29	10	S2505_005_0	5	3	Tier 3 - NonPreferred Brand, NonPreferred Generic			
S2505	005	0		29	10	S2505_005_0	5	2	Tier 2 - Preferred Brand			
S2505	007	0		29	10	S2505_007_0	5	3	Tier 3 - NonPreferred Brand, NonPreferred Generic			
S2505	007	0		29	10	S2505_007_0	5	1	Tier 1 - Preferred Generics			
S2505	007	0		29	10	S2505_007_0	5	2	Tier 2 - Preferred Brand			
S2505	007	0		29	10	S2505_007_0	5	4	Tier 4 - Speciality (Brand or Generic)			
S2873	002	0		29	10	S2873_002_0	3	4	Specialty-Tier 4			
S2873	002	0		29	10	S2873_002_0	3	3	Non-preferred Brand-Tier 3			
S2873	002	0		29	10	S2873_002_0	3	2	Preferred Brand-Tier 2			
S2873	002	0		29	10	S2873_002_0	3	1	Generic-Tier 1			
S2873	003	0		29	10	S2873_003_0	4	4	Specialty-Tier 4	2		
S2873	003	0		29	10	S2873_003_0	4	3	Non-preferred Brand-Tier 3	2		
S2873	003	0		29	10	S2873_003_0	4	3	Non-preferred Brand-Tier 3			
S2873	003	0		29	10	S2873_003_0	4	1	Generic-Tier 1	1		1
S2873	003	0		29	10	S2873_003_0	4	2	Preferred Brand-Tier 2	2		
S2873	003	0		29	10	S2873_003_0	4	4	Specialty-Tier 4			
S2873	003	0		29	10	S2873_003_0	4	1	Generic-Tier 1			
S2873	003	0		29	10	S2873_003_0	4	2	Preferred Brand-Tier 2			
S2874	001	0		29	10	S2874_001_0	1	3	Other - Non-Preferred (Gen/Brand)			
S2874	001	0		29	10	S2874_001_0	1	2	Preferred Brand			
S2874	001	0		29	10	S2874_001_0	1	1	Preferred Generic			
S2874	002	0		29	10	S2874_002_0	2	3	Non-Preferred Brand			
S2874	002	0		29	10	S2874_002_0	2	4	Specialty			
S2874	002	0		29	10	S2874_002_0	2	2	Preferred Brand			
S2874	002	0		29	10	S2874_002_0	2	1	Preferred Generic			
S2893	001	0		29	10	S2893_001_0	2	2	Tier 2 Preferred Brand			
S2893	001	0		29	10	S2893_001_0	2	3	Tier 3 Non-Preferred Brand			
S2893	001	0		29	10	S2893_001_0	2	4	Tier 4 Specialty			
S2893	001	0		29	10	S2893_001_0	2	1	Tier 1 Preferred Generic			
S2893	003	0		29	10	S2893_003_0	2	3	Tier 3 Non-Preferred Brand			
S2893	003	0		29	10	S2893_003_0	2	2	Tier 2 Preferred Brand			
S2893	003	0		29	10	S2893_003_0	2	1	Tier 1 Preferred Generic			
S2893	003	0		29	10	S2893_003_0	2	4	Tier 4 Specialty			
S2893	003	0		29	10	S2893_003_0	2	1	Tier 1 Preferred Generic	1		1
S2893	003	0		29	10	S2893_003_0	2	2	Tier 2 Preferred Brand	2		
S2893	003	0		29	10	S2893_003_0	2	4	Tier 4 Specialty	2		
S2893	003	0		29	10	S2893_003_0	2	3	Tier 3 Non-Preferred Brand	2		
S2893	014	0		29	10	S2893_014_0	2	1	Tier 1 Preferred Generic			
S2893	014	0		29	10	S2893_014_0	2	2	Tier 2 Preferred Brand			
S2893	014	0		29	10	S2893_014_0	2	3	Tier 3 Non-Preferred Brand			
S2893	014	0		29	10	S2893_014_0	2	4	Tier 4 Specialty			
S3389	005	0		29	10	S3389_005_0	4	3	Non-Preferred Brand			
S3389	005	0		29	10	S3389_005_0	4	2	Preferred Brand			
S3389	005	0		29	10	S3389_005_0	4	1	Generic			
S3389	005	0		29	10	S3389_005_0	4	4	Specialty			
S3440	001	0		29	10	S3440_001_0	7	4	Tier 4			
S3440	001	0		29	10	S3440_001_0	7	3	Tier 3			
S3440	001	0		29	10	S3440_001_0	7	2	Tier 2			
S3440	001	0		29	10	S3440_001_0	7	1	Tier 1			
S3440	002	0		29	10	S3440_002_0	6	3	Tier 3			
S3440	002	0		29	10	S3440_002_0	6	2	Tier 2			
S3440	002	0		29	10	S3440_002_0	6	1	Tier 1			
S3440	002	0		29	10	S3440_002_0	6	1	Tier 1	1		1
S3440	002	0		29	10	S3440_002_0	6	2	Tier 2	2		
S3440	002	0		29	10	S3440_002_0	6	4	Tier 4			
S3440	002	0		29	10	S3440_002_0	6	4	Tier 4	2		
S3440	002	0		29	10	S3440_002_0	6	3	Tier 3	2		
S3440	003	0		29	10	S3440_003_0	5	3	Tier 3			
S3440	003	0		29	10	S3440_003_0	5	4	Tier 4			
S3440	003	0		29	10	S3440_003_0	5	2	Tier 2			
S3440	003	0		29	10	S3440_003_0	5	1	Tier 1			
S3521	003	0		29	10	S3521_003_0	4	1	Generics			
S3521	003	0		29	10	S3521_003_0	4	2	Preferred Brand			
S3521	003	0		29	10	S3521_003_0	4	3	Non-Preferred Brand			
S3521	003	0		29	10	S3521_003_0	4	4	Specialty			
S4496	001	0		29	10	S4496_001_0	1	1	Generic			
S4496	001	0		29	10	S4496_001_0	1	2	Preferred Brand			
S4496	001	0		29	10	S4496_001_0	1	3	Non-Preferred Brand			
S4496	001	0		29	10	S4496_001_0	1	4	Specialty			
S4496	003	0		29	10	S4496_003_0	1	1	Generic			
S4496	003	0		29	10	S4496_003_0	1	2	Preferred Brand			
S4496	003	0		29	10	S4496_003_0	1	3	Non-preferred Brand			
S4496	003	0		29	10	S4496_003_0	1	4	Specialty			
S4802	001	0		29	10	S4802_001_0	5	1	Generic			
S4802	001	0		29	10	S4802_001_0	5	4	Specialty			
S4802	001	0		29	10	S4802_001_0	5	3	Non-Preferred Brand			
S4802	001	0		29	10	S4802_001_0	5	2	Preferred Brand			
S4802	002	0		29	10	S4802_002_0	5	4	Specialty			
S4802	002	0		29	10	S4802_002_0	5	3	Non-Preferred Brand			
S4802	002	0		29	10	S4802_002_0	5	2	Preferred Brand			
S4802	002	0		29	10	S4802_002_0	5	1	Generic			
S4802	003	0		29	10	S4802_003_0	6	2	Preferred Brand			
S4802	003	0		29	10	S4802_003_0	6	1	Generic			
S4802	003	0		29	10	S4802_003_0	6	3	Non-Preferred Brand			
S4802	003	0		29	10	S4802_003_0	6	4	Specialty			
S4802	004	0		29	10	S4802_004_0	6	2	Preferred Brand			
S4802	004	0		29	10	S4802_004_0	6	1	Generic			
S4802	004	0		29	10	S4802_004_0	6	4	Specialty			
S4802	004	0		29	10	S4802_004_0	6	3	Non-Preferred Brand			
S4802	005	0		29	10	S4802_005_0	6	4	Specialty			
S4802	005	0		29	10	S4802_005_0	6	3	Non-Preferred Brand			
S4802	005	0		29	10	S4802_005_0	6	2	Preferred Brand			
S4802	005	0		29	10	S4802_005_0	6	1	Generic			
S4802	006	0		29	10	S4802_006_0	6	2	Preferred Brand			
S4802	006	0		29	10	S4802_006_0	6	1	Generic			
S4802	006	0		29	10	S4802_006_0	6	4	Specialty			
S4802	006	0		29	10	S4802_006_0	6	3	Non-Preferred Brand			
S4802	007	0		29	10	S4802_007_0	6	2	Preferred Brand			
S4802	007	0		29	10	S4802_007_0	6	3	Non-Preferred Brand			
S4802	007	0		29	10	S4802_007_0	6	4	Specialty			
S4802	007	0		29	10	S4802_007_0	6	1	Generic			
S4802	008	0		29	10	S4802_008_0	6	1	Generic			
S4802	008	0		29	10	S4802_008_0	6	2	Preferred Brand			
S4802	008	0		29	10	S4802_008_0	6	4	Specialty			
S4802	008	0		29	10	S4802_008_0	6	3	Non-Preferred Brand			
S4802	009	0		29	10	S4802_009_0	6	4	Specialty			
S4802	009	0		29	10	S4802_009_0	6	2	Preferred Brand			
S4802	009	0		29	10	S4802_009_0	6	3	Non-Preferred Brand			
S4802	009	0		29	10	S4802_009_0	6	1	Generic			
S4802	010	0		29	10	S4802_010_0	6	2	Preferred Brand			
S4802	010	0		29	10	S4802_010_0	6	3	Non-Preferred Brand			
S4802	010	0		29	10	S4802_010_0	6	1	Generic			
S4802	010	0		29	10	S4802_010_0	6	4	Specialty			
S4802	011	0		29	10	S4802_011_0	6	1	Generic			
S4802	011	0		29	10	S4802_011_0	6	2	Preferred Brand			
S4802	011	0		29	10	S4802_011_0	6	3	Non-Preferred Brand			
S4802	011	0		29	10	S4802_011_0	6	4	Specialty			
S4802	012	0		29	10	S4802_012_0	6	3	Non-Preferred Brand			
S4802	012	0		29	10	S4802_012_0	6	2	Preferred Brand			
S4802	012	0		29	10	S4802_012_0	6	1	Generic			
S4802	012	0		29	10	S4802_012_0	6	4	Specialty			
S4802	013	0		29	10	S4802_013_0	5	4	Specialty			
S4802	013	0		29	10	S4802_013_0	5	1	Generic			
S4802	013	0		29	10	S4802_013_0	5	2	Preferred Brand			
S4802	013	0		29	10	S4802_013_0	5	3	Non-Preferred Brand			
S4802	014	0		29	10	S4802_014_0	5	1	Generic			
S4802	014	0		29	10	S4802_014_0	5	3	Non-Preferred Brand			
S4802	014	0		29	10	S4802_014_0	5	2	Preferred Brand			
S4802	014	0		29	10	S4802_014_0	5	4	Specialty			
S4802	015	0		29	10	S4802_015_0	6	3	Non-Preferred Brand			
S4802	015	0		29	10	S4802_015_0	6	2	Preferred Brand			
S4802	015	0		29	10	S4802_015_0	6	4	Specialty			
S4802	015	0		29	10	S4802_015_0	6	1	Generic			
S4802	016	0		29	10	S4802_016_0	6	1	Generic			
S4802	016	0		29	10	S4802_016_0	6	2	Preferred Brand			
S4802	016	0		29	10	S4802_016_0	6	3	Non-Preferred Brand			
S4802	016	0		29	10	S4802_016_0	6	4	Specialty			
S4802	017	0		29	10	S4802_017_0	6	3	Non-Preferred Brand			
S4802	017	0		29	10	S4802_017_0	6	2	Preferred Brand			
S4802	017	0		29	10	S4802_017_0	6	1	Generic			
S4802	017	0		29	10	S4802_017_0	6	4	Specialty			
S4802	018	0		29	10	S4802_018_0	6	1	Generic			
S4802	018	0		29	10	S4802_018_0	6	2	Preferred Brand			
S4802	018	0		29	10	S4802_018_0	6	3	Non-Preferred Brand			
S4802	018	0		29	10	S4802_018_0	6	4	Specialty			
S4802	019	0		29	10	S4802_019_0	6	3	Non-Preferred Brand			
S4802	019	0		29	10	S4802_019_0	6	2	Preferred Brand			
S4802	019	0		29	10	S4802_019_0	6	1	Generic			
S4802	019	0		29	10	S4802_019_0	6	4	Specialty			
S4802	020	0		29	10	S4802_020_0	6	1	Generic			
S4802	020	0		29	10	S4802_020_0	6	2	Preferred Brand			
S4802	020	0		29	10	S4802_020_0	6	3	Non-Preferred Brand			
S4802	020	0		29	10	S4802_020_0	6	4	Specialty			
S4802	021	0		29	10	S4802_021_0	6	1	Generic			
S4802	021	0		29	10	S4802_021_0	6	2	Preferred Brand			
S4802	021	0		29	10	S4802_021_0	6	4	Specialty			
S4802	021	0		29	10	S4802_021_0	6	3	Non-Preferred Brand			
S4802	022	0		29	10	S4802_022_0	6	1	Generic			
S4802	022	0		29	10	S4802_022_0	6	3	Non-Preferred Brand			
S4802	022	0		29	10	S4802_022_0	6	2	Preferred Brand			
S4802	022	0		29	10	S4802_022_0	6	4	Specialty			
S4802	023	0		29	10	S4802_023_0	6	3	Non-Preferred Brand			
S4802	023	0		29	10	S4802_023_0	6	4	Specialty			
S4802	023	0		29	10	S4802_023_0	6	1	Generic			
S4802	023	0		29	10	S4802_023_0	6	2	Preferred Brand			
S4802	024	0		29	10	S4802_024_0	6	3	Non-Preferred Brand			
S4802	024	0		29	10	S4802_024_0	6	2	Preferred Brand			
S4802	024	0		29	10	S4802_024_0	6	1	Generic			
S4802	024	0		29	10	S4802_024_0	6	4	Specialty			
S4802	025	0		29	10	S4802_025_0	6	1	Generic			
S4802	025	0		29	10	S4802_025_0	6	2	Preferred Brand			
S4802	025	0		29	10	S4802_025_0	6	3	Non-Preferred Brand			
S4802	025	0		29	10	S4802_025_0	6	4	Specialty			
S4802	026	0		29	10	S4802_026_0	6	3	Non-Preferred Brand			
S4802	026	0		29	10	S4802_026_0	6	2	Preferred Brand			
S4802	026	0		29	10	S4802_026_0	6	1	Generic			
S4802	026	0		29	10	S4802_026_0	6	4	Specialty			
S4802	027	0		29	10	S4802_027_0	6	1	Generic			
S4802	027	0		29	10	S4802_027_0	6	2	Preferred Brand			
S4802	027	0		29	10	S4802_027_0	6	3	Non-Preferred Brand			
S4802	027	0		29	10	S4802_027_0	6	4	Specialty			
S4802	028	0		29	10	S4802_028_0	6	1	Generic			
S4802	028	0		29	10	S4802_028_0	6	2	Preferred Brand			
S4802	028	0		29	10	S4802_028_0	6	4	Specialty			
S4802	028	0		29	10	S4802_028_0	6	3	Non-Preferred Brand			
S4802	029	0		29	10	S4802_029_0	6	1	Generic			
S4802	029	0		29	10	S4802_029_0	6	3	Non-Preferred Brand			
S4802	029	0		29	10	S4802_029_0	6	2	Preferred Brand			
S4802	029	0		29	10	S4802_029_0	6	4	Specialty			
S4802	030	0		29	10	S4802_030_0	6	1	Generic			
S4802	030	0		29	10	S4802_030_0	6	2	Preferred Brand			
S4802	030	0		29	10	S4802_030_0	6	4	Specialty			
S4802	030	0		29	10	S4802_030_0	6	3	Non-Preferred Brand			
S4802	031	0		29	10	S4802_031_0	6	1	Generic			
S4802	031	0		29	10	S4802_031_0	6	3	Non-Preferred Brand			
S4802	031	0		29	10	S4802_031_0	6	2	Preferred Brand			
S4802	031	0		29	10	S4802_031_0	6	4	Specialty			
S4802	032	0		29	10	S4802_032_0	6	4	Specialty			
S4802	032	0		29	10	S4802_032_0	6	1	Generic			
S4802	032	0		29	10	S4802_032_0	6	2	Preferred Brand			
S4802	032	0		29	10	S4802_032_0	6	3	Non-Preferred Brand			
S4802	033	0		29	10	S4802_033_0	6	3	Non-Preferred Brand			
S4802	033	0		29	10	S4802_033_0	6	4	Specialty			
S4802	033	0		29	10	S4802_033_0	6	2	Preferred Brand			
S4802	033	0		29	10	S4802_033_0	6	1	Generic			
S4802	067	0		29	10	S4802_067_0	6	2	Preferred Brand			
S4802	067	0		29	10	S4802_067_0	6	4	Specialty			
S4802	067	0		29	10	S4802_067_0	6	3	Non-Preferred Brand			
S4802	067	0		29	10	S4802_067_0	6	1	Generic			
S4877	002	0		29	10	S4877_002_0	3	4	Brand  Specialty			
S4877	002	0		29	10	S4877_002_0	3	3	Non-Preferred Brand			
S4877	002	0		29	10	S4877_002_0	3	2	Preferred Brand			
S4877	002	0		29	10	S4877_002_0	3	1	Generic			
S4877	002	0		29	10	S4877_002_0	3	1	Generic	1		1
S4877	002	0		29	10	S4877_002_0	3	2	Preferred Brand	2		
S4877	002	0		29	10	S4877_002_0	3	3	Non-Preferred Brand	2		
S4877	002	0		29	10	S4877_002_0	3	4	Brand  Specialty	2		
S5540	002	0		29	10	S5540_002_0	2	1	Tier 1 - Generic			
S5540	002	0		29	10	S5540_002_0	2	4	Tier 4 - Specialty			
S5540	002	0		29	10	S5540_002_0	2	3	Tier 3 - Non-preferred Brand			
S5540	002	0		29	10	S5540_002_0	2	2	Tier 2 - Preferred Brand			
S5540	004	0		29	10	S5540_004_0	2	4	Tier 4 - Specialty	2		
S5540	004	0		29	10	S5540_004_0	2	3	Tier 3 - Non-Preferred Brand			
S5540	004	0		29	10	S5540_004_0	2	2	Tier 2 - Preferred Brand			
S5540	004	0		29	10	S5540_004_0	2	1	Tier 1 - Generic			
S5540	004	0		29	10	S5540_004_0	2	3	Tier 3 - Non-Preferred Brand	2		
S5540	004	0		29	10	S5540_004_0	2	2	Tier 2 - Preferred Brand	2		
S5540	004	0		29	10	S5540_004_0	2	1	Tier 1 - Generic	1		1
S5540	004	0		29	10	S5540_004_0	2	4	Tier 4 - Specialty			
S5552	001	0		29	10	S5552_001_0	2	2	Preferred Brand			
S5552	001	0		29	10	S5552_001_0	2	1	Preferred Generic			
S5552	001	0		29	10	S5552_001_0	2	4	Specialty			
S5552	001	0		29	10	S5552_001_0	2	3	Non-Preferred Brand			
S5552	002	0		29	10	S5552_002_0	2	3	Non-Preferred Brand			
S5552	002	0		29	10	S5552_002_0	2	4	Specialty	2		
S5552	002	0		29	10	S5552_002_0	2	3	Non-Preferred Brand	2		
S5552	002	0		29	10	S5552_002_0	2	1	Preferred Generic			
S5552	002	0		29	10	S5552_002_0	2	2	Preferred Brand			
S5552	002	0		29	10	S5552_002_0	2	4	Specialty			
S5552	002	0		29	10	S5552_002_0	2	1	Preferred Generic	1		1
S5552	002	0		29	10	S5552_002_0	2	2	Preferred Brand	2		
S5552	003	0		29	10	S5552_003_0	2	1	Preferred Generic			
S5552	003	0		29	10	S5552_003_0	2	2	Preferred Brand			
S5552	003	0		29	10	S5552_003_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5555	001	0		29	10	S5555_001_0	4	2	Preferred Brand			
S5555	001	0		29	10	S5555_001_0	4	1	Generic			
S5555	001	0		29	10	S5555_001_0	4	3	Non-Preferred Brand			
S5555	001	0		29	10	S5555_001_0	4	4	Specialty			
S5557	004	0		29	10	S5557_004_0	2	2	Tier 2			
S5557	004	0		29	10	S5557_004_0	2	1	Tier 1			
S5557	004	0		29	10	S5557_004_0	2	3	Tier 3			
S5557	004	0		29	10	S5557_004_0	2	5	Tier 5			
S5557	004	0		29	10	S5557_004_0	2	4	Tier 4			
S5557	009	0		29	10	S5557_009_0	5	1	Tier 1			
S5557	009	0		29	10	S5557_009_0	5	2	Tier 2			
S5557	009	0		29	10	S5557_009_0	5	5	Tier 5	2		
S5557	009	0		29	10	S5557_009_0	5	4	Tier 4	2		
S5557	009	0		29	10	S5557_009_0	5	3	Tier 3	2		
S5557	009	0		29	10	S5557_009_0	5	2	Tier 2	2		
S5557	009	0		29	10	S5557_009_0	5	1	Tier 1	1		1
S5557	009	0		29	10	S5557_009_0	5	5	Tier 5			
S5557	009	0		29	10	S5557_009_0	5	4	Tier 4			
S5557	009	0		29	10	S5557_009_0	5	3	Tier 3			
S5557	011	0		29	10	S5557_011_0	5	1	Tier 1			
S5557	011	0		29	10	S5557_011_0	5	3	Tier 3	2		
S5557	011	0		29	10	S5557_011_0	5	4	Tier 4	2		
S5557	011	0		29	10	S5557_011_0	5	2	Tier 2	2		
S5557	011	0		29	10	S5557_011_0	5	5	Tier 5	2		
S5557	011	0		29	10	S5557_011_0	5	5	Tier 5			
S5557	011	0		29	10	S5557_011_0	5	4	Tier 4			
S5557	011	0		29	10	S5557_011_0	5	3	Tier 3			
S5557	011	0		29	10	S5557_011_0	5	2	Tier 2			
S5557	011	0		29	10	S5557_011_0	5	1	Tier 1	1		1
S5557	013	0		29	10	S5557_013_0	5	1	Tier 1	1		1
S5557	013	0		29	10	S5557_013_0	5	2	Tier 2	2		
S5557	013	0		29	10	S5557_013_0	5	3	Tier 3	2		
S5557	013	0		29	10	S5557_013_0	5	4	Tier 4	2		
S5557	013	0		29	10	S5557_013_0	5	5	Tier 5	2		
S5557	013	0		29	10	S5557_013_0	5	1	Tier 1			
S5557	013	0		29	10	S5557_013_0	5	2	Tier 2			
S5557	013	0		29	10	S5557_013_0	5	3	Tier 3			
S5557	013	0		29	10	S5557_013_0	5	4	Tier 4			
S5557	013	0		29	10	S5557_013_0	5	5	Tier 5			
S5557	015	0		29	10	S5557_015_0	5	4	Tier 4			
S5557	015	0		29	10	S5557_015_0	5	3	Tier 3			
S5557	015	0		29	10	S5557_015_0	5	2	Tier 2			
S5557	015	0		29	10	S5557_015_0	5	1	Tier 1			
S5557	015	0		29	10	S5557_015_0	5	5	Tier 5	2		
S5557	015	0		29	10	S5557_015_0	5	1	Tier 1	1		1
S5557	015	0		29	10	S5557_015_0	5	2	Tier 2	2		
S5557	015	0		29	10	S5557_015_0	5	3	Tier 3	2		
S5557	015	0		29	10	S5557_015_0	5	4	Tier 4	2		
S5557	015	0		29	10	S5557_015_0	5	5	Tier 5			
S5557	017	0		29	10	S5557_017_0	5	4	Tier 4			
S5557	017	0		29	10	S5557_017_0	5	3	Tier 3			
S5557	017	0		29	10	S5557_017_0	5	2	Tier 2			
S5557	017	0		29	10	S5557_017_0	5	1	Tier 1			
S5557	017	0		29	10	S5557_017_0	5	5	Tier 5			
S5557	017	0		29	10	S5557_017_0	5	5	Tier 5	2		
S5557	017	0		29	10	S5557_017_0	5	4	Tier 4	2		
S5557	017	0		29	10	S5557_017_0	5	3	Tier 3	2		
S5557	017	0		29	10	S5557_017_0	5	2	Tier 2	2		
S5557	017	0		29	10	S5557_017_0	5	1	Tier 1	1		1
S5557	019	0		29	10	S5557_019_0	5	1	Tier 1			
S5557	019	0		29	10	S5557_019_0	5	2	Tier 2			
S5557	019	0		29	10	S5557_019_0	5	3	Tier 3			
S5557	019	0		29	10	S5557_019_0	5	4	Tier 4			
S5557	019	0		29	10	S5557_019_0	5	5	Tier 5	2		
S5557	019	0		29	10	S5557_019_0	5	3	Tier 3	2		
S5557	019	0		29	10	S5557_019_0	5	2	Tier 2	2		
S5557	019	0		29	10	S5557_019_0	5	1	Tier 1	1		1
S5557	019	0		29	10	S5557_019_0	5	5	Tier 5			
S5557	019	0		29	10	S5557_019_0	5	4	Tier 4	2		
S5557	021	0		29	10	S5557_021_0	5	4	Tier 4			
S5557	021	0		29	10	S5557_021_0	5	3	Tier 3			
S5557	021	0		29	10	S5557_021_0	5	2	Tier 2			
S5557	021	0		29	10	S5557_021_0	5	1	Tier 1			
S5557	021	0		29	10	S5557_021_0	5	5	Tier 5	2		
S5557	021	0		29	10	S5557_021_0	5	1	Tier 1	1		1
S5557	021	0		29	10	S5557_021_0	5	2	Tier 2	2		
S5557	021	0		29	10	S5557_021_0	5	3	Tier 3	2		
S5557	021	0		29	10	S5557_021_0	5	4	Tier 4	2		
S5557	021	0		29	10	S5557_021_0	5	5	Tier 5			
S5557	023	0		29	10	S5557_023_0	3	4	Tier 4			
S5557	023	0		29	10	S5557_023_0	3	3	Tier 3			
S5557	023	0		29	10	S5557_023_0	3	2	Tier 2			
S5557	023	0		29	10	S5557_023_0	3	1	Tier 1			
S5557	023	0		29	10	S5557_023_0	3	5	Tier 5			
S5557	024	0		29	10	S5557_024_0	3	2	Tier 2			
S5557	024	0		29	10	S5557_024_0	3	1	Tier 1			
S5557	024	0		29	10	S5557_024_0	3	3	Tier 3			
S5557	024	0		29	10	S5557_024_0	3	4	Tier 4			
S5557	024	0		29	10	S5557_024_0	3	5	Tier 5			
S5557	025	0		29	10	S5557_025_0	2	2	Tier 2			
S5557	025	0		29	10	S5557_025_0	2	1	Tier 1			
S5557	025	0		29	10	S5557_025_0	2	3	Tier 3			
S5557	025	0		29	10	S5557_025_0	2	5	Tier 5			
S5557	025	0		29	10	S5557_025_0	2	4	Tier 4			
S5557	028	0		29	10	S5557_028_0	2	1	Tier 1			
S5557	028	0		29	10	S5557_028_0	2	2	Tier 2			
S5557	028	0		29	10	S5557_028_0	2	4	Tier 4			
S5557	028	0		29	10	S5557_028_0	2	3	Tier 3			
S5557	028	0		29	10	S5557_028_0	2	5	Tier 5			
S5557	031	0		29	10	S5557_031_0	3	1	Tier 1			
S5557	031	0		29	10	S5557_031_0	3	2	Tier 2			
S5557	031	0		29	10	S5557_031_0	3	5	Tier 5			
S5557	031	0		29	10	S5557_031_0	3	4	Tier 4			
S5557	031	0		29	10	S5557_031_0	3	3	Tier 3			
S5566	001	0		29	10	S5566_001_0	1	4	Specialty			
S5566	001	0		29	10	S5566_001_0	1	3	Brand			
S5566	001	0		29	10	S5566_001_0	1	2	Preferred Brand			
S5566	001	0		29	10	S5566_001_0	1	1	Generic			
S5566	002	0		29	10	S5566_002_0	2	4	Specialty			
S5566	002	0		29	10	S5566_002_0	2	3	Brand			
S5566	002	0		29	10	S5566_002_0	2	2	Preferred Brand			
S5566	002	0		29	10	S5566_002_0	2	1	Generic			
S5566	003	0		29	10	S5566_003_0	3	3	Brand	2		
S5566	003	0		29	10	S5566_003_0	3	4	Specialty	1	01000000	2
S5566	003	0		29	10	S5566_003_0	3	2	Preferred Brand	2		
S5566	003	0		29	10	S5566_003_0	3	1	Generic	1		1
S5566	003	0		29	10	S5566_003_0	3	4	Specialty			
S5566	003	0		29	10	S5566_003_0	3	3	Brand			
S5566	003	0		29	10	S5566_003_0	3	2	Preferred Brand			
S5566	003	0		29	10	S5566_003_0	3	1	Generic			
S5569	003	0		29	10	S5569_003_0	3	1	Preferred Generic			
S5569	003	0		29	10	S5569_003_0	3	2	Preferred Brand			
S5569	003	0		29	10	S5569_003_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5569	003	0		29	10	S5569_003_0	3	4	Specialty-Generic and Brand			
S5569	005	0		29	10	S5569_005_0	2	1	Preferred Generic			
S5569	005	0		29	10	S5569_005_0	2	2	Preferred Brand			
S5569	005	0		29	10	S5569_005_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5569	005	0		29	10	S5569_005_0	2	4	Specialty-Generic and Brand			
S5580	003	0		29	10	S5580_003_0	1	2	Preferred Brand			
S5580	003	0		29	10	S5580_003_0	1	1	Generic			
S5580	003	0		29	10	S5580_003_0	1	3	Non-Preferred Brand			
S5580	003	0		29	10	S5580_003_0	1	4	Specialty			
S5580	004	0		29	10	S5580_004_0	1	2	Preferred Brand			
S5580	004	0		29	10	S5580_004_0	1	1	Generic			
S5580	004	0		29	10	S5580_004_0	1	3	Non-Preferred Brand			
S5580	004	0		29	10	S5580_004_0	1	4	Specialty			
S5584	001	0		29	10	S5584_001_0	5	1	Generic			
S5584	001	0		29	10	S5584_001_0	5	2	Preferred Brand			
S5584	001	0		29	10	S5584_001_0	5	3	Non Preferred			
S5584	001	0		29	10	S5584_001_0	5	4	Specialty			
S5584	001	0		29	10	S5584_001_0	5	5	Non Self Administered Injectable			
S5584	002	0		29	10	S5584_002_0	4	1	Generic			
S5584	002	0		29	10	S5584_002_0	4	5	Non Self Administered Injectable	2		
S5584	002	0		29	10	S5584_002_0	4	4	Specialty	2		
S5584	002	0		29	10	S5584_002_0	4	3	Non Preferred	2		
S5584	002	0		29	10	S5584_002_0	4	2	Preferred Brand			
S5584	002	0		29	10	S5584_002_0	4	3	Non Preferred			
S5584	002	0		29	10	S5584_002_0	4	4	Specialty			
S5584	002	0		29	10	S5584_002_0	4	5	Non Self Administered Injectable			
S5584	002	0		29	10	S5584_002_0	4	1	Generic	1		1
S5584	002	0		29	10	S5584_002_0	4	2	Preferred Brand	2		
S5585	001	0		29	10	S5585_001_0	2	3	Non-Preferred Brand/Generic			
S5585	001	0		29	10	S5585_001_0	2	2	Preferred Brand			
S5585	001	0		29	10	S5585_001_0	2	1	Formulary Generic			
S5585	001	0		29	10	S5585_001_0	2	4	Specialty Injectables			
S5593	002	0		29	10	S5593_002_0	7	1	Generic			
S5593	002	0		29	10	S5593_002_0	7	2	Preferred Brand			
S5593	002	0		29	10	S5593_002_0	7	3	Non-Preferred Brand			
S5593	002	0		29	10	S5593_002_0	7	4	Specialty			
S5593	003	0		29	10	S5593_003_0	5	4	Specialty	2		
S5593	003	0		29	10	S5593_003_0	5	1	Generic	1		1
S5593	003	0		29	10	S5593_003_0	5	2	Preferred Brand	2		
S5593	003	0		29	10	S5593_003_0	5	3	Non-Preferred Brand	2		
S5593	003	0		29	10	S5593_003_0	5	4	Specialty			
S5593	003	0		29	10	S5593_003_0	5	3	Non-Preferred Brand			
S5593	003	0		29	10	S5593_003_0	5	2	Preferred Brand			
S5593	003	0		29	10	S5593_003_0	5	1	Generic			
S5593	004	0		29	10	S5593_004_0	5	1	Generic			
S5593	004	0		29	10	S5593_004_0	5	2	Preferred Brand			
S5593	004	0		29	10	S5593_004_0	5	3	Non-Preferred Brand			
S5593	004	0		29	10	S5593_004_0	5	4	Specialty			
S5596	001	0		29	10	S5596_001_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	001	0		29	10	S5596_001_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	001	0		29	10	S5596_001_0	3	2	Tier 2 Preferred Brand			
S5596	001	0		29	10	S5596_001_0	3	1	Tier 1 Preferred Generic			
S5596	001	0		29	10	S5596_001_0	3	5	Tier 5 Specialty			
S5596	003	0		29	10	S5596_003_0	4	4	Tier 4 Non-Specialty Injectable			
S5596	003	0		29	10	S5596_003_0	4	3	Tier 3 Non-Preferred Brand or Generic			
S5596	003	0		29	10	S5596_003_0	4	2	Tier 2 Preferred Brand			
S5596	003	0		29	10	S5596_003_0	4	1	Tier 1 Preferred Generic			
S5596	003	0		29	10	S5596_003_0	4	5	Tier 5 Specialty			
S5596	003	0		29	10	S5596_003_0	4	5	Tier 5 Specialty	2		
S5596	003	0		29	10	S5596_003_0	4	4	Tier 4 Non-Specialty Injectable	2		
S5596	003	0		29	10	S5596_003_0	4	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	003	0		29	10	S5596_003_0	4	2	Tier 2 Preferred Brand	2		
S5596	003	0		29	10	S5596_003_0	4	1	Tier 1 Preferred Generic	1		1
S5596	005	0		29	10	S5596_005_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	005	0		29	10	S5596_005_0	3	2	Tier 2 Preferred Brand			
S5596	005	0		29	10	S5596_005_0	3	1	Tier 1 Preferred Generic			
S5596	005	0		29	10	S5596_005_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	005	0		29	10	S5596_005_0	3	5	Tier 5 Specialty			
S5596	006	0		29	10	S5596_006_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	006	0		29	10	S5596_006_0	3	5	Tier 5 Specialty			
S5596	006	0		29	10	S5596_006_0	3	1	Tier 1 Preferred Generic			
S5596	006	0		29	10	S5596_006_0	3	2	Tier 2 Preferred Brand			
S5596	006	0		29	10	S5596_006_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	007	0		29	10	S5596_007_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	007	0		29	10	S5596_007_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	007	0		29	10	S5596_007_0	3	5	Tier 5 Specialty	2		
S5596	007	0		29	10	S5596_007_0	3	4	Tier 4 Non-Specialty Injectable	2		
S5596	007	0		29	10	S5596_007_0	3	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	007	0		29	10	S5596_007_0	3	2	Tier 2 Preferred Brand	2		
S5596	007	0		29	10	S5596_007_0	3	2	Tier 2 Preferred Brand			
S5596	007	0		29	10	S5596_007_0	3	1	Tier 1 Preferred Generic			
S5596	007	0		29	10	S5596_007_0	3	5	Tier 5 Specialty			
S5596	007	0		29	10	S5596_007_0	3	1	Tier 1 Preferred Generic	1		1
S5596	009	0		29	10	S5596_009_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	009	0		29	10	S5596_009_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	009	0		29	10	S5596_009_0	2	2	Tier 2 Preferred Brand			
S5596	009	0		29	10	S5596_009_0	2	1	Tier 1 Preferred Generic			
S5596	009	0		29	10	S5596_009_0	2	5	Tier 5 Specialty			
S5596	010	0		29	10	S5596_010_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	010	0		29	10	S5596_010_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	010	0		29	10	S5596_010_0	3	2	Tier 2 Preferred Brand			
S5596	010	0		29	10	S5596_010_0	3	1	Tier 1 Preferred Generic			
S5596	010	0		29	10	S5596_010_0	3	5	Tier 5 Specialty			
S5596	011	0		29	10	S5596_011_0	4	1	Tier 1 Preferred Generic			
S5596	011	0		29	10	S5596_011_0	4	2	Tier 2 Preferred Brand			
S5596	011	0		29	10	S5596_011_0	4	5	Tier 5 Specialty	2		
S5596	011	0		29	10	S5596_011_0	4	4	Tier 4 Non-Specialty Injectable	2		
S5596	011	0		29	10	S5596_011_0	4	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	011	0		29	10	S5596_011_0	4	2	Tier 2 Preferred Brand	2		
S5596	011	0		29	10	S5596_011_0	4	1	Tier 1 Preferred Generic	1		1
S5596	011	0		29	10	S5596_011_0	4	5	Tier 5 Specialty			
S5596	011	0		29	10	S5596_011_0	4	4	Tier 4 Non-Specialty Injectable			
S5596	011	0		29	10	S5596_011_0	4	3	Tier 3 Non-Preferred Brand or Generic			
S5596	013	0		29	10	S5596_013_0	2	2	Tier 2 Preferred Brand			
S5596	013	0		29	10	S5596_013_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	013	0		29	10	S5596_013_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	013	0		29	10	S5596_013_0	2	5	Tier 5 Specialty			
S5596	013	0		29	10	S5596_013_0	2	1	Tier 1 Preferred Generic			
S5596	014	0		29	10	S5596_014_0	3	5	Tier 5 Specialty			
S5596	014	0		29	10	S5596_014_0	3	2	Tier 2 Preferred Brand			
S5596	014	0		29	10	S5596_014_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	014	0		29	10	S5596_014_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	014	0		29	10	S5596_014_0	3	1	Tier 1 Preferred Generic			
S5596	015	0		29	10	S5596_015_0	3	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	015	0		29	10	S5596_015_0	3	4	Tier 4 Non-Specialty Injectable	2		
S5596	015	0		29	10	S5596_015_0	3	1	Tier 1 Preferred Generic			
S5596	015	0		29	10	S5596_015_0	3	2	Tier 2 Preferred Brand			
S5596	015	0		29	10	S5596_015_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	015	0		29	10	S5596_015_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	015	0		29	10	S5596_015_0	3	5	Tier 5 Specialty			
S5596	015	0		29	10	S5596_015_0	3	1	Tier 1 Preferred Generic	1		1
S5596	015	0		29	10	S5596_015_0	3	2	Tier 2 Preferred Brand	2		
S5596	015	0		29	10	S5596_015_0	3	5	Tier 5 Specialty	2		
S5596	017	0		29	10	S5596_017_0	2	1	Tier 1 Preferred Generic			
S5596	017	0		29	10	S5596_017_0	2	2	Tier 2 Preferred Brand			
S5596	017	0		29	10	S5596_017_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	017	0		29	10	S5596_017_0	2	5	Tier 5 Specialty			
S5596	017	0		29	10	S5596_017_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	018	0		29	10	S5596_018_0	3	5	Tier 5 Specialty			
S5596	018	0		29	10	S5596_018_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	018	0		29	10	S5596_018_0	3	2	Tier 2 Preferred Brand			
S5596	018	0		29	10	S5596_018_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	018	0		29	10	S5596_018_0	3	1	Tier 1 Preferred Generic			
S5596	019	0		29	10	S5596_019_0	3	1	Tier 1 Preferred Generic			
S5596	019	0		29	10	S5596_019_0	3	5	Tier 5 Specialty	2		
S5596	019	0		29	10	S5596_019_0	3	4	Tier 4 Non-Specialty Injectable	2		
S5596	019	0		29	10	S5596_019_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	019	0		29	10	S5596_019_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	019	0		29	10	S5596_019_0	3	1	Tier 1 Preferred Generic	1		1
S5596	019	0		29	10	S5596_019_0	3	2	Tier 2 Preferred Brand	2		
S5596	019	0		29	10	S5596_019_0	3	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	019	0		29	10	S5596_019_0	3	2	Tier 2 Preferred Brand			
S5596	019	0		29	10	S5596_019_0	3	5	Tier 5 Specialty			
S5596	021	0		29	10	S5596_021_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	021	0		29	10	S5596_021_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	021	0		29	10	S5596_021_0	2	5	Tier 5 Specialty			
S5596	021	0		29	10	S5596_021_0	2	1	Tier 1 Preferred Generic			
S5596	021	0		29	10	S5596_021_0	2	2	Tier 2 Preferred Brand			
S5596	022	0		29	10	S5596_022_0	3	5	Tier 5 Specialty			
S5596	022	0		29	10	S5596_022_0	3	2	Tier 2 Preferred Brand			
S5596	022	0		29	10	S5596_022_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	022	0		29	10	S5596_022_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	022	0		29	10	S5596_022_0	3	1	Tier 1 Preferred Generic			
S5596	023	0		29	10	S5596_023_0	4	5	Tier 5 Specialty	2		
S5596	023	0		29	10	S5596_023_0	4	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	023	0		29	10	S5596_023_0	4	4	Tier 4 Non-Specialty Injectable	2		
S5596	023	0		29	10	S5596_023_0	4	2	Tier 2 Preferred Brand	2		
S5596	023	0		29	10	S5596_023_0	4	1	Tier 1 Preferred Generic	1		1
S5596	023	0		29	10	S5596_023_0	4	5	Tier 5 Specialty			
S5596	023	0		29	10	S5596_023_0	4	4	Tier 4 Non-Specialty Injectable			
S5596	023	0		29	10	S5596_023_0	4	3	Tier 3 Non-Preferred Brand or Generic			
S5596	023	0		29	10	S5596_023_0	4	2	Tier 2 Preferred Brand			
S5596	023	0		29	10	S5596_023_0	4	1	Tier 1 Preferred Generic			
S5596	025	0		29	10	S5596_025_0	2	5	Tier 5 Specialty			
S5596	025	0		29	10	S5596_025_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	025	0		29	10	S5596_025_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	025	0		29	10	S5596_025_0	2	2	Tier 2 Preferred Brand			
S5596	025	0		29	10	S5596_025_0	2	1	Tier 1 Preferred Generic			
S5596	026	0		29	10	S5596_026_0	3	5	Tier 5 Specialty			
S5596	026	0		29	10	S5596_026_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	026	0		29	10	S5596_026_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	026	0		29	10	S5596_026_0	3	2	Tier 2 Preferred Brand			
S5596	026	0		29	10	S5596_026_0	3	1	Tier 1 Preferred Generic			
S5596	027	0		29	10	S5596_027_0	3	5	Tier 5 Specialty	2		
S5596	027	0		29	10	S5596_027_0	3	4	Tier 4 Non-Specialty Injectable	2		
S5596	027	0		29	10	S5596_027_0	3	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	027	0		29	10	S5596_027_0	3	2	Tier 2 Preferred Brand	2		
S5596	027	0		29	10	S5596_027_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	027	0		29	10	S5596_027_0	3	5	Tier 5 Specialty			
S5596	027	0		29	10	S5596_027_0	3	1	Tier 1 Preferred Generic	1		1
S5596	027	0		29	10	S5596_027_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	027	0		29	10	S5596_027_0	3	2	Tier 2 Preferred Brand			
S5596	027	0		29	10	S5596_027_0	3	1	Tier 1 Preferred Generic			
S5596	029	0		29	10	S5596_029_0	2	1	Tier 1 Preferred Generic			
S5596	029	0		29	10	S5596_029_0	2	2	Tier 2 Preferred Brand			
S5596	029	0		29	10	S5596_029_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	029	0		29	10	S5596_029_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	029	0		29	10	S5596_029_0	2	5	Tier 5 Specialty			
S5596	030	0		29	10	S5596_030_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	030	0		29	10	S5596_030_0	3	5	Tier 5 Specialty			
S5596	030	0		29	10	S5596_030_0	3	1	Tier 1 Preferred Generic			
S5596	030	0		29	10	S5596_030_0	3	2	Tier 2 Preferred Brand			
S5596	030	0		29	10	S5596_030_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	031	0		29	10	S5596_031_0	3	2	Tier 2 Preferred Brand	2		
S5596	031	0		29	10	S5596_031_0	3	1	Tier 1 Preferred Generic	1		1
S5596	031	0		29	10	S5596_031_0	3	5	Tier 5 Specialty	2		
S5596	031	0		29	10	S5596_031_0	3	4	Tier 4 Non-Specialty Injectable	2		
S5596	031	0		29	10	S5596_031_0	3	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	031	0		29	10	S5596_031_0	3	1	Tier 1 Preferred Generic			
S5596	031	0		29	10	S5596_031_0	3	2	Tier 2 Preferred Brand			
S5596	031	0		29	10	S5596_031_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	031	0		29	10	S5596_031_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	031	0		29	10	S5596_031_0	3	5	Tier 5 Specialty			
S5596	033	0		29	10	S5596_033_0	2	2	Tier 2 Preferred Brand			
S5596	033	0		29	10	S5596_033_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	033	0		29	10	S5596_033_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	033	0		29	10	S5596_033_0	2	5	Tier 5 Specialty			
S5596	033	0		29	10	S5596_033_0	2	1	Tier 1 Preferred Generic			
S5596	034	0		29	10	S5596_034_0	3	5	Tier 5 Specialty			
S5596	034	0		29	10	S5596_034_0	3	2	Tier 2 Preferred Brand			
S5596	034	0		29	10	S5596_034_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	034	0		29	10	S5596_034_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	034	0		29	10	S5596_034_0	3	1	Tier 1 Preferred Generic			
S5596	035	0		29	10	S5596_035_0	3	2	Tier 2 Preferred Brand	2		
S5596	035	0		29	10	S5596_035_0	3	1	Tier 1 Preferred Generic	1		1
S5596	035	0		29	10	S5596_035_0	3	5	Tier 5 Specialty			
S5596	035	0		29	10	S5596_035_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	035	0		29	10	S5596_035_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	035	0		29	10	S5596_035_0	3	2	Tier 2 Preferred Brand			
S5596	035	0		29	10	S5596_035_0	3	1	Tier 1 Preferred Generic			
S5596	035	0		29	10	S5596_035_0	3	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	035	0		29	10	S5596_035_0	3	5	Tier 5 Specialty	2		
S5596	035	0		29	10	S5596_035_0	3	4	Tier 4 Non-Specialty Injectable	2		
S5596	043	0		29	10	S5596_043_0	3	2	Tier 2 Preferred Brand			
S5596	043	0		29	10	S5596_043_0	3	1	Tier 1 Preferred Generic			
S5596	043	0		29	10	S5596_043_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5596	043	0		29	10	S5596_043_0	3	4	Tier 4 Non-Specialty Injectable			
S5596	043	0		29	10	S5596_043_0	3	5	Tier 5 Specialty			
S5596	044	0		29	10	S5596_044_0	4	1	Tier 1 Preferred Generic			
S5596	044	0		29	10	S5596_044_0	4	2	Tier 2 Preferred Brand			
S5596	044	0		29	10	S5596_044_0	4	3	Tier 3 Non-Preferred Brand or Generic			
S5596	044	0		29	10	S5596_044_0	4	4	Tier 4 Non-Specialty Injectable			
S5596	044	0		29	10	S5596_044_0	4	5	Tier 5 Specialty			
S5596	045	0		29	10	S5596_045_0	4	2	Tier 2 Preferred Brand			
S5596	045	0		29	10	S5596_045_0	4	1	Tier 1 Preferred Generic			
S5596	045	0		29	10	S5596_045_0	4	3	Tier 3 Non-Preferred Brand or Generic			
S5596	045	0		29	10	S5596_045_0	4	5	Tier 5 Specialty	2		
S5596	045	0		29	10	S5596_045_0	4	4	Tier 4 Non-Specialty Injectable	2		
S5596	045	0		29	10	S5596_045_0	4	3	Tier 3 Non-Preferred Brand or Generic	2		
S5596	045	0		29	10	S5596_045_0	4	2	Tier 2 Preferred Brand	2		
S5596	045	0		29	10	S5596_045_0	4	4	Tier 4 Non-Specialty Injectable			
S5596	045	0		29	10	S5596_045_0	4	5	Tier 5 Specialty			
S5596	045	0		29	10	S5596_045_0	4	1	Tier 1 Preferred Generic	1		1
S5596	046	0		29	10	S5596_046_0	2	1	Tier 1 Preferred Generic			
S5596	046	0		29	10	S5596_046_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5596	046	0		29	10	S5596_046_0	2	4	Tier 4 Non-Specialty Injectable			
S5596	046	0		29	10	S5596_046_0	2	2	Tier 2 Preferred Brand			
S5596	046	0		29	10	S5596_046_0	2	5	Tier 5 Specialty			
S5597	034	0		29	10	S5597_034_0	1	3	Specialty			
S5597	034	0		29	10	S5597_034_0	1	1	Generic			
S5597	034	0		29	10	S5597_034_0	1	2	Brand			
S5597	035	0		29	10	S5597_035_0	1	3	Specialty			
S5597	035	0		29	10	S5597_035_0	1	1	Generic			
S5597	035	0		29	10	S5597_035_0	1	2	Brand			
S5597	036	0		29	10	S5597_036_0	1	3	Specialty			
S5597	036	0		29	10	S5597_036_0	1	2	Brand			
S5597	036	0		29	10	S5597_036_0	1	1	Generic			
S5597	037	0		29	10	S5597_037_0	1	3	Specialty			
S5597	037	0		29	10	S5597_037_0	1	1	Generic			
S5597	037	0		29	10	S5597_037_0	1	2	Brand			
S5597	038	0		29	10	S5597_038_0	1	3	Specialty			
S5597	038	0		29	10	S5597_038_0	1	2	Brand			
S5597	038	0		29	10	S5597_038_0	1	1	Generic			
S5597	039	0		29	10	S5597_039_0	1	1	Generic			
S5597	039	0		29	10	S5597_039_0	1	2	Brand			
S5597	039	0		29	10	S5597_039_0	1	3	Specialty			
S5597	040	0		29	10	S5597_040_0	1	1	Generic			
S5597	040	0		29	10	S5597_040_0	1	2	Brand			
S5597	040	0		29	10	S5597_040_0	1	3	Specialty			
S5597	041	0		29	10	S5597_041_0	1	2	Brand			
S5597	041	0		29	10	S5597_041_0	1	1	Generic			
S5597	041	0		29	10	S5597_041_0	1	3	Specialty			
S5597	042	0		29	10	S5597_042_0	1	1	Generic			
S5597	042	0		29	10	S5597_042_0	1	2	Brand			
S5597	042	0		29	10	S5597_042_0	1	3	Specialty			
S5597	043	0		29	10	S5597_043_0	1	1	Generic			
S5597	043	0		29	10	S5597_043_0	1	2	Brand			
S5597	043	0		29	10	S5597_043_0	1	3	Specialty			
S5597	044	0		29	10	S5597_044_0	1	2	Brand			
S5597	044	0		29	10	S5597_044_0	1	1	Generic			
S5597	044	0		29	10	S5597_044_0	1	3	Specialty			
S5597	045	0		29	10	S5597_045_0	1	1	Generic			
S5597	045	0		29	10	S5597_045_0	1	2	Brand			
S5597	045	0		29	10	S5597_045_0	1	3	Specialty			
S5597	046	0		29	10	S5597_046_0	1	1	Generic			
S5597	046	0		29	10	S5597_046_0	1	2	Brand			
S5597	046	0		29	10	S5597_046_0	1	3	Specialty			
S5597	047	0		29	10	S5597_047_0	1	1	Generic			
S5597	047	0		29	10	S5597_047_0	1	2	Brand			
S5597	047	0		29	10	S5597_047_0	1	3	Specialty			
S5597	048	0		29	10	S5597_048_0	1	1	Generic			
S5597	048	0		29	10	S5597_048_0	1	2	Brand			
S5597	048	0		29	10	S5597_048_0	1	3	Specialty			
S5597	049	0		29	10	S5597_049_0	1	1	Generic			
S5597	049	0		29	10	S5597_049_0	1	2	Brand			
S5597	049	0		29	10	S5597_049_0	1	3	Specialty			
S5597	050	0		29	10	S5597_050_0	1	1	Generic			
S5597	050	0		29	10	S5597_050_0	1	3	Specialty			
S5597	050	0		29	10	S5597_050_0	1	2	Brand			
S5597	051	0		29	10	S5597_051_0	1	3	Specialty			
S5597	051	0		29	10	S5597_051_0	1	2	Brand			
S5597	051	0		29	10	S5597_051_0	1	1	Generic			
S5597	052	0		29	10	S5597_052_0	1	2	Brand			
S5597	052	0		29	10	S5597_052_0	1	1	Generic			
S5597	052	0		29	10	S5597_052_0	1	3	Specialty			
S5597	053	0		29	10	S5597_053_0	1	1	Generic			
S5597	053	0		29	10	S5597_053_0	1	2	Brand			
S5597	053	0		29	10	S5597_053_0	1	3	Specialty			
S5597	054	0		29	10	S5597_054_0	1	1	Generic			
S5597	054	0		29	10	S5597_054_0	1	2	Brand			
S5597	054	0		29	10	S5597_054_0	1	3	Specialty			
S5597	055	0		29	10	S5597_055_0	1	1	Generic			
S5597	055	0		29	10	S5597_055_0	1	2	Brand			
S5597	055	0		29	10	S5597_055_0	1	3	Specialty			
S5597	056	0		29	10	S5597_056_0	1	3	Specialty			
S5597	056	0		29	10	S5597_056_0	1	1	Generic			
S5597	056	0		29	10	S5597_056_0	1	2	Brand			
S5597	057	0		29	10	S5597_057_0	1	3	Specialty			
S5597	057	0		29	10	S5597_057_0	1	2	Brand			
S5597	057	0		29	10	S5597_057_0	1	1	Generic			
S5597	058	0		29	10	S5597_058_0	1	3	Specialty			
S5597	058	0		29	10	S5597_058_0	1	2	Brand			
S5597	058	0		29	10	S5597_058_0	1	1	Generic			
S5597	059	0		29	10	S5597_059_0	1	1	Generic			
S5597	059	0		29	10	S5597_059_0	1	2	Brand			
S5597	059	0		29	10	S5597_059_0	1	3	Specialty			
S5597	060	0		29	10	S5597_060_0	1	1	Generic			
S5597	060	0		29	10	S5597_060_0	1	2	Brand			
S5597	060	0		29	10	S5597_060_0	1	3	Specialty			
S5597	061	0		29	10	S5597_061_0	1	1	Generic			
S5597	061	0		29	10	S5597_061_0	1	2	Brand			
S5597	061	0		29	10	S5597_061_0	1	3	Specialty			
S5597	062	0		29	10	S5597_062_0	1	1	Generic			
S5597	062	0		29	10	S5597_062_0	1	2	Brand			
S5597	062	0		29	10	S5597_062_0	1	3	Specialty			
S5597	063	0		29	10	S5597_063_0	1	1	Generic			
S5597	063	0		29	10	S5597_063_0	1	2	Brand			
S5597	063	0		29	10	S5597_063_0	1	3	Specialty			
S5597	064	0		29	10	S5597_064_0	1	1	Generic			
S5597	064	0		29	10	S5597_064_0	1	2	Brand			
S5597	064	0		29	10	S5597_064_0	1	3	Specialty			
S5597	199	0		29	10	S5597_199_0	1	1	Generic			
S5597	199	0		29	10	S5597_199_0	1	2	Brand			
S5597	199	0		29	10	S5597_199_0	1	3	Specialty	2		
S5597	199	0		29	10	S5597_199_0	1	1	Generic	1		1
S5597	199	0		29	10	S5597_199_0	1	2	Brand	2		
S5597	199	0		29	10	S5597_199_0	1	3	Specialty			
S5597	200	0		29	10	S5597_200_0	1	1	Generic			
S5597	200	0		29	10	S5597_200_0	1	2	Brand			
S5597	200	0		29	10	S5597_200_0	1	3	Specialty			
S5597	200	0		29	10	S5597_200_0	1	1	Generic	1		1
S5597	200	0		29	10	S5597_200_0	1	2	Brand	2		
S5597	200	0		29	10	S5597_200_0	1	3	Specialty	2		
S5597	201	0		29	10	S5597_201_0	1	2	Brand	2		
S5597	201	0		29	10	S5597_201_0	1	1	Generic	1		1
S5597	201	0		29	10	S5597_201_0	1	3	Specialty			
S5597	201	0		29	10	S5597_201_0	1	2	Brand			
S5597	201	0		29	10	S5597_201_0	1	1	Generic			
S5597	201	0		29	10	S5597_201_0	1	3	Specialty	2		
S5597	202	0		29	10	S5597_202_0	1	1	Generic			
S5597	202	0		29	10	S5597_202_0	1	2	Brand			
S5597	202	0		29	10	S5597_202_0	1	3	Specialty			
S5597	202	0		29	10	S5597_202_0	1	1	Generic	1		1
S5597	202	0		29	10	S5597_202_0	1	2	Brand	2		
S5597	202	0		29	10	S5597_202_0	1	3	Specialty	2		
S5597	203	0		29	10	S5597_203_0	1	1	Generic			
S5597	203	0		29	10	S5597_203_0	1	2	Brand			
S5597	203	0		29	10	S5597_203_0	1	3	Specialty			
S5597	203	0		29	10	S5597_203_0	1	1	Generic	1		1
S5597	203	0		29	10	S5597_203_0	1	2	Brand	2		
S5597	203	0		29	10	S5597_203_0	1	3	Specialty	2		
S5597	204	0		29	10	S5597_204_0	1	2	Brand	2		
S5597	204	0		29	10	S5597_204_0	1	1	Generic	1		1
S5597	204	0		29	10	S5597_204_0	1	3	Specialty			
S5597	204	0		29	10	S5597_204_0	1	2	Brand			
S5597	204	0		29	10	S5597_204_0	1	1	Generic			
S5597	204	0		29	10	S5597_204_0	1	3	Specialty	2		
S5597	205	0		29	10	S5597_205_0	1	2	Brand			
S5597	205	0		29	10	S5597_205_0	1	3	Specialty			
S5597	205	0		29	10	S5597_205_0	1	1	Generic	1		1
S5597	205	0		29	10	S5597_205_0	1	2	Brand	2		
S5597	205	0		29	10	S5597_205_0	1	1	Generic			
S5597	205	0		29	10	S5597_205_0	1	3	Specialty	2		
S5597	206	0		29	10	S5597_206_0	1	3	Specialty	2		
S5597	206	0		29	10	S5597_206_0	1	2	Brand	2		
S5597	206	0		29	10	S5597_206_0	1	1	Generic	1		1
S5597	206	0		29	10	S5597_206_0	1	2	Brand			
S5597	206	0		29	10	S5597_206_0	1	3	Specialty			
S5597	206	0		29	10	S5597_206_0	1	1	Generic			
S5597	207	0		29	10	S5597_207_0	1	2	Brand	2		
S5597	207	0		29	10	S5597_207_0	1	1	Generic	1		1
S5597	207	0		29	10	S5597_207_0	1	3	Specialty			
S5597	207	0		29	10	S5597_207_0	1	2	Brand			
S5597	207	0		29	10	S5597_207_0	1	3	Specialty	2		
S5597	207	0		29	10	S5597_207_0	1	1	Generic			
S5597	208	0		29	10	S5597_208_0	1	3	Specialty	2		
S5597	208	0		29	10	S5597_208_0	1	2	Brand	2		
S5597	208	0		29	10	S5597_208_0	1	1	Generic	1		1
S5597	208	0		29	10	S5597_208_0	1	2	Brand			
S5597	208	0		29	10	S5597_208_0	1	3	Specialty			
S5597	208	0		29	10	S5597_208_0	1	1	Generic			
S5597	209	0		29	10	S5597_209_0	1	1	Generic	1		1
S5597	209	0		29	10	S5597_209_0	1	3	Specialty			
S5597	209	0		29	10	S5597_209_0	1	2	Brand			
S5597	209	0		29	10	S5597_209_0	1	1	Generic			
S5597	209	0		29	10	S5597_209_0	1	2	Brand	2		
S5597	209	0		29	10	S5597_209_0	1	3	Specialty	2		
S5597	210	0		29	10	S5597_210_0	1	1	Generic			
S5597	210	0		29	10	S5597_210_0	1	2	Brand			
S5597	210	0		29	10	S5597_210_0	1	3	Specialty			
S5597	210	0		29	10	S5597_210_0	1	1	Generic	1		1
S5597	210	0		29	10	S5597_210_0	1	2	Brand	2		
S5597	210	0		29	10	S5597_210_0	1	3	Specialty	2		
S5597	211	0		29	10	S5597_211_0	1	2	Brand	2		
S5597	211	0		29	10	S5597_211_0	1	1	Generic	1		1
S5597	211	0		29	10	S5597_211_0	1	3	Specialty			
S5597	211	0		29	10	S5597_211_0	1	1	Generic			
S5597	211	0		29	10	S5597_211_0	1	2	Brand			
S5597	211	0		29	10	S5597_211_0	1	3	Specialty	2		
S5597	212	0		29	10	S5597_212_0	1	2	Brand	2		
S5597	212	0		29	10	S5597_212_0	1	1	Generic	1		1
S5597	212	0		29	10	S5597_212_0	1	3	Specialty			
S5597	212	0		29	10	S5597_212_0	1	2	Brand			
S5597	212	0		29	10	S5597_212_0	1	1	Generic			
S5597	212	0		29	10	S5597_212_0	1	3	Specialty	2		
S5597	213	0		29	10	S5597_213_0	1	1	Generic			
S5597	213	0		29	10	S5597_213_0	1	2	Brand			
S5597	213	0		29	10	S5597_213_0	1	3	Specialty			
S5597	213	0		29	10	S5597_213_0	1	1	Generic	1		1
S5597	213	0		29	10	S5597_213_0	1	2	Brand	2		
S5597	213	0		29	10	S5597_213_0	1	3	Specialty	2		
S5597	214	0		29	10	S5597_214_0	1	1	Generic			
S5597	214	0		29	10	S5597_214_0	1	2	Brand			
S5597	214	0		29	10	S5597_214_0	1	3	Specialty			
S5597	214	0		29	10	S5597_214_0	1	1	Generic	1		1
S5597	214	0		29	10	S5597_214_0	1	2	Brand	2		
S5597	214	0		29	10	S5597_214_0	1	3	Specialty	2		
S5597	215	0		29	10	S5597_215_0	1	2	Brand			
S5597	215	0		29	10	S5597_215_0	1	1	Generic			
S5597	215	0		29	10	S5597_215_0	1	3	Specialty			
S5597	215	0		29	10	S5597_215_0	1	3	Specialty	2		
S5597	215	0		29	10	S5597_215_0	1	2	Brand	2		
S5597	215	0		29	10	S5597_215_0	1	1	Generic	1		1
S5597	216	0		29	10	S5597_216_0	1	2	Brand	2		
S5597	216	0		29	10	S5597_216_0	1	1	Generic			
S5597	216	0		29	10	S5597_216_0	1	2	Brand			
S5597	216	0		29	10	S5597_216_0	1	1	Generic	1		1
S5597	216	0		29	10	S5597_216_0	1	3	Specialty	2		
S5597	216	0		29	10	S5597_216_0	1	3	Specialty			
S5597	217	0		29	10	S5597_217_0	1	3	Specialty	2		
S5597	217	0		29	10	S5597_217_0	1	2	Brand	2		
S5597	217	0		29	10	S5597_217_0	1	1	Generic	1		1
S5597	217	0		29	10	S5597_217_0	1	2	Brand			
S5597	217	0		29	10	S5597_217_0	1	3	Specialty			
S5597	217	0		29	10	S5597_217_0	1	1	Generic			
S5597	218	0		29	10	S5597_218_0	1	2	Brand	2		
S5597	218	0		29	10	S5597_218_0	1	2	Brand			
S5597	218	0		29	10	S5597_218_0	1	1	Generic			
S5597	218	0		29	10	S5597_218_0	1	3	Specialty			
S5597	218	0		29	10	S5597_218_0	1	1	Generic	1		1
S5597	218	0		29	10	S5597_218_0	1	3	Specialty	2		
S5597	219	0		29	10	S5597_219_0	1	1	Generic			
S5597	219	0		29	10	S5597_219_0	1	3	Specialty	2		
S5597	219	0		29	10	S5597_219_0	1	2	Brand	2		
S5597	219	0		29	10	S5597_219_0	1	1	Generic	1		1
S5597	219	0		29	10	S5597_219_0	1	3	Specialty			
S5597	219	0		29	10	S5597_219_0	1	2	Brand			
S5597	220	0		29	10	S5597_220_0	1	1	Generic			
S5597	220	0		29	10	S5597_220_0	1	2	Brand			
S5597	220	0		29	10	S5597_220_0	1	3	Specialty			
S5597	220	0		29	10	S5597_220_0	1	1	Generic	1		1
S5597	220	0		29	10	S5597_220_0	1	2	Brand	2		
S5597	220	0		29	10	S5597_220_0	1	3	Specialty	2		
S5597	221	0		29	10	S5597_221_0	1	1	Generic			
S5597	221	0		29	10	S5597_221_0	1	2	Brand			
S5597	221	0		29	10	S5597_221_0	1	3	Specialty			
S5597	221	0		29	10	S5597_221_0	1	1	Generic	1		1
S5597	221	0		29	10	S5597_221_0	1	2	Brand	2		
S5597	221	0		29	10	S5597_221_0	1	3	Specialty	2		
S5597	222	0		29	10	S5597_222_0	1	2	Brand	2		
S5597	222	0		29	10	S5597_222_0	1	1	Generic	1		1
S5597	222	0		29	10	S5597_222_0	1	3	Specialty			
S5597	222	0		29	10	S5597_222_0	1	2	Brand			
S5597	222	0		29	10	S5597_222_0	1	1	Generic			
S5597	222	0		29	10	S5597_222_0	1	3	Specialty	2		
S5597	223	0		29	10	S5597_223_0	1	1	Generic	1		1
S5597	223	0		29	10	S5597_223_0	1	3	Specialty			
S5597	223	0		29	10	S5597_223_0	1	2	Brand			
S5597	223	0		29	10	S5597_223_0	1	1	Generic			
S5597	223	0		29	10	S5597_223_0	1	2	Brand	2		
S5597	223	0		29	10	S5597_223_0	1	3	Specialty	2		
S5597	224	0		29	10	S5597_224_0	1	1	Generic	1		1
S5597	224	0		29	10	S5597_224_0	1	2	Brand	2		
S5597	224	0		29	10	S5597_224_0	1	2	Brand			
S5597	224	0		29	10	S5597_224_0	1	1	Generic			
S5597	224	0		29	10	S5597_224_0	1	3	Specialty			
S5597	224	0		29	10	S5597_224_0	1	3	Specialty	2		
S5597	225	0		29	10	S5597_225_0	1	1	Generic	1		1
S5597	225	0		29	10	S5597_225_0	1	1	Generic			
S5597	225	0		29	10	S5597_225_0	1	2	Brand			
S5597	225	0		29	10	S5597_225_0	1	3	Specialty			
S5597	225	0		29	10	S5597_225_0	1	2	Brand	2		
S5597	225	0		29	10	S5597_225_0	1	3	Specialty	2		
S5597	226	0		29	10	S5597_226_0	1	3	Specialty	2		
S5597	226	0		29	10	S5597_226_0	1	2	Brand	2		
S5597	226	0		29	10	S5597_226_0	1	1	Generic	1		1
S5597	226	0		29	10	S5597_226_0	1	3	Specialty			
S5597	226	0		29	10	S5597_226_0	1	2	Brand			
S5597	226	0		29	10	S5597_226_0	1	1	Generic			
S5597	227	0		29	10	S5597_227_0	1	2	Brand			
S5597	227	0		29	10	S5597_227_0	1	1	Generic			
S5597	227	0		29	10	S5597_227_0	1	3	Specialty			
S5597	227	0		29	10	S5597_227_0	1	1	Generic	1		1
S5597	227	0		29	10	S5597_227_0	1	2	Brand	2		
S5597	227	0		29	10	S5597_227_0	1	3	Specialty	2		
S5597	228	0		29	10	S5597_228_0	1	2	Brand			
S5597	228	0		29	10	S5597_228_0	1	1	Generic			
S5597	228	0		29	10	S5597_228_0	1	3	Specialty			
S5597	228	0		29	10	S5597_228_0	1	3	Specialty	2		
S5597	228	0		29	10	S5597_228_0	1	2	Brand	2		
S5597	228	0		29	10	S5597_228_0	1	1	Generic	1		1
S5597	229	0		29	10	S5597_229_0	1	1	Generic			
S5597	229	0		29	10	S5597_229_0	1	2	Brand			
S5597	229	0		29	10	S5597_229_0	1	2	Brand	2		
S5597	229	0		29	10	S5597_229_0	1	1	Generic	1		1
S5597	229	0		29	10	S5597_229_0	1	3	Specialty			
S5597	229	0		29	10	S5597_229_0	1	3	Specialty	2		
S5597	230	0		29	10	S5597_230_0	1	2	Brand			
S5597	230	0		29	10	S5597_230_0	1	1	Generic			
S5597	230	0		29	10	S5597_230_0	1	3	Specialty			
S5597	232	0		29	10	S5597_232_0	1	1	Generic	1		1
S5597	232	0		29	10	S5597_232_0	1	2	Brand	2		
S5597	232	0		29	10	S5597_232_0	1	3	Specialty			
S5597	232	0		29	10	S5597_232_0	1	2	Brand			
S5597	232	0		29	10	S5597_232_0	1	1	Generic			
S5597	232	0		29	10	S5597_232_0	1	3	Specialty	2		
S5597	233	0		29	10	S5597_233_0	1	2	Brand			
S5597	233	0		29	10	S5597_233_0	1	1	Generic			
S5597	233	0		29	10	S5597_233_0	1	3	Specialty			
S5597	235	0		29	10	S5597_235_0	1	1	Generic	1		1
S5597	235	0		29	10	S5597_235_0	1	2	Brand	2		
S5597	235	0		29	10	S5597_235_0	1	3	Specialty			
S5597	235	0		29	10	S5597_235_0	1	3	Specialty	2		
S5597	235	0		29	10	S5597_235_0	1	1	Generic			
S5597	235	0		29	10	S5597_235_0	1	2	Brand			
S5601	002	0		29	10	S5601_002_0	9	1	Generic			
S5601	002	0		29	10	S5601_002_0	9	3	Non-Preferred Brand			
S5601	002	0		29	10	S5601_002_0	9	2	Preferred Brand			
S5601	002	0		29	10	S5601_002_0	9	4	Specialty			
S5601	003	0		29	10	S5601_003_0	4	6	Specialty	2		
S5601	003	0		29	10	S5601_003_0	4	1	Value Generic			
S5601	003	0		29	10	S5601_003_0	4	2	Generic			
S5601	003	0		29	10	S5601_003_0	4	5	Non-Preferred Brand	2		
S5601	003	0		29	10	S5601_003_0	4	4	Preferred Brand	2		
S5601	003	0		29	10	S5601_003_0	4	3	Value Brand			
S5601	003	0		29	10	S5601_003_0	4	2	Generic	1		1
S5601	003	0		29	10	S5601_003_0	4	1	Value Generic	1		1
S5601	003	0		29	10	S5601_003_0	4	6	Specialty			
S5601	003	0		29	10	S5601_003_0	4	5	Non-Preferred Brand			
S5601	003	0		29	10	S5601_003_0	4	4	Preferred Brand			
S5601	003	0		29	10	S5601_003_0	4	3	Value Brand	2		
S5601	004	0		29	10	S5601_004_0	8	3	Non-Preferred Brand			
S5601	004	0		29	10	S5601_004_0	8	4	Specialty			
S5601	004	0		29	10	S5601_004_0	8	2	Preferred Brand			
S5601	004	0		29	10	S5601_004_0	8	1	Generic			
S5601	005	0		29	10	S5601_005_0	4	4	Preferred Brand	2		
S5601	005	0		29	10	S5601_005_0	4	5	Non-Preferred Brand	2		
S5601	005	0		29	10	S5601_005_0	4	6	Specialty	2		
S5601	005	0		29	10	S5601_005_0	4	3	Value Brand	2		
S5601	005	0		29	10	S5601_005_0	4	2	Generic	1		1
S5601	005	0		29	10	S5601_005_0	4	1	Value Generic	1		1
S5601	005	0		29	10	S5601_005_0	4	6	Specialty			
S5601	005	0		29	10	S5601_005_0	4	5	Non-Preferred Brand			
S5601	005	0		29	10	S5601_005_0	4	4	Preferred Brand			
S5601	005	0		29	10	S5601_005_0	4	3	Value Brand			
S5601	005	0		29	10	S5601_005_0	4	2	Generic			
S5601	005	0		29	10	S5601_005_0	4	1	Value Generic			
S5601	006	0		29	10	S5601_006_0	7	1	Generic			
S5601	006	0		29	10	S5601_006_0	7	4	Specialty			
S5601	006	0		29	10	S5601_006_0	7	2	Preferred Brand			
S5601	006	0		29	10	S5601_006_0	7	3	Non-Preferred Brand			
S5601	007	0		29	10	S5601_007_0	4	6	Specialty	2		
S5601	007	0		29	10	S5601_007_0	4	1	Value Generic	1		1
S5601	007	0		29	10	S5601_007_0	4	3	Value Brand	2		
S5601	007	0		29	10	S5601_007_0	4	4	Preferred Brand	2		
S5601	007	0		29	10	S5601_007_0	4	5	Non-Preferred Brand	2		
S5601	007	0		29	10	S5601_007_0	4	2	Generic			
S5601	007	0		29	10	S5601_007_0	4	1	Value Generic			
S5601	007	0		29	10	S5601_007_0	4	2	Generic	1		1
S5601	007	0		29	10	S5601_007_0	4	6	Specialty			
S5601	007	0		29	10	S5601_007_0	4	5	Non-Preferred Brand			
S5601	007	0		29	10	S5601_007_0	4	4	Preferred Brand			
S5601	007	0		29	10	S5601_007_0	4	3	Value Brand			
S5601	008	0		29	10	S5601_008_0	7	4	Specialty			
S5601	008	0		29	10	S5601_008_0	7	3	Non-Preferred Brand			
S5601	008	0		29	10	S5601_008_0	7	2	Preferred Brand			
S5601	008	0		29	10	S5601_008_0	7	1	Generic			
S5601	009	0		29	10	S5601_009_0	4	2	Generic			
S5601	009	0		29	10	S5601_009_0	4	3	Value Brand			
S5601	009	0		29	10	S5601_009_0	4	4	Preferred Brand			
S5601	009	0		29	10	S5601_009_0	4	5	Non-Preferred Brand			
S5601	009	0		29	10	S5601_009_0	4	6	Specialty			
S5601	009	0		29	10	S5601_009_0	4	1	Value Generic	1		1
S5601	009	0		29	10	S5601_009_0	4	2	Generic	1		1
S5601	009	0		29	10	S5601_009_0	4	3	Value Brand	2		
S5601	009	0		29	10	S5601_009_0	4	4	Preferred Brand	2		
S5601	009	0		29	10	S5601_009_0	4	1	Value Generic			
S5601	009	0		29	10	S5601_009_0	4	5	Non-Preferred Brand	2		
S5601	009	0		29	10	S5601_009_0	4	6	Specialty	2		
S5601	010	0		29	10	S5601_010_0	7	3	Non-Preferred Brand			
S5601	010	0		29	10	S5601_010_0	7	2	Preferred Brand			
S5601	010	0		29	10	S5601_010_0	7	1	Generic			
S5601	010	0		29	10	S5601_010_0	7	4	Specialty			
S5601	011	0		29	10	S5601_011_0	4	1	Value Generic			
S5601	011	0		29	10	S5601_011_0	4	2	Generic			
S5601	011	0		29	10	S5601_011_0	4	3	Value Brand			
S5601	011	0		29	10	S5601_011_0	4	4	Preferred Brand			
S5601	011	0		29	10	S5601_011_0	4	5	Non-Preferred Brand			
S5601	011	0		29	10	S5601_011_0	4	6	Specialty			
S5601	011	0		29	10	S5601_011_0	4	1	Value Generic	1		1
S5601	011	0		29	10	S5601_011_0	4	5	Non-Preferred Brand	2		
S5601	011	0		29	10	S5601_011_0	4	4	Preferred Brand	2		
S5601	011	0		29	10	S5601_011_0	4	6	Specialty	2		
S5601	011	0		29	10	S5601_011_0	4	2	Generic	1		1
S5601	011	0		29	10	S5601_011_0	4	3	Value Brand	2		
S5601	012	0		29	10	S5601_012_0	7	3	Non-Preferred Brand			
S5601	012	0		29	10	S5601_012_0	7	4	Specialty			
S5601	012	0		29	10	S5601_012_0	7	1	Generic			
S5601	012	0		29	10	S5601_012_0	7	2	Preferred Brand			
S5601	013	0		29	10	S5601_013_0	4	1	Value Generic			
S5601	013	0		29	10	S5601_013_0	4	2	Generic			
S5601	013	0		29	10	S5601_013_0	4	6	Specialty	2		
S5601	013	0		29	10	S5601_013_0	4	5	Non-Preferred Brand	2		
S5601	013	0		29	10	S5601_013_0	4	4	Preferred Brand	2		
S5601	013	0		29	10	S5601_013_0	4	3	Value Brand			
S5601	013	0		29	10	S5601_013_0	4	4	Preferred Brand			
S5601	013	0		29	10	S5601_013_0	4	5	Non-Preferred Brand			
S5601	013	0		29	10	S5601_013_0	4	6	Specialty			
S5601	013	0		29	10	S5601_013_0	4	1	Value Generic	1		1
S5601	013	0		29	10	S5601_013_0	4	2	Generic	1		1
S5601	013	0		29	10	S5601_013_0	4	3	Value Brand	2		
S5601	014	0		29	10	S5601_014_0	7	2	Preferred Brand			
S5601	014	0		29	10	S5601_014_0	7	1	Generic			
S5601	014	0		29	10	S5601_014_0	7	4	Specialty			
S5601	014	0		29	10	S5601_014_0	7	3	Non-Preferred Brand			
S5601	015	0		29	10	S5601_015_0	4	4	Preferred Brand	2		
S5601	015	0		29	10	S5601_015_0	4	6	Specialty	2		
S5601	015	0		29	10	S5601_015_0	4	5	Non-Preferred Brand	2		
S5601	015	0		29	10	S5601_015_0	4	3	Value Brand	2		
S5601	015	0		29	10	S5601_015_0	4	2	Generic	1		1
S5601	015	0		29	10	S5601_015_0	4	1	Value Generic	1		1
S5601	015	0		29	10	S5601_015_0	4	6	Specialty			
S5601	015	0		29	10	S5601_015_0	4	5	Non-Preferred Brand			
S5601	015	0		29	10	S5601_015_0	4	4	Preferred Brand			
S5601	015	0		29	10	S5601_015_0	4	3	Value Brand			
S5601	015	0		29	10	S5601_015_0	4	2	Generic			
S5601	015	0		29	10	S5601_015_0	4	1	Value Generic			
S5601	016	0		29	10	S5601_016_0	7	4	Specialty			
S5601	016	0		29	10	S5601_016_0	7	3	Non-Preferred Brand			
S5601	016	0		29	10	S5601_016_0	7	2	Preferred Brand			
S5601	016	0		29	10	S5601_016_0	7	1	Generic			
S5601	017	0		29	10	S5601_017_0	4	1	Value Generic			
S5601	017	0		29	10	S5601_017_0	4	6	Specialty	2		
S5601	017	0		29	10	S5601_017_0	4	3	Value Brand			
S5601	017	0		29	10	S5601_017_0	4	2	Generic			
S5601	017	0		29	10	S5601_017_0	4	5	Non-Preferred Brand	2		
S5601	017	0		29	10	S5601_017_0	4	4	Preferred Brand	2		
S5601	017	0		29	10	S5601_017_0	4	3	Value Brand	2		
S5601	017	0		29	10	S5601_017_0	4	4	Preferred Brand			
S5601	017	0		29	10	S5601_017_0	4	5	Non-Preferred Brand			
S5601	017	0		29	10	S5601_017_0	4	6	Specialty			
S5601	017	0		29	10	S5601_017_0	4	1	Value Generic	1		1
S5601	017	0		29	10	S5601_017_0	4	2	Generic	1		1
S5601	018	0		29	10	S5601_018_0	7	1	Generic			
S5601	018	0		29	10	S5601_018_0	7	2	Preferred Brand			
S5601	018	0		29	10	S5601_018_0	7	3	Non-Preferred Brand			
S5601	018	0		29	10	S5601_018_0	7	4	Specialty			
S5601	019	0		29	10	S5601_019_0	4	5	Non-Preferred Brand	2		
S5601	019	0		29	10	S5601_019_0	4	3	Value Brand	2		
S5601	019	0		29	10	S5601_019_0	4	2	Generic	1		1
S5601	019	0		29	10	S5601_019_0	4	1	Value Generic			
S5601	019	0		29	10	S5601_019_0	4	2	Generic			
S5601	019	0		29	10	S5601_019_0	4	3	Value Brand			
S5601	019	0		29	10	S5601_019_0	4	4	Preferred Brand			
S5601	019	0		29	10	S5601_019_0	4	1	Value Generic	1		1
S5601	019	0		29	10	S5601_019_0	4	6	Specialty			
S5601	019	0		29	10	S5601_019_0	4	4	Preferred Brand	2		
S5601	019	0		29	10	S5601_019_0	4	5	Non-Preferred Brand			
S5601	019	0		29	10	S5601_019_0	4	6	Specialty	2		
S5601	020	0		29	10	S5601_020_0	7	3	Non-Preferred Brand			
S5601	020	0		29	10	S5601_020_0	7	4	Specialty			
S5601	020	0		29	10	S5601_020_0	7	1	Generic			
S5601	020	0		29	10	S5601_020_0	7	2	Preferred Brand			
S5601	021	0		29	10	S5601_021_0	4	1	Value Generic			
S5601	021	0		29	10	S5601_021_0	4	2	Generic			
S5601	021	0		29	10	S5601_021_0	4	3	Value Brand			
S5601	021	0		29	10	S5601_021_0	4	4	Preferred Brand			
S5601	021	0		29	10	S5601_021_0	4	5	Non-Preferred Brand			
S5601	021	0		29	10	S5601_021_0	4	6	Specialty	2		
S5601	021	0		29	10	S5601_021_0	4	1	Value Generic	1		1
S5601	021	0		29	10	S5601_021_0	4	2	Generic	1		1
S5601	021	0		29	10	S5601_021_0	4	3	Value Brand	2		
S5601	021	0		29	10	S5601_021_0	4	4	Preferred Brand	2		
S5601	021	0		29	10	S5601_021_0	4	5	Non-Preferred Brand	2		
S5601	021	0		29	10	S5601_021_0	4	6	Specialty			
S5601	022	0		29	10	S5601_022_0	7	1	Generic			
S5601	022	0		29	10	S5601_022_0	7	4	Specialty			
S5601	022	0		29	10	S5601_022_0	7	3	Non-Preferred Brand			
S5601	022	0		29	10	S5601_022_0	7	2	Preferred Brand			
S5601	023	0		29	10	S5601_023_0	4	1	Value Generic			
S5601	023	0		29	10	S5601_023_0	4	2	Generic			
S5601	023	0		29	10	S5601_023_0	4	3	Value Brand			
S5601	023	0		29	10	S5601_023_0	4	4	Preferred Brand			
S5601	023	0		29	10	S5601_023_0	4	5	Non-Preferred Brand			
S5601	023	0		29	10	S5601_023_0	4	6	Specialty	2		
S5601	023	0		29	10	S5601_023_0	4	1	Value Generic	1		1
S5601	023	0		29	10	S5601_023_0	4	2	Generic	1		1
S5601	023	0		29	10	S5601_023_0	4	3	Value Brand	2		
S5601	023	0		29	10	S5601_023_0	4	4	Preferred Brand	2		
S5601	023	0		29	10	S5601_023_0	4	5	Non-Preferred Brand	2		
S5601	023	0		29	10	S5601_023_0	4	6	Specialty			
S5601	024	0		29	10	S5601_024_0	7	1	Generic			
S5601	024	0		29	10	S5601_024_0	7	4	Specialty			
S5601	024	0		29	10	S5601_024_0	7	3	Non-Preferred Brand			
S5601	024	0		29	10	S5601_024_0	7	2	Preferred Brand			
S5601	025	0		29	10	S5601_025_0	4	1	Value Generic			
S5601	025	0		29	10	S5601_025_0	4	2	Generic			
S5601	025	0		29	10	S5601_025_0	4	3	Value Brand			
S5601	025	0		29	10	S5601_025_0	4	4	Preferred Brand			
S5601	025	0		29	10	S5601_025_0	4	5	Non-Preferred Brand			
S5601	025	0		29	10	S5601_025_0	4	6	Specialty	2		
S5601	025	0		29	10	S5601_025_0	4	1	Value Generic	1		1
S5601	025	0		29	10	S5601_025_0	4	2	Generic	1		1
S5601	025	0		29	10	S5601_025_0	4	3	Value Brand	2		
S5601	025	0		29	10	S5601_025_0	4	4	Preferred Brand	2		
S5601	025	0		29	10	S5601_025_0	4	5	Non-Preferred Brand	2		
S5601	025	0		29	10	S5601_025_0	4	6	Specialty			
S5601	026	0		29	10	S5601_026_0	7	1	Generic			
S5601	026	0		29	10	S5601_026_0	7	4	Specialty			
S5601	026	0		29	10	S5601_026_0	7	3	Non-Preferred Brand			
S5601	026	0		29	10	S5601_026_0	7	2	Preferred Brand			
S5601	027	0		29	10	S5601_027_0	4	2	Generic	1		1
S5601	027	0		29	10	S5601_027_0	4	3	Value Brand	2		
S5601	027	0		29	10	S5601_027_0	4	4	Preferred Brand	2		
S5601	027	0		29	10	S5601_027_0	4	5	Non-Preferred Brand	2		
S5601	027	0		29	10	S5601_027_0	4	1	Value Generic			
S5601	027	0		29	10	S5601_027_0	4	6	Specialty	2		
S5601	027	0		29	10	S5601_027_0	4	3	Value Brand			
S5601	027	0		29	10	S5601_027_0	4	4	Preferred Brand			
S5601	027	0		29	10	S5601_027_0	4	5	Non-Preferred Brand			
S5601	027	0		29	10	S5601_027_0	4	6	Specialty			
S5601	027	0		29	10	S5601_027_0	4	1	Value Generic	1		1
S5601	027	0		29	10	S5601_027_0	4	2	Generic			
S5601	028	0		29	10	S5601_028_0	7	1	Generic			
S5601	028	0		29	10	S5601_028_0	7	4	Specialty			
S5601	028	0		29	10	S5601_028_0	7	3	Non-Preferred Brand			
S5601	028	0		29	10	S5601_028_0	7	2	Preferred Brand			
S5601	029	0		29	10	S5601_029_0	4	1	Value Generic			
S5601	029	0		29	10	S5601_029_0	4	2	Generic			
S5601	029	0		29	10	S5601_029_0	4	3	Value Brand			
S5601	029	0		29	10	S5601_029_0	4	4	Preferred Brand			
S5601	029	0		29	10	S5601_029_0	4	5	Non-Preferred Brand			
S5601	029	0		29	10	S5601_029_0	4	6	Specialty	2		
S5601	029	0		29	10	S5601_029_0	4	1	Value Generic	1		1
S5601	029	0		29	10	S5601_029_0	4	2	Generic	1		1
S5601	029	0		29	10	S5601_029_0	4	3	Value Brand	2		
S5601	029	0		29	10	S5601_029_0	4	4	Preferred Brand	2		
S5601	029	0		29	10	S5601_029_0	4	5	Non-Preferred Brand	2		
S5601	029	0		29	10	S5601_029_0	4	6	Specialty			
S5601	030	0		29	10	S5601_030_0	7	1	Generic			
S5601	030	0		29	10	S5601_030_0	7	2	Preferred Brand			
S5601	030	0		29	10	S5601_030_0	7	4	Specialty			
S5601	030	0		29	10	S5601_030_0	7	3	Non-Preferred Brand			
S5601	031	0		29	10	S5601_031_0	4	4	Preferred Brand	2		
S5601	031	0		29	10	S5601_031_0	4	3	Value Brand	2		
S5601	031	0		29	10	S5601_031_0	4	6	Specialty			
S5601	031	0		29	10	S5601_031_0	4	1	Value Generic	1		1
S5601	031	0		29	10	S5601_031_0	4	1	Value Generic			
S5601	031	0		29	10	S5601_031_0	4	2	Generic	1		1
S5601	031	0		29	10	S5601_031_0	4	3	Value Brand			
S5601	031	0		29	10	S5601_031_0	4	4	Preferred Brand			
S5601	031	0		29	10	S5601_031_0	4	5	Non-Preferred Brand			
S5601	031	0		29	10	S5601_031_0	4	5	Non-Preferred Brand	2		
S5601	031	0		29	10	S5601_031_0	4	6	Specialty	2		
S5601	031	0		29	10	S5601_031_0	4	2	Generic			
S5601	032	0		29	10	S5601_032_0	7	4	Specialty			
S5601	032	0		29	10	S5601_032_0	7	3	Non-Preferred Brand			
S5601	032	0		29	10	S5601_032_0	7	2	Preferred Brand			
S5601	032	0		29	10	S5601_032_0	7	1	Generic			
S5601	033	0		29	10	S5601_033_0	4	1	Value Generic	1		1
S5601	033	0		29	10	S5601_033_0	4	6	Specialty	2		
S5601	033	0		29	10	S5601_033_0	4	5	Non-Preferred Brand			
S5601	033	0		29	10	S5601_033_0	4	4	Preferred Brand			
S5601	033	0		29	10	S5601_033_0	4	3	Value Brand			
S5601	033	0		29	10	S5601_033_0	4	2	Generic			
S5601	033	0		29	10	S5601_033_0	4	1	Value Generic			
S5601	033	0		29	10	S5601_033_0	4	6	Specialty			
S5601	033	0		29	10	S5601_033_0	4	5	Non-Preferred Brand	2		
S5601	033	0		29	10	S5601_033_0	4	4	Preferred Brand	2		
S5601	033	0		29	10	S5601_033_0	4	3	Value Brand	2		
S5601	033	0		29	10	S5601_033_0	4	2	Generic	1		1
S5601	034	0		29	10	S5601_034_0	7	1	Generic			
S5601	034	0		29	10	S5601_034_0	7	2	Preferred Brand			
S5601	034	0		29	10	S5601_034_0	7	3	Non-Preferred Brand			
S5601	034	0		29	10	S5601_034_0	7	4	Specialty			
S5601	035	0		29	10	S5601_035_0	4	4	Preferred Brand	2		
S5601	035	0		29	10	S5601_035_0	4	3	Value Brand	2		
S5601	035	0		29	10	S5601_035_0	4	2	Generic	1		1
S5601	035	0		29	10	S5601_035_0	4	4	Preferred Brand			
S5601	035	0		29	10	S5601_035_0	4	3	Value Brand			
S5601	035	0		29	10	S5601_035_0	4	2	Generic			
S5601	035	0		29	10	S5601_035_0	4	1	Value Generic			
S5601	035	0		29	10	S5601_035_0	4	6	Specialty	2		
S5601	035	0		29	10	S5601_035_0	4	1	Value Generic	1		1
S5601	035	0		29	10	S5601_035_0	4	5	Non-Preferred Brand	2		
S5601	035	0		29	10	S5601_035_0	4	5	Non-Preferred Brand			
S5601	035	0		29	10	S5601_035_0	4	6	Specialty			
S5601	036	0		29	10	S5601_036_0	7	1	Generic			
S5601	036	0		29	10	S5601_036_0	7	2	Preferred Brand			
S5601	036	0		29	10	S5601_036_0	7	3	Non-Preferred Brand			
S5601	036	0		29	10	S5601_036_0	7	4	Specialty			
S5601	037	0		29	10	S5601_037_0	4	1	Value Generic			
S5601	037	0		29	10	S5601_037_0	4	2	Generic			
S5601	037	0		29	10	S5601_037_0	4	3	Value Brand			
S5601	037	0		29	10	S5601_037_0	4	4	Preferred Brand			
S5601	037	0		29	10	S5601_037_0	4	5	Non-Preferred Brand			
S5601	037	0		29	10	S5601_037_0	4	6	Specialty	2		
S5601	037	0		29	10	S5601_037_0	4	1	Value Generic	1		1
S5601	037	0		29	10	S5601_037_0	4	2	Generic	1		1
S5601	037	0		29	10	S5601_037_0	4	3	Value Brand	2		
S5601	037	0		29	10	S5601_037_0	4	4	Preferred Brand	2		
S5601	037	0		29	10	S5601_037_0	4	5	Non-Preferred Brand	2		
S5601	037	0		29	10	S5601_037_0	4	6	Specialty			
S5601	038	0		29	10	S5601_038_0	7	1	Generic			
S5601	038	0		29	10	S5601_038_0	7	2	Preferred Brand			
S5601	038	0		29	10	S5601_038_0	7	4	Specialty			
S5601	038	0		29	10	S5601_038_0	7	3	Non-Preferred Brand			
S5601	039	0		29	10	S5601_039_0	4	1	Value Generic			
S5601	039	0		29	10	S5601_039_0	4	2	Generic			
S5601	039	0		29	10	S5601_039_0	4	3	Value Brand			
S5601	039	0		29	10	S5601_039_0	4	4	Preferred Brand			
S5601	039	0		29	10	S5601_039_0	4	5	Non-Preferred Brand			
S5601	039	0		29	10	S5601_039_0	4	6	Specialty	2		
S5601	039	0		29	10	S5601_039_0	4	1	Value Generic	1		1
S5601	039	0		29	10	S5601_039_0	4	2	Generic	1		1
S5601	039	0		29	10	S5601_039_0	4	3	Value Brand	2		
S5601	039	0		29	10	S5601_039_0	4	5	Non-Preferred Brand	2		
S5601	039	0		29	10	S5601_039_0	4	4	Preferred Brand	2		
S5601	039	0		29	10	S5601_039_0	4	6	Specialty			
S5601	040	0		29	10	S5601_040_0	7	1	Generic			
S5601	040	0		29	10	S5601_040_0	7	2	Preferred Brand			
S5601	040	0		29	10	S5601_040_0	7	3	Non-Preferred Brand			
S5601	040	0		29	10	S5601_040_0	7	4	Specialty			
S5601	041	0		29	10	S5601_041_0	4	1	Value Generic			
S5601	041	0		29	10	S5601_041_0	4	6	Specialty	2		
S5601	041	0		29	10	S5601_041_0	4	3	Value Brand			
S5601	041	0		29	10	S5601_041_0	4	2	Generic			
S5601	041	0		29	10	S5601_041_0	4	5	Non-Preferred Brand	2		
S5601	041	0		29	10	S5601_041_0	4	4	Preferred Brand	2		
S5601	041	0		29	10	S5601_041_0	4	3	Value Brand	2		
S5601	041	0		29	10	S5601_041_0	4	4	Preferred Brand			
S5601	041	0		29	10	S5601_041_0	4	5	Non-Preferred Brand			
S5601	041	0		29	10	S5601_041_0	4	6	Specialty			
S5601	041	0		29	10	S5601_041_0	4	1	Value Generic	1		1
S5601	041	0		29	10	S5601_041_0	4	2	Generic	1		1
S5601	042	0		29	10	S5601_042_0	7	1	Generic			
S5601	042	0		29	10	S5601_042_0	7	2	Preferred Brand			
S5601	042	0		29	10	S5601_042_0	7	3	Non-Preferred Brand			
S5601	042	0		29	10	S5601_042_0	7	4	Specialty			
S5601	043	0		29	10	S5601_043_0	4	1	Value Generic	1		1
S5601	043	0		29	10	S5601_043_0	4	6	Specialty			
S5601	043	0		29	10	S5601_043_0	4	5	Non-Preferred Brand			
S5601	043	0		29	10	S5601_043_0	4	4	Preferred Brand			
S5601	043	0		29	10	S5601_043_0	4	3	Value Brand			
S5601	043	0		29	10	S5601_043_0	4	2	Generic			
S5601	043	0		29	10	S5601_043_0	4	1	Value Generic			
S5601	043	0		29	10	S5601_043_0	4	5	Non-Preferred Brand	2		
S5601	043	0		29	10	S5601_043_0	4	4	Preferred Brand	2		
S5601	043	0		29	10	S5601_043_0	4	6	Specialty	2		
S5601	043	0		29	10	S5601_043_0	4	2	Generic	1		1
S5601	043	0		29	10	S5601_043_0	4	3	Value Brand	2		
S5601	044	0		29	10	S5601_044_0	7	3	Non-Preferred Brand			
S5601	044	0		29	10	S5601_044_0	7	4	Specialty			
S5601	044	0		29	10	S5601_044_0	7	1	Generic			
S5601	044	0		29	10	S5601_044_0	7	2	Preferred Brand			
S5601	045	0		29	10	S5601_045_0	4	5	Non-Preferred Brand			
S5601	045	0		29	10	S5601_045_0	4	4	Preferred Brand			
S5601	045	0		29	10	S5601_045_0	4	6	Specialty	2		
S5601	045	0		29	10	S5601_045_0	4	5	Non-Preferred Brand	2		
S5601	045	0		29	10	S5601_045_0	4	4	Preferred Brand	2		
S5601	045	0		29	10	S5601_045_0	4	3	Value Brand			
S5601	045	0		29	10	S5601_045_0	4	2	Generic			
S5601	045	0		29	10	S5601_045_0	4	1	Value Generic			
S5601	045	0		29	10	S5601_045_0	4	6	Specialty			
S5601	045	0		29	10	S5601_045_0	4	1	Value Generic	1		1
S5601	045	0		29	10	S5601_045_0	4	2	Generic	1		1
S5601	045	0		29	10	S5601_045_0	4	3	Value Brand	2		
S5601	046	0		29	10	S5601_046_0	7	2	Preferred Brand			
S5601	046	0		29	10	S5601_046_0	7	1	Generic			
S5601	046	0		29	10	S5601_046_0	7	3	Non-Preferred Brand			
S5601	046	0		29	10	S5601_046_0	7	4	Specialty			
S5601	047	0		29	10	S5601_047_0	4	5	Non-Preferred Brand			
S5601	047	0		29	10	S5601_047_0	4	4	Preferred Brand			
S5601	047	0		29	10	S5601_047_0	4	3	Value Brand			
S5601	047	0		29	10	S5601_047_0	4	2	Generic			
S5601	047	0		29	10	S5601_047_0	4	1	Value Generic			
S5601	047	0		29	10	S5601_047_0	4	6	Specialty			
S5601	047	0		29	10	S5601_047_0	4	6	Specialty	2		
S5601	047	0		29	10	S5601_047_0	4	5	Non-Preferred Brand	2		
S5601	047	0		29	10	S5601_047_0	4	4	Preferred Brand	2		
S5601	047	0		29	10	S5601_047_0	4	3	Value Brand	2		
S5601	047	0		29	10	S5601_047_0	4	2	Generic	1		1
S5601	047	0		29	10	S5601_047_0	4	1	Value Generic	1		1
S5601	048	0		29	10	S5601_048_0	7	3	Non-Preferred Brand			
S5601	048	0		29	10	S5601_048_0	7	2	Preferred Brand			
S5601	048	0		29	10	S5601_048_0	7	1	Generic			
S5601	048	0		29	10	S5601_048_0	7	4	Specialty			
S5601	049	0		29	10	S5601_049_0	4	5	Non-Preferred Brand			
S5601	049	0		29	10	S5601_049_0	4	5	Non-Preferred Brand	2		
S5601	049	0		29	10	S5601_049_0	4	4	Preferred Brand	2		
S5601	049	0		29	10	S5601_049_0	4	3	Value Brand	2		
S5601	049	0		29	10	S5601_049_0	4	2	Generic	1		1
S5601	049	0		29	10	S5601_049_0	4	1	Value Generic	1		1
S5601	049	0		29	10	S5601_049_0	4	6	Specialty			
S5601	049	0		29	10	S5601_049_0	4	6	Specialty	2		
S5601	049	0		29	10	S5601_049_0	4	3	Value Brand			
S5601	049	0		29	10	S5601_049_0	4	2	Generic			
S5601	049	0		29	10	S5601_049_0	4	1	Value Generic			
S5601	049	0		29	10	S5601_049_0	4	4	Preferred Brand			
S5601	050	0		29	10	S5601_050_0	7	3	Non-Preferred Brand			
S5601	050	0		29	10	S5601_050_0	7	2	Preferred Brand			
S5601	050	0		29	10	S5601_050_0	7	1	Generic			
S5601	050	0		29	10	S5601_050_0	7	4	Specialty			
S5601	051	0		29	10	S5601_051_0	4	1	Value Generic			
S5601	051	0		29	10	S5601_051_0	4	2	Generic			
S5601	051	0		29	10	S5601_051_0	4	3	Value Brand			
S5601	051	0		29	10	S5601_051_0	4	4	Preferred Brand			
S5601	051	0		29	10	S5601_051_0	4	5	Non-Preferred Brand			
S5601	051	0		29	10	S5601_051_0	4	6	Specialty			
S5601	051	0		29	10	S5601_051_0	4	1	Value Generic	1		1
S5601	051	0		29	10	S5601_051_0	4	5	Non-Preferred Brand	2		
S5601	051	0		29	10	S5601_051_0	4	4	Preferred Brand	2		
S5601	051	0		29	10	S5601_051_0	4	6	Specialty	2		
S5601	051	0		29	10	S5601_051_0	4	2	Generic	1		1
S5601	051	0		29	10	S5601_051_0	4	3	Value Brand	2		
S5601	052	0		29	10	S5601_052_0	7	3	Non-Preferred Brand			
S5601	052	0		29	10	S5601_052_0	7	4	Specialty			
S5601	052	0		29	10	S5601_052_0	7	1	Generic			
S5601	052	0		29	10	S5601_052_0	7	2	Preferred Brand			
S5601	053	0		29	10	S5601_053_0	4	1	Value Generic			
S5601	053	0		29	10	S5601_053_0	4	2	Generic			
S5601	053	0		29	10	S5601_053_0	4	6	Specialty	2		
S5601	053	0		29	10	S5601_053_0	4	5	Non-Preferred Brand	2		
S5601	053	0		29	10	S5601_053_0	4	4	Preferred Brand	2		
S5601	053	0		29	10	S5601_053_0	4	3	Value Brand			
S5601	053	0		29	10	S5601_053_0	4	4	Preferred Brand			
S5601	053	0		29	10	S5601_053_0	4	5	Non-Preferred Brand			
S5601	053	0		29	10	S5601_053_0	4	6	Specialty			
S5601	053	0		29	10	S5601_053_0	4	1	Value Generic	1		1
S5601	053	0		29	10	S5601_053_0	4	2	Generic	1		1
S5601	053	0		29	10	S5601_053_0	4	3	Value Brand	2		
S5601	054	0		29	10	S5601_054_0	7	2	Preferred Brand			
S5601	054	0		29	10	S5601_054_0	7	1	Generic			
S5601	054	0		29	10	S5601_054_0	7	4	Specialty			
S5601	054	0		29	10	S5601_054_0	7	3	Non-Preferred Brand			
S5601	055	0		29	10	S5601_055_0	4	4	Preferred Brand	2		
S5601	055	0		29	10	S5601_055_0	4	6	Specialty	2		
S5601	055	0		29	10	S5601_055_0	4	5	Non-Preferred Brand	2		
S5601	055	0		29	10	S5601_055_0	4	3	Value Brand	2		
S5601	055	0		29	10	S5601_055_0	4	2	Generic	1		1
S5601	055	0		29	10	S5601_055_0	4	1	Value Generic	1		1
S5601	055	0		29	10	S5601_055_0	4	6	Specialty			
S5601	055	0		29	10	S5601_055_0	4	5	Non-Preferred Brand			
S5601	055	0		29	10	S5601_055_0	4	4	Preferred Brand			
S5601	055	0		29	10	S5601_055_0	4	3	Value Brand			
S5601	055	0		29	10	S5601_055_0	4	2	Generic			
S5601	055	0		29	10	S5601_055_0	4	1	Value Generic			
S5601	056	0		29	10	S5601_056_0	7	4	Specialty			
S5601	056	0		29	10	S5601_056_0	7	3	Non-Preferred Brand			
S5601	056	0		29	10	S5601_056_0	7	2	Preferred Brand			
S5601	056	0		29	10	S5601_056_0	7	1	Generic			
S5601	057	0		29	10	S5601_057_0	4	1	Value Generic			
S5601	057	0		29	10	S5601_057_0	4	6	Specialty	2		
S5601	057	0		29	10	S5601_057_0	4	3	Value Brand			
S5601	057	0		29	10	S5601_057_0	4	2	Generic			
S5601	057	0		29	10	S5601_057_0	4	5	Non-Preferred Brand	2		
S5601	057	0		29	10	S5601_057_0	4	4	Preferred Brand	2		
S5601	057	0		29	10	S5601_057_0	4	3	Value Brand	2		
S5601	057	0		29	10	S5601_057_0	4	4	Preferred Brand			
S5601	057	0		29	10	S5601_057_0	4	5	Non-Preferred Brand			
S5601	057	0		29	10	S5601_057_0	4	6	Specialty			
S5601	057	0		29	10	S5601_057_0	4	1	Value Generic	1		1
S5601	057	0		29	10	S5601_057_0	4	2	Generic	1		1
S5601	058	0		29	10	S5601_058_0	7	1	Generic			
S5601	058	0		29	10	S5601_058_0	7	2	Preferred Brand			
S5601	058	0		29	10	S5601_058_0	7	3	Non-Preferred Brand			
S5601	058	0		29	10	S5601_058_0	7	4	Specialty			
S5601	059	0		29	10	S5601_059_0	4	5	Non-Preferred Brand	2		
S5601	059	0		29	10	S5601_059_0	4	3	Value Brand	2		
S5601	059	0		29	10	S5601_059_0	4	2	Generic	1		1
S5601	059	0		29	10	S5601_059_0	4	1	Value Generic			
S5601	059	0		29	10	S5601_059_0	4	2	Generic			
S5601	059	0		29	10	S5601_059_0	4	3	Value Brand			
S5601	059	0		29	10	S5601_059_0	4	4	Preferred Brand			
S5601	059	0		29	10	S5601_059_0	4	1	Value Generic	1		1
S5601	059	0		29	10	S5601_059_0	4	6	Specialty			
S5601	059	0		29	10	S5601_059_0	4	4	Preferred Brand	2		
S5601	059	0		29	10	S5601_059_0	4	5	Non-Preferred Brand			
S5601	059	0		29	10	S5601_059_0	4	6	Specialty	2		
S5601	060	0		29	10	S5601_060_0	7	3	Non-Preferred Brand			
S5601	060	0		29	10	S5601_060_0	7	4	Specialty			
S5601	060	0		29	10	S5601_060_0	7	1	Generic			
S5601	060	0		29	10	S5601_060_0	7	2	Preferred Brand			
S5601	061	0		29	10	S5601_061_0	4	1	Value Generic			
S5601	061	0		29	10	S5601_061_0	4	2	Generic			
S5601	061	0		29	10	S5601_061_0	4	3	Value Brand			
S5601	061	0		29	10	S5601_061_0	4	4	Preferred Brand			
S5601	061	0		29	10	S5601_061_0	4	5	Non-Preferred Brand			
S5601	061	0		29	10	S5601_061_0	4	6	Specialty	2		
S5601	061	0		29	10	S5601_061_0	4	1	Value Generic	1		1
S5601	061	0		29	10	S5601_061_0	4	2	Generic	1		1
S5601	061	0		29	10	S5601_061_0	4	3	Value Brand	2		
S5601	061	0		29	10	S5601_061_0	4	4	Preferred Brand	2		
S5601	061	0		29	10	S5601_061_0	4	5	Non-Preferred Brand	2		
S5601	061	0		29	10	S5601_061_0	4	6	Specialty			
S5601	062	0		29	10	S5601_062_0	7	1	Generic			
S5601	062	0		29	10	S5601_062_0	7	4	Specialty			
S5601	062	0		29	10	S5601_062_0	7	3	Non-Preferred Brand			
S5601	062	0		29	10	S5601_062_0	7	2	Preferred Brand			
S5601	063	0		29	10	S5601_063_0	4	1	Value Generic			
S5601	063	0		29	10	S5601_063_0	4	2	Generic			
S5601	063	0		29	10	S5601_063_0	4	3	Value Brand			
S5601	063	0		29	10	S5601_063_0	4	4	Preferred Brand			
S5601	063	0		29	10	S5601_063_0	4	5	Non-Preferred Brand			
S5601	063	0		29	10	S5601_063_0	4	6	Specialty	2		
S5601	063	0		29	10	S5601_063_0	4	1	Value Generic	1		1
S5601	063	0		29	10	S5601_063_0	4	2	Generic	1		1
S5601	063	0		29	10	S5601_063_0	4	3	Value Brand	2		
S5601	063	0		29	10	S5601_063_0	4	4	Preferred Brand	2		
S5601	063	0		29	10	S5601_063_0	4	5	Non-Preferred Brand	2		
S5601	063	0		29	10	S5601_063_0	4	6	Specialty			
S5601	064	0		29	10	S5601_064_0	7	1	Generic			
S5601	064	0		29	10	S5601_064_0	7	4	Specialty			
S5601	064	0		29	10	S5601_064_0	7	3	Non-Preferred Brand			
S5601	064	0		29	10	S5601_064_0	7	2	Preferred Brand			
S5601	065	0		29	10	S5601_065_0	4	1	Value Generic			
S5601	065	0		29	10	S5601_065_0	4	2	Generic			
S5601	065	0		29	10	S5601_065_0	4	3	Value Brand			
S5601	065	0		29	10	S5601_065_0	4	4	Preferred Brand			
S5601	065	0		29	10	S5601_065_0	4	5	Non-Preferred Brand			
S5601	065	0		29	10	S5601_065_0	4	6	Specialty	2		
S5601	065	0		29	10	S5601_065_0	4	1	Value Generic	1		1
S5601	065	0		29	10	S5601_065_0	4	2	Generic	1		1
S5601	065	0		29	10	S5601_065_0	4	3	Value Brand	2		
S5601	065	0		29	10	S5601_065_0	4	4	Preferred Brand	2		
S5601	065	0		29	10	S5601_065_0	4	5	Non-Preferred Brand	2		
S5601	065	0		29	10	S5601_065_0	4	6	Specialty			
S5601	066	0		29	10	S5601_066_0	7	1	Generic			
S5601	066	0		29	10	S5601_066_0	7	4	Specialty			
S5601	066	0		29	10	S5601_066_0	7	3	Non-Preferred Brand			
S5601	066	0		29	10	S5601_066_0	7	2	Preferred Brand			
S5601	067	0		29	10	S5601_067_0	4	2	Generic	1		1
S5601	067	0		29	10	S5601_067_0	4	3	Value Brand	2		
S5601	067	0		29	10	S5601_067_0	4	4	Preferred Brand	2		
S5601	067	0		29	10	S5601_067_0	4	5	Non-Preferred Brand	2		
S5601	067	0		29	10	S5601_067_0	4	1	Value Generic			
S5601	067	0		29	10	S5601_067_0	4	6	Specialty	2		
S5601	067	0		29	10	S5601_067_0	4	3	Value Brand			
S5601	067	0		29	10	S5601_067_0	4	4	Preferred Brand			
S5601	067	0		29	10	S5601_067_0	4	5	Non-Preferred Brand			
S5601	067	0		29	10	S5601_067_0	4	6	Specialty			
S5601	067	0		29	10	S5601_067_0	4	1	Value Generic	1		1
S5601	067	0		29	10	S5601_067_0	4	2	Generic			
S5601	068	0		29	10	S5601_068_0	7	1	Generic			
S5601	068	0		29	10	S5601_068_0	7	4	Specialty			
S5601	068	0		29	10	S5601_068_0	7	3	Non-Preferred Brand			
S5601	068	0		29	10	S5601_068_0	7	2	Preferred Brand			
S5601	069	0		29	10	S5601_069_0	4	1	Value Generic			
S5601	069	0		29	10	S5601_069_0	4	2	Generic			
S5601	069	0		29	10	S5601_069_0	4	3	Value Brand			
S5601	069	0		29	10	S5601_069_0	4	4	Preferred Brand			
S5601	069	0		29	10	S5601_069_0	4	5	Non-Preferred Brand			
S5601	069	0		29	10	S5601_069_0	4	6	Specialty	2		
S5601	069	0		29	10	S5601_069_0	4	1	Value Generic	1		1
S5601	069	0		29	10	S5601_069_0	4	2	Generic	1		1
S5601	069	0		29	10	S5601_069_0	4	3	Value Brand	2		
S5601	069	0		29	10	S5601_069_0	4	4	Preferred Brand	2		
S5601	069	0		29	10	S5601_069_0	4	5	Non-Preferred Brand	2		
S5601	069	0		29	10	S5601_069_0	4	6	Specialty			
S5601	070	0		29	10	S5601_070_0	7	4	Specialty			
S5601	070	0		29	10	S5601_070_0	7	3	Non-Preferred Brand			
S5601	070	0		29	10	S5601_070_0	7	2	Preferred Brand			
S5601	070	0		29	10	S5601_070_0	7	1	Generic			
S5601	071	0		29	10	S5601_071_0	4	5	Non-Preferred Brand			
S5601	071	0		29	10	S5601_071_0	4	6	Specialty			
S5601	071	0		29	10	S5601_071_0	4	1	Value Generic	1		1
S5601	071	0		29	10	S5601_071_0	4	2	Generic	1		1
S5601	071	0		29	10	S5601_071_0	4	4	Preferred Brand			
S5601	071	0		29	10	S5601_071_0	4	3	Value Brand			
S5601	071	0		29	10	S5601_071_0	4	2	Generic			
S5601	071	0		29	10	S5601_071_0	4	1	Value Generic			
S5601	071	0		29	10	S5601_071_0	4	3	Value Brand	2		
S5601	071	0		29	10	S5601_071_0	4	6	Specialty	2		
S5601	071	0		29	10	S5601_071_0	4	5	Non-Preferred Brand	2		
S5601	071	0		29	10	S5601_071_0	4	4	Preferred Brand	2		
S5601	072	0		29	10	S5601_072_0	4	1	Value Generic			
S5601	072	0		29	10	S5601_072_0	4	2	Generic			
S5601	072	0		29	10	S5601_072_0	4	3	Preferred Brand			
S5601	072	0		29	10	S5601_072_0	4	4	Non-Preferred Brand			
S5601	072	0		29	10	S5601_072_0	4	5	Specialty	2		
S5601	072	0		29	10	S5601_072_0	4	1	Value Generic	1		1
S5601	072	0		29	10	S5601_072_0	4	4	Non-Preferred Brand	2		
S5601	072	0		29	10	S5601_072_0	4	3	Preferred Brand	2		
S5601	072	0		29	10	S5601_072_0	4	2	Generic	1		1
S5601	072	0		29	10	S5601_072_0	4	5	Specialty			
S5601	073	0		29	10	S5601_073_0	4	1	Value Generic			
S5601	073	0		29	10	S5601_073_0	4	2	Generic			
S5601	073	0		29	10	S5601_073_0	4	3	Preferred Brand			
S5601	073	0		29	10	S5601_073_0	4	4	Non-Preferred Brand			
S5601	073	0		29	10	S5601_073_0	4	5	Specialty			
S5601	073	0		29	10	S5601_073_0	4	1	Value Generic	1		1
S5601	073	0		29	10	S5601_073_0	4	2	Generic	1		1
S5601	073	0		29	10	S5601_073_0	4	3	Preferred Brand	2		
S5601	073	0		29	10	S5601_073_0	4	4	Non-Preferred Brand	2		
S5601	073	0		29	10	S5601_073_0	4	5	Specialty	2		
S5601	074	0		29	10	S5601_074_0	4	3	Preferred Brand	2		
S5601	074	0		29	10	S5601_074_0	4	5	Specialty	2		
S5601	074	0		29	10	S5601_074_0	4	4	Non-Preferred Brand	2		
S5601	074	0		29	10	S5601_074_0	4	2	Generic	1		1
S5601	074	0		29	10	S5601_074_0	4	1	Value Generic	1		1
S5601	074	0		29	10	S5601_074_0	4	2	Generic			
S5601	074	0		29	10	S5601_074_0	4	3	Preferred Brand			
S5601	074	0		29	10	S5601_074_0	4	4	Non-Preferred Brand			
S5601	074	0		29	10	S5601_074_0	4	5	Specialty			
S5601	074	0		29	10	S5601_074_0	4	1	Value Generic			
S5601	075	0		29	10	S5601_075_0	4	4	Non-Preferred Brand			
S5601	075	0		29	10	S5601_075_0	4	3	Preferred Brand			
S5601	075	0		29	10	S5601_075_0	4	2	Generic			
S5601	075	0		29	10	S5601_075_0	4	1	Value Generic			
S5601	075	0		29	10	S5601_075_0	4	5	Specialty			
S5601	075	0		29	10	S5601_075_0	4	5	Specialty	2		
S5601	075	0		29	10	S5601_075_0	4	4	Non-Preferred Brand	2		
S5601	075	0		29	10	S5601_075_0	4	3	Preferred Brand	2		
S5601	075	0		29	10	S5601_075_0	4	2	Generic	1		1
S5601	075	0		29	10	S5601_075_0	4	1	Value Generic	1		1
S5601	076	0		29	10	S5601_076_0	4	1	Value Generic			
S5601	076	0		29	10	S5601_076_0	4	2	Generic			
S5601	076	0		29	10	S5601_076_0	4	3	Preferred Brand			
S5601	076	0		29	10	S5601_076_0	4	4	Non-Preferred Brand			
S5601	076	0		29	10	S5601_076_0	4	5	Specialty	2		
S5601	076	0		29	10	S5601_076_0	4	3	Preferred Brand	2		
S5601	076	0		29	10	S5601_076_0	4	2	Generic	1		1
S5601	076	0		29	10	S5601_076_0	4	1	Value Generic	1		1
S5601	076	0		29	10	S5601_076_0	4	5	Specialty			
S5601	076	0		29	10	S5601_076_0	4	4	Non-Preferred Brand	2		
S5601	077	0		29	10	S5601_077_0	4	1	Value Generic			
S5601	077	0		29	10	S5601_077_0	4	2	Generic			
S5601	077	0		29	10	S5601_077_0	4	3	Preferred Brand			
S5601	077	0		29	10	S5601_077_0	4	4	Non-Preferred Brand			
S5601	077	0		29	10	S5601_077_0	4	5	Specialty			
S5601	077	0		29	10	S5601_077_0	4	1	Value Generic	1		1
S5601	077	0		29	10	S5601_077_0	4	2	Generic	1		1
S5601	077	0		29	10	S5601_077_0	4	3	Preferred Brand	2		
S5601	077	0		29	10	S5601_077_0	4	4	Non-Preferred Brand	2		
S5601	077	0		29	10	S5601_077_0	4	5	Specialty	2		
S5601	078	0		29	10	S5601_078_0	4	5	Specialty			
S5601	078	0		29	10	S5601_078_0	4	4	Non-Preferred Brand			
S5601	078	0		29	10	S5601_078_0	4	3	Preferred Brand			
S5601	078	0		29	10	S5601_078_0	4	2	Generic			
S5601	078	0		29	10	S5601_078_0	4	1	Value Generic	1		1
S5601	078	0		29	10	S5601_078_0	4	5	Specialty	2		
S5601	078	0		29	10	S5601_078_0	4	4	Non-Preferred Brand	2		
S5601	078	0		29	10	S5601_078_0	4	3	Preferred Brand	2		
S5601	078	0		29	10	S5601_078_0	4	2	Generic	1		1
S5601	078	0		29	10	S5601_078_0	4	1	Value Generic			
S5601	079	0		29	10	S5601_079_0	4	5	Specialty			
S5601	079	0		29	10	S5601_079_0	4	4	Non-Preferred Brand			
S5601	079	0		29	10	S5601_079_0	4	3	Preferred Brand			
S5601	079	0		29	10	S5601_079_0	4	2	Generic			
S5601	079	0		29	10	S5601_079_0	4	1	Value Generic			
S5601	079	0		29	10	S5601_079_0	4	5	Specialty	2		
S5601	079	0		29	10	S5601_079_0	4	4	Non-Preferred Brand	2		
S5601	079	0		29	10	S5601_079_0	4	1	Value Generic	1		1
S5601	079	0		29	10	S5601_079_0	4	2	Generic	1		1
S5601	079	0		29	10	S5601_079_0	4	3	Preferred Brand	2		
S5601	080	0		29	10	S5601_080_0	4	1	Value Generic			
S5601	080	0		29	10	S5601_080_0	4	2	Generic			
S5601	080	0		29	10	S5601_080_0	4	3	Preferred Brand			
S5601	080	0		29	10	S5601_080_0	4	4	Non-Preferred Brand			
S5601	080	0		29	10	S5601_080_0	4	5	Specialty	2		
S5601	080	0		29	10	S5601_080_0	4	1	Value Generic	1		1
S5601	080	0		29	10	S5601_080_0	4	2	Generic	1		1
S5601	080	0		29	10	S5601_080_0	4	3	Preferred Brand	2		
S5601	080	0		29	10	S5601_080_0	4	4	Non-Preferred Brand	2		
S5601	080	0		29	10	S5601_080_0	4	5	Specialty			
S5601	081	0		29	10	S5601_081_0	4	2	Generic			
S5601	081	0		29	10	S5601_081_0	4	3	Preferred Brand			
S5601	081	0		29	10	S5601_081_0	4	4	Non-Preferred Brand			
S5601	081	0		29	10	S5601_081_0	4	5	Specialty			
S5601	081	0		29	10	S5601_081_0	4	5	Specialty	2		
S5601	081	0		29	10	S5601_081_0	4	1	Value Generic	1		1
S5601	081	0		29	10	S5601_081_0	4	2	Generic	1		1
S5601	081	0		29	10	S5601_081_0	4	3	Preferred Brand	2		
S5601	081	0		29	10	S5601_081_0	4	4	Non-Preferred Brand	2		
S5601	081	0		29	10	S5601_081_0	4	1	Value Generic			
S5601	082	0		29	10	S5601_082_0	4	1	Value Generic			
S5601	082	0		29	10	S5601_082_0	4	2	Generic			
S5601	082	0		29	10	S5601_082_0	4	3	Preferred Brand			
S5601	082	0		29	10	S5601_082_0	4	4	Non-Preferred Brand			
S5601	082	0		29	10	S5601_082_0	4	5	Specialty	2		
S5601	082	0		29	10	S5601_082_0	4	1	Value Generic	1		1
S5601	082	0		29	10	S5601_082_0	4	2	Generic	1		1
S5601	082	0		29	10	S5601_082_0	4	3	Preferred Brand	2		
S5601	082	0		29	10	S5601_082_0	4	4	Non-Preferred Brand	2		
S5601	082	0		29	10	S5601_082_0	4	5	Specialty			
S5601	083	0		29	10	S5601_083_0	4	5	Specialty			
S5601	083	0		29	10	S5601_083_0	4	1	Value Generic	1		1
S5601	083	0		29	10	S5601_083_0	4	2	Generic	1		1
S5601	083	0		29	10	S5601_083_0	4	3	Preferred Brand	2		
S5601	083	0		29	10	S5601_083_0	4	4	Non-Preferred Brand			
S5601	083	0		29	10	S5601_083_0	4	5	Specialty	2		
S5601	083	0		29	10	S5601_083_0	4	1	Value Generic			
S5601	083	0		29	10	S5601_083_0	4	2	Generic			
S5601	083	0		29	10	S5601_083_0	4	3	Preferred Brand			
S5601	083	0		29	10	S5601_083_0	4	4	Non-Preferred Brand	2		
S5601	084	0		29	10	S5601_084_0	4	1	Value Generic			
S5601	084	0		29	10	S5601_084_0	4	2	Generic			
S5601	084	0		29	10	S5601_084_0	4	3	Preferred Brand			
S5601	084	0		29	10	S5601_084_0	4	4	Non-Preferred Brand			
S5601	084	0		29	10	S5601_084_0	4	5	Specialty	2		
S5601	084	0		29	10	S5601_084_0	4	1	Value Generic	1		1
S5601	084	0		29	10	S5601_084_0	4	2	Generic	1		1
S5601	084	0		29	10	S5601_084_0	4	3	Preferred Brand	2		
S5601	084	0		29	10	S5601_084_0	4	4	Non-Preferred Brand	2		
S5601	084	0		29	10	S5601_084_0	4	5	Specialty			
S5601	085	0		29	10	S5601_085_0	4	1	Value Generic			
S5601	085	0		29	10	S5601_085_0	4	2	Generic			
S5601	085	0		29	10	S5601_085_0	4	3	Preferred Brand			
S5601	085	0		29	10	S5601_085_0	4	4	Non-Preferred Brand			
S5601	085	0		29	10	S5601_085_0	4	5	Specialty	2		
S5601	085	0		29	10	S5601_085_0	4	1	Value Generic	1		1
S5601	085	0		29	10	S5601_085_0	4	2	Generic	1		1
S5601	085	0		29	10	S5601_085_0	4	3	Preferred Brand	2		
S5601	085	0		29	10	S5601_085_0	4	4	Non-Preferred Brand	2		
S5601	085	0		29	10	S5601_085_0	4	5	Specialty			
S5601	086	0		29	10	S5601_086_0	4	1	Value Generic			
S5601	086	0		29	10	S5601_086_0	4	2	Generic			
S5601	086	0		29	10	S5601_086_0	4	3	Preferred Brand			
S5601	086	0		29	10	S5601_086_0	4	4	Non-Preferred Brand			
S5601	086	0		29	10	S5601_086_0	4	5	Specialty	2		
S5601	086	0		29	10	S5601_086_0	4	1	Value Generic	1		1
S5601	086	0		29	10	S5601_086_0	4	2	Generic	1		1
S5601	086	0		29	10	S5601_086_0	4	3	Preferred Brand	2		
S5601	086	0		29	10	S5601_086_0	4	4	Non-Preferred Brand	2		
S5601	086	0		29	10	S5601_086_0	4	5	Specialty			
S5601	087	0		29	10	S5601_087_0	4	1	Value Generic	1		1
S5601	087	0		29	10	S5601_087_0	4	2	Generic	1		1
S5601	087	0		29	10	S5601_087_0	4	3	Preferred Brand	2		
S5601	087	0		29	10	S5601_087_0	4	4	Non-Preferred Brand	2		
S5601	087	0		29	10	S5601_087_0	4	5	Specialty	2		
S5601	087	0		29	10	S5601_087_0	4	2	Generic			
S5601	087	0		29	10	S5601_087_0	4	3	Preferred Brand			
S5601	087	0		29	10	S5601_087_0	4	4	Non-Preferred Brand			
S5601	087	0		29	10	S5601_087_0	4	5	Specialty			
S5601	087	0		29	10	S5601_087_0	4	1	Value Generic			
S5601	088	0		29	10	S5601_088_0	4	5	Specialty			
S5601	088	0		29	10	S5601_088_0	4	1	Value Generic	1		1
S5601	088	0		29	10	S5601_088_0	4	2	Generic	1		1
S5601	088	0		29	10	S5601_088_0	4	3	Preferred Brand	2		
S5601	088	0		29	10	S5601_088_0	4	4	Non-Preferred Brand	2		
S5601	088	0		29	10	S5601_088_0	4	5	Specialty	2		
S5601	088	0		29	10	S5601_088_0	4	1	Value Generic			
S5601	088	0		29	10	S5601_088_0	4	2	Generic			
S5601	088	0		29	10	S5601_088_0	4	3	Preferred Brand			
S5601	088	0		29	10	S5601_088_0	4	4	Non-Preferred Brand			
S5601	089	0		29	10	S5601_089_0	4	1	Value Generic			
S5601	089	0		29	10	S5601_089_0	4	2	Generic			
S5601	089	0		29	10	S5601_089_0	4	3	Preferred Brand			
S5601	089	0		29	10	S5601_089_0	4	4	Non-Preferred Brand			
S5601	089	0		29	10	S5601_089_0	4	5	Specialty	2		
S5601	089	0		29	10	S5601_089_0	4	1	Value Generic	1		1
S5601	089	0		29	10	S5601_089_0	4	2	Generic	1		1
S5601	089	0		29	10	S5601_089_0	4	3	Preferred Brand	2		
S5601	089	0		29	10	S5601_089_0	4	4	Non-Preferred Brand	2		
S5601	089	0		29	10	S5601_089_0	4	5	Specialty			
S5601	090	0		29	10	S5601_090_0	4	1	Value Generic			
S5601	090	0		29	10	S5601_090_0	4	2	Generic			
S5601	090	0		29	10	S5601_090_0	4	3	Preferred Brand			
S5601	090	0		29	10	S5601_090_0	4	4	Non-Preferred Brand			
S5601	090	0		29	10	S5601_090_0	4	5	Specialty	2		
S5601	090	0		29	10	S5601_090_0	4	1	Value Generic	1		1
S5601	090	0		29	10	S5601_090_0	4	2	Generic	1		1
S5601	090	0		29	10	S5601_090_0	4	3	Preferred Brand	2		
S5601	090	0		29	10	S5601_090_0	4	4	Non-Preferred Brand	2		
S5601	090	0		29	10	S5601_090_0	4	5	Specialty			
S5601	091	0		29	10	S5601_091_0	4	5	Specialty	2		
S5601	091	0		29	10	S5601_091_0	4	4	Non-Preferred Brand	2		
S5601	091	0		29	10	S5601_091_0	4	3	Preferred Brand	2		
S5601	091	0		29	10	S5601_091_0	4	2	Generic	1		1
S5601	091	0		29	10	S5601_091_0	4	1	Value Generic	1		1
S5601	091	0		29	10	S5601_091_0	4	5	Specialty			
S5601	091	0		29	10	S5601_091_0	4	4	Non-Preferred Brand			
S5601	091	0		29	10	S5601_091_0	4	3	Preferred Brand			
S5601	091	0		29	10	S5601_091_0	4	1	Value Generic			
S5601	091	0		29	10	S5601_091_0	4	2	Generic			
S5601	092	0		29	10	S5601_092_0	4	5	Specialty	2		
S5601	092	0		29	10	S5601_092_0	4	1	Value Generic			
S5601	092	0		29	10	S5601_092_0	4	2	Generic			
S5601	092	0		29	10	S5601_092_0	4	3	Preferred Brand			
S5601	092	0		29	10	S5601_092_0	4	4	Non-Preferred Brand	2		
S5601	092	0		29	10	S5601_092_0	4	5	Specialty			
S5601	092	0		29	10	S5601_092_0	4	1	Value Generic	1		1
S5601	092	0		29	10	S5601_092_0	4	2	Generic	1		1
S5601	092	0		29	10	S5601_092_0	4	3	Preferred Brand	2		
S5601	092	0		29	10	S5601_092_0	4	4	Non-Preferred Brand			
S5601	093	0		29	10	S5601_093_0	4	5	Specialty	2		
S5601	093	0		29	10	S5601_093_0	4	4	Non-Preferred Brand	2		
S5601	093	0		29	10	S5601_093_0	4	3	Preferred Brand	2		
S5601	093	0		29	10	S5601_093_0	4	2	Generic	1		1
S5601	093	0		29	10	S5601_093_0	4	1	Value Generic	1		1
S5601	093	0		29	10	S5601_093_0	4	5	Specialty			
S5601	093	0		29	10	S5601_093_0	4	4	Non-Preferred Brand			
S5601	093	0		29	10	S5601_093_0	4	3	Preferred Brand			
S5601	093	0		29	10	S5601_093_0	4	1	Value Generic			
S5601	093	0		29	10	S5601_093_0	4	2	Generic			
S5601	094	0		29	10	S5601_094_0	4	4	Non-Preferred Brand			
S5601	094	0		29	10	S5601_094_0	4	5	Specialty			
S5601	094	0		29	10	S5601_094_0	4	1	Value Generic	1		1
S5601	094	0		29	10	S5601_094_0	4	2	Generic	1		1
S5601	094	0		29	10	S5601_094_0	4	3	Preferred Brand	2		
S5601	094	0		29	10	S5601_094_0	4	4	Non-Preferred Brand	2		
S5601	094	0		29	10	S5601_094_0	4	5	Specialty	2		
S5601	094	0		29	10	S5601_094_0	4	1	Value Generic			
S5601	094	0		29	10	S5601_094_0	4	2	Generic			
S5601	094	0		29	10	S5601_094_0	4	3	Preferred Brand			
S5601	095	0		29	10	S5601_095_0	4	2	Generic	1		1
S5601	095	0		29	10	S5601_095_0	4	1	Value Generic	1		1
S5601	095	0		29	10	S5601_095_0	4	5	Specialty			
S5601	095	0		29	10	S5601_095_0	4	4	Non-Preferred Brand			
S5601	095	0		29	10	S5601_095_0	4	4	Non-Preferred Brand	2		
S5601	095	0		29	10	S5601_095_0	4	2	Generic			
S5601	095	0		29	10	S5601_095_0	4	1	Value Generic			
S5601	095	0		29	10	S5601_095_0	4	5	Specialty	2		
S5601	095	0		29	10	S5601_095_0	4	3	Preferred Brand	2		
S5601	095	0		29	10	S5601_095_0	4	3	Preferred Brand			
S5601	096	0		29	10	S5601_096_0	4	1	Value Generic	1		1
S5601	096	0		29	10	S5601_096_0	4	5	Specialty			
S5601	096	0		29	10	S5601_096_0	4	4	Non-Preferred Brand			
S5601	096	0		29	10	S5601_096_0	4	3	Preferred Brand			
S5601	096	0		29	10	S5601_096_0	4	5	Specialty	2		
S5601	096	0		29	10	S5601_096_0	4	4	Non-Preferred Brand	2		
S5601	096	0		29	10	S5601_096_0	4	3	Preferred Brand	2		
S5601	096	0		29	10	S5601_096_0	4	2	Generic	1		1
S5601	096	0		29	10	S5601_096_0	4	2	Generic			
S5601	096	0		29	10	S5601_096_0	4	1	Value Generic			
S5601	097	0		29	10	S5601_097_0	4	4	Non-Preferred Brand			
S5601	097	0		29	10	S5601_097_0	4	3	Preferred Brand			
S5601	097	0		29	10	S5601_097_0	4	2	Generic			
S5601	097	0		29	10	S5601_097_0	4	1	Value Generic			
S5601	097	0		29	10	S5601_097_0	4	5	Specialty			
S5601	097	0		29	10	S5601_097_0	4	5	Specialty	2		
S5601	097	0		29	10	S5601_097_0	4	4	Non-Preferred Brand	2		
S5601	097	0		29	10	S5601_097_0	4	3	Preferred Brand	2		
S5601	097	0		29	10	S5601_097_0	4	2	Generic	1		1
S5601	097	0		29	10	S5601_097_0	4	1	Value Generic	1		1
S5601	098	0		29	10	S5601_098_0	4	1	Value Generic			
S5601	098	0		29	10	S5601_098_0	4	2	Generic			
S5601	098	0		29	10	S5601_098_0	4	5	Specialty	2		
S5601	098	0		29	10	S5601_098_0	4	4	Non-Preferred Brand	2		
S5601	098	0		29	10	S5601_098_0	4	3	Preferred Brand	2		
S5601	098	0		29	10	S5601_098_0	4	2	Generic	1		1
S5601	098	0		29	10	S5601_098_0	4	1	Value Generic	1		1
S5601	098	0		29	10	S5601_098_0	4	5	Specialty			
S5601	098	0		29	10	S5601_098_0	4	4	Non-Preferred Brand			
S5601	098	0		29	10	S5601_098_0	4	3	Preferred Brand			
S5601	099	0		29	10	S5601_099_0	4	1	Value Generic			
S5601	099	0		29	10	S5601_099_0	4	5	Specialty			
S5601	099	0		29	10	S5601_099_0	4	1	Value Generic	1		1
S5601	099	0		29	10	S5601_099_0	4	2	Generic	1		1
S5601	099	0		29	10	S5601_099_0	4	5	Specialty	2		
S5601	099	0		29	10	S5601_099_0	4	4	Non-Preferred Brand	2		
S5601	099	0		29	10	S5601_099_0	4	4	Non-Preferred Brand			
S5601	099	0		29	10	S5601_099_0	4	3	Preferred Brand			
S5601	099	0		29	10	S5601_099_0	4	2	Generic			
S5601	099	0		29	10	S5601_099_0	4	3	Preferred Brand	2		
S5601	100	0		29	10	S5601_100_0	4	4	Non-Preferred Brand			
S5601	100	0		29	10	S5601_100_0	4	5	Specialty			
S5601	100	0		29	10	S5601_100_0	4	1	Value Generic	1		1
S5601	100	0		29	10	S5601_100_0	4	2	Generic	1		1
S5601	100	0		29	10	S5601_100_0	4	1	Value Generic			
S5601	100	0		29	10	S5601_100_0	4	2	Generic			
S5601	100	0		29	10	S5601_100_0	4	3	Preferred Brand			
S5601	100	0		29	10	S5601_100_0	4	3	Preferred Brand	2		
S5601	100	0		29	10	S5601_100_0	4	4	Non-Preferred Brand	2		
S5601	100	0		29	10	S5601_100_0	4	5	Specialty	2		
S5601	101	0		29	10	S5601_101_0	4	1	Value Generic	1		1
S5601	101	0		29	10	S5601_101_0	4	2	Generic	1		1
S5601	101	0		29	10	S5601_101_0	4	4	Non-Preferred Brand			
S5601	101	0		29	10	S5601_101_0	4	3	Preferred Brand			
S5601	101	0		29	10	S5601_101_0	4	2	Generic			
S5601	101	0		29	10	S5601_101_0	4	1	Value Generic			
S5601	101	0		29	10	S5601_101_0	4	5	Specialty			
S5601	101	0		29	10	S5601_101_0	4	3	Preferred Brand	2		
S5601	101	0		29	10	S5601_101_0	4	4	Non-Preferred Brand	2		
S5601	101	0		29	10	S5601_101_0	4	5	Specialty	2		
S5601	102	0		29	10	S5601_102_0	4	2	Generic	1		1
S5601	102	0		29	10	S5601_102_0	4	3	Preferred Brand	2		
S5601	102	0		29	10	S5601_102_0	4	4	Non-Preferred Brand	2		
S5601	102	0		29	10	S5601_102_0	4	5	Specialty	2		
S5601	102	0		29	10	S5601_102_0	4	1	Value Generic	1		1
S5601	102	0		29	10	S5601_102_0	4	2	Generic			
S5601	102	0		29	10	S5601_102_0	4	3	Preferred Brand			
S5601	102	0		29	10	S5601_102_0	4	4	Non-Preferred Brand			
S5601	102	0		29	10	S5601_102_0	4	5	Specialty			
S5601	102	0		29	10	S5601_102_0	4	1	Value Generic			
S5601	103	0		29	10	S5601_103_0	4	5	Specialty	2		
S5601	103	0		29	10	S5601_103_0	4	4	Non-Preferred Brand	2		
S5601	103	0		29	10	S5601_103_0	4	3	Preferred Brand			
S5601	103	0		29	10	S5601_103_0	4	2	Generic	1		1
S5601	103	0		29	10	S5601_103_0	4	3	Preferred Brand	2		
S5601	103	0		29	10	S5601_103_0	4	4	Non-Preferred Brand			
S5601	103	0		29	10	S5601_103_0	4	5	Specialty			
S5601	103	0		29	10	S5601_103_0	4	1	Value Generic	1		1
S5601	103	0		29	10	S5601_103_0	4	2	Generic			
S5601	103	0		29	10	S5601_103_0	4	1	Value Generic			
S5601	104	0		29	10	S5601_104_0	4	1	Value Generic	1		1
S5601	104	0		29	10	S5601_104_0	4	5	Specialty			
S5601	104	0		29	10	S5601_104_0	4	4	Non-Preferred Brand			
S5601	104	0		29	10	S5601_104_0	4	3	Preferred Brand			
S5601	104	0		29	10	S5601_104_0	4	5	Specialty	2		
S5601	104	0		29	10	S5601_104_0	4	2	Generic			
S5601	104	0		29	10	S5601_104_0	4	2	Generic	1		1
S5601	104	0		29	10	S5601_104_0	4	3	Preferred Brand	2		
S5601	104	0		29	10	S5601_104_0	4	4	Non-Preferred Brand	2		
S5601	104	0		29	10	S5601_104_0	4	1	Value Generic			
S5601	105	0		29	10	S5601_105_0	4	1	Value Generic	1		1
S5601	105	0		29	10	S5601_105_0	4	4	Non-Preferred Brand	2		
S5601	105	0		29	10	S5601_105_0	4	3	Preferred Brand	2		
S5601	105	0		29	10	S5601_105_0	4	2	Generic	1		1
S5601	105	0		29	10	S5601_105_0	4	2	Generic			
S5601	105	0		29	10	S5601_105_0	4	1	Value Generic			
S5601	105	0		29	10	S5601_105_0	4	5	Specialty	2		
S5601	105	0		29	10	S5601_105_0	4	5	Specialty			
S5601	105	0		29	10	S5601_105_0	4	4	Non-Preferred Brand			
S5601	105	0		29	10	S5601_105_0	4	3	Preferred Brand			
S5601	106	0		29	10	S5601_106_0	4	1	Value Generic	1		1
S5601	106	0		29	10	S5601_106_0	4	5	Specialty			
S5601	106	0		29	10	S5601_106_0	4	4	Non-Preferred Brand			
S5601	106	0		29	10	S5601_106_0	4	3	Preferred Brand			
S5601	106	0		29	10	S5601_106_0	4	5	Specialty	2		
S5601	106	0		29	10	S5601_106_0	4	1	Value Generic			
S5601	106	0		29	10	S5601_106_0	4	2	Generic	1		1
S5601	106	0		29	10	S5601_106_0	4	3	Preferred Brand	2		
S5601	106	0		29	10	S5601_106_0	4	4	Non-Preferred Brand	2		
S5601	106	0		29	10	S5601_106_0	4	2	Generic			
S5609	001	0		29	10	S5609_001_0	2	4	Miscellaneous Injectables			
S5609	001	0		29	10	S5609_001_0	2	3	Non-Preferred Brand			
S5609	001	0		29	10	S5609_001_0	2	2	Preferred Brand			
S5609	001	0		29	10	S5609_001_0	2	1	Generic			
S5609	001	0		29	10	S5609_001_0	2	5	Specialty			
S5609	002	0		29	10	S5609_002_0	2	1	Generic	1		1
S5609	002	0		29	10	S5609_002_0	2	2	Preferred Brand	2		
S5609	002	0		29	10	S5609_002_0	2	3	Non-Preferred Brand	2		
S5609	002	0		29	10	S5609_002_0	2	4	Miscellaneous Injectables	2		
S5609	002	0		29	10	S5609_002_0	2	5	Specialty Medications			
S5609	002	0		29	10	S5609_002_0	2	4	Miscellaneous Injectables			
S5609	002	0		29	10	S5609_002_0	2	5	Specialty Medications	2		
S5609	002	0		29	10	S5609_002_0	2	2	Preferred Brand			
S5609	002	0		29	10	S5609_002_0	2	1	Generic			
S5609	002	0		29	10	S5609_002_0	2	3	Non-Preferred Brand			
S5617	003	0		29	10	S5617_003_0	2	2	Tier 2			
S5617	003	0		29	10	S5617_003_0	2	1	Tier 1			
S5617	003	0		29	10	S5617_003_0	2	3	Tier 3			
S5617	003	0		29	10	S5617_003_0	2	4	Tier 4			
S5617	005	0		29	10	S5617_005_0	2	2	Tier 2			
S5617	005	0		29	10	S5617_005_0	2	1	Tier 1			
S5617	005	0		29	10	S5617_005_0	2	3	Tier 3			
S5617	005	0		29	10	S5617_005_0	2	5	Tier 5			
S5617	005	0		29	10	S5617_005_0	2	4	Tier 4			
S5617	008	0		29	10	S5617_008_0	2	1	Tier 1			
S5617	008	0		29	10	S5617_008_0	2	3	Tier 3			
S5617	008	0		29	10	S5617_008_0	2	2	Tier 2			
S5617	008	0		29	10	S5617_008_0	2	4	Tier 4			
S5617	010	0		29	10	S5617_010_0	2	3	Tier 3			
S5617	010	0		29	10	S5617_010_0	2	2	Tier 2			
S5617	010	0		29	10	S5617_010_0	2	1	Tier 1			
S5617	010	0		29	10	S5617_010_0	2	4	Tier 4			
S5617	010	0		29	10	S5617_010_0	2	5	Tier 5			
S5617	013	0		29	10	S5617_013_0	2	3	Tier 3			
S5617	013	0		29	10	S5617_013_0	2	2	Tier 2			
S5617	013	0		29	10	S5617_013_0	2	1	Tier 1			
S5617	013	0		29	10	S5617_013_0	2	4	Tier 4			
S5617	015	0		29	10	S5617_015_0	2	1	Tier 1			
S5617	015	0		29	10	S5617_015_0	2	2	Tier 2			
S5617	015	0		29	10	S5617_015_0	2	3	Tier 3			
S5617	015	0		29	10	S5617_015_0	2	4	Tier 4			
S5617	015	0		29	10	S5617_015_0	2	5	Tier 5			
S5617	018	0		29	10	S5617_018_0	2	1	Tier 1			
S5617	018	0		29	10	S5617_018_0	2	2	Tier 2			
S5617	018	0		29	10	S5617_018_0	2	3	Tier 3			
S5617	018	0		29	10	S5617_018_0	2	4	Tier 4			
S5617	020	0		29	10	S5617_020_0	2	1	Tier 1			
S5617	020	0		29	10	S5617_020_0	2	2	Tier 2			
S5617	020	0		29	10	S5617_020_0	2	3	Tier 3			
S5617	020	0		29	10	S5617_020_0	2	4	Tier 4			
S5617	020	0		29	10	S5617_020_0	2	5	Tier 5			
S5617	023	0		29	10	S5617_023_0	2	4	Tier 4			
S5617	023	0		29	10	S5617_023_0	2	1	Tier 1			
S5617	023	0		29	10	S5617_023_0	2	2	Tier 2			
S5617	023	0		29	10	S5617_023_0	2	3	Tier 3			
S5617	025	0		29	10	S5617_025_0	2	5	Tier 5			
S5617	025	0		29	10	S5617_025_0	2	4	Tier 4			
S5617	025	0		29	10	S5617_025_0	2	3	Tier 3			
S5617	025	0		29	10	S5617_025_0	2	1	Tier 1			
S5617	025	0		29	10	S5617_025_0	2	2	Tier 2			
S5617	028	0		29	10	S5617_028_0	2	3	Tier 3			
S5617	028	0		29	10	S5617_028_0	2	2	Tier 2			
S5617	028	0		29	10	S5617_028_0	2	1	Tier 1			
S5617	028	0		29	10	S5617_028_0	2	4	Tier 4			
S5617	030	0		29	10	S5617_030_0	2	3	Tier 3			
S5617	030	0		29	10	S5617_030_0	2	2	Tier 2			
S5617	030	0		29	10	S5617_030_0	2	1	Tier 1			
S5617	030	0		29	10	S5617_030_0	2	4	Tier 4			
S5617	030	0		29	10	S5617_030_0	2	5	Tier 5			
S5617	033	0		29	10	S5617_033_0	2	3	Tier 3			
S5617	033	0		29	10	S5617_033_0	2	2	Tier 2			
S5617	033	0		29	10	S5617_033_0	2	1	Tier 1			
S5617	033	0		29	10	S5617_033_0	2	4	Tier 4			
S5617	035	0		29	10	S5617_035_0	2	1	Tier 1			
S5617	035	0		29	10	S5617_035_0	2	2	Tier 2			
S5617	035	0		29	10	S5617_035_0	2	3	Tier 3			
S5617	035	0		29	10	S5617_035_0	2	4	Tier 4			
S5617	035	0		29	10	S5617_035_0	2	5	Tier 5			
S5617	038	0		29	10	S5617_038_0	2	1	Tier 1			
S5617	038	0		29	10	S5617_038_0	2	2	Tier 2			
S5617	038	0		29	10	S5617_038_0	2	3	Tier 3			
S5617	038	0		29	10	S5617_038_0	2	4	Tier 4			
S5617	040	0		29	10	S5617_040_0	2	3	Tier 3			
S5617	040	0		29	10	S5617_040_0	2	2	Tier 2			
S5617	040	0		29	10	S5617_040_0	2	1	Tier 1			
S5617	040	0		29	10	S5617_040_0	2	4	Tier 4			
S5617	040	0		29	10	S5617_040_0	2	5	Tier 5			
S5617	043	0		29	10	S5617_043_0	2	3	Tier 3			
S5617	043	0		29	10	S5617_043_0	2	2	Tier 2			
S5617	043	0		29	10	S5617_043_0	2	1	Tier 1			
S5617	043	0		29	10	S5617_043_0	2	4	Tier 4			
S5617	045	0		29	10	S5617_045_0	2	1	Tier 1			
S5617	045	0		29	10	S5617_045_0	2	2	Tier 2			
S5617	045	0		29	10	S5617_045_0	2	3	Tier 3			
S5617	045	0		29	10	S5617_045_0	2	4	Tier 4			
S5617	045	0		29	10	S5617_045_0	2	5	Tier 5			
S5617	048	0		29	10	S5617_048_0	2	1	Tier 1			
S5617	048	0		29	10	S5617_048_0	2	2	Tier 2			
S5617	048	0		29	10	S5617_048_0	2	3	Tier 3			
S5617	048	0		29	10	S5617_048_0	2	4	Tier 4			
S5617	050	0		29	10	S5617_050_0	2	2	Tier 2			
S5617	050	0		29	10	S5617_050_0	2	5	Tier 5			
S5617	050	0		29	10	S5617_050_0	2	4	Tier 4			
S5617	050	0		29	10	S5617_050_0	2	3	Tier 3			
S5617	050	0		29	10	S5617_050_0	2	1	Tier 1			
S5617	053	0		29	10	S5617_053_0	2	1	Tier 1			
S5617	053	0		29	10	S5617_053_0	2	2	Tier 2			
S5617	053	0		29	10	S5617_053_0	2	3	Tier 3			
S5617	053	0		29	10	S5617_053_0	2	4	Tier 4			
S5617	055	0		29	10	S5617_055_0	2	5	Tier 5			
S5617	055	0		29	10	S5617_055_0	2	2	Tier 2			
S5617	055	0		29	10	S5617_055_0	2	4	Tier 4			
S5617	055	0		29	10	S5617_055_0	2	3	Tier 3			
S5617	055	0		29	10	S5617_055_0	2	1	Tier 1			
S5617	058	0		29	10	S5617_058_0	2	1	Tier 1			
S5617	058	0		29	10	S5617_058_0	2	2	Tier 2			
S5617	058	0		29	10	S5617_058_0	2	3	Tier 3			
S5617	058	0		29	10	S5617_058_0	2	4	Tier 4			
S5617	060	0		29	10	S5617_060_0	2	3	Tier 3			
S5617	060	0		29	10	S5617_060_0	2	2	Tier 2			
S5617	060	0		29	10	S5617_060_0	2	1	Tier 1			
S5617	060	0		29	10	S5617_060_0	2	4	Tier 4			
S5617	060	0		29	10	S5617_060_0	2	5	Tier 5			
S5617	063	0		29	10	S5617_063_0	2	3	Tier 3			
S5617	063	0		29	10	S5617_063_0	2	2	Tier 2			
S5617	063	0		29	10	S5617_063_0	2	1	Tier 1			
S5617	063	0		29	10	S5617_063_0	2	4	Tier 4			
S5617	065	0		29	10	S5617_065_0	2	1	Tier 1			
S5617	065	0		29	10	S5617_065_0	2	2	Tier 2			
S5617	065	0		29	10	S5617_065_0	2	3	Tier 3			
S5617	065	0		29	10	S5617_065_0	2	4	Tier 4			
S5617	065	0		29	10	S5617_065_0	2	5	Tier 5			
S5617	068	0		29	10	S5617_068_0	2	1	Tier 1			
S5617	068	0		29	10	S5617_068_0	2	2	Tier 2			
S5617	068	0		29	10	S5617_068_0	2	3	Tier 3			
S5617	068	0		29	10	S5617_068_0	2	4	Tier 4			
S5617	070	0		29	10	S5617_070_0	2	3	Tier 3			
S5617	070	0		29	10	S5617_070_0	2	2	Tier 2			
S5617	070	0		29	10	S5617_070_0	2	1	Tier 1			
S5617	070	0		29	10	S5617_070_0	2	4	Tier 4			
S5617	070	0		29	10	S5617_070_0	2	5	Tier 5			
S5617	073	0		29	10	S5617_073_0	2	3	Tier 3			
S5617	073	0		29	10	S5617_073_0	2	2	Tier 2			
S5617	073	0		29	10	S5617_073_0	2	1	Tier 1			
S5617	073	0		29	10	S5617_073_0	2	4	Tier 4			
S5617	075	0		29	10	S5617_075_0	2	1	Tier 1			
S5617	075	0		29	10	S5617_075_0	2	2	Tier 2			
S5617	075	0		29	10	S5617_075_0	2	3	Tier 3			
S5617	075	0		29	10	S5617_075_0	2	4	Tier 4			
S5617	075	0		29	10	S5617_075_0	2	5	Tier 5			
S5617	078	0		29	10	S5617_078_0	2	1	Tier 1			
S5617	078	0		29	10	S5617_078_0	2	2	Tier 2			
S5617	078	0		29	10	S5617_078_0	2	3	Tier 3			
S5617	078	0		29	10	S5617_078_0	2	4	Tier 4			
S5617	080	0		29	10	S5617_080_0	2	3	Tier 3			
S5617	080	0		29	10	S5617_080_0	2	2	Tier 2			
S5617	080	0		29	10	S5617_080_0	2	1	Tier 1			
S5617	080	0		29	10	S5617_080_0	2	4	Tier 4			
S5617	080	0		29	10	S5617_080_0	2	5	Tier 5			
S5617	083	0		29	10	S5617_083_0	2	3	Tier 3			
S5617	083	0		29	10	S5617_083_0	2	2	Tier 2			
S5617	083	0		29	10	S5617_083_0	2	1	Tier 1			
S5617	083	0		29	10	S5617_083_0	2	4	Tier 4			
S5617	085	0		29	10	S5617_085_0	2	1	Tier 1			
S5617	085	0		29	10	S5617_085_0	2	2	Tier 2			
S5617	085	0		29	10	S5617_085_0	2	3	Tier 3			
S5617	085	0		29	10	S5617_085_0	2	4	Tier 4			
S5617	085	0		29	10	S5617_085_0	2	5	Tier 5			
S5617	088	0		29	10	S5617_088_0	2	1	Tier 1			
S5617	088	0		29	10	S5617_088_0	2	2	Tier 2			
S5617	088	0		29	10	S5617_088_0	2	3	Tier 3			
S5617	088	0		29	10	S5617_088_0	2	4	Tier 4			
S5617	090	0		29	10	S5617_090_0	2	2	Tier 2			
S5617	090	0		29	10	S5617_090_0	2	5	Tier 5			
S5617	090	0		29	10	S5617_090_0	2	4	Tier 4			
S5617	090	0		29	10	S5617_090_0	2	3	Tier 3			
S5617	090	0		29	10	S5617_090_0	2	1	Tier 1			
S5617	093	0		29	10	S5617_093_0	2	1	Tier 1			
S5617	093	0		29	10	S5617_093_0	2	4	Tier 4			
S5617	093	0		29	10	S5617_093_0	2	3	Tier 3			
S5617	093	0		29	10	S5617_093_0	2	2	Tier 2			
S5617	095	0		29	10	S5617_095_0	2	1	Tier 1			
S5617	095	0		29	10	S5617_095_0	2	2	Tier 2			
S5617	095	0		29	10	S5617_095_0	2	3	Tier 3			
S5617	095	0		29	10	S5617_095_0	2	4	Tier 4			
S5617	095	0		29	10	S5617_095_0	2	5	Tier 5			
S5617	098	0		29	10	S5617_098_0	2	1	Tier 1			
S5617	098	0		29	10	S5617_098_0	2	4	Tier 4			
S5617	098	0		29	10	S5617_098_0	2	3	Tier 3			
S5617	098	0		29	10	S5617_098_0	2	2	Tier 2			
S5617	100	0		29	10	S5617_100_0	2	3	Tier 3			
S5617	100	0		29	10	S5617_100_0	2	2	Tier 2			
S5617	100	0		29	10	S5617_100_0	2	1	Tier 1			
S5617	100	0		29	10	S5617_100_0	2	4	Tier 4			
S5617	100	0		29	10	S5617_100_0	2	5	Tier 5			
S5617	103	0		29	10	S5617_103_0	2	3	Tier 3			
S5617	103	0		29	10	S5617_103_0	2	2	Tier 2			
S5617	103	0		29	10	S5617_103_0	2	1	Tier 1			
S5617	103	0		29	10	S5617_103_0	2	4	Tier 4			
S5617	105	0		29	10	S5617_105_0	2	1	Tier 1			
S5617	105	0		29	10	S5617_105_0	2	2	Tier 2			
S5617	105	0		29	10	S5617_105_0	2	3	Tier 3			
S5617	105	0		29	10	S5617_105_0	2	4	Tier 4			
S5617	105	0		29	10	S5617_105_0	2	5	Tier 5			
S5617	108	0		29	10	S5617_108_0	2	1	Tier 1			
S5617	108	0		29	10	S5617_108_0	2	2	Tier 2			
S5617	108	0		29	10	S5617_108_0	2	3	Tier 3			
S5617	108	0		29	10	S5617_108_0	2	4	Tier 4			
S5617	110	0		29	10	S5617_110_0	2	1	Tier 1			
S5617	110	0		29	10	S5617_110_0	2	2	Tier 2			
S5617	110	0		29	10	S5617_110_0	2	3	Tier 3			
S5617	110	0		29	10	S5617_110_0	2	4	Tier 4			
S5617	110	0		29	10	S5617_110_0	2	5	Tier 5			
S5617	113	0		29	10	S5617_113_0	2	4	Tier 4			
S5617	113	0		29	10	S5617_113_0	2	3	Tier 3			
S5617	113	0		29	10	S5617_113_0	2	2	Tier 2			
S5617	113	0		29	10	S5617_113_0	2	1	Tier 1			
S5617	115	0		29	10	S5617_115_0	2	1	Tier 1			
S5617	115	0		29	10	S5617_115_0	2	2	Tier 2			
S5617	115	0		29	10	S5617_115_0	2	3	Tier 3			
S5617	115	0		29	10	S5617_115_0	2	5	Tier 5			
S5617	115	0		29	10	S5617_115_0	2	4	Tier 4			
S5617	118	0		29	10	S5617_118_0	2	3	Tier 3			
S5617	118	0		29	10	S5617_118_0	2	2	Tier 2			
S5617	118	0		29	10	S5617_118_0	2	1	Tier 1			
S5617	118	0		29	10	S5617_118_0	2	4	Tier 4			
S5617	120	0		29	10	S5617_120_0	2	5	Tier 5			
S5617	120	0		29	10	S5617_120_0	2	1	Tier 1			
S5617	120	0		29	10	S5617_120_0	2	2	Tier 2			
S5617	120	0		29	10	S5617_120_0	2	3	Tier 3			
S5617	120	0		29	10	S5617_120_0	2	4	Tier 4			
S5617	123	0		29	10	S5617_123_0	2	3	Tier 3			
S5617	123	0		29	10	S5617_123_0	2	4	Tier 4			
S5617	123	0		29	10	S5617_123_0	2	2	Tier 2			
S5617	123	0		29	10	S5617_123_0	2	1	Tier 1			
S5617	125	0		29	10	S5617_125_0	2	5	Tier 5			
S5617	125	0		29	10	S5617_125_0	2	4	Tier 4			
S5617	125	0		29	10	S5617_125_0	2	3	Tier 3			
S5617	125	0		29	10	S5617_125_0	2	2	Tier 2			
S5617	125	0		29	10	S5617_125_0	2	1	Tier 1			
S5617	128	0		29	10	S5617_128_0	2	2	Tier 2			
S5617	128	0		29	10	S5617_128_0	2	4	Tier 4			
S5617	128	0		29	10	S5617_128_0	2	1	Tier 1			
S5617	128	0		29	10	S5617_128_0	2	3	Tier 3			
S5617	130	0		29	10	S5617_130_0	2	3	Tier 3			
S5617	130	0		29	10	S5617_130_0	2	2	Tier 2			
S5617	130	0		29	10	S5617_130_0	2	1	Tier 1			
S5617	130	0		29	10	S5617_130_0	2	4	Tier 4			
S5617	130	0		29	10	S5617_130_0	2	5	Tier 5			
S5617	133	0		29	10	S5617_133_0	2	3	Tier 3			
S5617	133	0		29	10	S5617_133_0	2	2	Tier 2			
S5617	133	0		29	10	S5617_133_0	2	1	Tier 1			
S5617	133	0		29	10	S5617_133_0	2	4	Tier 4			
S5617	135	0		29	10	S5617_135_0	2	1	Tier 1			
S5617	135	0		29	10	S5617_135_0	2	2	Tier 2			
S5617	135	0		29	10	S5617_135_0	2	3	Tier 3			
S5617	135	0		29	10	S5617_135_0	2	4	Tier 4			
S5617	135	0		29	10	S5617_135_0	2	5	Tier 5			
S5617	138	0		29	10	S5617_138_0	2	1	Tier 1			
S5617	138	0		29	10	S5617_138_0	2	2	Tier 2			
S5617	138	0		29	10	S5617_138_0	2	3	Tier 3			
S5617	138	0		29	10	S5617_138_0	2	4	Tier 4			
S5617	140	0		29	10	S5617_140_0	2	1	Tier 1			
S5617	140	0		29	10	S5617_140_0	2	4	Tier 4			
S5617	140	0		29	10	S5617_140_0	2	3	Tier 3			
S5617	140	0		29	10	S5617_140_0	2	2	Tier 2			
S5617	140	0		29	10	S5617_140_0	2	5	Tier 5			
S5617	143	0		29	10	S5617_143_0	2	1	Tier 1			
S5617	143	0		29	10	S5617_143_0	2	2	Tier 2			
S5617	143	0		29	10	S5617_143_0	2	3	Tier 3			
S5617	143	0		29	10	S5617_143_0	2	4	Tier 4			
S5617	145	0		29	10	S5617_145_0	2	4	Tier 4			
S5617	145	0		29	10	S5617_145_0	2	5	Tier 5			
S5617	145	0		29	10	S5617_145_0	2	3	Tier 3			
S5617	145	0		29	10	S5617_145_0	2	2	Tier 2			
S5617	145	0		29	10	S5617_145_0	2	1	Tier 1			
S5617	148	0		29	10	S5617_148_0	2	1	Tier 1			
S5617	148	0		29	10	S5617_148_0	2	2	Tier 2			
S5617	148	0		29	10	S5617_148_0	2	3	Tier 3			
S5617	148	0		29	10	S5617_148_0	2	4	Tier 4			
S5617	150	0		29	10	S5617_150_0	2	3	Tier 3			
S5617	150	0		29	10	S5617_150_0	2	2	Tier 2			
S5617	150	0		29	10	S5617_150_0	2	1	Tier 1			
S5617	150	0		29	10	S5617_150_0	2	4	Tier 4			
S5617	150	0		29	10	S5617_150_0	2	5	Tier 5			
S5617	153	0		29	10	S5617_153_0	2	3	Tier 3			
S5617	153	0		29	10	S5617_153_0	2	2	Tier 2			
S5617	153	0		29	10	S5617_153_0	2	1	Tier 1			
S5617	153	0		29	10	S5617_153_0	2	4	Tier 4			
S5617	155	0		29	10	S5617_155_0	2	1	Tier 1			
S5617	155	0		29	10	S5617_155_0	2	2	Tier 2			
S5617	155	0		29	10	S5617_155_0	2	3	Tier 3			
S5617	155	0		29	10	S5617_155_0	2	4	Tier 4			
S5617	155	0		29	10	S5617_155_0	2	5	Tier 5			
S5617	158	0		29	10	S5617_158_0	2	1	Tier 1			
S5617	158	0		29	10	S5617_158_0	2	2	Tier 2			
S5617	158	0		29	10	S5617_158_0	2	3	Tier 3			
S5617	158	0		29	10	S5617_158_0	2	4	Tier 4			
S5617	160	0		29	10	S5617_160_0	2	3	Tier 3			
S5617	160	0		29	10	S5617_160_0	2	2	Tier 2			
S5617	160	0		29	10	S5617_160_0	2	1	Tier 1			
S5617	160	0		29	10	S5617_160_0	2	4	Tier 4			
S5617	160	0		29	10	S5617_160_0	2	5	Tier 5			
S5617	163	0		29	10	S5617_163_0	2	1	Tier 1			
S5617	163	0		29	10	S5617_163_0	2	2	Tier 2			
S5617	163	0		29	10	S5617_163_0	2	4	Tier 4			
S5617	163	0		29	10	S5617_163_0	2	3	Tier 3			
S5617	165	0		29	10	S5617_165_0	3	5	Tier 5			
S5617	165	0		29	10	S5617_165_0	3	2	Tier 2			
S5617	165	0		29	10	S5617_165_0	3	4	Tier 4			
S5617	165	0		29	10	S5617_165_0	3	1	Tier 1			
S5617	165	0		29	10	S5617_165_0	3	3	Tier 3			
S5617	168	0		29	10	S5617_168_0	2	1	Tier 1			
S5617	168	0		29	10	S5617_168_0	2	4	Tier 4			
S5617	168	0		29	10	S5617_168_0	2	2	Tier 2			
S5617	168	0		29	10	S5617_168_0	2	3	Tier 3			
S5617	170	0		29	10	S5617_170_0	2	1	Tier 1			
S5617	170	0		29	10	S5617_170_0	2	2	Tier 2			
S5617	170	0		29	10	S5617_170_0	2	3	Tier 3			
S5617	170	0		29	10	S5617_170_0	2	4	Tier 4			
S5617	170	0		29	10	S5617_170_0	2	5	Tier 5			
S5617	171	0		29	10	S5617_171_0	2	2	Tier 2			
S5617	171	0		29	10	S5617_171_0	2	3	Tier 3			
S5617	171	0		29	10	S5617_171_0	2	4	Tier 4			
S5617	171	0		29	10	S5617_171_0	2	1	Tier 1	1	00001000	2
S5617	171	0		29	10	S5617_171_0	2	2	Tier 2	2		
S5617	171	0		29	10	S5617_171_0	2	3	Tier 3	2		
S5617	171	0		29	10	S5617_171_0	2	4	Tier 4	2		
S5617	171	0		29	10	S5617_171_0	2	1	Tier 1			
S5617	172	0		29	10	S5617_172_0	2	1	Tier 1			
S5617	172	0		29	10	S5617_172_0	2	2	Tier 2			
S5617	172	0		29	10	S5617_172_0	2	3	Tier 3			
S5617	172	0		29	10	S5617_172_0	2	4	Tier 4			
S5617	172	0		29	10	S5617_172_0	2	1	Tier 1	1	00001000	2
S5617	172	0		29	10	S5617_172_0	2	2	Tier 2	2		
S5617	172	0		29	10	S5617_172_0	2	4	Tier 4	2		
S5617	172	0		29	10	S5617_172_0	2	3	Tier 3	2		
S5617	173	0		29	10	S5617_173_0	2	3	Tier 3	2		
S5617	173	0		29	10	S5617_173_0	2	2	Tier 2			
S5617	173	0		29	10	S5617_173_0	2	1	Tier 1			
S5617	173	0		29	10	S5617_173_0	2	4	Tier 4	2		
S5617	173	0		29	10	S5617_173_0	2	3	Tier 3			
S5617	173	0		29	10	S5617_173_0	2	2	Tier 2	2		
S5617	173	0		29	10	S5617_173_0	2	1	Tier 1	1	00001000	2
S5617	173	0		29	10	S5617_173_0	2	4	Tier 4			
S5617	174	0		29	10	S5617_174_0	2	1	Tier 1	1	00001000	2
S5617	174	0		29	10	S5617_174_0	2	1	Tier 1			
S5617	174	0		29	10	S5617_174_0	2	2	Tier 2			
S5617	174	0		29	10	S5617_174_0	2	3	Tier 3			
S5617	174	0		29	10	S5617_174_0	2	4	Tier 4			
S5617	174	0		29	10	S5617_174_0	2	4	Tier 4	2		
S5617	174	0		29	10	S5617_174_0	2	3	Tier 3	2		
S5617	174	0		29	10	S5617_174_0	2	2	Tier 2	2		
S5617	175	0		29	10	S5617_175_0	2	2	Tier 2	2		
S5617	175	0		29	10	S5617_175_0	2	1	Tier 1			
S5617	175	0		29	10	S5617_175_0	2	2	Tier 2			
S5617	175	0		29	10	S5617_175_0	2	3	Tier 3			
S5617	175	0		29	10	S5617_175_0	2	4	Tier 4			
S5617	175	0		29	10	S5617_175_0	2	1	Tier 1	1	00001000	2
S5617	175	0		29	10	S5617_175_0	2	3	Tier 3	2		
S5617	175	0		29	10	S5617_175_0	2	4	Tier 4	2		
S5617	176	0		29	10	S5617_176_0	2	3	Tier 3	2		
S5617	176	0		29	10	S5617_176_0	2	4	Tier 4	2		
S5617	176	0		29	10	S5617_176_0	2	2	Tier 2	2		
S5617	176	0		29	10	S5617_176_0	2	4	Tier 4			
S5617	176	0		29	10	S5617_176_0	2	1	Tier 1	1	00001000	2
S5617	176	0		29	10	S5617_176_0	2	3	Tier 3			
S5617	176	0		29	10	S5617_176_0	2	2	Tier 2			
S5617	176	0		29	10	S5617_176_0	2	1	Tier 1			
S5617	177	0		29	10	S5617_177_0	2	3	Tier 3			
S5617	177	0		29	10	S5617_177_0	2	4	Tier 4			
S5617	177	0		29	10	S5617_177_0	2	1	Tier 1	1	00001000	2
S5617	177	0		29	10	S5617_177_0	2	2	Tier 2	2		
S5617	177	0		29	10	S5617_177_0	2	3	Tier 3	2		
S5617	177	0		29	10	S5617_177_0	2	4	Tier 4	2		
S5617	177	0		29	10	S5617_177_0	2	1	Tier 1			
S5617	177	0		29	10	S5617_177_0	2	2	Tier 2			
S5617	178	0		29	10	S5617_178_0	2	1	Tier 1			
S5617	178	0		29	10	S5617_178_0	2	2	Tier 2			
S5617	178	0		29	10	S5617_178_0	2	4	Tier 4	2		
S5617	178	0		29	10	S5617_178_0	2	3	Tier 3	2		
S5617	178	0		29	10	S5617_178_0	2	2	Tier 2	2		
S5617	178	0		29	10	S5617_178_0	2	1	Tier 1	1	00001000	2
S5617	178	0		29	10	S5617_178_0	2	4	Tier 4			
S5617	178	0		29	10	S5617_178_0	2	3	Tier 3			
S5617	179	0		29	10	S5617_179_0	2	1	Tier 1			
S5617	179	0		29	10	S5617_179_0	2	3	Tier 3	2		
S5617	179	0		29	10	S5617_179_0	2	2	Tier 2	2		
S5617	179	0		29	10	S5617_179_0	2	1	Tier 1	1	00001000	2
S5617	179	0		29	10	S5617_179_0	2	4	Tier 4			
S5617	179	0		29	10	S5617_179_0	2	3	Tier 3			
S5617	179	0		29	10	S5617_179_0	2	2	Tier 2			
S5617	179	0		29	10	S5617_179_0	2	4	Tier 4	2		
S5617	180	0		29	10	S5617_180_0	2	1	Tier 1			
S5617	180	0		29	10	S5617_180_0	2	2	Tier 2			
S5617	180	0		29	10	S5617_180_0	2	3	Tier 3			
S5617	180	0		29	10	S5617_180_0	2	4	Tier 4			
S5617	180	0		29	10	S5617_180_0	2	1	Tier 1	1	00001000	2
S5617	180	0		29	10	S5617_180_0	2	4	Tier 4	2		
S5617	180	0		29	10	S5617_180_0	2	3	Tier 3	2		
S5617	180	0		29	10	S5617_180_0	2	2	Tier 2	2		
S5617	181	0		29	10	S5617_181_0	2	4	Tier 4	2		
S5617	181	0		29	10	S5617_181_0	2	3	Tier 3	2		
S5617	181	0		29	10	S5617_181_0	2	2	Tier 2	2		
S5617	181	0		29	10	S5617_181_0	2	3	Tier 3			
S5617	181	0		29	10	S5617_181_0	2	4	Tier 4			
S5617	181	0		29	10	S5617_181_0	2	1	Tier 1	1	00001000	2
S5617	181	0		29	10	S5617_181_0	2	2	Tier 2			
S5617	181	0		29	10	S5617_181_0	2	1	Tier 1			
S5617	182	0		29	10	S5617_182_0	2	4	Tier 4	2		
S5617	182	0		29	10	S5617_182_0	2	3	Tier 3	2		
S5617	182	0		29	10	S5617_182_0	2	2	Tier 2	2		
S5617	182	0		29	10	S5617_182_0	2	1	Tier 1	1	00001000	2
S5617	182	0		29	10	S5617_182_0	2	4	Tier 4			
S5617	182	0		29	10	S5617_182_0	2	1	Tier 1			
S5617	182	0		29	10	S5617_182_0	2	2	Tier 2			
S5617	182	0		29	10	S5617_182_0	2	3	Tier 3			
S5617	183	0		29	10	S5617_183_0	2	4	Tier 4	2		
S5617	183	0		29	10	S5617_183_0	2	3	Tier 3	2		
S5617	183	0		29	10	S5617_183_0	2	2	Tier 2	2		
S5617	183	0		29	10	S5617_183_0	2	1	Tier 1			
S5617	183	0		29	10	S5617_183_0	2	4	Tier 4			
S5617	183	0		29	10	S5617_183_0	2	1	Tier 1	1	00001000	2
S5617	183	0		29	10	S5617_183_0	2	2	Tier 2			
S5617	183	0		29	10	S5617_183_0	2	3	Tier 3			
S5617	184	0		29	10	S5617_184_0	2	1	Tier 1	1	00001000	2
S5617	184	0		29	10	S5617_184_0	2	4	Tier 4			
S5617	184	0		29	10	S5617_184_0	2	3	Tier 3			
S5617	184	0		29	10	S5617_184_0	2	2	Tier 2			
S5617	184	0		29	10	S5617_184_0	2	1	Tier 1			
S5617	184	0		29	10	S5617_184_0	2	2	Tier 2	2		
S5617	184	0		29	10	S5617_184_0	2	3	Tier 3	2		
S5617	184	0		29	10	S5617_184_0	2	4	Tier 4	2		
S5617	185	0		29	10	S5617_185_0	2	2	Tier 2			
S5617	185	0		29	10	S5617_185_0	2	3	Tier 3			
S5617	185	0		29	10	S5617_185_0	2	4	Tier 4			
S5617	185	0		29	10	S5617_185_0	2	1	Tier 1	1	00001000	2
S5617	185	0		29	10	S5617_185_0	2	2	Tier 2	2		
S5617	185	0		29	10	S5617_185_0	2	3	Tier 3	2		
S5617	185	0		29	10	S5617_185_0	2	4	Tier 4	2		
S5617	185	0		29	10	S5617_185_0	2	1	Tier 1			
S5617	186	0		29	10	S5617_186_0	2	2	Tier 2			
S5617	186	0		29	10	S5617_186_0	2	1	Tier 1			
S5617	186	0		29	10	S5617_186_0	2	4	Tier 4	2		
S5617	186	0		29	10	S5617_186_0	2	3	Tier 3	2		
S5617	186	0		29	10	S5617_186_0	2	2	Tier 2	2		
S5617	186	0		29	10	S5617_186_0	2	1	Tier 1	1	00001000	2
S5617	186	0		29	10	S5617_186_0	2	4	Tier 4			
S5617	186	0		29	10	S5617_186_0	2	3	Tier 3			
S5617	187	0		29	10	S5617_187_0	2	2	Tier 2	2		
S5617	187	0		29	10	S5617_187_0	2	3	Tier 3	2		
S5617	187	0		29	10	S5617_187_0	2	1	Tier 1	1	00001000	2
S5617	187	0		29	10	S5617_187_0	2	4	Tier 4			
S5617	187	0		29	10	S5617_187_0	2	3	Tier 3			
S5617	187	0		29	10	S5617_187_0	2	2	Tier 2			
S5617	187	0		29	10	S5617_187_0	2	1	Tier 1			
S5617	187	0		29	10	S5617_187_0	2	4	Tier 4	2		
S5617	188	0		29	10	S5617_188_0	2	3	Tier 3	2		
S5617	188	0		29	10	S5617_188_0	2	2	Tier 2	2		
S5617	188	0		29	10	S5617_188_0	2	1	Tier 1	1	00001000	2
S5617	188	0		29	10	S5617_188_0	2	4	Tier 4			
S5617	188	0		29	10	S5617_188_0	2	2	Tier 2			
S5617	188	0		29	10	S5617_188_0	2	1	Tier 1			
S5617	188	0		29	10	S5617_188_0	2	4	Tier 4	2		
S5617	188	0		29	10	S5617_188_0	2	3	Tier 3			
S5617	189	0		29	10	S5617_189_0	2	2	Tier 2			
S5617	189	0		29	10	S5617_189_0	2	1	Tier 1			
S5617	189	0		29	10	S5617_189_0	2	4	Tier 4	2		
S5617	189	0		29	10	S5617_189_0	2	3	Tier 3	2		
S5617	189	0		29	10	S5617_189_0	2	2	Tier 2	2		
S5617	189	0		29	10	S5617_189_0	2	3	Tier 3			
S5617	189	0		29	10	S5617_189_0	2	4	Tier 4			
S5617	189	0		29	10	S5617_189_0	2	1	Tier 1	1	00001000	2
S5617	190	0		29	10	S5617_190_0	2	1	Tier 1			
S5617	190	0		29	10	S5617_190_0	2	2	Tier 2			
S5617	190	0		29	10	S5617_190_0	2	3	Tier 3			
S5617	190	0		29	10	S5617_190_0	2	4	Tier 4			
S5617	190	0		29	10	S5617_190_0	2	1	Tier 1	1	00001000	2
S5617	190	0		29	10	S5617_190_0	2	2	Tier 2	2		
S5617	190	0		29	10	S5617_190_0	2	3	Tier 3	2		
S5617	190	0		29	10	S5617_190_0	2	4	Tier 4	2		
S5617	191	0		29	10	S5617_191_0	2	3	Tier 3			
S5617	191	0		29	10	S5617_191_0	2	2	Tier 2			
S5617	191	0		29	10	S5617_191_0	2	1	Tier 1			
S5617	191	0		29	10	S5617_191_0	2	4	Tier 4			
S5617	191	0		29	10	S5617_191_0	2	4	Tier 4	2		
S5617	191	0		29	10	S5617_191_0	2	3	Tier 3	2		
S5617	191	0		29	10	S5617_191_0	2	2	Tier 2	2		
S5617	191	0		29	10	S5617_191_0	2	1	Tier 1	1	00001000	2
S5617	192	0		29	10	S5617_192_0	2	1	Tier 1			
S5617	192	0		29	10	S5617_192_0	2	2	Tier 2			
S5617	192	0		29	10	S5617_192_0	2	3	Tier 3			
S5617	192	0		29	10	S5617_192_0	2	3	Tier 3	2		
S5617	192	0		29	10	S5617_192_0	2	2	Tier 2	2		
S5617	192	0		29	10	S5617_192_0	2	1	Tier 1	1	00001000	2
S5617	192	0		29	10	S5617_192_0	2	4	Tier 4			
S5617	192	0		29	10	S5617_192_0	2	4	Tier 4	2		
S5617	193	0		29	10	S5617_193_0	2	3	Tier 3			
S5617	193	0		29	10	S5617_193_0	2	2	Tier 2			
S5617	193	0		29	10	S5617_193_0	2	1	Tier 1			
S5617	193	0		29	10	S5617_193_0	2	4	Tier 4			
S5617	193	0		29	10	S5617_193_0	2	4	Tier 4	2		
S5617	193	0		29	10	S5617_193_0	2	3	Tier 3	2		
S5617	193	0		29	10	S5617_193_0	2	2	Tier 2	2		
S5617	193	0		29	10	S5617_193_0	2	1	Tier 1	1	00001000	2
S5617	194	0		29	10	S5617_194_0	2	3	Tier 3			
S5617	194	0		29	10	S5617_194_0	2	2	Tier 2			
S5617	194	0		29	10	S5617_194_0	2	1	Tier 1			
S5617	194	0		29	10	S5617_194_0	2	4	Tier 4			
S5617	194	0		29	10	S5617_194_0	2	1	Tier 1	1	00001000	2
S5617	194	0		29	10	S5617_194_0	2	2	Tier 2	2		
S5617	194	0		29	10	S5617_194_0	2	3	Tier 3	2		
S5617	194	0		29	10	S5617_194_0	2	4	Tier 4	2		
S5617	195	0		29	10	S5617_195_0	2	3	Tier 3			
S5617	195	0		29	10	S5617_195_0	2	2	Tier 2			
S5617	195	0		29	10	S5617_195_0	2	1	Tier 1			
S5617	195	0		29	10	S5617_195_0	2	4	Tier 4			
S5617	195	0		29	10	S5617_195_0	2	4	Tier 4	2		
S5617	195	0		29	10	S5617_195_0	2	3	Tier 3	2		
S5617	195	0		29	10	S5617_195_0	2	2	Tier 2	2		
S5617	195	0		29	10	S5617_195_0	2	1	Tier 1	1	00001000	2
S5617	196	0		29	10	S5617_196_0	2	1	Tier 1			
S5617	196	0		29	10	S5617_196_0	2	2	Tier 2			
S5617	196	0		29	10	S5617_196_0	2	3	Tier 3			
S5617	196	0		29	10	S5617_196_0	2	4	Tier 4			
S5617	196	0		29	10	S5617_196_0	2	1	Tier 1	1	00001000	2
S5617	196	0		29	10	S5617_196_0	2	2	Tier 2	2		
S5617	196	0		29	10	S5617_196_0	2	3	Tier 3	2		
S5617	196	0		29	10	S5617_196_0	2	4	Tier 4	2		
S5617	197	0		29	10	S5617_197_0	2	3	Tier 3	2		
S5617	197	0		29	10	S5617_197_0	2	4	Tier 4	2		
S5617	197	0		29	10	S5617_197_0	2	4	Tier 4			
S5617	197	0		29	10	S5617_197_0	2	1	Tier 1	1	00001000	2
S5617	197	0		29	10	S5617_197_0	2	2	Tier 2	2		
S5617	197	0		29	10	S5617_197_0	2	1	Tier 1			
S5617	197	0		29	10	S5617_197_0	2	2	Tier 2			
S5617	197	0		29	10	S5617_197_0	2	3	Tier 3			
S5617	198	0		29	10	S5617_198_0	2	2	Tier 2	2		
S5617	198	0		29	10	S5617_198_0	2	1	Tier 1	1	00001000	2
S5617	198	0		29	10	S5617_198_0	2	4	Tier 4	2		
S5617	198	0		29	10	S5617_198_0	2	3	Tier 3	2		
S5617	198	0		29	10	S5617_198_0	2	1	Tier 1			
S5617	198	0		29	10	S5617_198_0	2	2	Tier 2			
S5617	198	0		29	10	S5617_198_0	2	3	Tier 3			
S5617	198	0		29	10	S5617_198_0	2	4	Tier 4			
S5617	199	0		29	10	S5617_199_0	2	1	Tier 1			
S5617	199	0		29	10	S5617_199_0	2	3	Tier 3	2		
S5617	199	0		29	10	S5617_199_0	2	2	Tier 2	2		
S5617	199	0		29	10	S5617_199_0	2	1	Tier 1	1	00001000	2
S5617	199	0		29	10	S5617_199_0	2	4	Tier 4			
S5617	199	0		29	10	S5617_199_0	2	3	Tier 3			
S5617	199	0		29	10	S5617_199_0	2	2	Tier 2			
S5617	199	0		29	10	S5617_199_0	2	4	Tier 4	2		
S5617	200	0		29	10	S5617_200_0	2	2	Tier 2	2		
S5617	200	0		29	10	S5617_200_0	2	1	Tier 1	1	00001000	2
S5617	200	0		29	10	S5617_200_0	2	4	Tier 4			
S5617	200	0		29	10	S5617_200_0	2	3	Tier 3			
S5617	200	0		29	10	S5617_200_0	2	2	Tier 2			
S5617	200	0		29	10	S5617_200_0	2	1	Tier 1			
S5617	200	0		29	10	S5617_200_0	2	4	Tier 4	2		
S5617	200	0		29	10	S5617_200_0	2	3	Tier 3	2		
S5617	201	0		29	10	S5617_201_0	2	4	Tier 4			
S5617	201	0		29	10	S5617_201_0	2	2	Tier 2			
S5617	201	0		29	10	S5617_201_0	2	2	Tier 2	2		
S5617	201	0		29	10	S5617_201_0	2	3	Tier 3	2		
S5617	201	0		29	10	S5617_201_0	2	4	Tier 4	2		
S5617	201	0		29	10	S5617_201_0	2	1	Tier 1	1	00001000	2
S5617	201	0		29	10	S5617_201_0	2	3	Tier 3			
S5617	201	0		29	10	S5617_201_0	2	1	Tier 1			
S5617	202	0		29	10	S5617_202_0	2	4	Tier 4			
S5617	202	0		29	10	S5617_202_0	2	1	Tier 1			
S5617	202	0		29	10	S5617_202_0	2	2	Tier 2	2		
S5617	202	0		29	10	S5617_202_0	2	3	Tier 3	2		
S5617	202	0		29	10	S5617_202_0	2	4	Tier 4	2		
S5617	202	0		29	10	S5617_202_0	2	1	Tier 1	1	00001000	2
S5617	202	0		29	10	S5617_202_0	2	2	Tier 2			
S5617	202	0		29	10	S5617_202_0	2	3	Tier 3			
S5617	203	0		29	10	S5617_203_0	2	4	Tier 4			
S5617	203	0		29	10	S5617_203_0	2	1	Tier 1			
S5617	203	0		29	10	S5617_203_0	2	2	Tier 2	2		
S5617	203	0		29	10	S5617_203_0	2	3	Tier 3	2		
S5617	203	0		29	10	S5617_203_0	2	4	Tier 4	2		
S5617	203	0		29	10	S5617_203_0	2	1	Tier 1	1	00001000	2
S5617	203	0		29	10	S5617_203_0	2	2	Tier 2			
S5617	203	0		29	10	S5617_203_0	2	3	Tier 3			
S5617	204	0		29	10	S5617_204_0	2	4	Tier 4			
S5617	204	0		29	10	S5617_204_0	2	1	Tier 1	1	00001000	2
S5617	204	0		29	10	S5617_204_0	2	2	Tier 2	2		
S5617	204	0		29	10	S5617_204_0	2	3	Tier 3	2		
S5617	204	0		29	10	S5617_204_0	2	4	Tier 4	2		
S5617	204	0		29	10	S5617_204_0	2	3	Tier 3			
S5617	204	0		29	10	S5617_204_0	2	2	Tier 2			
S5617	204	0		29	10	S5617_204_0	2	1	Tier 1			
S5644	004	0		29	10	S5644_004_0	4	1	Preferred Generic			
S5644	004	0		29	10	S5644_004_0	4	2	Preferred Brand			
S5644	004	0		29	10	S5644_004_0	4	3	Specialty			
S5644	004	0		29	10	S5644_004_0	4	4	Non-Preferred			
S5644	005	0		29	10	S5644_005_0	3	1	Preferred Generic			
S5644	005	0		29	10	S5644_005_0	3	2	Preferred Brand			
S5644	005	0		29	10	S5644_005_0	3	3	Specialty			
S5644	005	0		29	10	S5644_005_0	3	4	Non-Preferred			
S5644	012	0		29	10	S5644_012_0	3	1	Preferred Generic			
S5644	012	0		29	10	S5644_012_0	3	4	Non-Preferred			
S5644	012	0		29	10	S5644_012_0	3	3	Specialty			
S5644	012	0		29	10	S5644_012_0	3	2	Preferred Brand			
S5644	045	0		29	10	S5644_045_0	4	3	Specialty			
S5644	045	0		29	10	S5644_045_0	4	2	Preferred Brand			
S5644	045	0		29	10	S5644_045_0	4	1	Preferred Generic			
S5644	045	0		29	10	S5644_045_0	4	4	Non-Preferred			
S5644	047	0		29	10	S5644_047_0	3	3	Specialty			
S5644	047	0		29	10	S5644_047_0	3	2	Preferred Brand			
S5644	047	0		29	10	S5644_047_0	3	1	Preferred Generic			
S5644	047	0		29	10	S5644_047_0	3	4	Non-Preferred			
S5644	048	0		29	10	S5644_048_0	3	1	Preferred Generic			
S5644	048	0		29	10	S5644_048_0	3	2	Preferred Brand			
S5644	048	0		29	10	S5644_048_0	3	3	Specialty			
S5644	048	0		29	10	S5644_048_0	3	4	Non-Preferred			
S5644	049	0		29	10	S5644_049_0	3	1	Preferred Generic			
S5644	049	0		29	10	S5644_049_0	3	2	Preferred Brand			
S5644	049	0		29	10	S5644_049_0	3	3	Specialty			
S5644	049	0		29	10	S5644_049_0	3	4	Non-Preferred			
S5644	050	0		29	10	S5644_050_0	3	1	Preferred Generic			
S5644	050	0		29	10	S5644_050_0	3	2	Preferred Brand			
S5644	050	0		29	10	S5644_050_0	3	4	Non-Preferred			
S5644	050	0		29	10	S5644_050_0	3	3	Specialty			
S5644	051	0		29	10	S5644_051_0	3	2	Preferred Brand			
S5644	051	0		29	10	S5644_051_0	3	3	Specialty			
S5644	051	0		29	10	S5644_051_0	3	4	Non-Preferred			
S5644	051	0		29	10	S5644_051_0	3	1	Preferred Generic			
S5644	052	0		29	10	S5644_052_0	3	4	Non-Preferred			
S5644	052	0		29	10	S5644_052_0	3	3	Specialty			
S5644	052	0		29	10	S5644_052_0	3	1	Preferred Generic			
S5644	052	0		29	10	S5644_052_0	3	2	Preferred Brand			
S5644	053	0		29	10	S5644_053_0	3	1	Preferred Generic			
S5644	053	0		29	10	S5644_053_0	3	3	Specialty			
S5644	053	0		29	10	S5644_053_0	3	4	Non-Preferred			
S5644	053	0		29	10	S5644_053_0	3	2	Preferred Brand			
S5644	054	0		29	10	S5644_054_0	3	1	Preferred Generic			
S5644	054	0		29	10	S5644_054_0	3	2	Preferred Brand			
S5644	054	0		29	10	S5644_054_0	3	4	Non-Preferred			
S5644	054	0		29	10	S5644_054_0	3	3	Specialty			
S5644	055	0		29	10	S5644_055_0	3	2	Preferred Brand			
S5644	055	0		29	10	S5644_055_0	3	3	Specialty			
S5644	055	0		29	10	S5644_055_0	3	4	Non-Preferred			
S5644	055	0		29	10	S5644_055_0	3	1	Preferred Generic			
S5644	056	0		29	10	S5644_056_0	3	4	Non-Preferred			
S5644	056	0		29	10	S5644_056_0	3	3	Specialty			
S5644	056	0		29	10	S5644_056_0	3	2	Preferred Brand			
S5644	056	0		29	10	S5644_056_0	3	1	Preferred Generic			
S5644	057	0		29	10	S5644_057_0	3	4	Non-Preferred			
S5644	057	0		29	10	S5644_057_0	3	2	Preferred Brand			
S5644	057	0		29	10	S5644_057_0	3	1	Preferred Generic			
S5644	057	0		29	10	S5644_057_0	3	3	Specialty			
S5644	058	0		29	10	S5644_058_0	3	4	Non-Preferred			
S5644	058	0		29	10	S5644_058_0	3	2	Preferred Brand			
S5644	058	0		29	10	S5644_058_0	3	1	Preferred Generic			
S5644	058	0		29	10	S5644_058_0	3	3	Specialty			
S5644	059	0		29	10	S5644_059_0	3	1	Preferred Generic			
S5644	059	0		29	10	S5644_059_0	3	4	Non-Preferred			
S5644	059	0		29	10	S5644_059_0	3	3	Specialty			
S5644	059	0		29	10	S5644_059_0	3	2	Preferred Brand			
S5644	060	0		29	10	S5644_060_0	3	1	Preferred Generic			
S5644	060	0		29	10	S5644_060_0	3	4	Non-Preferred			
S5644	060	0		29	10	S5644_060_0	3	3	Specialty			
S5644	060	0		29	10	S5644_060_0	3	2	Preferred Brand			
S5644	061	0		29	10	S5644_061_0	3	1	Preferred Generic			
S5644	061	0		29	10	S5644_061_0	3	2	Preferred Brand			
S5644	061	0		29	10	S5644_061_0	3	3	Specialty			
S5644	061	0		29	10	S5644_061_0	3	4	Non-Preferred			
S5644	062	0		29	10	S5644_062_0	3	1	Preferred Generic			
S5644	062	0		29	10	S5644_062_0	3	2	Preferred Brand			
S5644	062	0		29	10	S5644_062_0	3	3	Specialty			
S5644	062	0		29	10	S5644_062_0	3	4	Non-Preferred			
S5644	063	0		29	10	S5644_063_0	3	1	Preferred Generic			
S5644	063	0		29	10	S5644_063_0	3	3	Specialty			
S5644	063	0		29	10	S5644_063_0	3	2	Preferred Brand			
S5644	063	0		29	10	S5644_063_0	3	4	Non-Preferred			
S5644	064	0		29	10	S5644_064_0	3	1	Preferred Generic			
S5644	064	0		29	10	S5644_064_0	3	3	Specialty			
S5644	064	0		29	10	S5644_064_0	3	2	Preferred Brand			
S5644	064	0		29	10	S5644_064_0	3	4	Non-Preferred			
S5644	065	0		29	10	S5644_065_0	3	1	Preferred Generic			
S5644	065	0		29	10	S5644_065_0	3	3	Specialty			
S5644	065	0		29	10	S5644_065_0	3	2	Preferred Brand			
S5644	065	0		29	10	S5644_065_0	3	4	Non-Preferred			
S5644	067	0		29	10	S5644_067_0	3	1	Preferred Generic			
S5644	067	0		29	10	S5644_067_0	3	3	Specialty			
S5644	067	0		29	10	S5644_067_0	3	2	Preferred Brand			
S5644	067	0		29	10	S5644_067_0	3	4	Non-Preferred			
S5644	068	0		29	10	S5644_068_0	3	1	Preferred Generic			
S5644	068	0		29	10	S5644_068_0	3	2	Preferred Brand			
S5644	068	0		29	10	S5644_068_0	3	3	Specialty			
S5644	068	0		29	10	S5644_068_0	3	4	Non-Preferred			
S5644	071	0		29	10	S5644_071_0	3	1	Preferred Generic			
S5644	071	0		29	10	S5644_071_0	3	2	Preferred Brand			
S5644	071	0		29	10	S5644_071_0	3	3	Specialty			
S5644	071	0		29	10	S5644_071_0	3	4	Non-Preferred			
S5644	072	0		29	10	S5644_072_0	3	1	Preferred Generic			
S5644	072	0		29	10	S5644_072_0	3	2	Preferred Brand			
S5644	072	0		29	10	S5644_072_0	3	4	Non-Preferred			
S5644	072	0		29	10	S5644_072_0	3	3	Specialty			
S5644	073	0		29	10	S5644_073_0	3	1	Preferred Generic			
S5644	073	0		29	10	S5644_073_0	3	3	Specialty			
S5644	073	0		29	10	S5644_073_0	3	2	Preferred Brand			
S5644	073	0		29	10	S5644_073_0	3	4	Non-Preferred			
S5644	074	0		29	10	S5644_074_0	3	1	Preferred Generic			
S5644	074	0		29	10	S5644_074_0	3	2	Preferred Brand			
S5644	074	0		29	10	S5644_074_0	3	3	Specialty			
S5644	074	0		29	10	S5644_074_0	3	4	Non-Preferred			
S5644	075	0		29	10	S5644_075_0	3	1	Preferred Generic			
S5644	075	0		29	10	S5644_075_0	3	2	Preferred Brand			
S5644	075	0		29	10	S5644_075_0	3	4	Non-Preferred			
S5644	075	0		29	10	S5644_075_0	3	3	Specialty			
S5644	076	0		29	10	S5644_076_0	3	1	Preferred Generic			
S5644	076	0		29	10	S5644_076_0	3	2	Preferred Brand			
S5644	076	0		29	10	S5644_076_0	3	3	Specialty			
S5644	076	0		29	10	S5644_076_0	3	4	Non-Preferred			
S5644	078	0		29	10	S5644_078_0	3	1	Preferred Generic			
S5644	078	0		29	10	S5644_078_0	3	3	Specialty			
S5644	078	0		29	10	S5644_078_0	3	4	Non-Preferred			
S5644	078	0		29	10	S5644_078_0	3	2	Preferred Brand			
S5644	079	0		29	10	S5644_079_0	3	4	Non-Preferred			
S5644	079	0		29	10	S5644_079_0	3	1	Preferred Generic			
S5644	079	0		29	10	S5644_079_0	3	2	Preferred Brand			
S5644	079	0		29	10	S5644_079_0	3	3	Specialty			
S5644	080	0		29	10	S5644_080_0	3	3	Specialty			
S5644	080	0		29	10	S5644_080_0	3	4	Non-Preferred			
S5644	080	0		29	10	S5644_080_0	3	2	Preferred Brand			
S5644	080	0		29	10	S5644_080_0	3	1	Preferred Generic			
S5644	081	0		29	10	S5644_081_0	3	3	Specialty			
S5644	081	0		29	10	S5644_081_0	3	4	Non-Preferred			
S5644	081	0		29	10	S5644_081_0	3	1	Preferred Generic			
S5644	081	0		29	10	S5644_081_0	3	2	Preferred Brand			
S5644	082	0		29	10	S5644_082_0	3	1	Preferred Generic			
S5644	082	0		29	10	S5644_082_0	3	2	Preferred Brand			
S5644	082	0		29	10	S5644_082_0	3	3	Specialty			
S5644	082	0		29	10	S5644_082_0	3	4	Non-Preferred			
S5644	083	0		29	10	S5644_083_0	3	4	Non-Preferred			
S5644	083	0		29	10	S5644_083_0	3	1	Preferred Generic			
S5644	083	0		29	10	S5644_083_0	3	2	Preferred Brand			
S5644	083	0		29	10	S5644_083_0	3	3	Specialty			
S5644	084	0		29	10	S5644_084_0	3	3	Specialty			
S5644	084	0		29	10	S5644_084_0	3	4	Non-Preferred			
S5644	084	0		29	10	S5644_084_0	3	2	Preferred Brand			
S5644	084	0		29	10	S5644_084_0	3	1	Preferred Generic			
S5644	085	0		29	10	S5644_085_0	3	1	Preferred Generic			
S5644	085	0		29	10	S5644_085_0	3	3	Specialty			
S5644	085	0		29	10	S5644_085_0	3	4	Non-Preferred			
S5644	085	0		29	10	S5644_085_0	3	2	Preferred Brand			
S5644	087	0		29	10	S5644_087_0	3	1	Preferred Generic			
S5644	087	0		29	10	S5644_087_0	3	2	Preferred Brand			
S5644	087	0		29	10	S5644_087_0	3	3	Specialty			
S5644	087	0		29	10	S5644_087_0	3	4	Non-Preferred			
S5644	174	0		29	10	S5644_174_0	3	4	Non-Preferred			
S5644	174	0		29	10	S5644_174_0	3	2	Preferred Brand			
S5644	174	0		29	10	S5644_174_0	3	1	Preferred Generic			
S5644	174	0		29	10	S5644_174_0	3	3	Specialty			
S5644	175	0		29	10	S5644_175_0	3	1	Preferred Generic			
S5644	175	0		29	10	S5644_175_0	3	2	Preferred Brand			
S5644	175	0		29	10	S5644_175_0	3	4	Non-Preferred			
S5644	175	0		29	10	S5644_175_0	3	3	Specialty			
S5644	176	0		29	10	S5644_176_0	3	2	Preferred Brand			
S5644	176	0		29	10	S5644_176_0	3	3	Specialty			
S5644	176	0		29	10	S5644_176_0	3	4	Non-Preferred			
S5644	176	0		29	10	S5644_176_0	3	1	Preferred Generic			
S5644	177	0		29	10	S5644_177_0	3	1	Preferred Generic			
S5644	177	0		29	10	S5644_177_0	3	4	Non-Preferred			
S5644	177	0		29	10	S5644_177_0	3	3	Specialty			
S5644	177	0		29	10	S5644_177_0	3	2	Preferred Brand			
S5644	178	0		29	10	S5644_178_0	3	2	Preferred Brand			
S5644	178	0		29	10	S5644_178_0	3	3	Specialty			
S5644	178	0		29	10	S5644_178_0	3	4	Non-Preferred			
S5644	178	0		29	10	S5644_178_0	3	1	Preferred Generic			
S5644	179	0		29	10	S5644_179_0	3	4	Non-Preferred			
S5644	179	0		29	10	S5644_179_0	3	1	Preferred Generic			
S5644	179	0		29	10	S5644_179_0	3	2	Preferred Brand			
S5644	179	0		29	10	S5644_179_0	3	3	Specialty			
S5644	180	0		29	10	S5644_180_0	3	3	Specialty			
S5644	180	0		29	10	S5644_180_0	3	4	Non-Preferred			
S5644	180	0		29	10	S5644_180_0	3	2	Preferred Brand			
S5644	180	0		29	10	S5644_180_0	3	1	Preferred Generic			
S5644	181	0		29	10	S5644_181_0	3	2	Preferred Brand			
S5644	181	0		29	10	S5644_181_0	3	1	Preferred Generic			
S5644	181	0		29	10	S5644_181_0	3	3	Specialty			
S5644	181	0		29	10	S5644_181_0	3	4	Non-Preferred			
S5644	182	0		29	10	S5644_182_0	3	3	Specialty			
S5644	182	0		29	10	S5644_182_0	3	2	Preferred Brand			
S5644	182	0		29	10	S5644_182_0	3	1	Preferred Generic			
S5644	182	0		29	10	S5644_182_0	3	4	Non-Preferred			
S5644	183	0		29	10	S5644_183_0	3	1	Preferred Generic			
S5644	183	0		29	10	S5644_183_0	3	2	Preferred Brand			
S5644	183	0		29	10	S5644_183_0	3	3	Specialty			
S5644	183	0		29	10	S5644_183_0	3	4	Non-Preferred			
S5644	184	0		29	10	S5644_184_0	3	3	Specialty			
S5644	184	0		29	10	S5644_184_0	3	2	Preferred Brand			
S5644	184	0		29	10	S5644_184_0	3	1	Preferred Generic			
S5644	184	0		29	10	S5644_184_0	3	4	Non-Preferred			
S5644	185	0		29	10	S5644_185_0	3	1	Preferred Generic			
S5644	185	0		29	10	S5644_185_0	3	2	Preferred Brand			
S5644	185	0		29	10	S5644_185_0	3	3	Specialty			
S5644	185	0		29	10	S5644_185_0	3	4	Non-Preferred			
S5644	186	0		29	10	S5644_186_0	3	1	Preferred Generic			
S5644	186	0		29	10	S5644_186_0	3	2	Preferred Brand			
S5644	186	0		29	10	S5644_186_0	3	4	Non-Preferred			
S5644	186	0		29	10	S5644_186_0	3	3	Specialty			
S5644	187	0		29	10	S5644_187_0	3	4	Non-Preferred			
S5644	187	0		29	10	S5644_187_0	3	2	Preferred Brand			
S5644	187	0		29	10	S5644_187_0	3	3	Specialty			
S5644	187	0		29	10	S5644_187_0	3	1	Preferred Generic			
S5644	188	0		29	10	S5644_188_0	3	3	Specialty			
S5644	188	0		29	10	S5644_188_0	3	4	Non-Preferred			
S5644	188	0		29	10	S5644_188_0	3	1	Preferred Generic			
S5644	188	0		29	10	S5644_188_0	3	2	Preferred Brand			
S5644	189	0		29	10	S5644_189_0	3	2	Preferred Brand			
S5644	189	0		29	10	S5644_189_0	3	1	Preferred Generic			
S5644	189	0		29	10	S5644_189_0	3	3	Specialty			
S5644	189	0		29	10	S5644_189_0	3	4	Non-Preferred			
S5644	190	0		29	10	S5644_190_0	3	2	Preferred Brand			
S5644	190	0		29	10	S5644_190_0	3	1	Preferred Generic			
S5644	190	0		29	10	S5644_190_0	3	3	Specialty			
S5644	190	0		29	10	S5644_190_0	3	4	Non-Preferred			
S5644	191	0		29	10	S5644_191_0	3	2	Preferred Brand			
S5644	191	0		29	10	S5644_191_0	3	3	Specialty			
S5644	191	0		29	10	S5644_191_0	3	4	Non-Preferred			
S5644	191	0		29	10	S5644_191_0	3	1	Preferred Generic			
S5644	192	0		29	10	S5644_192_0	3	4	Non-Preferred			
S5644	192	0		29	10	S5644_192_0	3	3	Specialty			
S5644	192	0		29	10	S5644_192_0	3	1	Preferred Generic			
S5644	192	0		29	10	S5644_192_0	3	2	Preferred Brand			
S5644	193	0		29	10	S5644_193_0	3	2	Preferred Brand			
S5644	193	0		29	10	S5644_193_0	3	4	Non-Preferred			
S5644	193	0		29	10	S5644_193_0	3	3	Specialty			
S5644	193	0		29	10	S5644_193_0	3	1	Preferred Generic			
S5644	194	0		29	10	S5644_194_0	3	4	Non-Preferred			
S5644	194	0		29	10	S5644_194_0	3	3	Specialty			
S5644	194	0		29	10	S5644_194_0	3	2	Preferred Brand			
S5644	194	0		29	10	S5644_194_0	3	1	Preferred Generic			
S5644	195	0		29	10	S5644_195_0	3	2	Preferred Brand			
S5644	195	0		29	10	S5644_195_0	3	3	Specialty			
S5644	195	0		29	10	S5644_195_0	3	1	Preferred Generic			
S5644	195	0		29	10	S5644_195_0	3	4	Non-Preferred			
S5644	196	0		29	10	S5644_196_0	3	4	Non-Preferred			
S5644	196	0		29	10	S5644_196_0	3	3	Specialty			
S5644	196	0		29	10	S5644_196_0	3	2	Preferred Brand			
S5644	196	0		29	10	S5644_196_0	3	1	Preferred Generic			
S5644	197	0		29	10	S5644_197_0	3	1	Preferred Generic			
S5644	197	0		29	10	S5644_197_0	3	3	Specialty			
S5644	197	0		29	10	S5644_197_0	3	2	Preferred Brand			
S5644	197	0		29	10	S5644_197_0	3	4	Non-Preferred			
S5644	198	0		29	10	S5644_198_0	3	2	Preferred Brand			
S5644	198	0		29	10	S5644_198_0	3	3	Specialty			
S5644	198	0		29	10	S5644_198_0	3	4	Non-Preferred			
S5644	198	0		29	10	S5644_198_0	3	1	Preferred Generic			
S5644	199	0		29	10	S5644_199_0	3	2	Preferred Brand			
S5644	199	0		29	10	S5644_199_0	3	4	Non-Preferred			
S5644	199	0		29	10	S5644_199_0	3	3	Specialty			
S5644	199	0		29	10	S5644_199_0	3	1	Preferred Generic			
S5644	200	0		29	10	S5644_200_0	3	1	Preferred Generic			
S5644	200	0		29	10	S5644_200_0	3	2	Preferred Brand			
S5644	200	0		29	10	S5644_200_0	3	3	Specialty			
S5644	200	0		29	10	S5644_200_0	3	4	Non-Preferred			
S5644	201	0		29	10	S5644_201_0	3	1	Preferred Generic			
S5644	201	0		29	10	S5644_201_0	3	2	Preferred Brand			
S5644	201	0		29	10	S5644_201_0	3	3	Specialty			
S5644	201	0		29	10	S5644_201_0	3	4	Non-Preferred			
S5660	001	0		29	10	S5660_001_0	5	1	Generic			
S5660	001	0		29	10	S5660_001_0	5	2	Preferred Brand			
S5660	001	0		29	10	S5660_001_0	5	3	Non-Preferred Brand			
S5660	001	0		29	10	S5660_001_0	5	4	Specialty			
S5660	003	0		29	10	S5660_003_0	3	1	Generic			
S5660	003	0		29	10	S5660_003_0	3	2	Preferred Brand			
S5660	003	0		29	10	S5660_003_0	3	3	Non-Preferred Brand			
S5660	003	0		29	10	S5660_003_0	3	4	Specialty			
S5660	004	0		29	10	S5660_004_0	3	1	Generic			
S5660	004	0		29	10	S5660_004_0	3	2	Preferred Brand			
S5660	004	0		29	10	S5660_004_0	3	4	Specialty			
S5660	004	0		29	10	S5660_004_0	3	3	Non-Preferred Brand			
S5660	005	0		29	10	S5660_005_0	3	1	Generic			
S5660	005	0		29	10	S5660_005_0	3	2	Preferred Brand			
S5660	005	0		29	10	S5660_005_0	3	3	Non-Preferred Brand			
S5660	005	0		29	10	S5660_005_0	3	4	Specialty			
S5660	006	0		29	10	S5660_006_0	3	1	Generic			
S5660	006	0		29	10	S5660_006_0	3	3	Non-Preferred Brand			
S5660	006	0		29	10	S5660_006_0	3	2	Preferred Brand			
S5660	006	0		29	10	S5660_006_0	3	4	Specialty			
S5660	007	0		29	10	S5660_007_0	3	1	Generic			
S5660	007	0		29	10	S5660_007_0	3	2	Preferred Brand			
S5660	007	0		29	10	S5660_007_0	3	4	Specialty			
S5660	007	0		29	10	S5660_007_0	3	3	Non-Preferred Brand			
S5660	008	0		29	10	S5660_008_0	3	1	Generic			
S5660	008	0		29	10	S5660_008_0	3	2	Preferred Brand			
S5660	008	0		29	10	S5660_008_0	3	3	Non-Preferred Brand			
S5660	008	0		29	10	S5660_008_0	3	4	Specialty			
S5660	009	0		29	10	S5660_009_0	3	1	Generic			
S5660	009	0		29	10	S5660_009_0	3	2	Preferred Brand			
S5660	009	0		29	10	S5660_009_0	3	3	Non-Preferred Brand			
S5660	009	0		29	10	S5660_009_0	3	4	Specialty			
S5660	010	0		29	10	S5660_010_0	3	1	Generic			
S5660	010	0		29	10	S5660_010_0	3	2	Preferred Brand			
S5660	010	0		29	10	S5660_010_0	3	4	Specialty			
S5660	010	0		29	10	S5660_010_0	3	3	Non-Preferred Brand			
S5660	012	0		29	10	S5660_012_0	3	1	Generic			
S5660	012	0		29	10	S5660_012_0	3	2	Preferred Brand			
S5660	012	0		29	10	S5660_012_0	3	3	Non-Preferred Brand			
S5660	012	0		29	10	S5660_012_0	3	4	Specialty			
S5660	013	0		29	10	S5660_013_0	3	1	Generic			
S5660	013	0		29	10	S5660_013_0	3	2	Preferred Brand			
S5660	013	0		29	10	S5660_013_0	3	3	Non-Preferred Brand			
S5660	013	0		29	10	S5660_013_0	3	4	Specialty			
S5660	014	0		29	10	S5660_014_0	3	3	Non-Preferred Brand			
S5660	014	0		29	10	S5660_014_0	3	4	Specialty			
S5660	014	0		29	10	S5660_014_0	3	1	Generic			
S5660	014	0		29	10	S5660_014_0	3	2	Preferred Brand			
S5660	015	0		29	10	S5660_015_0	3	1	Generic			
S5660	015	0		29	10	S5660_015_0	3	2	Preferred Brand			
S5660	015	0		29	10	S5660_015_0	3	4	Specialty			
S5660	015	0		29	10	S5660_015_0	3	3	Non-Preferred Brand			
S5660	016	0		29	10	S5660_016_0	3	1	Generic			
S5660	016	0		29	10	S5660_016_0	3	2	Preferred Brand			
S5660	016	0		29	10	S5660_016_0	3	3	Non-Preferred Brand			
S5660	016	0		29	10	S5660_016_0	3	4	Specialty			
S5660	017	0		29	10	S5660_017_0	3	1	Generic			
S5660	017	0		29	10	S5660_017_0	3	2	Preferred Brand			
S5660	017	0		29	10	S5660_017_0	3	4	Specialty			
S5660	017	0		29	10	S5660_017_0	3	3	Non-Preferred Brand			
S5660	018	0		29	10	S5660_018_0	3	1	Generic			
S5660	018	0		29	10	S5660_018_0	3	2	Preferred Brand			
S5660	018	0		29	10	S5660_018_0	3	3	Non-Preferred Brand			
S5660	018	0		29	10	S5660_018_0	3	4	Specialty			
S5660	019	0		29	10	S5660_019_0	3	1	Generic			
S5660	019	0		29	10	S5660_019_0	3	3	Non-Preferred Brand			
S5660	019	0		29	10	S5660_019_0	3	2	Preferred Brand			
S5660	019	0		29	10	S5660_019_0	3	4	Specialty			
S5660	020	0		29	10	S5660_020_0	3	1	Generic			
S5660	020	0		29	10	S5660_020_0	3	2	Preferred Brand			
S5660	020	0		29	10	S5660_020_0	3	4	Specialty			
S5660	020	0		29	10	S5660_020_0	3	3	Non-Preferred Brand			
S5660	021	0		29	10	S5660_021_0	3	2	Preferred Brand			
S5660	021	0		29	10	S5660_021_0	3	4	Specialty			
S5660	021	0		29	10	S5660_021_0	3	3	Non-Preferred Brand			
S5660	021	0		29	10	S5660_021_0	3	1	Generic			
S5660	022	0		29	10	S5660_022_0	3	2	Preferred Brand			
S5660	022	0		29	10	S5660_022_0	3	1	Generic			
S5660	022	0		29	10	S5660_022_0	3	3	Non-Preferred Brand			
S5660	022	0		29	10	S5660_022_0	3	4	Specialty			
S5660	023	0		29	10	S5660_023_0	3	1	Generic			
S5660	023	0		29	10	S5660_023_0	3	2	Preferred Brand			
S5660	023	0		29	10	S5660_023_0	3	3	Non-Preferred Brand			
S5660	023	0		29	10	S5660_023_0	3	4	Specialty			
S5660	024	0		29	10	S5660_024_0	3	2	Preferred Brand			
S5660	024	0		29	10	S5660_024_0	3	4	Specialty			
S5660	024	0		29	10	S5660_024_0	3	3	Non-Preferred Brand			
S5660	024	0		29	10	S5660_024_0	3	1	Generic			
S5660	025	0		29	10	S5660_025_0	3	3	Non-Preferred Brand			
S5660	025	0		29	10	S5660_025_0	3	4	Specialty			
S5660	025	0		29	10	S5660_025_0	3	2	Preferred Brand			
S5660	025	0		29	10	S5660_025_0	3	1	Generic			
S5660	026	0		29	10	S5660_026_0	3	1	Generic			
S5660	026	0		29	10	S5660_026_0	3	2	Preferred Brand			
S5660	026	0		29	10	S5660_026_0	3	3	Non-Preferred Brand			
S5660	026	0		29	10	S5660_026_0	3	4	Specialty			
S5660	027	0		29	10	S5660_027_0	3	2	Preferred Brand			
S5660	027	0		29	10	S5660_027_0	3	3	Non-Preferred Brand			
S5660	027	0		29	10	S5660_027_0	3	4	Specialty			
S5660	027	0		29	10	S5660_027_0	3	1	Generic			
S5660	028	0		29	10	S5660_028_0	3	4	Specialty			
S5660	028	0		29	10	S5660_028_0	3	2	Preferred Brand			
S5660	028	0		29	10	S5660_028_0	3	1	Generic			
S5660	028	0		29	10	S5660_028_0	3	3	Non-Preferred Brand			
S5660	029	0		29	10	S5660_029_0	3	3	Non-Preferred Brand			
S5660	029	0		29	10	S5660_029_0	3	2	Preferred Brand			
S5660	029	0		29	10	S5660_029_0	3	1	Generic			
S5660	029	0		29	10	S5660_029_0	3	4	Specialty			
S5660	030	0		29	10	S5660_030_0	3	3	Non-Preferred Brand			
S5660	030	0		29	10	S5660_030_0	3	2	Preferred Brand			
S5660	030	0		29	10	S5660_030_0	3	1	Generic			
S5660	030	0		29	10	S5660_030_0	3	4	Specialty			
S5660	031	0		29	10	S5660_031_0	3	1	Generic			
S5660	031	0		29	10	S5660_031_0	3	2	Preferred Brand			
S5660	031	0		29	10	S5660_031_0	3	3	Non-Preferred Brand			
S5660	031	0		29	10	S5660_031_0	3	4	Specialty			
S5660	032	0		29	10	S5660_032_0	3	3	Non-Preferred Brand			
S5660	032	0		29	10	S5660_032_0	3	2	Preferred Brand			
S5660	032	0		29	10	S5660_032_0	3	1	Generic			
S5660	032	0		29	10	S5660_032_0	3	4	Specialty			
S5660	033	0		29	10	S5660_033_0	3	1	Generic			
S5660	033	0		29	10	S5660_033_0	3	2	Preferred Brand			
S5660	033	0		29	10	S5660_033_0	3	3	Non-Preferred Brand			
S5660	033	0		29	10	S5660_033_0	3	4	Specialty			
S5660	034	0		29	10	S5660_034_0	3	1	Generic			
S5660	034	0		29	10	S5660_034_0	3	2	Preferred Brand			
S5660	034	0		29	10	S5660_034_0	3	4	Specialty			
S5660	034	0		29	10	S5660_034_0	3	3	Non-Preferred Brand			
S5660	035	0		29	10	S5660_035_0	3	1	Generic			
S5660	035	0		29	10	S5660_035_0	3	3	Non-Preferred Brand			
S5660	035	0		29	10	S5660_035_0	3	2	Preferred Brand			
S5660	035	0		29	10	S5660_035_0	3	4	Specialty			
S5660	103	0		29	10	S5660_103_0	3	3	Non-Preferred Brand			
S5660	103	0		29	10	S5660_103_0	3	2	Preferred Brand			
S5660	103	0		29	10	S5660_103_0	3	1	Generic			
S5660	103	0		29	10	S5660_103_0	3	4	Specialty			
S5660	104	0		29	10	S5660_104_0	2	3	Non-Preferred Brand			
S5660	104	0		29	10	S5660_104_0	2	2	Preferred Brand			
S5660	104	0		29	10	S5660_104_0	2	1	Generic			
S5660	104	0		29	10	S5660_104_0	2	4	Specialty			
S5660	105	0		29	10	S5660_105_0	2	1	Generic			
S5660	105	0		29	10	S5660_105_0	2	2	Preferred Brand			
S5660	105	0		29	10	S5660_105_0	2	3	Non-Preferred Brand			
S5660	105	0		29	10	S5660_105_0	2	4	Specialty			
S5660	106	0		29	10	S5660_106_0	2	1	Generic			
S5660	106	0		29	10	S5660_106_0	2	2	Preferred Brand			
S5660	106	0		29	10	S5660_106_0	2	3	Non-Preferred Brand			
S5660	106	0		29	10	S5660_106_0	2	4	Specialty			
S5660	107	0		29	10	S5660_107_0	2	1	Generic			
S5660	107	0		29	10	S5660_107_0	2	2	Preferred Brand			
S5660	107	0		29	10	S5660_107_0	2	4	Specialty			
S5660	107	0		29	10	S5660_107_0	2	3	Non-Preferred Brand			
S5660	108	0		29	10	S5660_108_0	2	3	Non-Preferred Brand			
S5660	108	0		29	10	S5660_108_0	2	2	Preferred Brand			
S5660	108	0		29	10	S5660_108_0	2	1	Generic			
S5660	108	0		29	10	S5660_108_0	2	4	Specialty			
S5660	109	0		29	10	S5660_109_0	2	3	Non-Preferred Brand			
S5660	109	0		29	10	S5660_109_0	2	2	Preferred Brand			
S5660	109	0		29	10	S5660_109_0	2	1	Generic			
S5660	109	0		29	10	S5660_109_0	2	4	Specialty			
S5660	110	0		29	10	S5660_110_0	2	1	Generic			
S5660	110	0		29	10	S5660_110_0	2	2	Preferred Brand			
S5660	110	0		29	10	S5660_110_0	2	3	Non-Preferred Brand			
S5660	110	0		29	10	S5660_110_0	2	4	Specialty			
S5660	111	0		29	10	S5660_111_0	2	1	Generic			
S5660	111	0		29	10	S5660_111_0	2	4	Specialty			
S5660	111	0		29	10	S5660_111_0	2	2	Preferred Brand			
S5660	111	0		29	10	S5660_111_0	2	3	Non-Preferred Brand			
S5660	112	0		29	10	S5660_112_0	2	1	Generic			
S5660	112	0		29	10	S5660_112_0	2	2	Preferred Brand			
S5660	112	0		29	10	S5660_112_0	2	3	Non-Preferred Brand			
S5660	112	0		29	10	S5660_112_0	2	4	Specialty			
S5660	113	0		29	10	S5660_113_0	2	1	Generic			
S5660	113	0		29	10	S5660_113_0	2	2	Preferred Brand			
S5660	113	0		29	10	S5660_113_0	2	3	Non-Preferred Brand			
S5660	113	0		29	10	S5660_113_0	2	4	Specialty			
S5660	114	0		29	10	S5660_114_0	3	1	Generic			
S5660	114	0		29	10	S5660_114_0	3	2	Preferred Brand			
S5660	114	0		29	10	S5660_114_0	3	4	Specialty			
S5660	114	0		29	10	S5660_114_0	3	3	Non-Preferred Brand			
S5660	115	0		29	10	S5660_115_0	2	1	Generic			
S5660	115	0		29	10	S5660_115_0	2	3	Non-Preferred Brand			
S5660	115	0		29	10	S5660_115_0	2	2	Preferred Brand			
S5660	115	0		29	10	S5660_115_0	2	4	Specialty			
S5660	116	0		29	10	S5660_116_0	2	1	Generic			
S5660	116	0		29	10	S5660_116_0	2	2	Preferred Brand			
S5660	116	0		29	10	S5660_116_0	2	4	Specialty			
S5660	116	0		29	10	S5660_116_0	2	3	Non-Preferred Brand			
S5660	117	0		29	10	S5660_117_0	2	1	Generic			
S5660	117	0		29	10	S5660_117_0	2	2	Preferred Brand			
S5660	117	0		29	10	S5660_117_0	2	3	Non-Preferred Brand			
S5660	117	0		29	10	S5660_117_0	2	4	Specialty			
S5660	118	0		29	10	S5660_118_0	2	1	Generic			
S5660	118	0		29	10	S5660_118_0	2	2	Preferred Brand			
S5660	118	0		29	10	S5660_118_0	2	4	Specialty			
S5660	118	0		29	10	S5660_118_0	2	3	Non-Preferred Brand			
S5660	119	0		29	10	S5660_119_0	2	1	Generic			
S5660	119	0		29	10	S5660_119_0	2	2	Preferred Brand			
S5660	119	0		29	10	S5660_119_0	2	3	Non-Preferred Brand			
S5660	119	0		29	10	S5660_119_0	2	4	Specialty			
S5660	120	0		29	10	S5660_120_0	2	4	Specialty			
S5660	120	0		29	10	S5660_120_0	2	2	Preferred Brand			
S5660	120	0		29	10	S5660_120_0	2	1	Generic			
S5660	120	0		29	10	S5660_120_0	2	3	Non-Preferred Brand			
S5660	121	0		29	10	S5660_121_0	2	1	Generic			
S5660	121	0		29	10	S5660_121_0	2	2	Preferred Brand			
S5660	121	0		29	10	S5660_121_0	2	4	Specialty			
S5660	121	0		29	10	S5660_121_0	2	3	Non-Preferred Brand			
S5660	122	0		29	10	S5660_122_0	2	2	Preferred Brand			
S5660	122	0		29	10	S5660_122_0	2	3	Non-Preferred Brand			
S5660	122	0		29	10	S5660_122_0	2	4	Specialty			
S5660	122	0		29	10	S5660_122_0	2	1	Generic			
S5660	123	0		29	10	S5660_123_0	2	2	Preferred Brand			
S5660	123	0		29	10	S5660_123_0	2	3	Non-Preferred Brand			
S5660	123	0		29	10	S5660_123_0	2	4	Specialty			
S5660	123	0		29	10	S5660_123_0	2	1	Generic			
S5660	124	0		29	10	S5660_124_0	2	1	Generic			
S5660	124	0		29	10	S5660_124_0	2	4	Specialty			
S5660	124	0		29	10	S5660_124_0	2	2	Preferred Brand			
S5660	124	0		29	10	S5660_124_0	2	3	Non-Preferred Brand			
S5660	125	0		29	10	S5660_125_0	3	1	Generic			
S5660	125	0		29	10	S5660_125_0	3	4	Specialty			
S5660	125	0		29	10	S5660_125_0	3	3	Non-Preferred Brand			
S5660	125	0		29	10	S5660_125_0	3	2	Preferred Brand			
S5660	126	0		29	10	S5660_126_0	2	1	Generic			
S5660	126	0		29	10	S5660_126_0	2	4	Specialty			
S5660	126	0		29	10	S5660_126_0	2	3	Non-Preferred Brand			
S5660	126	0		29	10	S5660_126_0	2	2	Preferred Brand			
S5660	127	0		29	10	S5660_127_0	2	3	Non-Preferred Brand			
S5660	127	0		29	10	S5660_127_0	2	4	Specialty			
S5660	127	0		29	10	S5660_127_0	2	2	Preferred Brand			
S5660	127	0		29	10	S5660_127_0	2	1	Generic			
S5660	128	0		29	10	S5660_128_0	2	4	Specialty			
S5660	128	0		29	10	S5660_128_0	2	3	Non-Preferred Brand			
S5660	128	0		29	10	S5660_128_0	2	2	Preferred Brand			
S5660	128	0		29	10	S5660_128_0	2	1	Generic			
S5660	129	0		29	10	S5660_129_0	2	2	Preferred Brand			
S5660	129	0		29	10	S5660_129_0	2	1	Generic			
S5660	129	0		29	10	S5660_129_0	2	3	Non-Preferred Brand			
S5660	129	0		29	10	S5660_129_0	2	4	Specialty			
S5660	130	0		29	10	S5660_130_0	2	3	Non-Preferred Brand			
S5660	130	0		29	10	S5660_130_0	2	2	Preferred Brand			
S5660	130	0		29	10	S5660_130_0	2	1	Generic			
S5660	130	0		29	10	S5660_130_0	2	4	Specialty			
S5660	131	0		29	10	S5660_131_0	2	1	Generic			
S5660	131	0		29	10	S5660_131_0	2	2	Preferred Brand			
S5660	131	0		29	10	S5660_131_0	2	4	Specialty			
S5660	131	0		29	10	S5660_131_0	2	3	Non-Preferred Brand			
S5660	132	0		29	10	S5660_132_0	2	1	Generic			
S5660	132	0		29	10	S5660_132_0	2	3	Non-Preferred Brand			
S5660	132	0		29	10	S5660_132_0	2	2	Preferred Brand			
S5660	132	0		29	10	S5660_132_0	2	4	Specialty			
S5660	133	0		29	10	S5660_133_0	2	3	Non-Preferred Brand			
S5660	133	0		29	10	S5660_133_0	2	2	Preferred Brand			
S5660	133	0		29	10	S5660_133_0	2	1	Generic			
S5660	133	0		29	10	S5660_133_0	2	4	Specialty			
S5660	134	0		29	10	S5660_134_0	2	3	Non-Preferred Brand			
S5660	134	0		29	10	S5660_134_0	2	2	Preferred Brand			
S5660	134	0		29	10	S5660_134_0	2	1	Generic			
S5660	134	0		29	10	S5660_134_0	2	4	Specialty			
S5660	135	0		29	10	S5660_135_0	2	3	Non-Preferred Brand			
S5660	135	0		29	10	S5660_135_0	2	2	Preferred Brand			
S5660	135	0		29	10	S5660_135_0	2	1	Generic			
S5660	135	0		29	10	S5660_135_0	2	4	Specialty			
S5660	136	0		29	10	S5660_136_0	2	1	Generic			
S5660	136	0		29	10	S5660_136_0	2	2	Preferred Brand			
S5660	136	0		29	10	S5660_136_0	2	3	Non-Preferred Brand			
S5660	136	0		29	10	S5660_136_0	2	4	Specialty			
S5660	137	0		29	10	S5660_137_0	2	1	Generic			
S5660	137	0		29	10	S5660_137_0	2	2	Preferred Brand			
S5660	137	0		29	10	S5660_137_0	2	3	Non-Preferred Brand			
S5660	137	0		29	10	S5660_137_0	2	4	Specialty			
S5660	172	0		29	10	S5660_172_0	3	1	Generic			
S5660	172	0		29	10	S5660_172_0	3	2	Preferred Brand			
S5660	172	0		29	10	S5660_172_0	3	3	Non-Preferred Brand			
S5660	172	0		29	10	S5660_172_0	3	4	Specialty			
S5660	172	0		29	10	S5660_172_0	3	1	Generic	1		1
S5660	172	0		29	10	S5660_172_0	3	2	Preferred Brand	2		
S5660	172	0		29	10	S5660_172_0	3	3	Non-Preferred Brand	2		
S5660	172	0		29	10	S5660_172_0	3	4	Specialty	2		
S5660	173	0		29	10	S5660_173_0	3	1	Generic			
S5660	173	0		29	10	S5660_173_0	3	3	Non-Preferred Brand	2		
S5660	173	0		29	10	S5660_173_0	3	3	Non-Preferred Brand			
S5660	173	0		29	10	S5660_173_0	3	2	Preferred Brand			
S5660	173	0		29	10	S5660_173_0	3	2	Preferred Brand	2		
S5660	173	0		29	10	S5660_173_0	3	1	Generic	1		1
S5660	173	0		29	10	S5660_173_0	3	4	Specialty			
S5660	173	0		29	10	S5660_173_0	3	4	Specialty	2		
S5660	174	0		29	10	S5660_174_0	3	4	Specialty			
S5660	174	0		29	10	S5660_174_0	3	3	Non-Preferred Brand	2		
S5660	174	0		29	10	S5660_174_0	3	2	Preferred Brand	2		
S5660	174	0		29	10	S5660_174_0	3	4	Specialty	2		
S5660	174	0		29	10	S5660_174_0	3	1	Generic	1		1
S5660	174	0		29	10	S5660_174_0	3	1	Generic			
S5660	174	0		29	10	S5660_174_0	3	2	Preferred Brand			
S5660	174	0		29	10	S5660_174_0	3	3	Non-Preferred Brand			
S5660	175	0		29	10	S5660_175_0	3	1	Generic	1		1
S5660	175	0		29	10	S5660_175_0	3	2	Preferred Brand	2		
S5660	175	0		29	10	S5660_175_0	3	3	Non-Preferred Brand	2		
S5660	175	0		29	10	S5660_175_0	3	4	Specialty	2		
S5660	175	0		29	10	S5660_175_0	3	4	Specialty			
S5660	175	0		29	10	S5660_175_0	3	3	Non-Preferred Brand			
S5660	175	0		29	10	S5660_175_0	3	2	Preferred Brand			
S5660	175	0		29	10	S5660_175_0	3	1	Generic			
S5660	176	0		29	10	S5660_176_0	3	4	Specialty	2		
S5660	176	0		29	10	S5660_176_0	3	3	Non-Preferred Brand	2		
S5660	176	0		29	10	S5660_176_0	3	4	Specialty			
S5660	176	0		29	10	S5660_176_0	3	3	Non-Preferred Brand			
S5660	176	0		29	10	S5660_176_0	3	2	Preferred Brand			
S5660	176	0		29	10	S5660_176_0	3	1	Generic			
S5660	176	0		29	10	S5660_176_0	3	1	Generic	1		1
S5660	176	0		29	10	S5660_176_0	3	2	Preferred Brand	2		
S5660	177	0		29	10	S5660_177_0	4	3	Non-Preferred Brand	2		
S5660	177	0		29	10	S5660_177_0	4	1	Generic	1		1
S5660	177	0		29	10	S5660_177_0	4	4	Specialty	2		
S5660	177	0		29	10	S5660_177_0	4	2	Preferred Brand	2		
S5660	177	0		29	10	S5660_177_0	4	1	Generic			
S5660	177	0		29	10	S5660_177_0	4	2	Preferred Brand			
S5660	177	0		29	10	S5660_177_0	4	3	Non-Preferred Brand			
S5660	177	0		29	10	S5660_177_0	4	4	Specialty			
S5660	178	0		29	10	S5660_178_0	3	3	Non-Preferred Brand	2		
S5660	178	0		29	10	S5660_178_0	3	1	Generic			
S5660	178	0		29	10	S5660_178_0	3	4	Specialty	2		
S5660	178	0		29	10	S5660_178_0	3	2	Preferred Brand			
S5660	178	0		29	10	S5660_178_0	3	3	Non-Preferred Brand			
S5660	178	0		29	10	S5660_178_0	3	4	Specialty			
S5660	178	0		29	10	S5660_178_0	3	1	Generic	1		1
S5660	178	0		29	10	S5660_178_0	3	2	Preferred Brand	2		
S5660	179	0		29	10	S5660_179_0	3	3	Non-Preferred Brand	2		
S5660	179	0		29	10	S5660_179_0	3	4	Specialty	2		
S5660	179	0		29	10	S5660_179_0	3	2	Preferred Brand	2		
S5660	179	0		29	10	S5660_179_0	3	1	Generic	1		1
S5660	179	0		29	10	S5660_179_0	3	4	Specialty			
S5660	179	0		29	10	S5660_179_0	3	3	Non-Preferred Brand			
S5660	179	0		29	10	S5660_179_0	3	2	Preferred Brand			
S5660	179	0		29	10	S5660_179_0	3	1	Generic			
S5660	180	0		29	10	S5660_180_0	3	3	Non-Preferred Brand	2		
S5660	180	0		29	10	S5660_180_0	3	2	Preferred Brand	2		
S5660	180	0		29	10	S5660_180_0	3	1	Generic	1		1
S5660	180	0		29	10	S5660_180_0	3	4	Specialty			
S5660	180	0		29	10	S5660_180_0	3	3	Non-Preferred Brand			
S5660	180	0		29	10	S5660_180_0	3	2	Preferred Brand			
S5660	180	0		29	10	S5660_180_0	3	1	Generic			
S5660	180	0		29	10	S5660_180_0	3	4	Specialty	2		
S5660	181	0		29	10	S5660_181_0	3	3	Non-Preferred Brand	2		
S5660	181	0		29	10	S5660_181_0	3	2	Preferred Brand	2		
S5660	181	0		29	10	S5660_181_0	3	1	Generic	1		1
S5660	181	0		29	10	S5660_181_0	3	4	Specialty			
S5660	181	0		29	10	S5660_181_0	3	3	Non-Preferred Brand			
S5660	181	0		29	10	S5660_181_0	3	2	Preferred Brand			
S5660	181	0		29	10	S5660_181_0	3	1	Generic			
S5660	181	0		29	10	S5660_181_0	3	4	Specialty	2		
S5660	182	0		29	10	S5660_182_0	3	4	Specialty	2		
S5660	182	0		29	10	S5660_182_0	3	2	Preferred Brand	2		
S5660	182	0		29	10	S5660_182_0	3	1	Generic	1		1
S5660	182	0		29	10	S5660_182_0	3	4	Specialty			
S5660	182	0		29	10	S5660_182_0	3	3	Non-Preferred Brand			
S5660	182	0		29	10	S5660_182_0	3	2	Preferred Brand			
S5660	182	0		29	10	S5660_182_0	3	1	Generic			
S5660	182	0		29	10	S5660_182_0	3	3	Non-Preferred Brand	2		
S5660	183	0		29	10	S5660_183_0	3	4	Specialty	2		
S5660	183	0		29	10	S5660_183_0	3	3	Non-Preferred Brand	2		
S5660	183	0		29	10	S5660_183_0	3	2	Preferred Brand	2		
S5660	183	0		29	10	S5660_183_0	3	1	Generic	1		1
S5660	183	0		29	10	S5660_183_0	3	4	Specialty			
S5660	183	0		29	10	S5660_183_0	3	3	Non-Preferred Brand			
S5660	183	0		29	10	S5660_183_0	3	2	Preferred Brand			
S5660	183	0		29	10	S5660_183_0	3	1	Generic			
S5660	184	0		29	10	S5660_184_0	3	1	Generic			
S5660	184	0		29	10	S5660_184_0	3	2	Preferred Brand			
S5660	184	0		29	10	S5660_184_0	3	3	Non-Preferred Brand			
S5660	184	0		29	10	S5660_184_0	3	4	Specialty			
S5660	184	0		29	10	S5660_184_0	3	3	Non-Preferred Brand	2		
S5660	184	0		29	10	S5660_184_0	3	4	Specialty	2		
S5660	184	0		29	10	S5660_184_0	3	1	Generic	1		1
S5660	184	0		29	10	S5660_184_0	3	2	Preferred Brand	2		
S5660	185	0		29	10	S5660_185_0	3	3	Non-Preferred Brand			
S5660	185	0		29	10	S5660_185_0	3	2	Preferred Brand			
S5660	185	0		29	10	S5660_185_0	3	4	Specialty	2		
S5660	185	0		29	10	S5660_185_0	3	3	Non-Preferred Brand	2		
S5660	185	0		29	10	S5660_185_0	3	2	Preferred Brand	2		
S5660	185	0		29	10	S5660_185_0	3	1	Generic	1		1
S5660	185	0		29	10	S5660_185_0	3	4	Specialty			
S5660	185	0		29	10	S5660_185_0	3	1	Generic			
S5660	186	0		29	10	S5660_186_0	3	1	Generic			
S5660	186	0		29	10	S5660_186_0	3	3	Non-Preferred Brand	2		
S5660	186	0		29	10	S5660_186_0	3	2	Preferred Brand	2		
S5660	186	0		29	10	S5660_186_0	3	1	Generic	1		1
S5660	186	0		29	10	S5660_186_0	3	4	Specialty			
S5660	186	0		29	10	S5660_186_0	3	3	Non-Preferred Brand			
S5660	186	0		29	10	S5660_186_0	3	2	Preferred Brand			
S5660	186	0		29	10	S5660_186_0	3	4	Specialty	2		
S5660	187	0		29	10	S5660_187_0	3	3	Non-Preferred Brand			
S5660	187	0		29	10	S5660_187_0	3	2	Preferred Brand			
S5660	187	0		29	10	S5660_187_0	3	1	Generic			
S5660	187	0		29	10	S5660_187_0	3	4	Specialty			
S5660	187	0		29	10	S5660_187_0	3	4	Specialty	2		
S5660	187	0		29	10	S5660_187_0	3	3	Non-Preferred Brand	2		
S5660	187	0		29	10	S5660_187_0	3	2	Preferred Brand	2		
S5660	187	0		29	10	S5660_187_0	3	1	Generic	1		1
S5660	188	0		29	10	S5660_188_0	3	1	Generic			
S5660	188	0		29	10	S5660_188_0	3	2	Preferred Brand			
S5660	188	0		29	10	S5660_188_0	3	4	Specialty	2		
S5660	188	0		29	10	S5660_188_0	3	3	Non-Preferred Brand	2		
S5660	188	0		29	10	S5660_188_0	3	2	Preferred Brand	2		
S5660	188	0		29	10	S5660_188_0	3	1	Generic	1		1
S5660	188	0		29	10	S5660_188_0	3	4	Specialty			
S5660	188	0		29	10	S5660_188_0	3	3	Non-Preferred Brand			
S5660	189	0		29	10	S5660_189_0	3	1	Generic			
S5660	189	0		29	10	S5660_189_0	3	4	Specialty			
S5660	189	0		29	10	S5660_189_0	3	1	Generic	1		1
S5660	189	0		29	10	S5660_189_0	3	2	Preferred Brand	2		
S5660	189	0		29	10	S5660_189_0	3	3	Non-Preferred Brand	2		
S5660	189	0		29	10	S5660_189_0	3	3	Non-Preferred Brand			
S5660	189	0		29	10	S5660_189_0	3	2	Preferred Brand			
S5660	189	0		29	10	S5660_189_0	3	4	Specialty	2		
S5660	190	0		29	10	S5660_190_0	3	4	Specialty	2		
S5660	190	0		29	10	S5660_190_0	3	2	Preferred Brand	2		
S5660	190	0		29	10	S5660_190_0	3	1	Generic	1		1
S5660	190	0		29	10	S5660_190_0	3	3	Non-Preferred Brand	2		
S5660	190	0		29	10	S5660_190_0	3	4	Specialty			
S5660	190	0		29	10	S5660_190_0	3	1	Generic			
S5660	190	0		29	10	S5660_190_0	3	2	Preferred Brand			
S5660	190	0		29	10	S5660_190_0	3	3	Non-Preferred Brand			
S5660	191	0		29	10	S5660_191_0	3	4	Specialty	2		
S5660	191	0		29	10	S5660_191_0	3	3	Non-Preferred Brand	2		
S5660	191	0		29	10	S5660_191_0	3	2	Preferred Brand	2		
S5660	191	0		29	10	S5660_191_0	3	4	Specialty			
S5660	191	0		29	10	S5660_191_0	3	3	Non-Preferred Brand			
S5660	191	0		29	10	S5660_191_0	3	2	Preferred Brand			
S5660	191	0		29	10	S5660_191_0	3	1	Generic			
S5660	191	0		29	10	S5660_191_0	3	1	Generic	1		1
S5660	192	0		29	10	S5660_192_0	3	2	Preferred Brand			
S5660	192	0		29	10	S5660_192_0	3	3	Non-Preferred Brand			
S5660	192	0		29	10	S5660_192_0	3	4	Specialty			
S5660	192	0		29	10	S5660_192_0	3	4	Specialty	2		
S5660	192	0		29	10	S5660_192_0	3	1	Generic	1		1
S5660	192	0		29	10	S5660_192_0	3	2	Preferred Brand	2		
S5660	192	0		29	10	S5660_192_0	3	3	Non-Preferred Brand	2		
S5660	192	0		29	10	S5660_192_0	3	1	Generic			
S5660	193	0		29	10	S5660_193_0	3	3	Non-Preferred Brand			
S5660	193	0		29	10	S5660_193_0	3	2	Preferred Brand			
S5660	193	0		29	10	S5660_193_0	3	1	Generic			
S5660	193	0		29	10	S5660_193_0	3	4	Specialty			
S5660	193	0		29	10	S5660_193_0	3	4	Specialty	2		
S5660	193	0		29	10	S5660_193_0	3	3	Non-Preferred Brand	2		
S5660	193	0		29	10	S5660_193_0	3	2	Preferred Brand	2		
S5660	193	0		29	10	S5660_193_0	3	1	Generic	1		1
S5660	194	0		29	10	S5660_194_0	3	3	Non-Preferred Brand			
S5660	194	0		29	10	S5660_194_0	3	2	Preferred Brand			
S5660	194	0		29	10	S5660_194_0	3	1	Generic			
S5660	194	0		29	10	S5660_194_0	3	4	Specialty			
S5660	194	0		29	10	S5660_194_0	3	1	Generic	1		1
S5660	194	0		29	10	S5660_194_0	3	2	Preferred Brand	2		
S5660	194	0		29	10	S5660_194_0	3	3	Non-Preferred Brand	2		
S5660	194	0		29	10	S5660_194_0	3	4	Specialty	2		
S5660	195	0		29	10	S5660_195_0	3	3	Non-Preferred Brand			
S5660	195	0		29	10	S5660_195_0	3	2	Preferred Brand			
S5660	195	0		29	10	S5660_195_0	3	1	Generic			
S5660	195	0		29	10	S5660_195_0	3	4	Specialty			
S5660	195	0		29	10	S5660_195_0	3	4	Specialty	2		
S5660	195	0		29	10	S5660_195_0	3	3	Non-Preferred Brand	2		
S5660	195	0		29	10	S5660_195_0	3	2	Preferred Brand	2		
S5660	195	0		29	10	S5660_195_0	3	1	Generic	1		1
S5660	196	0		29	10	S5660_196_0	3	1	Generic			
S5660	196	0		29	10	S5660_196_0	3	2	Preferred Brand			
S5660	196	0		29	10	S5660_196_0	3	3	Non-Preferred Brand			
S5660	196	0		29	10	S5660_196_0	3	4	Specialty			
S5660	196	0		29	10	S5660_196_0	3	1	Generic	1		1
S5660	196	0		29	10	S5660_196_0	3	2	Preferred Brand	2		
S5660	196	0		29	10	S5660_196_0	3	3	Non-Preferred Brand	2		
S5660	196	0		29	10	S5660_196_0	3	4	Specialty	2		
S5660	197	0		29	10	S5660_197_0	3	1	Generic			
S5660	197	0		29	10	S5660_197_0	3	2	Preferred Brand			
S5660	197	0		29	10	S5660_197_0	3	3	Non-Preferred Brand			
S5660	197	0		29	10	S5660_197_0	3	4	Specialty			
S5660	197	0		29	10	S5660_197_0	3	1	Generic	1		1
S5660	197	0		29	10	S5660_197_0	3	2	Preferred Brand	2		
S5660	197	0		29	10	S5660_197_0	3	3	Non-Preferred Brand	2		
S5660	197	0		29	10	S5660_197_0	3	4	Specialty	2		
S5660	198	0		29	10	S5660_198_0	3	1	Generic			
S5660	198	0		29	10	S5660_198_0	3	2	Preferred Brand			
S5660	198	0		29	10	S5660_198_0	3	4	Specialty	2		
S5660	198	0		29	10	S5660_198_0	3	3	Non-Preferred Brand	2		
S5660	198	0		29	10	S5660_198_0	3	2	Preferred Brand	2		
S5660	198	0		29	10	S5660_198_0	3	1	Generic	1		1
S5660	198	0		29	10	S5660_198_0	3	4	Specialty			
S5660	198	0		29	10	S5660_198_0	3	3	Non-Preferred Brand			
S5660	199	0		29	10	S5660_199_0	3	1	Generic			
S5660	199	0		29	10	S5660_199_0	3	3	Non-Preferred Brand	2		
S5660	199	0		29	10	S5660_199_0	3	2	Preferred Brand	2		
S5660	199	0		29	10	S5660_199_0	3	1	Generic	1		1
S5660	199	0		29	10	S5660_199_0	3	4	Specialty			
S5660	199	0		29	10	S5660_199_0	3	3	Non-Preferred Brand			
S5660	199	0		29	10	S5660_199_0	3	2	Preferred Brand			
S5660	199	0		29	10	S5660_199_0	3	4	Specialty	2		
S5660	200	0		29	10	S5660_200_0	3	1	Generic	1		1
S5660	200	0		29	10	S5660_200_0	3	2	Preferred Brand	2		
S5660	200	0		29	10	S5660_200_0	3	1	Generic			
S5660	200	0		29	10	S5660_200_0	3	2	Preferred Brand			
S5660	200	0		29	10	S5660_200_0	3	3	Non-Preferred Brand			
S5660	200	0		29	10	S5660_200_0	3	4	Specialty			
S5660	200	0		29	10	S5660_200_0	3	4	Specialty	2		
S5660	200	0		29	10	S5660_200_0	3	3	Non-Preferred Brand	2		
S5660	201	0		29	10	S5660_201_0	3	3	Non-Preferred Brand	2		
S5660	201	0		29	10	S5660_201_0	3	4	Specialty	2		
S5660	201	0		29	10	S5660_201_0	3	3	Non-Preferred Brand			
S5660	201	0		29	10	S5660_201_0	3	2	Preferred Brand			
S5660	201	0		29	10	S5660_201_0	3	1	Generic			
S5660	201	0		29	10	S5660_201_0	3	1	Generic	1		1
S5660	201	0		29	10	S5660_201_0	3	2	Preferred Brand	2		
S5660	201	0		29	10	S5660_201_0	3	4	Specialty			
S5660	202	0		29	10	S5660_202_0	3	4	Specialty	2		
S5660	202	0		29	10	S5660_202_0	3	3	Non-Preferred Brand	2		
S5660	202	0		29	10	S5660_202_0	3	2	Preferred Brand	2		
S5660	202	0		29	10	S5660_202_0	3	1	Generic	1		1
S5660	202	0		29	10	S5660_202_0	3	4	Specialty			
S5660	202	0		29	10	S5660_202_0	3	3	Non-Preferred Brand			
S5660	202	0		29	10	S5660_202_0	3	1	Generic			
S5660	202	0		29	10	S5660_202_0	3	2	Preferred Brand			
S5660	203	0		29	10	S5660_203_0	3	3	Non-Preferred Brand	2		
S5660	203	0		29	10	S5660_203_0	3	2	Preferred Brand	2		
S5660	203	0		29	10	S5660_203_0	3	1	Generic	1		1
S5660	203	0		29	10	S5660_203_0	3	4	Specialty			
S5660	203	0		29	10	S5660_203_0	3	3	Non-Preferred Brand			
S5660	203	0		29	10	S5660_203_0	3	2	Preferred Brand			
S5660	203	0		29	10	S5660_203_0	3	1	Generic			
S5660	203	0		29	10	S5660_203_0	3	4	Specialty	2		
S5660	204	0		29	10	S5660_204_0	3	1	Generic			
S5660	204	0		29	10	S5660_204_0	3	2	Preferred Brand			
S5660	204	0		29	10	S5660_204_0	3	3	Non-Preferred Brand			
S5660	204	0		29	10	S5660_204_0	3	4	Specialty	2		
S5660	204	0		29	10	S5660_204_0	3	1	Generic	1		1
S5660	204	0		29	10	S5660_204_0	3	2	Preferred Brand	2		
S5660	204	0		29	10	S5660_204_0	3	3	Non-Preferred Brand	2		
S5660	204	0		29	10	S5660_204_0	3	4	Specialty			
S5660	205	0		29	10	S5660_205_0	3	3	Non-Preferred Brand	2		
S5660	205	0		29	10	S5660_205_0	3	2	Preferred Brand	2		
S5660	205	0		29	10	S5660_205_0	3	1	Generic	1		1
S5660	205	0		29	10	S5660_205_0	3	4	Specialty			
S5660	205	0		29	10	S5660_205_0	3	3	Non-Preferred Brand			
S5660	205	0		29	10	S5660_205_0	3	2	Preferred Brand			
S5660	205	0		29	10	S5660_205_0	3	1	Generic			
S5660	205	0		29	10	S5660_205_0	3	4	Specialty	2		
S5670	027	0		29	10	S5670_027_0	5	1	Preferred Generic			
S5670	027	0		29	10	S5670_027_0	5	2	Preferred Brand			
S5670	027	0		29	10	S5670_027_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	027	0		29	10	S5670_027_0	5	4	Specialty- Generic and Brand			
S5670	028	0		29	10	S5670_028_0	6	1	Preferred Genric			
S5670	028	0		29	10	S5670_028_0	6	2	Preferred Brand			
S5670	028	0		29	10	S5670_028_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	028	0		29	10	S5670_028_0	6	4	Specialty-Generic and Brand			
S5670	030	0		29	10	S5670_030_0	6	1	Preferred Generic			
S5670	030	0		29	10	S5670_030_0	6	2	Preferred Brand			
S5670	030	0		29	10	S5670_030_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	030	0		29	10	S5670_030_0	6	4	Specialty-Generic and Brand			
S5670	030	0		29	10	S5670_030_0	6	1	Preferred Generic	1		1
S5670	030	0		29	10	S5670_030_0	6	2	Preferred Brand	2		
S5670	030	0		29	10	S5670_030_0	6	4	Specialty-Generic and Brand	2		
S5670	030	0		29	10	S5670_030_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	033	0		29	10	S5670_033_0	5	1	Preferred Generic			
S5670	033	0		29	10	S5670_033_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	033	0		29	10	S5670_033_0	5	2	Preferred Brand			
S5670	033	0		29	10	S5670_033_0	5	4	Specialty- Generic and Brand			
S5670	034	0		29	10	S5670_034_0	6	1	Preferred Genric			
S5670	034	0		29	10	S5670_034_0	6	2	Preferred Brand			
S5670	034	0		29	10	S5670_034_0	6	4	Specialty-Generic and Brand			
S5670	034	0		29	10	S5670_034_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	036	0		29	10	S5670_036_0	7	1	Preferred Generic			
S5670	036	0		29	10	S5670_036_0	7	2	Preferred Brand			
S5670	036	0		29	10	S5670_036_0	7	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	036	0		29	10	S5670_036_0	7	4	Specialty-Generic and Brand			
S5670	036	0		29	10	S5670_036_0	7	1	Preferred Generic	1		1
S5670	036	0		29	10	S5670_036_0	7	2	Preferred Brand	2		
S5670	036	0		29	10	S5670_036_0	7	4	Specialty-Generic and Brand	2		
S5670	036	0		29	10	S5670_036_0	7	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	039	0		29	10	S5670_039_0	5	1	Preferred Generic			
S5670	039	0		29	10	S5670_039_0	5	2	Preferred Brand			
S5670	039	0		29	10	S5670_039_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	039	0		29	10	S5670_039_0	5	4	Specialty- Generic and Brand			
S5670	040	0		29	10	S5670_040_0	6	1	Preferred Genric			
S5670	040	0		29	10	S5670_040_0	6	2	Preferred Brand			
S5670	040	0		29	10	S5670_040_0	6	4	Specialty-Generic and Brand			
S5670	040	0		29	10	S5670_040_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	042	0		29	10	S5670_042_0	6	4	Specialty-Generic and Brand			
S5670	042	0		29	10	S5670_042_0	6	4	Specialty-Generic and Brand	2		
S5670	042	0		29	10	S5670_042_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	042	0		29	10	S5670_042_0	6	2	Preferred Brand	2		
S5670	042	0		29	10	S5670_042_0	6	1	Preferred Generic	1		1
S5670	042	0		29	10	S5670_042_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	042	0		29	10	S5670_042_0	6	2	Preferred Brand			
S5670	042	0		29	10	S5670_042_0	6	1	Preferred Generic			
S5670	045	0		29	10	S5670_045_0	5	1	Preferred Generic			
S5670	045	0		29	10	S5670_045_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	045	0		29	10	S5670_045_0	5	4	Specialty- Generic and Brand			
S5670	045	0		29	10	S5670_045_0	5	2	Preferred Brand			
S5670	046	0		29	10	S5670_046_0	6	1	Preferred Genric			
S5670	046	0		29	10	S5670_046_0	6	4	Specialty-Generic and Brand			
S5670	046	0		29	10	S5670_046_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	046	0		29	10	S5670_046_0	6	2	Preferred Brand			
S5670	048	0		29	10	S5670_048_0	6	2	Preferred Brand	2		
S5670	048	0		29	10	S5670_048_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	048	0		29	10	S5670_048_0	6	4	Specialty-Generic and Brand	2		
S5670	048	0		29	10	S5670_048_0	6	4	Specialty-Generic and Brand			
S5670	048	0		29	10	S5670_048_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	048	0		29	10	S5670_048_0	6	1	Preferred Generic			
S5670	048	0		29	10	S5670_048_0	6	1	Preferred Generic	1		1
S5670	048	0		29	10	S5670_048_0	6	2	Preferred Brand			
S5670	051	0		29	10	S5670_051_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	051	0		29	10	S5670_051_0	5	2	Preferred Brand			
S5670	051	0		29	10	S5670_051_0	5	1	Preferred Generic			
S5670	051	0		29	10	S5670_051_0	5	4	Specialty- Generic and Brand			
S5670	052	0		29	10	S5670_052_0	7	1	Preferred Genric			
S5670	052	0		29	10	S5670_052_0	7	2	Preferred Brand			
S5670	052	0		29	10	S5670_052_0	7	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	052	0		29	10	S5670_052_0	7	4	Specialty-Generic and Brand			
S5670	054	0		29	10	S5670_054_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	054	0		29	10	S5670_054_0	6	2	Preferred Brand			
S5670	054	0		29	10	S5670_054_0	6	1	Preferred Generic			
S5670	054	0		29	10	S5670_054_0	6	4	Specialty-Generic and Brand			
S5670	054	0		29	10	S5670_054_0	6	4	Specialty-Generic and Brand	2		
S5670	054	0		29	10	S5670_054_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	054	0		29	10	S5670_054_0	6	2	Preferred Brand	2		
S5670	054	0		29	10	S5670_054_0	6	1	Preferred Generic	1		1
S5670	057	0		29	10	S5670_057_0	7	1	Preferred Generic			
S5670	057	0		29	10	S5670_057_0	7	2	Preferred Brand			
S5670	057	0		29	10	S5670_057_0	7	3	Non-Preferred Genric/Non Preferred Brand			
S5670	057	0		29	10	S5670_057_0	7	4	Specialty- Generic and Brand			
S5670	058	0		29	10	S5670_058_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	058	0		29	10	S5670_058_0	6	2	Preferred Brand			
S5670	058	0		29	10	S5670_058_0	6	1	Preferred Genric			
S5670	058	0		29	10	S5670_058_0	6	4	Specialty-Generic and Brand			
S5670	060	0		29	10	S5670_060_0	6	4	Specialty-Generic and Brand	2		
S5670	060	0		29	10	S5670_060_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	060	0		29	10	S5670_060_0	6	2	Preferred Brand	2		
S5670	060	0		29	10	S5670_060_0	6	1	Preferred Generic			
S5670	060	0		29	10	S5670_060_0	6	2	Preferred Brand			
S5670	060	0		29	10	S5670_060_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	060	0		29	10	S5670_060_0	6	4	Specialty-Generic and Brand			
S5670	060	0		29	10	S5670_060_0	6	1	Preferred Generic	1		1
S5670	063	0		29	10	S5670_063_0	6	4	Specialty- Generic and Brand			
S5670	063	0		29	10	S5670_063_0	6	3	Non-Preferred Genric/Non Preferred Brand			
S5670	063	0		29	10	S5670_063_0	6	2	Preferred Brand			
S5670	063	0		29	10	S5670_063_0	6	1	Preferred Generic			
S5670	064	0		29	10	S5670_064_0	6	1	Preferred Genric			
S5670	064	0		29	10	S5670_064_0	6	2	Preferred Brand			
S5670	064	0		29	10	S5670_064_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	064	0		29	10	S5670_064_0	6	4	Specialty-Generic and Brand			
S5670	066	0		29	10	S5670_066_0	6	1	Preferred Generic			
S5670	066	0		29	10	S5670_066_0	6	2	Preferred Brand			
S5670	066	0		29	10	S5670_066_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	066	0		29	10	S5670_066_0	6	4	Specialty-Generic and Brand			
S5670	066	0		29	10	S5670_066_0	6	1	Preferred Generic	1		1
S5670	066	0		29	10	S5670_066_0	6	2	Preferred Brand	2		
S5670	066	0		29	10	S5670_066_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	066	0		29	10	S5670_066_0	6	4	Specialty-Generic and Brand	2		
S5670	069	0		29	10	S5670_069_0	6	1	Preferred Generic			
S5670	069	0		29	10	S5670_069_0	6	4	Specialty- Generic and Brand			
S5670	069	0		29	10	S5670_069_0	6	3	Non-Preferred Genric/Non Preferred Brand			
S5670	069	0		29	10	S5670_069_0	6	2	Preferred Brand			
S5670	070	0		29	10	S5670_070_0	6	2	Preferred Brand			
S5670	070	0		29	10	S5670_070_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	070	0		29	10	S5670_070_0	6	1	Preferred Genric			
S5670	070	0		29	10	S5670_070_0	6	4	Specialty-Generic and Brand			
S5670	072	0		29	10	S5670_072_0	6	1	Preferred Generic			
S5670	072	0		29	10	S5670_072_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	072	0		29	10	S5670_072_0	6	2	Preferred Brand			
S5670	072	0		29	10	S5670_072_0	6	4	Specialty-Generic and Brand	2		
S5670	072	0		29	10	S5670_072_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	072	0		29	10	S5670_072_0	6	2	Preferred Brand	2		
S5670	072	0		29	10	S5670_072_0	6	1	Preferred Generic	1		1
S5670	072	0		29	10	S5670_072_0	6	4	Specialty-Generic and Brand			
S5670	075	0		29	10	S5670_075_0	5	1	Preferred Generic			
S5670	075	0		29	10	S5670_075_0	5	2	Preferred Brand			
S5670	075	0		29	10	S5670_075_0	5	4	Specialty- Generic and Brand			
S5670	075	0		29	10	S5670_075_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	076	0		29	10	S5670_076_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	076	0		29	10	S5670_076_0	6	2	Preferred Brand			
S5670	076	0		29	10	S5670_076_0	6	1	Preferred Genric			
S5670	076	0		29	10	S5670_076_0	6	4	Specialty-Generic and Brand			
S5670	078	0		29	10	S5670_078_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	078	0		29	10	S5670_078_0	6	2	Preferred Brand	2		
S5670	078	0		29	10	S5670_078_0	6	1	Preferred Generic	1		1
S5670	078	0		29	10	S5670_078_0	6	4	Specialty-Generic and Brand			
S5670	078	0		29	10	S5670_078_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	078	0		29	10	S5670_078_0	6	4	Specialty-Generic and Brand	2		
S5670	078	0		29	10	S5670_078_0	6	1	Preferred Generic			
S5670	078	0		29	10	S5670_078_0	6	2	Preferred Brand			
S5670	081	0		29	10	S5670_081_0	5	4	Specialty- Generic and Brand			
S5670	081	0		29	10	S5670_081_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	081	0		29	10	S5670_081_0	5	1	Preferred Generic			
S5670	081	0		29	10	S5670_081_0	5	2	Preferred Brand			
S5670	082	0		29	10	S5670_082_0	6	1	Preferred Genric			
S5670	082	0		29	10	S5670_082_0	6	2	Preferred Brand			
S5670	082	0		29	10	S5670_082_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	082	0		29	10	S5670_082_0	6	4	Specialty-Generic and Brand			
S5670	084	0		29	10	S5670_084_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	084	0		29	10	S5670_084_0	6	2	Preferred Brand			
S5670	084	0		29	10	S5670_084_0	6	1	Preferred Generic			
S5670	084	0		29	10	S5670_084_0	6	4	Specialty-Generic and Brand			
S5670	084	0		29	10	S5670_084_0	6	4	Specialty-Generic and Brand	2		
S5670	084	0		29	10	S5670_084_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	084	0		29	10	S5670_084_0	6	2	Preferred Brand	2		
S5670	084	0		29	10	S5670_084_0	6	1	Preferred Generic	1		1
S5670	087	0		29	10	S5670_087_0	5	1	Preferred Generic			
S5670	087	0		29	10	S5670_087_0	5	2	Preferred Brand			
S5670	087	0		29	10	S5670_087_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	087	0		29	10	S5670_087_0	5	4	Specialty- Generic and Brand			
S5670	088	0		29	10	S5670_088_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	088	0		29	10	S5670_088_0	6	2	Preferred Brand			
S5670	088	0		29	10	S5670_088_0	6	1	Preferred Genric			
S5670	088	0		29	10	S5670_088_0	6	4	Specialty-Generic and Brand			
S5670	090	0		29	10	S5670_090_0	6	2	Preferred Brand	2		
S5670	090	0		29	10	S5670_090_0	6	1	Preferred Generic	1		1
S5670	090	0		29	10	S5670_090_0	6	4	Specialty-Generic and Brand	2		
S5670	090	0		29	10	S5670_090_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	090	0		29	10	S5670_090_0	6	4	Specialty-Generic and Brand			
S5670	090	0		29	10	S5670_090_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	090	0		29	10	S5670_090_0	6	2	Preferred Brand			
S5670	090	0		29	10	S5670_090_0	6	1	Preferred Generic			
S5670	093	0		29	10	S5670_093_0	7	4	Specialty- Generic and Brand			
S5670	093	0		29	10	S5670_093_0	7	3	Non-Preferred Genric/Non Preferred Brand			
S5670	093	0		29	10	S5670_093_0	7	1	Preferred Generic			
S5670	093	0		29	10	S5670_093_0	7	2	Preferred Brand			
S5670	094	0		29	10	S5670_094_0	6	4	Specialty-Generic and Brand			
S5670	094	0		29	10	S5670_094_0	6	2	Preferred Brand			
S5670	094	0		29	10	S5670_094_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	094	0		29	10	S5670_094_0	6	1	Preferred Genric			
S5670	096	0		29	10	S5670_096_0	6	1	Preferred Generic	1		1
S5670	096	0		29	10	S5670_096_0	6	2	Preferred Brand			
S5670	096	0		29	10	S5670_096_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	096	0		29	10	S5670_096_0	6	2	Preferred Brand	2		
S5670	096	0		29	10	S5670_096_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	096	0		29	10	S5670_096_0	6	4	Specialty-Generic and Brand			
S5670	096	0		29	10	S5670_096_0	6	4	Specialty-Generic and Brand	2		
S5670	096	0		29	10	S5670_096_0	6	1	Preferred Generic			
S5670	099	0		29	10	S5670_099_0	5	4	Specialty- Generic and Brand			
S5670	099	0		29	10	S5670_099_0	5	2	Preferred Brand			
S5670	099	0		29	10	S5670_099_0	5	1	Preferred Generic			
S5670	099	0		29	10	S5670_099_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	100	0		29	10	S5670_100_0	6	1	Preferred Genric			
S5670	100	0		29	10	S5670_100_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	100	0		29	10	S5670_100_0	6	4	Specialty-Generic and Brand			
S5670	100	0		29	10	S5670_100_0	6	2	Preferred Brand			
S5670	102	0		29	10	S5670_102_0	6	2	Preferred Brand	2		
S5670	102	0		29	10	S5670_102_0	6	1	Preferred Generic			
S5670	102	0		29	10	S5670_102_0	6	2	Preferred Brand			
S5670	102	0		29	10	S5670_102_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	102	0		29	10	S5670_102_0	6	4	Specialty-Generic and Brand	2		
S5670	102	0		29	10	S5670_102_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	102	0		29	10	S5670_102_0	6	1	Preferred Generic	1		1
S5670	102	0		29	10	S5670_102_0	6	4	Specialty-Generic and Brand			
S5670	105	0		29	10	S5670_105_0	6	2	Preferred Brand			
S5670	105	0		29	10	S5670_105_0	6	3	Non-Preferred Genric/Non Preferred Brand			
S5670	105	0		29	10	S5670_105_0	6	4	Specialty- Generic and Brand			
S5670	105	0		29	10	S5670_105_0	6	1	Preferred Generic			
S5670	106	0		29	10	S5670_106_0	7	4	Specialty-Generic and Brand			
S5670	106	0		29	10	S5670_106_0	7	2	Preferred Brand			
S5670	106	0		29	10	S5670_106_0	7	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	106	0		29	10	S5670_106_0	7	1	Preferred Genric			
S5670	108	0		29	10	S5670_108_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	108	0		29	10	S5670_108_0	6	4	Specialty-Generic and Brand			
S5670	108	0		29	10	S5670_108_0	6	1	Preferred Generic	1		1
S5670	108	0		29	10	S5670_108_0	6	2	Preferred Brand			
S5670	108	0		29	10	S5670_108_0	6	1	Preferred Generic			
S5670	108	0		29	10	S5670_108_0	6	4	Specialty-Generic and Brand	2		
S5670	108	0		29	10	S5670_108_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	108	0		29	10	S5670_108_0	6	2	Preferred Brand	2		
S5670	111	0		29	10	S5670_111_0	5	1	Preferred Generic			
S5670	111	0		29	10	S5670_111_0	5	2	Preferred Brand			
S5670	111	0		29	10	S5670_111_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	111	0		29	10	S5670_111_0	5	4	Specialty- Generic and Brand			
S5670	112	0		29	10	S5670_112_0	6	1	Preferred Genric			
S5670	112	0		29	10	S5670_112_0	6	2	Preferred Brand			
S5670	112	0		29	10	S5670_112_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	112	0		29	10	S5670_112_0	6	4	Specialty-Generic and Brand			
S5670	114	0		29	10	S5670_114_0	6	1	Preferred Generic			
S5670	114	0		29	10	S5670_114_0	6	2	Preferred Brand			
S5670	114	0		29	10	S5670_114_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	114	0		29	10	S5670_114_0	6	4	Specialty-Generic and Brand			
S5670	114	0		29	10	S5670_114_0	6	1	Preferred Generic	1		1
S5670	114	0		29	10	S5670_114_0	6	2	Preferred Brand	2		
S5670	114	0		29	10	S5670_114_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	114	0		29	10	S5670_114_0	6	4	Specialty-Generic and Brand	2		
S5670	117	0		29	10	S5670_117_0	5	1	Preferred Generic			
S5670	117	0		29	10	S5670_117_0	5	2	Preferred Brand			
S5670	117	0		29	10	S5670_117_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	117	0		29	10	S5670_117_0	5	4	Specialty- Generic and Brand			
S5670	118	0		29	10	S5670_118_0	6	1	Preferred Genric			
S5670	118	0		29	10	S5670_118_0	6	2	Preferred Brand			
S5670	118	0		29	10	S5670_118_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	118	0		29	10	S5670_118_0	6	4	Specialty-Generic and Brand			
S5670	120	0		29	10	S5670_120_0	6	1	Preferred Generic			
S5670	120	0		29	10	S5670_120_0	6	2	Preferred Brand			
S5670	120	0		29	10	S5670_120_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	120	0		29	10	S5670_120_0	6	4	Specialty-Generic and Brand			
S5670	120	0		29	10	S5670_120_0	6	1	Preferred Generic	1		1
S5670	120	0		29	10	S5670_120_0	6	2	Preferred Brand	2		
S5670	120	0		29	10	S5670_120_0	6	4	Specialty-Generic and Brand	2		
S5670	120	0		29	10	S5670_120_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	123	0		29	10	S5670_123_0	7	1	Preferred Generic			
S5670	123	0		29	10	S5670_123_0	7	3	Non-Preferred Genric/Non Preferred Brand			
S5670	123	0		29	10	S5670_123_0	7	2	Preferred Brand			
S5670	123	0		29	10	S5670_123_0	7	4	Specialty- Generic and Brand			
S5670	124	0		29	10	S5670_124_0	6	1	Preferred Genric			
S5670	124	0		29	10	S5670_124_0	6	2	Preferred Brand			
S5670	124	0		29	10	S5670_124_0	6	4	Specialty-Generic and Brand			
S5670	124	0		29	10	S5670_124_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	126	0		29	10	S5670_126_0	6	1	Preferred Generic			
S5670	126	0		29	10	S5670_126_0	6	2	Preferred Brand			
S5670	126	0		29	10	S5670_126_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	126	0		29	10	S5670_126_0	6	4	Specialty-Generic and Brand			
S5670	126	0		29	10	S5670_126_0	6	1	Preferred Generic	1		1
S5670	126	0		29	10	S5670_126_0	6	2	Preferred Brand	2		
S5670	126	0		29	10	S5670_126_0	6	4	Specialty-Generic and Brand	2		
S5670	126	0		29	10	S5670_126_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	129	0		29	10	S5670_129_0	5	1	Preferred Genric			
S5670	129	0		29	10	S5670_129_0	5	2	Preferred Brand			
S5670	129	0		29	10	S5670_129_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	129	0		29	10	S5670_129_0	5	4	Specialty- Generic and Brand			
S5670	130	0		29	10	S5670_130_0	6	1	Preferred Genric			
S5670	130	0		29	10	S5670_130_0	6	2	Preferred Brand			
S5670	130	0		29	10	S5670_130_0	6	4	Specialty-Generic and Brand			
S5670	130	0		29	10	S5670_130_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	132	0		29	10	S5670_132_0	6	2	Preferred Brand			
S5670	132	0		29	10	S5670_132_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	132	0		29	10	S5670_132_0	6	2	Preferred Brand	2		
S5670	132	0		29	10	S5670_132_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	132	0		29	10	S5670_132_0	6	4	Specialty-Generic and Brand	2		
S5670	132	0		29	10	S5670_132_0	6	1	Preferred Generic			
S5670	132	0		29	10	S5670_132_0	6	4	Specialty-Generic and Brand			
S5670	132	0		29	10	S5670_132_0	6	1	Preferred Generic	1		1
S5670	135	0		29	10	S5670_135_0	5	4	Specialty- Generic and Brand			
S5670	135	0		29	10	S5670_135_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	135	0		29	10	S5670_135_0	5	2	Preferred Brand			
S5670	135	0		29	10	S5670_135_0	5	1	Preferred Genric			
S5670	136	0		29	10	S5670_136_0	6	4	Specialty-Generic and Brand			
S5670	136	0		29	10	S5670_136_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	136	0		29	10	S5670_136_0	6	2	Preferred Brand			
S5670	136	0		29	10	S5670_136_0	6	1	Preferred Genric			
S5670	138	0		29	10	S5670_138_0	6	4	Specialty-Generic and Brand			
S5670	138	0		29	10	S5670_138_0	6	1	Preferred Generic	1		1
S5670	138	0		29	10	S5670_138_0	6	2	Preferred Brand			
S5670	138	0		29	10	S5670_138_0	6	1	Preferred Generic			
S5670	138	0		29	10	S5670_138_0	6	4	Specialty-Generic and Brand	2		
S5670	138	0		29	10	S5670_138_0	6	2	Preferred Brand	2		
S5670	138	0		29	10	S5670_138_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	138	0		29	10	S5670_138_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	141	0		29	10	S5670_141_0	5	1	Preferred Generic			
S5670	141	0		29	10	S5670_141_0	5	2	Preferred Brand			
S5670	141	0		29	10	S5670_141_0	5	4	Specialty- Generic and Brand			
S5670	141	0		29	10	S5670_141_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	142	0		29	10	S5670_142_0	6	2	Preferred Brand			
S5670	142	0		29	10	S5670_142_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	142	0		29	10	S5670_142_0	6	4	Specialty-Generic and Brand			
S5670	142	0		29	10	S5670_142_0	6	1	Preferred Genric			
S5670	144	0		29	10	S5670_144_0	5	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	144	0		29	10	S5670_144_0	5	1	Preferred Generic	1		1
S5670	144	0		29	10	S5670_144_0	5	4	Specialty-Generic and Brand	2		
S5670	144	0		29	10	S5670_144_0	5	2	Preferred Brand	2		
S5670	144	0		29	10	S5670_144_0	5	1	Preferred Generic			
S5670	144	0		29	10	S5670_144_0	5	2	Preferred Brand			
S5670	144	0		29	10	S5670_144_0	5	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	144	0		29	10	S5670_144_0	5	4	Specialty-Generic and Brand			
S5670	147	0		29	10	S5670_147_0	5	4	Specialty- Generic and Brand			
S5670	147	0		29	10	S5670_147_0	5	3	Non-Preferred Genric/Non Preferred Brand			
S5670	147	0		29	10	S5670_147_0	5	2	Preferred Brand			
S5670	147	0		29	10	S5670_147_0	5	1	Preferred Genric			
S5670	148	0		29	10	S5670_148_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	148	0		29	10	S5670_148_0	6	4	Specialty-Generic and Brand			
S5670	148	0		29	10	S5670_148_0	6	2	Preferred Brand			
S5670	148	0		29	10	S5670_148_0	6	1	Preferred Genric			
S5670	150	0		29	10	S5670_150_0	6	1	Preferred Generic			
S5670	150	0		29	10	S5670_150_0	6	2	Preferred Brand			
S5670	150	0		29	10	S5670_150_0	6	3	Non-Preferred Generic/Non-Preferred Brand			
S5670	150	0		29	10	S5670_150_0	6	4	Specialty-Generic and Brand	2		
S5670	150	0		29	10	S5670_150_0	6	1	Preferred Generic	1		1
S5670	150	0		29	10	S5670_150_0	6	2	Preferred Brand	2		
S5670	150	0		29	10	S5670_150_0	6	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5670	150	0		29	10	S5670_150_0	6	4	Specialty-Generic and Brand			
S5674	002	0		29	10	S5674_002_0	3	1	Preferred Generic			
S5674	002	0		29	10	S5674_002_0	3	2	Preferred Brand			
S5674	002	0		29	10	S5674_002_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	002	0		29	10	S5674_002_0	3	4	Specialty-Generic and Brand			
S5674	003	0		29	10	S5674_003_0	3	1	Preferred Generic			
S5674	003	0		29	10	S5674_003_0	3	2	Preferred Brand			
S5674	003	0		29	10	S5674_003_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	003	0		29	10	S5674_003_0	3	4	Specialty-Generic and Brand			
S5674	005	0		29	10	S5674_005_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	005	0		29	10	S5674_005_0	3	4	Specialty-Generic and Brand	2		
S5674	005	0		29	10	S5674_005_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	005	0		29	10	S5674_005_0	3	2	Preferred Brand	2		
S5674	005	0		29	10	S5674_005_0	3	1	Preferred Generic	1		1
S5674	005	0		29	10	S5674_005_0	3	4	Specialty-Generic and Brand			
S5674	005	0		29	10	S5674_005_0	3	2	Preferred Brand			
S5674	005	0		29	10	S5674_005_0	3	1	Preferred Generic			
S5674	008	0		29	10	S5674_008_0	2	4	Specialty-Generic and Brand			
S5674	008	0		29	10	S5674_008_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	008	0		29	10	S5674_008_0	2	2	Preferred Brand			
S5674	008	0		29	10	S5674_008_0	2	1	Preferred Generic			
S5674	009	0		29	10	S5674_009_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	009	0		29	10	S5674_009_0	3	2	Preferred Brand			
S5674	009	0		29	10	S5674_009_0	3	1	Preferred Generic			
S5674	009	0		29	10	S5674_009_0	3	4	Specialty-Generic and Brand			
S5674	011	0		29	10	S5674_011_0	3	2	Preferred Brand	2		
S5674	011	0		29	10	S5674_011_0	3	4	Specialty-Generic and Brand			
S5674	011	0		29	10	S5674_011_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	011	0		29	10	S5674_011_0	3	2	Preferred Brand			
S5674	011	0		29	10	S5674_011_0	3	1	Preferred Generic			
S5674	011	0		29	10	S5674_011_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	011	0		29	10	S5674_011_0	3	1	Preferred Generic	1		1
S5674	011	0		29	10	S5674_011_0	3	4	Specialty-Generic and Brand	2		
S5674	014	0		29	10	S5674_014_0	2	2	Preferred Brand			
S5674	014	0		29	10	S5674_014_0	2	1	Preferred Generic			
S5674	014	0		29	10	S5674_014_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	014	0		29	10	S5674_014_0	2	4	Specialty-Generic and Brand			
S5674	015	0		29	10	S5674_015_0	3	1	Preferred Generic			
S5674	015	0		29	10	S5674_015_0	3	2	Preferred Brand			
S5674	015	0		29	10	S5674_015_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	015	0		29	10	S5674_015_0	3	4	Specialty-Generic and Brand			
S5674	017	0		29	10	S5674_017_0	3	1	Preferred Generic			
S5674	017	0		29	10	S5674_017_0	3	2	Preferred Brand			
S5674	017	0		29	10	S5674_017_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	017	0		29	10	S5674_017_0	3	4	Specialty-Generic and Brand	2		
S5674	017	0		29	10	S5674_017_0	3	1	Preferred Generic	1		1
S5674	017	0		29	10	S5674_017_0	3	2	Preferred Brand	2		
S5674	017	0		29	10	S5674_017_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	017	0		29	10	S5674_017_0	3	4	Specialty-Generic and Brand			
S5674	020	0		29	10	S5674_020_0	3	1	Preferred Generic			
S5674	020	0		29	10	S5674_020_0	3	2	Preferred Brand			
S5674	020	0		29	10	S5674_020_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	020	0		29	10	S5674_020_0	3	4	Specialty-Generic and Brand			
S5674	021	0		29	10	S5674_021_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	021	0		29	10	S5674_021_0	3	4	Specialty-Generic and Brand			
S5674	021	0		29	10	S5674_021_0	3	1	Preferred Generic			
S5674	021	0		29	10	S5674_021_0	3	2	Preferred Brand			
S5674	023	0		29	10	S5674_023_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	023	0		29	10	S5674_023_0	3	4	Specialty-Generic and Brand	2		
S5674	023	0		29	10	S5674_023_0	3	1	Preferred Generic			
S5674	023	0		29	10	S5674_023_0	3	2	Preferred Brand	2		
S5674	023	0		29	10	S5674_023_0	3	4	Specialty-Generic and Brand			
S5674	023	0		29	10	S5674_023_0	3	2	Preferred Brand			
S5674	023	0		29	10	S5674_023_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	023	0		29	10	S5674_023_0	3	1	Preferred Generic	1		1
S5674	026	0		29	10	S5674_026_0	2	4	Specialty-Generic and Brand			
S5674	026	0		29	10	S5674_026_0	2	2	Preferred Brand			
S5674	026	0		29	10	S5674_026_0	2	1	Preferred Generic			
S5674	026	0		29	10	S5674_026_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	027	0		29	10	S5674_027_0	3	4	Specialty-Generic and Brand			
S5674	027	0		29	10	S5674_027_0	3	1	Preferred Generic			
S5674	027	0		29	10	S5674_027_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	027	0		29	10	S5674_027_0	3	2	Preferred Brand			
S5674	029	0		29	10	S5674_029_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	029	0		29	10	S5674_029_0	3	2	Preferred Brand			
S5674	029	0		29	10	S5674_029_0	3	1	Preferred Generic			
S5674	029	0		29	10	S5674_029_0	3	4	Specialty-Generic and Brand			
S5674	029	0		29	10	S5674_029_0	3	2	Preferred Brand	2		
S5674	029	0		29	10	S5674_029_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	029	0		29	10	S5674_029_0	3	4	Specialty-Generic and Brand	2		
S5674	029	0		29	10	S5674_029_0	3	1	Preferred Generic	1		1
S5674	032	0		29	10	S5674_032_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	032	0		29	10	S5674_032_0	2	2	Preferred Brand			
S5674	032	0		29	10	S5674_032_0	2	1	Preferred Generic			
S5674	032	0		29	10	S5674_032_0	2	4	Specialty-Generic and Brand			
S5674	033	0		29	10	S5674_033_0	3	1	Preferred Generic			
S5674	033	0		29	10	S5674_033_0	3	2	Preferred Brand			
S5674	033	0		29	10	S5674_033_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	033	0		29	10	S5674_033_0	3	4	Specialty-Generic and Brand			
S5674	035	0		29	10	S5674_035_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	035	0		29	10	S5674_035_0	3	2	Preferred Brand			
S5674	035	0		29	10	S5674_035_0	3	1	Preferred Generic			
S5674	035	0		29	10	S5674_035_0	3	4	Specialty-Generic and Brand			
S5674	035	0		29	10	S5674_035_0	3	4	Specialty-Generic and Brand	2		
S5674	035	0		29	10	S5674_035_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	035	0		29	10	S5674_035_0	3	2	Preferred Brand	2		
S5674	035	0		29	10	S5674_035_0	3	1	Preferred Generic	1		1
S5674	038	0		29	10	S5674_038_0	3	1	Preferred Generic			
S5674	038	0		29	10	S5674_038_0	3	2	Preferred Brand			
S5674	038	0		29	10	S5674_038_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	038	0		29	10	S5674_038_0	3	4	Specialty-Generic and Brand			
S5674	039	0		29	10	S5674_039_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	039	0		29	10	S5674_039_0	3	2	Preferred Brand			
S5674	039	0		29	10	S5674_039_0	3	1	Preferred Generic			
S5674	039	0		29	10	S5674_039_0	3	4	Specialty-Generic and Brand			
S5674	041	0		29	10	S5674_041_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	041	0		29	10	S5674_041_0	3	2	Preferred Brand			
S5674	041	0		29	10	S5674_041_0	3	1	Preferred Generic			
S5674	041	0		29	10	S5674_041_0	3	4	Specialty-Generic and Brand			
S5674	041	0		29	10	S5674_041_0	3	1	Preferred Generic	1		1
S5674	041	0		29	10	S5674_041_0	3	2	Preferred Brand	2		
S5674	041	0		29	10	S5674_041_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	041	0		29	10	S5674_041_0	3	4	Specialty-Generic and Brand	2		
S5674	044	0		29	10	S5674_044_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	044	0		29	10	S5674_044_0	3	2	Preferred Brand			
S5674	044	0		29	10	S5674_044_0	3	1	Preferred Generic			
S5674	044	0		29	10	S5674_044_0	3	4	Specialty-Generic and Brand			
S5674	045	0		29	10	S5674_045_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	045	0		29	10	S5674_045_0	3	2	Preferred Brand			
S5674	045	0		29	10	S5674_045_0	3	1	Preferred Generic			
S5674	045	0		29	10	S5674_045_0	3	4	Specialty-Generic and Brand			
S5674	047	0		29	10	S5674_047_0	3	1	Preferred Generic	1		1
S5674	047	0		29	10	S5674_047_0	3	2	Preferred Brand	2		
S5674	047	0		29	10	S5674_047_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	047	0		29	10	S5674_047_0	3	4	Specialty-Generic and Brand			
S5674	047	0		29	10	S5674_047_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	047	0		29	10	S5674_047_0	3	4	Specialty-Generic and Brand	2		
S5674	047	0		29	10	S5674_047_0	3	1	Preferred Generic			
S5674	047	0		29	10	S5674_047_0	3	2	Preferred Brand			
S5674	050	0		29	10	S5674_050_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	050	0		29	10	S5674_050_0	2	4	Specialty-Generic and Brand			
S5674	050	0		29	10	S5674_050_0	2	2	Preferred Brand			
S5674	050	0		29	10	S5674_050_0	2	1	Preferred Generic			
S5674	051	0		29	10	S5674_051_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	051	0		29	10	S5674_051_0	3	1	Preferred Generic			
S5674	051	0		29	10	S5674_051_0	3	2	Preferred Brand			
S5674	051	0		29	10	S5674_051_0	3	4	Specialty-Generic and Brand			
S5674	053	0		29	10	S5674_053_0	3	1	Preferred Generic			
S5674	053	0		29	10	S5674_053_0	3	2	Preferred Brand			
S5674	053	0		29	10	S5674_053_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	053	0		29	10	S5674_053_0	3	4	Specialty-Generic and Brand			
S5674	053	0		29	10	S5674_053_0	3	1	Preferred Generic	1		1
S5674	053	0		29	10	S5674_053_0	3	2	Preferred Brand	2		
S5674	053	0		29	10	S5674_053_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	053	0		29	10	S5674_053_0	3	4	Specialty-Generic and Brand	2		
S5674	056	0		29	10	S5674_056_0	2	1	Preferred Generic			
S5674	056	0		29	10	S5674_056_0	2	4	Specialty-Generic and Brand			
S5674	056	0		29	10	S5674_056_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	056	0		29	10	S5674_056_0	2	2	Preferred Brand			
S5674	057	0		29	10	S5674_057_0	3	2	Preferred Brand			
S5674	057	0		29	10	S5674_057_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	057	0		29	10	S5674_057_0	3	4	Specialty-Generic and Brand			
S5674	057	0		29	10	S5674_057_0	3	1	Preferred Generic			
S5674	059	0		29	10	S5674_059_0	3	1	Preferred Generic			
S5674	059	0		29	10	S5674_059_0	3	2	Preferred Brand			
S5674	059	0		29	10	S5674_059_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	059	0		29	10	S5674_059_0	3	2	Preferred Brand	2		
S5674	059	0		29	10	S5674_059_0	3	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	059	0		29	10	S5674_059_0	3	4	Specialty-Generic and Brand	2		
S5674	059	0		29	10	S5674_059_0	3	4	Specialty-Generic and Brand			
S5674	059	0		29	10	S5674_059_0	3	1	Preferred Generic	1		1
S5674	062	0		29	10	S5674_062_0	2	2	Preferred Brand			
S5674	062	0		29	10	S5674_062_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	062	0		29	10	S5674_062_0	2	4	Specialty-Generic and Brand			
S5674	062	0		29	10	S5674_062_0	2	1	Preferred Generic			
S5674	063	0		29	10	S5674_063_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	063	0		29	10	S5674_063_0	2	4	Specialty-Generic and Brand			
S5674	063	0		29	10	S5674_063_0	2	2	Preferred Brand			
S5674	063	0		29	10	S5674_063_0	2	1	Preferred Generic			
S5674	065	0		29	10	S5674_065_0	2	4	Specialty-Generic and Brand	2		
S5674	065	0		29	10	S5674_065_0	2	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	065	0		29	10	S5674_065_0	2	2	Preferred Brand	2		
S5674	065	0		29	10	S5674_065_0	2	1	Preferred Generic			
S5674	065	0		29	10	S5674_065_0	2	2	Preferred Brand			
S5674	065	0		29	10	S5674_065_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	065	0		29	10	S5674_065_0	2	4	Specialty-Generic and Brand			
S5674	065	0		29	10	S5674_065_0	2	1	Preferred Generic	1		1
S5674	068	0		29	10	S5674_068_0	2	1	Preferred Generic			
S5674	068	0		29	10	S5674_068_0	2	2	Preferred Brand			
S5674	068	0		29	10	S5674_068_0	2	4	Specialty-Generic and Brand			
S5674	068	0		29	10	S5674_068_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	069	0		29	10	S5674_069_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	069	0		29	10	S5674_069_0	2	2	Preferred Brand			
S5674	069	0		29	10	S5674_069_0	2	1	Preferred Generic			
S5674	069	0		29	10	S5674_069_0	2	4	Specialty-Generic and Brand			
S5674	071	0		29	10	S5674_071_0	2	4	Specialty-Generic and Brand			
S5674	071	0		29	10	S5674_071_0	2	1	Preferred Generic	1		1
S5674	071	0		29	10	S5674_071_0	2	2	Preferred Brand	2		
S5674	071	0		29	10	S5674_071_0	2	4	Specialty-Generic and Brand	2		
S5674	071	0		29	10	S5674_071_0	2	3	Non-Preferred Generic/Non-Preferred Brand	2		
S5674	071	0		29	10	S5674_071_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5674	071	0		29	10	S5674_071_0	2	2	Preferred Brand			
S5674	071	0		29	10	S5674_071_0	2	1	Preferred Generic			
S5678	001	0		29	10	S5678_001_0	2	4	Injectable			
S5678	001	0		29	10	S5678_001_0	2	5	Specialty			
S5678	001	0		29	10	S5678_001_0	2	3	Non-Preferred Brand			
S5678	001	0		29	10	S5678_001_0	2	1	Preferred Generic			
S5678	001	0		29	10	S5678_001_0	2	2	Preferred Brand			
S5678	002	0		29	10	S5678_002_0	2	1	Preferred Generic			
S5678	002	0		29	10	S5678_002_0	2	2	Preferred Brand			
S5678	002	0		29	10	S5678_002_0	2	4	Injectable			
S5678	002	0		29	10	S5678_002_0	2	5	Specialty			
S5678	002	0		29	10	S5678_002_0	2	3	Non-Preferred Brand			
S5678	003	0		29	10	S5678_003_0	2	2	Preferred Brand			
S5678	003	0		29	10	S5678_003_0	2	3	Non-Preferred Brand			
S5678	003	0		29	10	S5678_003_0	2	4	Injectable			
S5678	003	0		29	10	S5678_003_0	2	5	Specialty			
S5678	003	0		29	10	S5678_003_0	2	1	Preferred Generic			
S5678	004	0		29	10	S5678_004_0	2	2	Preferred Brand			
S5678	004	0		29	10	S5678_004_0	2	3	Non-Preferred Brand			
S5678	004	0		29	10	S5678_004_0	2	4	Injectable			
S5678	004	0		29	10	S5678_004_0	2	5	Specialty			
S5678	004	0		29	10	S5678_004_0	2	1	Preferred Generic			
S5678	005	0		29	10	S5678_005_0	2	5	Specialty			
S5678	005	0		29	10	S5678_005_0	2	4	Injectable			
S5678	005	0		29	10	S5678_005_0	2	2	Preferred Brand			
S5678	005	0		29	10	S5678_005_0	2	3	Non-Preferred Brand			
S5678	005	0		29	10	S5678_005_0	2	1	Preferred Generic			
S5678	006	0		29	10	S5678_006_0	2	3	Non-Preferred Brand			
S5678	006	0		29	10	S5678_006_0	2	4	Injectable			
S5678	006	0		29	10	S5678_006_0	2	5	Specialty			
S5678	006	0		29	10	S5678_006_0	2	2	Preferred Brand			
S5678	006	0		29	10	S5678_006_0	2	1	Preferred Generic			
S5678	007	0		29	10	S5678_007_0	2	1	Preferred Generic			
S5678	007	0		29	10	S5678_007_0	2	2	Preferred Brand			
S5678	007	0		29	10	S5678_007_0	2	3	Non-Preferred Brand			
S5678	007	0		29	10	S5678_007_0	2	4	Injectable			
S5678	007	0		29	10	S5678_007_0	2	5	Specialty			
S5678	008	0		29	10	S5678_008_0	2	1	Preferred Generic			
S5678	008	0		29	10	S5678_008_0	2	5	Specialty			
S5678	008	0		29	10	S5678_008_0	2	2	Preferred Brand			
S5678	008	0		29	10	S5678_008_0	2	3	Non-Preferred Brand			
S5678	008	0		29	10	S5678_008_0	2	4	Injectable			
S5678	009	0		29	10	S5678_009_0	2	1	Preferred Generic			
S5678	009	0		29	10	S5678_009_0	2	3	Non-Preferred Brand			
S5678	009	0		29	10	S5678_009_0	2	2	Preferred Brand			
S5678	009	0		29	10	S5678_009_0	2	4	Injectable			
S5678	009	0		29	10	S5678_009_0	2	5	Specialty			
S5678	010	0		29	10	S5678_010_0	2	1	Preferred Generic			
S5678	010	0		29	10	S5678_010_0	2	2	Preferred Brand			
S5678	010	0		29	10	S5678_010_0	2	3	Non-Preferred Brand			
S5678	010	0		29	10	S5678_010_0	2	4	Injectable			
S5678	010	0		29	10	S5678_010_0	2	5	Specialty			
S5678	011	0		29	10	S5678_011_0	2	1	Preferred Generic			
S5678	011	0		29	10	S5678_011_0	2	2	Preferred Brand			
S5678	011	0		29	10	S5678_011_0	2	3	Non-Preferred Brand			
S5678	011	0		29	10	S5678_011_0	2	5	Specialty			
S5678	011	0		29	10	S5678_011_0	2	4	Injectable			
S5678	012	0		29	10	S5678_012_0	2	3	Non-Preferred Brand			
S5678	012	0		29	10	S5678_012_0	2	2	Preferred Brand			
S5678	012	0		29	10	S5678_012_0	2	5	Specialty			
S5678	012	0		29	10	S5678_012_0	2	4	Injectable			
S5678	012	0		29	10	S5678_012_0	2	1	Preferred Generic			
S5678	013	0		29	10	S5678_013_0	2	4	Injectable			
S5678	013	0		29	10	S5678_013_0	2	3	Non-Preferred Brand			
S5678	013	0		29	10	S5678_013_0	2	1	Preferred Generic			
S5678	013	0		29	10	S5678_013_0	2	2	Preferred Brand			
S5678	013	0		29	10	S5678_013_0	2	5	Specialty			
S5678	014	0		29	10	S5678_014_0	2	5	Specialty			
S5678	014	0		29	10	S5678_014_0	2	4	Injectable			
S5678	014	0		29	10	S5678_014_0	2	3	Non-Preferred Brand			
S5678	014	0		29	10	S5678_014_0	2	1	Preferred Generic			
S5678	014	0		29	10	S5678_014_0	2	2	Preferred Brand			
S5678	015	0		29	10	S5678_015_0	2	5	Specialty			
S5678	015	0		29	10	S5678_015_0	2	4	Injectable			
S5678	015	0		29	10	S5678_015_0	2	2	Preferred Brand			
S5678	015	0		29	10	S5678_015_0	2	3	Non-Preferred Brand			
S5678	015	0		29	10	S5678_015_0	2	1	Preferred Generic			
S5678	016	0		29	10	S5678_016_0	2	1	Preferred Generic			
S5678	016	0		29	10	S5678_016_0	2	2	Preferred Brand			
S5678	016	0		29	10	S5678_016_0	2	5	Specialty			
S5678	016	0		29	10	S5678_016_0	2	4	Injectable			
S5678	016	0		29	10	S5678_016_0	2	3	Non-Preferred Brand			
S5678	017	0		29	10	S5678_017_0	2	4	Injectable			
S5678	017	0		29	10	S5678_017_0	2	2	Preferred Brand			
S5678	017	0		29	10	S5678_017_0	2	1	Preferred Generic			
S5678	017	0		29	10	S5678_017_0	2	3	Non-Preferred Brand			
S5678	017	0		29	10	S5678_017_0	2	5	Specialty			
S5678	018	0		29	10	S5678_018_0	2	1	Preferred Generic			
S5678	018	0		29	10	S5678_018_0	2	2	Preferred Brand			
S5678	018	0		29	10	S5678_018_0	2	3	Non-Preferred Brand			
S5678	018	0		29	10	S5678_018_0	2	4	Injectable			
S5678	018	0		29	10	S5678_018_0	2	5	Specialty			
S5678	019	0		29	10	S5678_019_0	2	1	Preferred Generic			
S5678	019	0		29	10	S5678_019_0	2	2	Preferred Brand			
S5678	019	0		29	10	S5678_019_0	2	3	Non-Preferred Brand			
S5678	019	0		29	10	S5678_019_0	2	4	Injectable			
S5678	019	0		29	10	S5678_019_0	2	5	Specialty			
S5678	020	0		29	10	S5678_020_0	2	4	Injectable			
S5678	020	0		29	10	S5678_020_0	2	3	Non-Preferred Brand			
S5678	020	0		29	10	S5678_020_0	2	5	Specialty			
S5678	020	0		29	10	S5678_020_0	2	2	Preferred Brand			
S5678	020	0		29	10	S5678_020_0	2	1	Preferred Generic			
S5678	021	0		29	10	S5678_021_0	2	4	Injectable			
S5678	021	0		29	10	S5678_021_0	2	1	Preferred Generic			
S5678	021	0		29	10	S5678_021_0	2	5	Specialty			
S5678	021	0		29	10	S5678_021_0	2	2	Preferred Brand			
S5678	021	0		29	10	S5678_021_0	2	3	Non-Preferred Brand			
S5678	022	0		29	10	S5678_022_0	2	4	Injectable			
S5678	022	0		29	10	S5678_022_0	2	1	Preferred Generic			
S5678	022	0		29	10	S5678_022_0	2	5	Specialty			
S5678	022	0		29	10	S5678_022_0	2	2	Preferred Brand			
S5678	022	0		29	10	S5678_022_0	2	3	Non-Preferred Brand			
S5678	023	0		29	10	S5678_023_0	2	4	Injectable			
S5678	023	0		29	10	S5678_023_0	2	1	Preferred Generic			
S5678	023	0		29	10	S5678_023_0	2	5	Specialty			
S5678	023	0		29	10	S5678_023_0	2	2	Preferred Brand			
S5678	023	0		29	10	S5678_023_0	2	3	Non-Preferred Brand			
S5678	024	0		29	10	S5678_024_0	2	3	Non-Preferred Brand			
S5678	024	0		29	10	S5678_024_0	2	4	Injectable			
S5678	024	0		29	10	S5678_024_0	2	2	Preferred Brand			
S5678	024	0		29	10	S5678_024_0	2	1	Preferred Generic			
S5678	024	0		29	10	S5678_024_0	2	5	Specialty			
S5678	025	0		29	10	S5678_025_0	2	4	Injectable			
S5678	025	0		29	10	S5678_025_0	2	5	Specialty			
S5678	025	0		29	10	S5678_025_0	2	3	Non-Preferred Brand			
S5678	025	0		29	10	S5678_025_0	2	1	Preferred Generic			
S5678	025	0		29	10	S5678_025_0	2	2	Preferred Brand			
S5678	026	0		29	10	S5678_026_0	2	2	Preferred Brand			
S5678	026	0		29	10	S5678_026_0	2	3	Non-Preferred Brand			
S5678	026	0		29	10	S5678_026_0	2	5	Specialty			
S5678	026	0		29	10	S5678_026_0	2	4	Injectable			
S5678	026	0		29	10	S5678_026_0	2	1	Preferred Generic			
S5678	027	0		29	10	S5678_027_0	2	4	Injectable			
S5678	027	0		29	10	S5678_027_0	2	3	Non-Preferred Brand			
S5678	027	0		29	10	S5678_027_0	2	5	Specialty			
S5678	027	0		29	10	S5678_027_0	2	2	Preferred Brand			
S5678	027	0		29	10	S5678_027_0	2	1	Preferred Generic			
S5678	028	0		29	10	S5678_028_0	2	5	Specialty			
S5678	028	0		29	10	S5678_028_0	2	4	Injectable			
S5678	028	0		29	10	S5678_028_0	2	3	Non-Preferred Brand			
S5678	028	0		29	10	S5678_028_0	2	2	Preferred Brand			
S5678	028	0		29	10	S5678_028_0	2	1	Preferred Generic			
S5678	029	0		29	10	S5678_029_0	2	1	Preferred Generic			
S5678	029	0		29	10	S5678_029_0	2	2	Preferred Brand			
S5678	029	0		29	10	S5678_029_0	2	3	Non-Preferred Brand			
S5678	029	0		29	10	S5678_029_0	2	4	Injectable			
S5678	029	0		29	10	S5678_029_0	2	5	Specialty			
S5678	030	0		29	10	S5678_030_0	2	4	Injectable			
S5678	030	0		29	10	S5678_030_0	2	5	Specialty			
S5678	030	0		29	10	S5678_030_0	2	1	Preferred Generic			
S5678	030	0		29	10	S5678_030_0	2	2	Preferred Brand			
S5678	030	0		29	10	S5678_030_0	2	3	Non-Preferred Brand			
S5678	031	0		29	10	S5678_031_0	2	4	Injectable			
S5678	031	0		29	10	S5678_031_0	2	3	Non-Preferred Brand			
S5678	031	0		29	10	S5678_031_0	2	1	Preferred Generic			
S5678	031	0		29	10	S5678_031_0	2	2	Preferred Brand			
S5678	031	0		29	10	S5678_031_0	2	5	Specialty			
S5678	032	0		29	10	S5678_032_0	2	4	Injectable			
S5678	032	0		29	10	S5678_032_0	2	3	Non-Preferred Brand			
S5678	032	0		29	10	S5678_032_0	2	2	Preferred Brand			
S5678	032	0		29	10	S5678_032_0	2	1	Preferred Generic			
S5678	032	0		29	10	S5678_032_0	2	5	Specialty			
S5678	033	0		29	10	S5678_033_0	2	1	Preferred Generic			
S5678	033	0		29	10	S5678_033_0	2	2	Preferred Brand			
S5678	033	0		29	10	S5678_033_0	2	3	Non-Preferred Brand			
S5678	033	0		29	10	S5678_033_0	2	4	Injectable			
S5678	033	0		29	10	S5678_033_0	2	5	Specialty			
S5678	034	0		29	10	S5678_034_0	2	1	Preferred Generic			
S5678	034	0		29	10	S5678_034_0	2	2	Preferred Brand			
S5678	034	0		29	10	S5678_034_0	2	3	Non-Preferred Brand			
S5678	034	0		29	10	S5678_034_0	2	4	Injectable			
S5678	034	0		29	10	S5678_034_0	2	5	Specialty			
S5678	035	0		29	10	S5678_035_0	2	2	Preferred Brand			
S5678	035	0		29	10	S5678_035_0	2	1	Preferred Generic			
S5678	035	0		29	10	S5678_035_0	2	3	Non-Preferred Brand			
S5678	035	0		29	10	S5678_035_0	2	5	Specialty			
S5678	035	0		29	10	S5678_035_0	2	4	Injectable			
S5678	036	0		29	10	S5678_036_0	2	4	Injectable			
S5678	036	0		29	10	S5678_036_0	2	3	Non-Preferred Brand			
S5678	036	0		29	10	S5678_036_0	2	2	Preferred Brand			
S5678	036	0		29	10	S5678_036_0	2	1	Preferred Generic			
S5678	036	0		29	10	S5678_036_0	2	5	Specialty			
S5678	037	0		29	10	S5678_037_0	2	4	Injectable			
S5678	037	0		29	10	S5678_037_0	2	3	Non-Preferred Brand			
S5678	037	0		29	10	S5678_037_0	2	2	Preferred Brand			
S5678	037	0		29	10	S5678_037_0	2	1	Preferred Generic			
S5678	037	0		29	10	S5678_037_0	2	5	Specialty			
S5678	038	0		29	10	S5678_038_0	2	1	Preferred Generic			
S5678	038	0		29	10	S5678_038_0	2	2	Preferred Brand			
S5678	038	0		29	10	S5678_038_0	2	3	Non-Preferred Brand			
S5678	038	0		29	10	S5678_038_0	2	4	Injectable			
S5678	038	0		29	10	S5678_038_0	2	5	Specialty			
S5678	039	0		29	10	S5678_039_0	2	1	Preferred Generic			
S5678	039	0		29	10	S5678_039_0	2	2	Preferred Brand			
S5678	039	0		29	10	S5678_039_0	2	4	Injectable			
S5678	039	0		29	10	S5678_039_0	2	3	Non-Preferred Brand			
S5678	039	0		29	10	S5678_039_0	2	5	Specialty			
S5678	040	0		29	10	S5678_040_0	2	1	Preferred Generic			
S5678	040	0		29	10	S5678_040_0	2	2	Preferred Brand			
S5678	040	0		29	10	S5678_040_0	2	3	Non-Preferred Brand			
S5678	040	0		29	10	S5678_040_0	2	4	Injectable			
S5678	040	0		29	10	S5678_040_0	2	5	Specialty			
S5678	041	0		29	10	S5678_041_0	3	1	Preferred Generic			
S5678	041	0		29	10	S5678_041_0	3	2	Preferred Brand			
S5678	041	0		29	10	S5678_041_0	3	3	Non-Preferred Brand			
S5678	041	0		29	10	S5678_041_0	3	4	Injectable			
S5678	041	0		29	10	S5678_041_0	3	5	Specialty			
S5678	042	0		29	10	S5678_042_0	2	1	Preferred Generic			
S5678	042	0		29	10	S5678_042_0	2	2	Preferred Brand			
S5678	042	0		29	10	S5678_042_0	2	3	Non-Preferred Brand			
S5678	042	0		29	10	S5678_042_0	2	5	Specialty			
S5678	042	0		29	10	S5678_042_0	2	4	Injectable			
S5678	043	0		29	10	S5678_043_0	2	3	Non-Preferred Brand			
S5678	043	0		29	10	S5678_043_0	2	2	Preferred Brand			
S5678	043	0		29	10	S5678_043_0	2	1	Preferred Generic			
S5678	043	0		29	10	S5678_043_0	2	4	Injectable			
S5678	043	0		29	10	S5678_043_0	2	5	Specialty			
S5678	044	0		29	10	S5678_044_0	2	5	Specialty			
S5678	044	0		29	10	S5678_044_0	2	4	Injectable			
S5678	044	0		29	10	S5678_044_0	2	3	Non-Preferred Brand			
S5678	044	0		29	10	S5678_044_0	2	2	Preferred Brand			
S5678	044	0		29	10	S5678_044_0	2	1	Preferred Generic			
S5678	045	0		29	10	S5678_045_0	2	4	Injectable			
S5678	045	0		29	10	S5678_045_0	2	5	Specialty			
S5678	045	0		29	10	S5678_045_0	2	1	Preferred Generic			
S5678	045	0		29	10	S5678_045_0	2	2	Preferred Brand			
S5678	045	0		29	10	S5678_045_0	2	3	Non-Preferred Brand			
S5678	046	0		29	10	S5678_046_0	2	1	Preferred Generic			
S5678	046	0		29	10	S5678_046_0	2	4	Injectable			
S5678	046	0		29	10	S5678_046_0	2	3	Non-Preferred Brand			
S5678	046	0		29	10	S5678_046_0	2	2	Preferred Brand			
S5678	046	0		29	10	S5678_046_0	2	5	Specialty			
S5678	047	0		29	10	S5678_047_0	2	1	Preferred Generic			
S5678	047	0		29	10	S5678_047_0	2	3	Non-Preferred Brand			
S5678	047	0		29	10	S5678_047_0	2	4	Injectable			
S5678	047	0		29	10	S5678_047_0	2	5	Specialty			
S5678	047	0		29	10	S5678_047_0	2	2	Preferred Brand			
S5678	048	0		29	10	S5678_048_0	2	5	Specialty			
S5678	048	0		29	10	S5678_048_0	2	1	Preferred Generic			
S5678	048	0		29	10	S5678_048_0	2	3	Non-Preferred Brand			
S5678	048	0		29	10	S5678_048_0	2	2	Preferred Brand			
S5678	048	0		29	10	S5678_048_0	2	4	Injectable			
S5678	049	0		29	10	S5678_049_0	2	1	Preferred Generic			
S5678	049	0		29	10	S5678_049_0	2	2	Preferred Brand			
S5678	049	0		29	10	S5678_049_0	2	3	Non-Preferred Brand			
S5678	049	0		29	10	S5678_049_0	2	5	Specialty			
S5678	049	0		29	10	S5678_049_0	2	4	Injectable			
S5678	050	0		29	10	S5678_050_0	2	1	Preferred Generic			
S5678	050	0		29	10	S5678_050_0	2	2	Preferred Brand			
S5678	050	0		29	10	S5678_050_0	2	3	Non-Preferred Brand			
S5678	050	0		29	10	S5678_050_0	2	4	Injectable			
S5678	050	0		29	10	S5678_050_0	2	5	Specialty			
S5678	051	0		29	10	S5678_051_0	2	1	Preferred Generic			
S5678	051	0		29	10	S5678_051_0	2	2	Preferred Brand			
S5678	051	0		29	10	S5678_051_0	2	5	Specialty			
S5678	051	0		29	10	S5678_051_0	2	4	Injectable			
S5678	051	0		29	10	S5678_051_0	2	3	Non-Preferred Brand			
S5678	052	0		29	10	S5678_052_0	2	3	Non-Preferred Brand			
S5678	052	0		29	10	S5678_052_0	2	5	Specialty			
S5678	052	0		29	10	S5678_052_0	2	4	Injectable			
S5678	052	0		29	10	S5678_052_0	2	2	Preferred Brand			
S5678	052	0		29	10	S5678_052_0	2	1	Preferred Generic			
S5678	053	0		29	10	S5678_053_0	2	1	Preferred Generic			
S5678	053	0		29	10	S5678_053_0	2	2	Preferred Brand			
S5678	053	0		29	10	S5678_053_0	2	5	Specialty			
S5678	053	0		29	10	S5678_053_0	2	4	Injectable			
S5678	053	0		29	10	S5678_053_0	2	3	Non-Preferred Brand			
S5678	054	0		29	10	S5678_054_0	2	5	Specialty			
S5678	054	0		29	10	S5678_054_0	2	2	Preferred Brand			
S5678	054	0		29	10	S5678_054_0	2	1	Preferred Generic			
S5678	054	0		29	10	S5678_054_0	2	4	Injectable			
S5678	054	0		29	10	S5678_054_0	2	3	Non-Preferred Brand			
S5678	055	0		29	10	S5678_055_0	2	4	Injectable			
S5678	055	0		29	10	S5678_055_0	2	5	Specialty			
S5678	055	0		29	10	S5678_055_0	2	3	Non-Preferred Brand			
S5678	055	0		29	10	S5678_055_0	2	2	Preferred Brand			
S5678	055	0		29	10	S5678_055_0	2	1	Preferred Generic			
S5678	056	0		29	10	S5678_056_0	2	3	Non-Preferred Brand			
S5678	056	0		29	10	S5678_056_0	2	4	Injectable			
S5678	056	0		29	10	S5678_056_0	2	5	Specialty			
S5678	056	0		29	10	S5678_056_0	2	2	Preferred Brand			
S5678	056	0		29	10	S5678_056_0	2	1	Preferred Generic			
S5678	057	0		29	10	S5678_057_0	2	4	Injectable			
S5678	057	0		29	10	S5678_057_0	2	5	Specialty			
S5678	057	0		29	10	S5678_057_0	2	2	Preferred Brand			
S5678	057	0		29	10	S5678_057_0	2	1	Preferred Generic			
S5678	057	0		29	10	S5678_057_0	2	3	Non-Preferred Brand			
S5678	058	0		29	10	S5678_058_0	2	1	Preferred Generic			
S5678	058	0		29	10	S5678_058_0	2	2	Preferred Brand			
S5678	058	0		29	10	S5678_058_0	2	5	Specialty			
S5678	058	0		29	10	S5678_058_0	2	4	Injectable			
S5678	058	0		29	10	S5678_058_0	2	3	Non-Preferred Brand			
S5678	059	0		29	10	S5678_059_0	2	4	Injectable			
S5678	059	0		29	10	S5678_059_0	2	3	Non-Preferred Brand			
S5678	059	0		29	10	S5678_059_0	2	5	Specialty			
S5678	059	0		29	10	S5678_059_0	2	2	Preferred Brand			
S5678	059	0		29	10	S5678_059_0	2	1	Preferred Generic			
S5678	060	0		29	10	S5678_060_0	2	4	Injectable			
S5678	060	0		29	10	S5678_060_0	2	3	Non-Preferred Brand			
S5678	060	0		29	10	S5678_060_0	2	1	Preferred Generic			
S5678	060	0		29	10	S5678_060_0	2	2	Preferred Brand			
S5678	060	0		29	10	S5678_060_0	2	5	Specialty			
S5678	061	0		29	10	S5678_061_0	2	4	Injectable			
S5678	061	0		29	10	S5678_061_0	2	3	Non-Preferred Brand			
S5678	061	0		29	10	S5678_061_0	2	2	Preferred Brand			
S5678	061	0		29	10	S5678_061_0	2	1	Preferred Generic			
S5678	061	0		29	10	S5678_061_0	2	5	Specialty			
S5678	062	0		29	10	S5678_062_0	2	1	Preferred Generic			
S5678	062	0		29	10	S5678_062_0	2	2	Preferred Brand			
S5678	062	0		29	10	S5678_062_0	2	3	Non-Preferred Brand			
S5678	062	0		29	10	S5678_062_0	2	4	Injectable			
S5678	062	0		29	10	S5678_062_0	2	5	Specialty			
S5678	063	0		29	10	S5678_063_0	2	1	Preferred Generic			
S5678	063	0		29	10	S5678_063_0	2	2	Preferred Brand			
S5678	063	0		29	10	S5678_063_0	2	3	Non-Preferred Brand			
S5678	063	0		29	10	S5678_063_0	2	4	Injectable			
S5678	063	0		29	10	S5678_063_0	2	5	Specialty			
S5678	064	0		29	10	S5678_064_0	2	2	Preferred Brand			
S5678	064	0		29	10	S5678_064_0	2	1	Preferred Generic			
S5678	064	0		29	10	S5678_064_0	2	3	Non-Preferred Brand			
S5678	064	0		29	10	S5678_064_0	2	5	Specialty			
S5678	064	0		29	10	S5678_064_0	2	4	Injectable			
S5678	065	0		29	10	S5678_065_0	2	4	Injectable			
S5678	065	0		29	10	S5678_065_0	2	3	Non-Preferred Brand			
S5678	065	0		29	10	S5678_065_0	2	2	Preferred Brand			
S5678	065	0		29	10	S5678_065_0	2	1	Preferred Generic			
S5678	065	0		29	10	S5678_065_0	2	5	Specialty			
S5678	066	0		29	10	S5678_066_0	2	4	Injectable			
S5678	066	0		29	10	S5678_066_0	2	3	Non-Preferred Brand			
S5678	066	0		29	10	S5678_066_0	2	2	Preferred Brand			
S5678	066	0		29	10	S5678_066_0	2	1	Preferred Generic			
S5678	066	0		29	10	S5678_066_0	2	5	Specialty			
S5678	067	0		29	10	S5678_067_0	2	1	Preferred Generic			
S5678	067	0		29	10	S5678_067_0	2	2	Preferred Brand			
S5678	067	0		29	10	S5678_067_0	2	3	Non-Preferred Brand			
S5678	067	0		29	10	S5678_067_0	2	4	Injectable			
S5678	067	0		29	10	S5678_067_0	2	5	Specialty			
S5678	068	0		29	10	S5678_068_0	2	1	Preferred Generic			
S5678	068	0		29	10	S5678_068_0	2	2	Preferred Brand			
S5678	068	0		29	10	S5678_068_0	2	4	Injectable			
S5678	068	0		29	10	S5678_068_0	2	3	Non-Preferred Brand			
S5678	068	0		29	10	S5678_068_0	2	5	Specialty			
S5715	001	0		29	10	S5715_001_0	2	2	Preferred Brand			
S5715	001	0		29	10	S5715_001_0	2	3	Brand			
S5715	001	0		29	10	S5715_001_0	2	1	Generic			
S5715	001	0		29	10	S5715_001_0	2	4	Specialty			
S5715	002	0		29	10	S5715_002_0	2	1	Generic			
S5715	002	0		29	10	S5715_002_0	2	3	Brand			
S5715	002	0		29	10	S5715_002_0	2	2	Preferred Brand			
S5715	002	0		29	10	S5715_002_0	2	4	Specialty	1	01000000	2
S5715	002	0		29	10	S5715_002_0	2	3	Brand	2		
S5715	002	0		29	10	S5715_002_0	2	2	Preferred Brand	2		
S5715	002	0		29	10	S5715_002_0	2	4	Specialty			
S5715	002	0		29	10	S5715_002_0	2	1	Generic	1		1
S5715	003	0		29	10	S5715_003_0	2	1	Generic			
S5715	003	0		29	10	S5715_003_0	2	3	Brand			
S5715	003	0		29	10	S5715_003_0	2	2	Preferred Brand			
S5715	003	0		29	10	S5715_003_0	2	4	Specialty			
S5715	004	0		29	10	S5715_004_0	2	3	Brand	2		
S5715	004	0		29	10	S5715_004_0	2	2	Preferred Brand	2		
S5715	004	0		29	10	S5715_004_0	2	1	Generic	1		1
S5715	004	0		29	10	S5715_004_0	2	4	Specialty			
S5715	004	0		29	10	S5715_004_0	2	3	Brand			
S5715	004	0		29	10	S5715_004_0	2	2	Preferred Brand			
S5715	004	0		29	10	S5715_004_0	2	1	Generic			
S5715	004	0		29	10	S5715_004_0	2	4	Specialty	1	01000000	2
S5715	005	0		29	10	S5715_005_0	1	3	Brand			
S5715	005	0		29	10	S5715_005_0	1	2	Preferred Brand			
S5715	005	0		29	10	S5715_005_0	1	1	Generic			
S5715	005	0		29	10	S5715_005_0	1	4	Specialty			
S5715	006	0		29	10	S5715_006_0	2	1	Generic	1		1
S5715	006	0		29	10	S5715_006_0	2	2	Preferred Brand	2		
S5715	006	0		29	10	S5715_006_0	2	3	Brand	2		
S5715	006	0		29	10	S5715_006_0	2	4	Specialty			
S5715	006	0		29	10	S5715_006_0	2	3	Brand			
S5715	006	0		29	10	S5715_006_0	2	2	Preferred Brand			
S5715	006	0		29	10	S5715_006_0	2	1	Generic			
S5715	006	0		29	10	S5715_006_0	2	4	Specialty	1	01000000	2
S5715	007	0		29	10	S5715_007_0	2	1	Generic			
S5715	007	0		29	10	S5715_007_0	2	2	Preferred Brand			
S5715	007	0		29	10	S5715_007_0	2	3	Brand			
S5715	007	0		29	10	S5715_007_0	2	4	Specialty			
S5715	008	0		29	10	S5715_008_0	1	1	Generic			
S5715	008	0		29	10	S5715_008_0	1	2	Preferred Brand			
S5715	008	0		29	10	S5715_008_0	1	4	Specialty			
S5715	008	0		29	10	S5715_008_0	1	3	Brand			
S5715	009	0		29	10	S5715_009_0	1	1	Generic			
S5715	009	0		29	10	S5715_009_0	1	3	Brand			
S5715	009	0		29	10	S5715_009_0	1	2	Preferred Brand			
S5715	009	0		29	10	S5715_009_0	1	4	Specialty			
S5726	013	0		29	10	S5726_013_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5726	013	0		29	10	S5726_013_0	2	4	Tier 4 Non-Specialty Injectable			
S5726	013	0		29	10	S5726_013_0	2	5	Tier 5 Specialty			
S5726	013	0		29	10	S5726_013_0	2	1	Tier 1 Preferred Generic			
S5726	013	0		29	10	S5726_013_0	2	2	Tier 2 Preferred Brand			
S5726	014	0		29	10	S5726_014_0	3	1	Tier 1 Preferred Generic			
S5726	014	0		29	10	S5726_014_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5726	014	0		29	10	S5726_014_0	3	4	Tier 4 Non-Specialty Injectable			
S5726	014	0		29	10	S5726_014_0	3	5	Tier 5 Specialty			
S5726	014	0		29	10	S5726_014_0	3	2	Tier 2 Preferred Brand			
S5726	015	0		29	10	S5726_015_0	3	1	Tier 1 Preferred Generic			
S5726	015	0		29	10	S5726_015_0	3	5	Tier 5 Specialty	2		
S5726	015	0		29	10	S5726_015_0	3	4	Tier 4 Non-Specialty Injectable	2		
S5726	015	0		29	10	S5726_015_0	3	3	Tier 3 Non-Preferred Brand or Generic	2		
S5726	015	0		29	10	S5726_015_0	3	2	Tier 2 Preferred Brand	2		
S5726	015	0		29	10	S5726_015_0	3	1	Tier 1 Preferred Generic	1		1
S5726	015	0		29	10	S5726_015_0	3	5	Tier 5 Specialty			
S5726	015	0		29	10	S5726_015_0	3	2	Tier 2 Preferred Brand			
S5726	015	0		29	10	S5726_015_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5726	015	0		29	10	S5726_015_0	3	4	Tier 4 Non-Specialty Injectable			
S5741	001	0		29	10	S5741_001_0	3	4	Tier 4			
S5741	001	0		29	10	S5741_001_0	3	3	Tier 3			
S5741	001	0		29	10	S5741_001_0	3	1	Tier 1			
S5741	001	0		29	10	S5741_001_0	3	2	Tier 2			
S5741	003	0		29	10	S5741_003_0	2	1	Tier 1			
S5741	003	0		29	10	S5741_003_0	2	2	Tier 2			
S5741	003	0		29	10	S5741_003_0	2	3	Tier 3			
S5741	003	0		29	10	S5741_003_0	2	4	Tier 4			
S5741	003	0		29	10	S5741_003_0	2	1	Tier 1	1		1
S5741	003	0		29	10	S5741_003_0	2	4	Tier 4	2		
S5741	003	0		29	10	S5741_003_0	2	2	Tier 2	2		
S5741	003	0		29	10	S5741_003_0	2	3	Tier 3	2		
S5743	001	0		29	10	S5743_001_0	2	1	Level 1: Covered Generic			
S5743	001	0		29	10	S5743_001_0	2	4	Covered Specialty			
S5743	001	0		29	10	S5743_001_0	2	3	Level 3: Covered Brand			
S5743	001	0		29	10	S5743_001_0	2	2	Level 2: Covered Preferred Brand			
S5743	003	0		29	10	S5743_003_0	5	4	Covered Specialty			
S5743	003	0		29	10	S5743_003_0	5	2	Level 2: Covered Preferred Brand			
S5743	003	0		29	10	S5743_003_0	5	1	Level 1: Covered Generic			
S5743	003	0		29	10	S5743_003_0	5	3	Level 3: Covered Brand			
S5743	004	0		29	10	S5743_004_0	5	4	Covered Specialty	2		
S5743	004	0		29	10	S5743_004_0	5	3	Level 3: Covered Brand	2		
S5743	004	0		29	10	S5743_004_0	5	2	Level 2: Covered Preferred Brand	2		
S5743	004	0		29	10	S5743_004_0	5	1	Level 1: Covered Generic	1		1
S5743	004	0		29	10	S5743_004_0	5	4	Covered Specialty			
S5743	004	0		29	10	S5743_004_0	5	3	Level 3: Covered Brand			
S5743	004	0		29	10	S5743_004_0	5	2	Level 2: Covered Preferred Brand			
S5743	004	0		29	10	S5743_004_0	5	1	Level 1: Covered Generic			
S5753	006	0		29	10	S5753_006_0	6	3	Non-Preferred Brand			
S5753	006	0		29	10	S5753_006_0	6	2	Preferred Brand			
S5753	006	0		29	10	S5753_006_0	6	1	Generic			
S5753	006	0		29	10	S5753_006_0	6	4	Specialty Brand			
S5753	007	0		29	10	S5753_007_0	6	1	Generic	1		1
S5753	007	0		29	10	S5753_007_0	6	2	Preferred Brand	2		
S5753	007	0		29	10	S5753_007_0	6	3	Non-Preferred Brand	2		
S5753	007	0		29	10	S5753_007_0	6	4	Specialty Brand			
S5753	007	0		29	10	S5753_007_0	6	3	Non-Preferred Brand			
S5753	007	0		29	10	S5753_007_0	6	4	Specialty Brand	2		
S5753	007	0		29	10	S5753_007_0	6	1	Generic			
S5753	007	0		29	10	S5753_007_0	6	2	Preferred Brand			
S5755	005	0		29	10	S5755_005_0	1	1	Generic			
S5755	005	0		29	10	S5755_005_0	1	2	Preferred Brand			
S5755	005	0		29	10	S5755_005_0	1	4	Specialty			
S5755	005	0		29	10	S5755_005_0	1	3	Non-Preferred Brand			
S5755	006	0		29	10	S5755_006_0	1	2	Preferred Brand			
S5755	006	0		29	10	S5755_006_0	1	4	Specialty			
S5755	006	0		29	10	S5755_006_0	1	3	Non-Preferred Brand			
S5755	006	0		29	10	S5755_006_0	1	1	Generic			
S5755	007	0		29	10	S5755_007_0	1	2	Preferred Brand			
S5755	007	0		29	10	S5755_007_0	1	1	Generic			
S5755	007	0		29	10	S5755_007_0	1	3	Non-Preferred Brand			
S5755	007	0		29	10	S5755_007_0	1	4	Specialty			
S5755	008	0		29	10	S5755_008_0	1	1	Generic			
S5755	008	0		29	10	S5755_008_0	1	2	Preferred Brand			
S5755	008	0		29	10	S5755_008_0	1	3	Non-Preferred Brand			
S5755	008	0		29	10	S5755_008_0	1	4	Specialty			
S5755	009	0		29	10	S5755_009_0	1	4	Specialty			
S5755	009	0		29	10	S5755_009_0	1	3	Non-Preferred Brand			
S5755	009	0		29	10	S5755_009_0	1	2	Preferred Brand			
S5755	009	0		29	10	S5755_009_0	1	1	Generic			
S5755	010	0		29	10	S5755_010_0	1	3	Non-Preferred Brand			
S5755	010	0		29	10	S5755_010_0	1	4	Specialty			
S5755	010	0		29	10	S5755_010_0	1	2	Preferred Brand			
S5755	010	0		29	10	S5755_010_0	1	1	Generic			
S5755	011	0		29	10	S5755_011_0	1	3	Non-Preferred Brand			
S5755	011	0		29	10	S5755_011_0	1	4	Specialty			
S5755	011	0		29	10	S5755_011_0	1	1	Generic			
S5755	011	0		29	10	S5755_011_0	1	2	Preferred Brand			
S5755	012	0		29	10	S5755_012_0	1	4	Specialty			
S5755	012	0		29	10	S5755_012_0	1	3	Non-Preferred Brand			
S5755	012	0		29	10	S5755_012_0	1	2	Preferred Brand			
S5755	012	0		29	10	S5755_012_0	1	1	Generic			
S5755	013	0		29	10	S5755_013_0	1	3	Non-Preferred Brand			
S5755	013	0		29	10	S5755_013_0	1	2	Preferred Brand			
S5755	013	0		29	10	S5755_013_0	1	1	Generic			
S5755	013	0		29	10	S5755_013_0	1	4	Specialty			
S5755	014	0		29	10	S5755_014_0	1	4	Specialty			
S5755	014	0		29	10	S5755_014_0	1	2	Preferred Brand			
S5755	014	0		29	10	S5755_014_0	1	3	Non-Preferred Brand			
S5755	014	0		29	10	S5755_014_0	1	1	Generic			
S5755	015	0		29	10	S5755_015_0	1	1	Generic			
S5755	015	0		29	10	S5755_015_0	1	2	Preferred Brand			
S5755	015	0		29	10	S5755_015_0	1	3	Non-Preferred Brand			
S5755	015	0		29	10	S5755_015_0	1	4	Specialty			
S5755	016	0		29	10	S5755_016_0	1	1	Generic			
S5755	016	0		29	10	S5755_016_0	1	2	Preferred Brand			
S5755	016	0		29	10	S5755_016_0	1	3	Non-Preferred Brand			
S5755	016	0		29	10	S5755_016_0	1	4	Specialty			
S5755	017	0		29	10	S5755_017_0	1	2	Preferred Brand			
S5755	017	0		29	10	S5755_017_0	1	4	Specialty			
S5755	017	0		29	10	S5755_017_0	1	1	Generic			
S5755	017	0		29	10	S5755_017_0	1	3	Non-Preferred Brand			
S5755	018	0		29	10	S5755_018_0	1	4	Specialty			
S5755	018	0		29	10	S5755_018_0	1	3	Non-Preferred Brand			
S5755	018	0		29	10	S5755_018_0	1	1	Generic			
S5755	018	0		29	10	S5755_018_0	1	2	Preferred Brand			
S5755	019	0		29	10	S5755_019_0	1	2	Preferred Brand			
S5755	019	0		29	10	S5755_019_0	1	3	Non-Preferred Brand			
S5755	019	0		29	10	S5755_019_0	1	4	Specialty			
S5755	019	0		29	10	S5755_019_0	1	1	Generic			
S5755	020	0		29	10	S5755_020_0	1	1	Generic			
S5755	020	0		29	10	S5755_020_0	1	4	Specialty			
S5755	020	0		29	10	S5755_020_0	1	3	Non-Preferred Brand			
S5755	020	0		29	10	S5755_020_0	1	2	Preferred Brand			
S5755	021	0		29	10	S5755_021_0	1	1	Generic			
S5755	021	0		29	10	S5755_021_0	1	2	Preferred Brand			
S5755	021	0		29	10	S5755_021_0	1	3	Non-Preferred Brand			
S5755	021	0		29	10	S5755_021_0	1	4	Specialty			
S5755	022	0		29	10	S5755_022_0	1	1	Generic			
S5755	022	0		29	10	S5755_022_0	1	4	Specialty			
S5755	022	0		29	10	S5755_022_0	1	2	Preferred Brand			
S5755	022	0		29	10	S5755_022_0	1	3	Non-Preferred Brand			
S5755	023	0		29	10	S5755_023_0	1	2	Preferred Brand			
S5755	023	0		29	10	S5755_023_0	1	3	Non-Preferred Brand			
S5755	023	0		29	10	S5755_023_0	1	1	Generic			
S5755	023	0		29	10	S5755_023_0	1	4	Specialty			
S5755	024	0		29	10	S5755_024_0	2	1	Generic			
S5755	024	0		29	10	S5755_024_0	2	3	Non-Preferred Brand			
S5755	024	0		29	10	S5755_024_0	2	4	Specialty			
S5755	024	0		29	10	S5755_024_0	2	2	Preferred Brand			
S5755	025	0		29	10	S5755_025_0	1	4	Specialty			
S5755	025	0		29	10	S5755_025_0	1	3	Non-Preferred Brand			
S5755	025	0		29	10	S5755_025_0	1	1	Generic			
S5755	025	0		29	10	S5755_025_0	1	2	Preferred Brand			
S5755	026	0		29	10	S5755_026_0	1	1	Generic			
S5755	026	0		29	10	S5755_026_0	1	4	Specialty			
S5755	026	0		29	10	S5755_026_0	1	3	Non-Preferred Brand			
S5755	026	0		29	10	S5755_026_0	1	2	Preferred Brand			
S5755	027	0		29	10	S5755_027_0	1	1	Generic			
S5755	027	0		29	10	S5755_027_0	1	4	Specialty			
S5755	027	0		29	10	S5755_027_0	1	2	Preferred Brand			
S5755	027	0		29	10	S5755_027_0	1	3	Non-Preferred Brand			
S5755	028	0		29	10	S5755_028_0	1	1	Generic			
S5755	028	0		29	10	S5755_028_0	1	2	Preferred Brand			
S5755	028	0		29	10	S5755_028_0	1	3	Non-Preferred Brand			
S5755	028	0		29	10	S5755_028_0	1	4	Specialty			
S5755	029	0		29	10	S5755_029_0	1	1	Generic			
S5755	029	0		29	10	S5755_029_0	1	3	Non-Preferred Brand			
S5755	029	0		29	10	S5755_029_0	1	2	Preferred Brand			
S5755	029	0		29	10	S5755_029_0	1	4	Specialty			
S5755	030	0		29	10	S5755_030_0	1	2	Preferred Brand			
S5755	030	0		29	10	S5755_030_0	1	3	Non-Preferred Brand			
S5755	030	0		29	10	S5755_030_0	1	4	Specialty			
S5755	030	0		29	10	S5755_030_0	1	1	Generic			
S5755	031	0		29	10	S5755_031_0	1	4	Specialty			
S5755	031	0		29	10	S5755_031_0	1	3	Non-Preferred Brand			
S5755	031	0		29	10	S5755_031_0	1	1	Generic			
S5755	031	0		29	10	S5755_031_0	1	2	Preferred Brand			
S5755	032	0		29	10	S5755_032_0	1	2	Preferred Brand			
S5755	032	0		29	10	S5755_032_0	1	4	Specialty			
S5755	032	0		29	10	S5755_032_0	1	3	Non-Preferred Brand			
S5755	032	0		29	10	S5755_032_0	1	1	Generic			
S5755	033	0		29	10	S5755_033_0	1	4	Specialty			
S5755	033	0		29	10	S5755_033_0	1	3	Non-Preferred Brand			
S5755	033	0		29	10	S5755_033_0	1	2	Preferred Brand			
S5755	033	0		29	10	S5755_033_0	1	1	Generic			
S5755	034	0		29	10	S5755_034_0	1	1	Generic			
S5755	034	0		29	10	S5755_034_0	1	2	Preferred Brand			
S5755	034	0		29	10	S5755_034_0	1	4	Specialty			
S5755	034	0		29	10	S5755_034_0	1	3	Non-Preferred Brand			
S5755	035	0		29	10	S5755_035_0	1	4	Specialty			
S5755	035	0		29	10	S5755_035_0	1	3	Non-Preferred Brand			
S5755	035	0		29	10	S5755_035_0	1	2	Preferred Brand			
S5755	035	0		29	10	S5755_035_0	1	1	Generic			
S5755	038	0		29	10	S5755_038_0	1	4	Specialty			
S5755	038	0		29	10	S5755_038_0	1	2	Preferred Brand			
S5755	038	0		29	10	S5755_038_0	1	1	Generic			
S5755	038	0		29	10	S5755_038_0	1	3	Non-Preferred Brand			
S5755	039	0		29	10	S5755_039_0	1	1	Generic			
S5755	039	0		29	10	S5755_039_0	1	2	Preferred Brand			
S5755	039	0		29	10	S5755_039_0	1	4	Specialty			
S5755	039	0		29	10	S5755_039_0	1	3	Non-Preferred Brand			
S5755	040	0		29	10	S5755_040_0	1	2	Preferred Brand			
S5755	040	0		29	10	S5755_040_0	1	1	Generic			
S5755	040	0		29	10	S5755_040_0	1	3	Non-Preferred Brand			
S5755	040	0		29	10	S5755_040_0	1	4	Specialty			
S5755	041	0		29	10	S5755_041_0	1	1	Generic			
S5755	041	0		29	10	S5755_041_0	1	2	Preferred Brand			
S5755	041	0		29	10	S5755_041_0	1	4	Specialty			
S5755	041	0		29	10	S5755_041_0	1	3	Non-Preferred Brand			
S5755	042	0		29	10	S5755_042_0	1	1	Generic			
S5755	042	0		29	10	S5755_042_0	1	3	Non-Preferred Brand			
S5755	042	0		29	10	S5755_042_0	1	2	Preferred Brand			
S5755	042	0		29	10	S5755_042_0	1	4	Specialty			
S5755	043	0		29	10	S5755_043_0	1	3	Non-Preferred Brand			
S5755	043	0		29	10	S5755_043_0	1	1	Generic			
S5755	043	0		29	10	S5755_043_0	1	2	Preferred Brand			
S5755	043	0		29	10	S5755_043_0	1	4	Specialty			
S5755	044	0		29	10	S5755_044_0	1	2	Preferred Brand			
S5755	044	0		29	10	S5755_044_0	1	1	Generic			
S5755	044	0		29	10	S5755_044_0	1	3	Non-Preferred Brand			
S5755	044	0		29	10	S5755_044_0	1	4	Specialty			
S5755	045	0		29	10	S5755_045_0	1	4	Specialty			
S5755	045	0		29	10	S5755_045_0	1	3	Non-Preferred Brand			
S5755	045	0		29	10	S5755_045_0	1	1	Generic			
S5755	045	0		29	10	S5755_045_0	1	2	Preferred Brand			
S5755	046	0		29	10	S5755_046_0	1	4	Specialty			
S5755	046	0		29	10	S5755_046_0	1	3	Non-Preferred Brand			
S5755	046	0		29	10	S5755_046_0	1	1	Generic			
S5755	046	0		29	10	S5755_046_0	1	2	Preferred Brand			
S5755	047	0		29	10	S5755_047_0	1	2	Preferred Brand			
S5755	047	0		29	10	S5755_047_0	1	3	Non-Preferred Brand			
S5755	047	0		29	10	S5755_047_0	1	4	Specialty			
S5755	047	0		29	10	S5755_047_0	1	1	Generic			
S5755	048	0		29	10	S5755_048_0	1	4	Specialty			
S5755	048	0		29	10	S5755_048_0	1	3	Non-Preferred Brand			
S5755	048	0		29	10	S5755_048_0	1	2	Preferred Brand			
S5755	048	0		29	10	S5755_048_0	1	1	Generic			
S5755	049	0		29	10	S5755_049_0	1	1	Generic			
S5755	049	0		29	10	S5755_049_0	1	2	Preferred Brand			
S5755	049	0		29	10	S5755_049_0	1	3	Non-Preferred Brand			
S5755	049	0		29	10	S5755_049_0	1	4	Specialty			
S5755	050	0		29	10	S5755_050_0	1	4	Specialty			
S5755	050	0		29	10	S5755_050_0	1	3	Non-Preferred Brand			
S5755	050	0		29	10	S5755_050_0	1	2	Preferred Brand			
S5755	050	0		29	10	S5755_050_0	1	1	Generic			
S5755	051	0		29	10	S5755_051_0	1	1	Generic			
S5755	051	0		29	10	S5755_051_0	1	2	Preferred Brand			
S5755	051	0		29	10	S5755_051_0	1	3	Non-Preferred Brand			
S5755	051	0		29	10	S5755_051_0	1	4	Specialty			
S5755	052	0		29	10	S5755_052_0	1	1	Generic			
S5755	052	0		29	10	S5755_052_0	1	2	Preferred Brand			
S5755	052	0		29	10	S5755_052_0	1	4	Specialty			
S5755	052	0		29	10	S5755_052_0	1	3	Non-Preferred Brand			
S5755	053	0		29	10	S5755_053_0	1	2	Preferred Brand			
S5755	053	0		29	10	S5755_053_0	1	3	Non-Preferred Brand			
S5755	053	0		29	10	S5755_053_0	1	4	Specialty			
S5755	053	0		29	10	S5755_053_0	1	1	Generic			
S5755	054	0		29	10	S5755_054_0	1	4	Specialty			
S5755	054	0		29	10	S5755_054_0	1	2	Preferred Brand			
S5755	054	0		29	10	S5755_054_0	1	3	Non-Preferred Brand			
S5755	054	0		29	10	S5755_054_0	1	1	Generic			
S5755	055	0		29	10	S5755_055_0	1	4	Specialty			
S5755	055	0		29	10	S5755_055_0	1	3	Non-Preferred Brand			
S5755	055	0		29	10	S5755_055_0	1	1	Generic			
S5755	055	0		29	10	S5755_055_0	1	2	Preferred Brand			
S5755	056	0		29	10	S5755_056_0	1	2	Preferred Brand			
S5755	056	0		29	10	S5755_056_0	1	1	Generic			
S5755	056	0		29	10	S5755_056_0	1	3	Non-Preferred Brand			
S5755	056	0		29	10	S5755_056_0	1	4	Specialty			
S5755	057	0		29	10	S5755_057_0	1	4	Specialty			
S5755	057	0		29	10	S5755_057_0	1	3	Non-Preferred Brand			
S5755	057	0		29	10	S5755_057_0	1	2	Preferred Brand			
S5755	057	0		29	10	S5755_057_0	1	1	Generic			
S5755	058	0		29	10	S5755_058_0	1	3	Non-Preferred Brand			
S5755	058	0		29	10	S5755_058_0	1	2	Preferred Brand			
S5755	058	0		29	10	S5755_058_0	1	1	Generic			
S5755	058	0		29	10	S5755_058_0	1	4	Specialty			
S5755	059	0		29	10	S5755_059_0	1	4	Specialty			
S5755	059	0		29	10	S5755_059_0	1	1	Generic			
S5755	059	0		29	10	S5755_059_0	1	2	Preferred Brand			
S5755	059	0		29	10	S5755_059_0	1	3	Non-Preferred Brand			
S5755	060	0		29	10	S5755_060_0	1	1	Generic			
S5755	060	0		29	10	S5755_060_0	1	2	Preferred Brand			
S5755	060	0		29	10	S5755_060_0	1	3	Non-Preferred Brand			
S5755	060	0		29	10	S5755_060_0	1	4	Specialty			
S5755	061	0		29	10	S5755_061_0	1	3	Non-Preferred Brand			
S5755	061	0		29	10	S5755_061_0	1	2	Preferred Brand			
S5755	061	0		29	10	S5755_061_0	1	1	Generic			
S5755	061	0		29	10	S5755_061_0	1	4	Specialty			
S5755	062	0		29	10	S5755_062_0	1	1	Generic			
S5755	062	0		29	10	S5755_062_0	1	2	Preferred Brand			
S5755	062	0		29	10	S5755_062_0	1	3	Non-Preferred Brand			
S5755	062	0		29	10	S5755_062_0	1	4	Specialty			
S5755	063	0		29	10	S5755_063_0	1	1	Generic			
S5755	063	0		29	10	S5755_063_0	1	2	Preferred Brand			
S5755	063	0		29	10	S5755_063_0	1	3	Non-Preferred Brand			
S5755	063	0		29	10	S5755_063_0	1	4	Specialty			
S5755	064	0		29	10	S5755_064_0	1	3	Non-Preferred Brand			
S5755	064	0		29	10	S5755_064_0	1	2	Preferred Brand			
S5755	064	0		29	10	S5755_064_0	1	1	Generic			
S5755	064	0		29	10	S5755_064_0	1	4	Specialty			
S5755	065	0		29	10	S5755_065_0	1	1	Generic			
S5755	065	0		29	10	S5755_065_0	1	2	Preferred Brand			
S5755	065	0		29	10	S5755_065_0	1	3	Non-Preferred Brand			
S5755	065	0		29	10	S5755_065_0	1	4	Specialty			
S5755	066	0		29	10	S5755_066_0	1	1	Generic			
S5755	066	0		29	10	S5755_066_0	1	2	Preferred Brand			
S5755	066	0		29	10	S5755_066_0	1	3	Non-Preferred Brand			
S5755	066	0		29	10	S5755_066_0	1	4	Specialty			
S5755	067	0		29	10	S5755_067_0	1	1	Generic			
S5755	067	0		29	10	S5755_067_0	1	2	Preferred Brand			
S5755	067	0		29	10	S5755_067_0	1	4	Specialty			
S5755	067	0		29	10	S5755_067_0	1	3	Non-Preferred Brand			
S5755	068	0		29	10	S5755_068_0	1	1	Generic			
S5755	068	0		29	10	S5755_068_0	1	2	Preferred Brand			
S5755	068	0		29	10	S5755_068_0	1	3	Non-Preferred Brand			
S5755	068	0		29	10	S5755_068_0	1	4	Specialty			
S5755	069	0		29	10	S5755_069_0	1	1	Generic			
S5755	069	0		29	10	S5755_069_0	1	3	Non-Preferred Brand			
S5755	069	0		29	10	S5755_069_0	1	2	Preferred Brand			
S5755	069	0		29	10	S5755_069_0	1	4	Specialty			
S5755	070	0		29	10	S5755_070_0	1	1	Generic			
S5755	070	0		29	10	S5755_070_0	1	2	Preferred Brand			
S5755	070	0		29	10	S5755_070_0	1	3	Non-Preferred Brand			
S5755	070	0		29	10	S5755_070_0	1	4	Specialty			
S5755	071	0		29	10	S5755_071_0	1	1	Generic			
S5755	071	0		29	10	S5755_071_0	1	2	Preferred Brand			
S5755	071	0		29	10	S5755_071_0	1	3	Non-Preferred Brand			
S5755	071	0		29	10	S5755_071_0	1	4	Specialty			
S5755	072	0		29	10	S5755_072_0	1	4	Specialty			
S5755	072	0		29	10	S5755_072_0	1	1	Generic			
S5755	072	0		29	10	S5755_072_0	1	2	Preferred Brand			
S5755	072	0		29	10	S5755_072_0	1	3	Non-Preferred Brand			
S5766	002	0		29	10	S5766_002_0	4	3	Non-Preferred Brand			
S5766	002	0		29	10	S5766_002_0	4	2	Preferred Brand			
S5766	002	0		29	10	S5766_002_0	4	1	Generic			
S5766	002	0		29	10	S5766_002_0	4	4	Non-Self-Administered Medical Injectables			
S5766	003	0		29	10	S5766_003_0	5	1	Generic	1		1
S5766	003	0		29	10	S5766_003_0	5	2	Preferred Brand	2		
S5766	003	0		29	10	S5766_003_0	5	3	Non-Preferred Brand	2		
S5766	003	0		29	10	S5766_003_0	5	4	Non-Self-Administered Medical Injectables			
S5766	003	0		29	10	S5766_003_0	5	3	Non-Preferred Brand			
S5766	003	0		29	10	S5766_003_0	5	4	Non-Self-Administered Medical Injectables	2		
S5766	003	0		29	10	S5766_003_0	5	1	Generic			
S5766	003	0		29	10	S5766_003_0	5	2	Preferred Brand			
S5768	005	0		29	10	S5768_005_0	3	1	Preferred Generic			
S5768	005	0		29	10	S5768_005_0	3	2	Preferred Brand			
S5768	005	0		29	10	S5768_005_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	005	0		29	10	S5768_005_0	3	4	Specialty-Generic and Brand			
S5768	007	0		29	10	S5768_007_0	3	4	Specialty-Generic and Brand			
S5768	007	0		29	10	S5768_007_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	007	0		29	10	S5768_007_0	3	2	Preferred Brand			
S5768	007	0		29	10	S5768_007_0	3	1	Preferred Generic			
S5768	008	0		29	10	S5768_008_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	008	0		29	10	S5768_008_0	3	4	Specialty-Generic and Brand			
S5768	008	0		29	10	S5768_008_0	3	2	Preferred Brand			
S5768	008	0		29	10	S5768_008_0	3	1	Preferred Generic			
S5768	009	0		29	10	S5768_009_0	2	4	Specialty-Generic and Brand			
S5768	009	0		29	10	S5768_009_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	009	0		29	10	S5768_009_0	2	2	Preferred Brand			
S5768	009	0		29	10	S5768_009_0	2	1	Preferred Generic			
S5768	010	0		29	10	S5768_010_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	010	0		29	10	S5768_010_0	3	4	Specialty-Generic and Brand			
S5768	010	0		29	10	S5768_010_0	3	2	Preferred Brand			
S5768	010	0		29	10	S5768_010_0	3	1	Preferred Generic			
S5768	012	0		29	10	S5768_012_0	3	4	Specialty-Generic and Brand			
S5768	012	0		29	10	S5768_012_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	012	0		29	10	S5768_012_0	3	2	Preferred Brand			
S5768	012	0		29	10	S5768_012_0	3	1	Preferred Generic			
S5768	015	0		29	10	S5768_015_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	015	0		29	10	S5768_015_0	3	4	Specialty-Generic and Brand			
S5768	015	0		29	10	S5768_015_0	3	2	Preferred Brand			
S5768	015	0		29	10	S5768_015_0	3	1	Preferred Generic			
S5768	016	0		29	10	S5768_016_0	3	4	Specialty-Generic and Brand			
S5768	016	0		29	10	S5768_016_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	016	0		29	10	S5768_016_0	3	2	Preferred Brand			
S5768	016	0		29	10	S5768_016_0	3	1	Preferred Generic			
S5768	017	0		29	10	S5768_017_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	017	0		29	10	S5768_017_0	2	4	Specialty-Generic and Brand			
S5768	017	0		29	10	S5768_017_0	2	2	Preferred Brand			
S5768	017	0		29	10	S5768_017_0	2	1	Preferred Generic			
S5768	018	0		29	10	S5768_018_0	3	1	Preferred Generic			
S5768	018	0		29	10	S5768_018_0	3	2	Preferred Brand			
S5768	018	0		29	10	S5768_018_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	018	0		29	10	S5768_018_0	3	4	Specialty-Generic and Brand			
S5768	021	0		29	10	S5768_021_0	3	1	Preferred Generic			
S5768	021	0		29	10	S5768_021_0	3	2	Preferred Brand			
S5768	021	0		29	10	S5768_021_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	021	0		29	10	S5768_021_0	3	4	Specialty-Generic and Brand			
S5768	031	0		29	10	S5768_031_0	3	1	Preferred Generic			
S5768	031	0		29	10	S5768_031_0	3	2	Preferred Brand			
S5768	031	0		29	10	S5768_031_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	031	0		29	10	S5768_031_0	3	4	Specialty-Generic and Brand			
S5768	038	0		29	10	S5768_038_0	2	1	Preferred Generic			
S5768	038	0		29	10	S5768_038_0	2	2	Preferred Brand			
S5768	038	0		29	10	S5768_038_0	2	4	Specialty-Generic and Brand			
S5768	038	0		29	10	S5768_038_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	039	0		29	10	S5768_039_0	2	1	Preferred Generic			
S5768	039	0		29	10	S5768_039_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	039	0		29	10	S5768_039_0	2	2	Preferred Brand			
S5768	039	0		29	10	S5768_039_0	2	4	Specialty-Generic and Brand			
S5768	040	0		29	10	S5768_040_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	040	0		29	10	S5768_040_0	2	2	Preferred Brand			
S5768	040	0		29	10	S5768_040_0	2	1	Preferred Generic			
S5768	040	0		29	10	S5768_040_0	2	4	Specialty-Generic and Brand			
S5768	041	0		29	10	S5768_041_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	041	0		29	10	S5768_041_0	2	2	Preferred Brand			
S5768	041	0		29	10	S5768_041_0	2	1	Preferred Generic			
S5768	041	0		29	10	S5768_041_0	2	4	Specialty-Generic and Brand			
S5768	042	0		29	10	S5768_042_0	3	1	Preferred Generic			
S5768	042	0		29	10	S5768_042_0	3	2	Preferred Brand			
S5768	042	0		29	10	S5768_042_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	042	0		29	10	S5768_042_0	3	4	Specialty-Generic and Brand			
S5768	043	0		29	10	S5768_043_0	2	1	Preferred Generic			
S5768	043	0		29	10	S5768_043_0	2	2	Preferred Brand			
S5768	043	0		29	10	S5768_043_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	043	0		29	10	S5768_043_0	2	4	Specialty-Generic and Brand			
S5768	044	0		29	10	S5768_044_0	2	1	Preferred Generic			
S5768	044	0		29	10	S5768_044_0	2	2	Preferred Brand			
S5768	044	0		29	10	S5768_044_0	2	4	Specialty-Generic and Brand			
S5768	044	0		29	10	S5768_044_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	045	0		29	10	S5768_045_0	3	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	045	0		29	10	S5768_045_0	3	2	Preferred Brand			
S5768	045	0		29	10	S5768_045_0	3	1	Preferred Generic			
S5768	045	0		29	10	S5768_045_0	3	4	Specialty-Generic and Brand			
S5768	046	0		29	10	S5768_046_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	046	0		29	10	S5768_046_0	2	2	Preferred Brand			
S5768	046	0		29	10	S5768_046_0	2	1	Preferred Generic			
S5768	046	0		29	10	S5768_046_0	2	4	Specialty-Generic and Brand			
S5768	047	0		29	10	S5768_047_0	2	1	Preferred Generic			
S5768	047	0		29	10	S5768_047_0	2	2	Preferred Brand			
S5768	047	0		29	10	S5768_047_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	047	0		29	10	S5768_047_0	2	4	Specialty-Generic and Brand			
S5768	048	0		29	10	S5768_048_0	2	1	Preferred Generic			
S5768	048	0		29	10	S5768_048_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	048	0		29	10	S5768_048_0	2	2	Preferred Brand			
S5768	048	0		29	10	S5768_048_0	2	4	Specialty-Generic and Brand			
S5768	082	0		29	10	S5768_082_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	082	0		29	10	S5768_082_0	1	2	Preferred Brand			
S5768	082	0		29	10	S5768_082_0	1	4	Specialty-Generic and Brand			
S5768	082	0		29	10	S5768_082_0	1	1	Preferred Generic			
S5768	083	0		29	10	S5768_083_0	1	1	Preferred Generic			
S5768	083	0		29	10	S5768_083_0	1	2	Preferred Brand			
S5768	083	0		29	10	S5768_083_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	083	0		29	10	S5768_083_0	1	4	Specialty-Generic and Brand			
S5768	084	0		29	10	S5768_084_0	2	1	Preferred Generic			
S5768	084	0		29	10	S5768_084_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	084	0		29	10	S5768_084_0	2	4	Specialty-Generic and Brand			
S5768	084	0		29	10	S5768_084_0	2	2	Preferred Brand			
S5768	085	0		29	10	S5768_085_0	2	4	Specialty-Generic and Brand			
S5768	085	0		29	10	S5768_085_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	085	0		29	10	S5768_085_0	2	1	Preferred Generic			
S5768	085	0		29	10	S5768_085_0	2	2	Preferred Brand			
S5768	086	0		29	10	S5768_086_0	2	4	Specialty-Generic and Brand			
S5768	086	0		29	10	S5768_086_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	086	0		29	10	S5768_086_0	2	2	Preferred Brand			
S5768	086	0		29	10	S5768_086_0	2	1	Preferred Generic			
S5768	087	0		29	10	S5768_087_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	087	0		29	10	S5768_087_0	2	2	Preferred Brand			
S5768	087	0		29	10	S5768_087_0	2	1	Preferred Generic			
S5768	087	0		29	10	S5768_087_0	2	4	Specialty-Generic and Brand			
S5768	088	0		29	10	S5768_088_0	2	1	Preferred Generic			
S5768	088	0		29	10	S5768_088_0	2	2	Preferred Brand			
S5768	088	0		29	10	S5768_088_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	088	0		29	10	S5768_088_0	2	4	Specialty-Generic and Brand			
S5768	089	0		29	10	S5768_089_0	2	2	Preferred Brand			
S5768	089	0		29	10	S5768_089_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	089	0		29	10	S5768_089_0	2	4	Specialty-Generic and Brand			
S5768	089	0		29	10	S5768_089_0	2	1	Preferred Generic			
S5768	090	0		29	10	S5768_090_0	2	1	Preferred Generic			
S5768	090	0		29	10	S5768_090_0	2	2	Preferred Brand			
S5768	090	0		29	10	S5768_090_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	090	0		29	10	S5768_090_0	2	4	Specialty-Generic and Brand			
S5768	091	0		29	10	S5768_091_0	2	4	Specialty-Generic and Brand			
S5768	091	0		29	10	S5768_091_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	091	0		29	10	S5768_091_0	2	1	Preferred Generic			
S5768	091	0		29	10	S5768_091_0	2	2	Preferred Brand			
S5768	092	0		29	10	S5768_092_0	2	2	Preferred Brand			
S5768	092	0		29	10	S5768_092_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	092	0		29	10	S5768_092_0	2	4	Specialty-Generic and Brand			
S5768	092	0		29	10	S5768_092_0	2	1	Preferred Generic			
S5768	093	0		29	10	S5768_093_0	2	1	Preferred Generic			
S5768	093	0		29	10	S5768_093_0	2	2	Preferred Brand			
S5768	093	0		29	10	S5768_093_0	2	4	Specialty-Generic and Brand			
S5768	093	0		29	10	S5768_093_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	094	0		29	10	S5768_094_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	094	0		29	10	S5768_094_0	2	4	Specialty-Generic and Brand			
S5768	094	0		29	10	S5768_094_0	2	2	Preferred Brand			
S5768	094	0		29	10	S5768_094_0	2	1	Preferred Generic			
S5768	095	0		29	10	S5768_095_0	2	1	Preferred Generic			
S5768	095	0		29	10	S5768_095_0	2	2	Preferred Brand			
S5768	095	0		29	10	S5768_095_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	095	0		29	10	S5768_095_0	2	4	Specialty-Generic and Brand			
S5768	096	0		29	10	S5768_096_0	2	2	Preferred Brand			
S5768	096	0		29	10	S5768_096_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	096	0		29	10	S5768_096_0	2	4	Specialty-Generic and Brand			
S5768	096	0		29	10	S5768_096_0	2	1	Preferred Generic			
S5768	097	0		29	10	S5768_097_0	2	1	Preferred Generic			
S5768	097	0		29	10	S5768_097_0	2	2	Preferred Brand			
S5768	097	0		29	10	S5768_097_0	2	4	Specialty-Generic and Brand			
S5768	097	0		29	10	S5768_097_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	098	0		29	10	S5768_098_0	2	1	Preferred Generic			
S5768	098	0		29	10	S5768_098_0	2	2	Preferred Brand			
S5768	098	0		29	10	S5768_098_0	2	4	Specialty-Generic and Brand			
S5768	098	0		29	10	S5768_098_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	099	0		29	10	S5768_099_0	2	1	Preferred Generic			
S5768	099	0		29	10	S5768_099_0	2	2	Preferred Brand			
S5768	099	0		29	10	S5768_099_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	099	0		29	10	S5768_099_0	2	4	Specialty-Generic and Brand			
S5768	100	0		29	10	S5768_100_0	2	1	Preferred Generic			
S5768	100	0		29	10	S5768_100_0	2	2	Preferred Brand			
S5768	100	0		29	10	S5768_100_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	100	0		29	10	S5768_100_0	2	4	Specialty-Generic and Brand			
S5768	101	0		29	10	S5768_101_0	2	1	Preferred Generic			
S5768	101	0		29	10	S5768_101_0	2	2	Preferred Brand			
S5768	101	0		29	10	S5768_101_0	2	4	Specialty-Generic and Brand			
S5768	101	0		29	10	S5768_101_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	102	0		29	10	S5768_102_0	2	1	Preferred Generic			
S5768	102	0		29	10	S5768_102_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	102	0		29	10	S5768_102_0	2	2	Preferred Brand			
S5768	102	0		29	10	S5768_102_0	2	4	Specialty-Generic and Brand			
S5768	103	0		29	10	S5768_103_0	2	1	Preferred Generic			
S5768	103	0		29	10	S5768_103_0	2	2	Preferred Brand			
S5768	103	0		29	10	S5768_103_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	103	0		29	10	S5768_103_0	2	4	Specialty-Generic and Brand			
S5768	104	0		29	10	S5768_104_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	104	0		29	10	S5768_104_0	2	2	Preferred Brand			
S5768	104	0		29	10	S5768_104_0	2	1	Preferred Generic			
S5768	104	0		29	10	S5768_104_0	2	4	Specialty-Generic and Brand			
S5768	105	0		29	10	S5768_105_0	2	1	Preferred Generic			
S5768	105	0		29	10	S5768_105_0	2	2	Preferred Brand			
S5768	105	0		29	10	S5768_105_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	105	0		29	10	S5768_105_0	2	4	Specialty-Generic and Brand			
S5768	106	0		29	10	S5768_106_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	106	0		29	10	S5768_106_0	2	2	Preferred Brand			
S5768	106	0		29	10	S5768_106_0	2	1	Preferred Generic			
S5768	106	0		29	10	S5768_106_0	2	4	Specialty-Generic and Brand			
S5768	107	0		29	10	S5768_107_0	2	1	Preferred Generic			
S5768	107	0		29	10	S5768_107_0	2	2	Preferred Brand			
S5768	107	0		29	10	S5768_107_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	107	0		29	10	S5768_107_0	2	4	Specialty-Generic and Brand			
S5768	108	0		29	10	S5768_108_0	2	1	Preferred Generic			
S5768	108	0		29	10	S5768_108_0	2	2	Preferred Brand			
S5768	108	0		29	10	S5768_108_0	2	4	Specialty-Generic and Brand			
S5768	108	0		29	10	S5768_108_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	109	0		29	10	S5768_109_0	2	1	Preferred Generic			
S5768	109	0		29	10	S5768_109_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	109	0		29	10	S5768_109_0	2	2	Preferred Brand			
S5768	109	0		29	10	S5768_109_0	2	4	Specialty-Generic and Brand			
S5768	110	0		29	10	S5768_110_0	2	1	Preferred Generic			
S5768	110	0		29	10	S5768_110_0	2	2	Preferred Brand			
S5768	110	0		29	10	S5768_110_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	110	0		29	10	S5768_110_0	2	4	Specialty-Generic and Brand			
S5768	111	0		29	10	S5768_111_0	2	1	Preferred Generic			
S5768	111	0		29	10	S5768_111_0	2	2	Preferred Brand			
S5768	111	0		29	10	S5768_111_0	2	4	Specialty-Generic and Brand			
S5768	111	0		29	10	S5768_111_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	112	0		29	10	S5768_112_0	2	4	Specialty-Generic and Brand			
S5768	112	0		29	10	S5768_112_0	2	2	Preferred Brand			
S5768	112	0		29	10	S5768_112_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	112	0		29	10	S5768_112_0	2	1	Preferred Generic			
S5768	113	0		29	10	S5768_113_0	2	4	Specialty-Generic and Brand			
S5768	113	0		29	10	S5768_113_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	113	0		29	10	S5768_113_0	2	2	Preferred Brand			
S5768	113	0		29	10	S5768_113_0	2	1	Preferred Generic			
S5768	114	0		29	10	S5768_114_0	2	1	Preferred Generic			
S5768	114	0		29	10	S5768_114_0	2	2	Preferred Brand			
S5768	114	0		29	10	S5768_114_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	114	0		29	10	S5768_114_0	2	4	Specialty-Generic and Brand			
S5768	115	0		29	10	S5768_115_0	2	4	Specialty-Generic and Brand			
S5768	115	0		29	10	S5768_115_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	115	0		29	10	S5768_115_0	2	2	Preferred Brand			
S5768	115	0		29	10	S5768_115_0	2	1	Preferred Generic			
S5768	116	0		29	10	S5768_116_0	2	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	116	0		29	10	S5768_116_0	2	4	Specialty-Generic and Brand			
S5768	116	0		29	10	S5768_116_0	2	2	Preferred Brand			
S5768	116	0		29	10	S5768_116_0	2	1	Preferred Generic			
S5768	117	0		29	10	S5768_117_0	1	1	Preferred Generic			
S5768	117	0		29	10	S5768_117_0	1	2	Preferred Brand			
S5768	117	0		29	10	S5768_117_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	117	0		29	10	S5768_117_0	1	4	Specialty-Generic and Brand			
S5768	118	0		29	10	S5768_118_0	1	1	Preferred Generic			
S5768	118	0		29	10	S5768_118_0	1	2	Preferred Brand			
S5768	118	0		29	10	S5768_118_0	1	4	Specialty-Generic and Brand			
S5768	118	0		29	10	S5768_118_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	119	0		29	10	S5768_119_0	1	1	Preferred Generic			
S5768	119	0		29	10	S5768_119_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	119	0		29	10	S5768_119_0	1	2	Preferred Brand			
S5768	119	0		29	10	S5768_119_0	1	4	Specialty-Generic and Brand			
S5768	120	0		29	10	S5768_120_0	1	1	Preferred Generic			
S5768	120	0		29	10	S5768_120_0	1	2	Preferred Brand			
S5768	120	0		29	10	S5768_120_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	120	0		29	10	S5768_120_0	1	4	Specialty-Generic and Brand			
S5768	121	0		29	10	S5768_121_0	1	1	Preferred Generic			
S5768	121	0		29	10	S5768_121_0	1	2	Preferred Brand			
S5768	121	0		29	10	S5768_121_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	121	0		29	10	S5768_121_0	1	4	Specialty-Generic and Brand			
S5768	122	0		29	10	S5768_122_0	1	1	Preferred Generic			
S5768	122	0		29	10	S5768_122_0	1	2	Preferred Brand			
S5768	122	0		29	10	S5768_122_0	1	4	Specialty-Generic and Brand			
S5768	122	0		29	10	S5768_122_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	123	0		29	10	S5768_123_0	1	1	Preferred Generic			
S5768	123	0		29	10	S5768_123_0	1	2	Preferred Brand			
S5768	123	0		29	10	S5768_123_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	123	0		29	10	S5768_123_0	1	4	Specialty-Generic and Brand			
S5768	124	0		29	10	S5768_124_0	1	1	Preferred Generic			
S5768	124	0		29	10	S5768_124_0	1	3	Non-Preferred Generic/Non-Preferred Brand			
S5768	124	0		29	10	S5768_124_0	1	2	Preferred Brand			
S5768	124	0		29	10	S5768_124_0	1	4	Specialty-Generic and Brand			
S5775	001	0		29	10	S5775_001_0	6	3	Tier 3			
S5775	001	0		29	10	S5775_001_0	6	2	Tier 2			
S5775	001	0		29	10	S5775_001_0	6	1	Tier 1			
S5775	001	0		29	10	S5775_001_0	6	4	Tier 4			
S5775	002	0		29	10	S5775_002_0	6	3	Tier 3			
S5775	002	0		29	10	S5775_002_0	6	2	Tier 2			
S5775	002	0		29	10	S5775_002_0	6	1	Tier 1			
S5775	002	0		29	10	S5775_002_0	6	4	Tier 4			
S5775	003	0		29	10	S5775_003_0	9	1	Tier 1			
S5775	003	0		29	10	S5775_003_0	9	2	Tier 2			
S5775	003	0		29	10	S5775_003_0	9	3	Tier 3			
S5775	003	0		29	10	S5775_003_0	9	4	Tier 4			
S5775	003	0		29	10	S5775_003_0	9	1	Tier 1	1		1
S5775	003	0		29	10	S5775_003_0	9	2	Tier 2	2		
S5775	003	0		29	10	S5775_003_0	9	3	Tier 3	2		
S5775	003	0		29	10	S5775_003_0	9	4	Tier 4	2		
S5795	002	0		29	10	S5795_002_0	3	3	Non-Preferred Brand			
S5795	002	0		29	10	S5795_002_0	3	2	Preferred Brand			
S5795	002	0		29	10	S5795_002_0	3	1	Generic			
S5795	002	0		29	10	S5795_002_0	3	4	Specialty	2		
S5795	002	0		29	10	S5795_002_0	3	3	Non-Preferred Brand	2		
S5795	002	0		29	10	S5795_002_0	3	2	Preferred Brand	2		
S5795	002	0		29	10	S5795_002_0	3	1	Generic	1		1
S5795	002	0		29	10	S5795_002_0	3	4	Specialty			
S5795	003	0		29	10	S5795_003_0	3	4	Specialty			
S5795	003	0		29	10	S5795_003_0	3	3	Non Preferred Brand			
S5795	003	0		29	10	S5795_003_0	3	1	Generic			
S5795	003	0		29	10	S5795_003_0	3	2	Preferred Brand			
S5795	006	0		29	10	S5795_006_0	3	3	Non-Preferred Brand			
S5795	006	0		29	10	S5795_006_0	3	2	Preferred Brand			
S5795	006	0		29	10	S5795_006_0	3	1	Generic			
S5795	006	0		29	10	S5795_006_0	3	4	Specialty			
S5803	070	0		29	10	S5803_070_0	1	1	Generic			
S5803	070	0		29	10	S5803_070_0	1	3	Non-Preferred Brand			
S5803	070	0		29	10	S5803_070_0	1	2	Preferred Brand			
S5803	071	0		29	10	S5803_071_0	1	2	Preferred Brand			
S5803	071	0		29	10	S5803_071_0	1	1	Generic			
S5803	071	0		29	10	S5803_071_0	1	3	Non-Preferred Brand			
S5803	072	0		29	10	S5803_072_0	1	1	Generic			
S5803	072	0		29	10	S5803_072_0	1	2	Preferred Brand			
S5803	072	0		29	10	S5803_072_0	1	3	Non-Preferred Brand			
S5803	073	0		29	10	S5803_073_0	1	3	Non-Preferred Brand			
S5803	073	0		29	10	S5803_073_0	1	1	Generic			
S5803	073	0		29	10	S5803_073_0	1	2	Preferred Brand			
S5803	074	0		29	10	S5803_074_0	1	3	Non-Preferred Brand			
S5803	074	0		29	10	S5803_074_0	1	2	Preferred Brand			
S5803	074	0		29	10	S5803_074_0	1	1	Generic			
S5803	075	0		29	10	S5803_075_0	1	3	Non-Preferred Brand			
S5803	075	0		29	10	S5803_075_0	1	1	Generic			
S5803	075	0		29	10	S5803_075_0	1	2	Preferred Brand			
S5803	076	0		29	10	S5803_076_0	1	3	Non-Preferred Brand			
S5803	076	0		29	10	S5803_076_0	1	2	Preferred Brand			
S5803	076	0		29	10	S5803_076_0	1	1	Generic			
S5803	077	0		29	10	S5803_077_0	1	3	Non-Preferred Brand			
S5803	077	0		29	10	S5803_077_0	1	1	Generic			
S5803	077	0		29	10	S5803_077_0	1	2	Preferred Brand			
S5803	078	0		29	10	S5803_078_0	1	3	Non-Preferred Brand			
S5803	078	0		29	10	S5803_078_0	1	2	Preferred Brand			
S5803	078	0		29	10	S5803_078_0	1	1	Generic			
S5803	079	0		29	10	S5803_079_0	1	2	Preferred Brand			
S5803	079	0		29	10	S5803_079_0	1	3	Non-Preferred Brand			
S5803	079	0		29	10	S5803_079_0	1	1	Generic			
S5803	080	0		29	10	S5803_080_0	1	2	Preferred Brand			
S5803	080	0		29	10	S5803_080_0	1	1	Generic			
S5803	080	0		29	10	S5803_080_0	1	3	Non-Preferred Brand			
S5803	081	0		29	10	S5803_081_0	1	2	Preferred Brand			
S5803	081	0		29	10	S5803_081_0	1	1	Generic			
S5803	081	0		29	10	S5803_081_0	1	3	Non-Preferred Brand			
S5803	082	0		29	10	S5803_082_0	1	1	Generic			
S5803	082	0		29	10	S5803_082_0	1	2	Preferred Brand			
S5803	082	0		29	10	S5803_082_0	1	3	Non-Preferred Brand			
S5803	083	0		29	10	S5803_083_0	1	1	Generic			
S5803	083	0		29	10	S5803_083_0	1	3	Non-Preferred Brand			
S5803	083	0		29	10	S5803_083_0	1	2	Preferred Brand			
S5803	084	0		29	10	S5803_084_0	1	1	Generic			
S5803	084	0		29	10	S5803_084_0	1	2	Preferred Brand			
S5803	084	0		29	10	S5803_084_0	1	3	Non-Preferred Brand			
S5803	085	0		29	10	S5803_085_0	1	1	Generic			
S5803	085	0		29	10	S5803_085_0	1	2	Preferred Brand			
S5803	085	0		29	10	S5803_085_0	1	3	Non-Preferred Brand			
S5803	086	0		29	10	S5803_086_0	1	1	Generic			
S5803	086	0		29	10	S5803_086_0	1	2	Preferred Brand			
S5803	086	0		29	10	S5803_086_0	1	3	Non-Preferred Brand			
S5803	087	0		29	10	S5803_087_0	1	1	Generic			
S5803	087	0		29	10	S5803_087_0	1	2	Preferred Brand			
S5803	087	0		29	10	S5803_087_0	1	3	Non-Preferred Brand			
S5803	088	0		29	10	S5803_088_0	1	1	Generic			
S5803	088	0		29	10	S5803_088_0	1	2	Preferred Brand			
S5803	088	0		29	10	S5803_088_0	1	3	Non-Preferred Brand			
S5803	089	0		29	10	S5803_089_0	1	1	Generic			
S5803	089	0		29	10	S5803_089_0	1	2	Preferred Brand			
S5803	089	0		29	10	S5803_089_0	1	3	Non-Preferred Brand			
S5803	090	0		29	10	S5803_090_0	1	1	Generic			
S5803	090	0		29	10	S5803_090_0	1	2	Preferred Brand			
S5803	090	0		29	10	S5803_090_0	1	3	Non-Preferred Brand			
S5803	091	0		29	10	S5803_091_0	1	1	Generic			
S5803	091	0		29	10	S5803_091_0	1	2	Preferred Brand			
S5803	091	0		29	10	S5803_091_0	1	3	Non-Preferred Brand			
S5803	092	0		29	10	S5803_092_0	1	1	Generic			
S5803	092	0		29	10	S5803_092_0	1	2	Preferred Brand			
S5803	092	0		29	10	S5803_092_0	1	3	Non-Preferred Brand			
S5803	093	0		29	10	S5803_093_0	1	1	Generic			
S5803	093	0		29	10	S5803_093_0	1	2	Preferred Brand			
S5803	093	0		29	10	S5803_093_0	1	3	Non-Preferred Brand			
S5803	094	0		29	10	S5803_094_0	1	1	Generic			
S5803	094	0		29	10	S5803_094_0	1	2	Preferred Brand			
S5803	094	0		29	10	S5803_094_0	1	3	Non-Preferred Brand			
S5803	095	0		29	10	S5803_095_0	1	1	Generic			
S5803	095	0		29	10	S5803_095_0	1	2	Preferred Brand			
S5803	095	0		29	10	S5803_095_0	1	3	Non-Preferred Brand			
S5803	096	0		29	10	S5803_096_0	1	1	Generic			
S5803	096	0		29	10	S5803_096_0	1	2	Preferred Brand			
S5803	096	0		29	10	S5803_096_0	1	3	Non-Preferred Brand			
S5803	097	0		29	10	S5803_097_0	1	1	Generic			
S5803	097	0		29	10	S5803_097_0	1	2	Preferred Brand			
S5803	097	0		29	10	S5803_097_0	1	3	Non-Preferred Brand			
S5803	098	0		29	10	S5803_098_0	1	1	Generic			
S5803	098	0		29	10	S5803_098_0	1	2	Preferred Brand			
S5803	098	0		29	10	S5803_098_0	1	3	Non-Preferred Brand			
S5803	099	0		29	10	S5803_099_0	1	1	Generic			
S5803	099	0		29	10	S5803_099_0	1	2	Preferred Brand			
S5803	099	0		29	10	S5803_099_0	1	3	Non-Preferred Brand			
S5803	100	0		29	10	S5803_100_0	1	1	Generic			
S5803	100	0		29	10	S5803_100_0	1	2	Preferred Brand			
S5803	100	0		29	10	S5803_100_0	1	3	Non-Preferred Brand			
S5803	101	0		29	10	S5803_101_0	1	2	Preferred Brand			
S5803	101	0		29	10	S5803_101_0	1	1	Generic			
S5803	101	0		29	10	S5803_101_0	1	3	Non-Preferred Brand			
S5803	102	0		29	10	S5803_102_0	1	2	Preferred Brand			
S5803	102	0		29	10	S5803_102_0	1	3	Non-Preferred Brand			
S5803	102	0		29	10	S5803_102_0	1	1	Generic			
S5803	103	0		29	10	S5803_103_0	1	2	Preferred Brand			
S5803	103	0		29	10	S5803_103_0	1	1	Generic			
S5803	103	0		29	10	S5803_103_0	1	3	Non-Preferred Brand			
S5803	138	0		29	10	S5803_138_0	1	3	Non-Preferred Brand			
S5803	138	0		29	10	S5803_138_0	1	4	Specialty			
S5803	138	0		29	10	S5803_138_0	1	1	Generic			
S5803	138	0		29	10	S5803_138_0	1	2	Preferred Brand			
S5803	139	0		29	10	S5803_139_0	1	2	Preferred Brand			
S5803	139	0		29	10	S5803_139_0	1	3	Non-Preferred Brand			
S5803	139	0		29	10	S5803_139_0	1	4	Specialty			
S5803	139	0		29	10	S5803_139_0	1	1	Generic			
S5803	140	0		29	10	S5803_140_0	1	1	Generic			
S5803	140	0		29	10	S5803_140_0	1	2	Preferred Brand			
S5803	140	0		29	10	S5803_140_0	1	3	Non-Preferred Brand			
S5803	140	0		29	10	S5803_140_0	1	4	Specialty			
S5803	141	0		29	10	S5803_141_0	1	3	Non-Preferred Brand			
S5803	141	0		29	10	S5803_141_0	1	4	Specialty			
S5803	141	0		29	10	S5803_141_0	1	2	Preferred Brand			
S5803	141	0		29	10	S5803_141_0	1	1	Generic			
S5803	142	0		29	10	S5803_142_0	1	4	Specialty			
S5803	142	0		29	10	S5803_142_0	1	3	Non-Preferred Brand			
S5803	142	0		29	10	S5803_142_0	1	2	Preferred Brand			
S5803	142	0		29	10	S5803_142_0	1	1	Generic			
S5803	143	0		29	10	S5803_143_0	1	3	Non-Preferred Brand			
S5803	143	0		29	10	S5803_143_0	1	2	Preferred Brand			
S5803	143	0		29	10	S5803_143_0	1	1	Generic			
S5803	143	0		29	10	S5803_143_0	1	4	Specialty			
S5803	144	0		29	10	S5803_144_0	1	1	Generic			
S5803	144	0		29	10	S5803_144_0	1	2	Preferred Brand			
S5803	144	0		29	10	S5803_144_0	1	4	Specialty			
S5803	144	0		29	10	S5803_144_0	1	3	Non-Preferred Brand			
S5803	145	0		29	10	S5803_145_0	1	3	Non-Preferred Brand			
S5803	145	0		29	10	S5803_145_0	1	2	Preferred Brand			
S5803	145	0		29	10	S5803_145_0	1	1	Generic			
S5803	145	0		29	10	S5803_145_0	1	4	Specialty			
S5803	146	0		29	10	S5803_146_0	1	3	Non-Preferred Brand			
S5803	146	0		29	10	S5803_146_0	1	2	Preferred Brand			
S5803	146	0		29	10	S5803_146_0	1	1	Generic			
S5803	146	0		29	10	S5803_146_0	1	4	Specialty			
S5803	147	0		29	10	S5803_147_0	1	1	Generic			
S5803	147	0		29	10	S5803_147_0	1	2	Preferred Brand			
S5803	147	0		29	10	S5803_147_0	1	3	Non-Preferred Brand			
S5803	147	0		29	10	S5803_147_0	1	4	Specialty			
S5803	148	0		29	10	S5803_148_0	1	4	Specialty			
S5803	148	0		29	10	S5803_148_0	1	1	Generic			
S5803	148	0		29	10	S5803_148_0	1	3	Non-Preferred Brand			
S5803	148	0		29	10	S5803_148_0	1	2	Preferred Brand			
S5803	149	0		29	10	S5803_149_0	1	1	Generic			
S5803	149	0		29	10	S5803_149_0	1	2	Preferred Brand			
S5803	149	0		29	10	S5803_149_0	1	3	Non-Preferred Brand			
S5803	149	0		29	10	S5803_149_0	1	4	Specialty			
S5803	150	0		29	10	S5803_150_0	1	1	Generic			
S5803	150	0		29	10	S5803_150_0	1	3	Non-Preferred Brand			
S5803	150	0		29	10	S5803_150_0	1	4	Specialty			
S5803	150	0		29	10	S5803_150_0	1	2	Preferred Brand			
S5803	151	0		29	10	S5803_151_0	1	3	Non-Preferred Brand			
S5803	151	0		29	10	S5803_151_0	1	4	Specialty			
S5803	151	0		29	10	S5803_151_0	1	2	Preferred Brand			
S5803	151	0		29	10	S5803_151_0	1	1	Generic			
S5803	152	0		29	10	S5803_152_0	1	3	Non-Preferred Brand			
S5803	152	0		29	10	S5803_152_0	1	4	Specialty			
S5803	152	0		29	10	S5803_152_0	1	1	Generic			
S5803	152	0		29	10	S5803_152_0	1	2	Preferred Brand			
S5803	153	0		29	10	S5803_153_0	1	2	Preferred Brand			
S5803	153	0		29	10	S5803_153_0	1	3	Non-Preferred Brand			
S5803	153	0		29	10	S5803_153_0	1	1	Generic			
S5803	153	0		29	10	S5803_153_0	1	4	Specialty			
S5803	154	0		29	10	S5803_154_0	1	3	Non-Preferred Brand			
S5803	154	0		29	10	S5803_154_0	1	2	Preferred Brand			
S5803	154	0		29	10	S5803_154_0	1	1	Generic			
S5803	154	0		29	10	S5803_154_0	1	4	Specialty			
S5803	155	0		29	10	S5803_155_0	1	1	Generic			
S5803	155	0		29	10	S5803_155_0	1	2	Preferred Brand			
S5803	155	0		29	10	S5803_155_0	1	3	Non-Preferred Brand			
S5803	155	0		29	10	S5803_155_0	1	4	Specialty			
S5803	156	0		29	10	S5803_156_0	1	1	Generic			
S5803	156	0		29	10	S5803_156_0	1	2	Preferred Brand			
S5803	156	0		29	10	S5803_156_0	1	3	Non-Preferred Brand			
S5803	156	0		29	10	S5803_156_0	1	4	Specialty			
S5803	157	0		29	10	S5803_157_0	1	1	Generic			
S5803	157	0		29	10	S5803_157_0	1	2	Preferred Brand			
S5803	157	0		29	10	S5803_157_0	1	4	Specialty			
S5803	157	0		29	10	S5803_157_0	1	3	Non-Preferred Brand			
S5803	158	0		29	10	S5803_158_0	1	1	Generic			
S5803	158	0		29	10	S5803_158_0	1	2	Preferred Brand			
S5803	158	0		29	10	S5803_158_0	1	3	Non-Preferred Brand			
S5803	158	0		29	10	S5803_158_0	1	4	Specialty			
S5803	159	0		29	10	S5803_159_0	1	1	Generic			
S5803	159	0		29	10	S5803_159_0	1	3	Non-Preferred Brand			
S5803	159	0		29	10	S5803_159_0	1	2	Preferred Brand			
S5803	159	0		29	10	S5803_159_0	1	4	Specialty			
S5803	160	0		29	10	S5803_160_0	1	2	Preferred Brand			
S5803	160	0		29	10	S5803_160_0	1	1	Generic			
S5803	160	0		29	10	S5803_160_0	1	3	Non-Preferred Brand			
S5803	160	0		29	10	S5803_160_0	1	4	Specialty			
S5803	161	0		29	10	S5803_161_0	1	3	Non-Preferred Brand			
S5803	161	0		29	10	S5803_161_0	1	2	Preferred Brand			
S5803	161	0		29	10	S5803_161_0	1	1	Generic			
S5803	161	0		29	10	S5803_161_0	1	4	Specialty			
S5803	162	0		29	10	S5803_162_0	1	2	Preferred Brand			
S5803	162	0		29	10	S5803_162_0	1	3	Non-Preferred Brand			
S5803	162	0		29	10	S5803_162_0	1	4	Specialty			
S5803	162	0		29	10	S5803_162_0	1	1	Generic			
S5803	163	0		29	10	S5803_163_0	1	4	Specialty			
S5803	163	0		29	10	S5803_163_0	1	3	Non-Preferred Brand			
S5803	163	0		29	10	S5803_163_0	1	2	Preferred Brand			
S5803	163	0		29	10	S5803_163_0	1	1	Generic			
S5803	164	0		29	10	S5803_164_0	1	1	Generic			
S5803	164	0		29	10	S5803_164_0	1	2	Preferred Brand			
S5803	164	0		29	10	S5803_164_0	1	3	Non-Preferred Brand			
S5803	164	0		29	10	S5803_164_0	1	4	Specialty			
S5803	165	0		29	10	S5803_165_0	1	4	Specialty			
S5803	165	0		29	10	S5803_165_0	1	3	Non-Preferred Brand			
S5803	165	0		29	10	S5803_165_0	1	2	Preferred Brand			
S5803	165	0		29	10	S5803_165_0	1	1	Generic			
S5803	166	0		29	10	S5803_166_0	1	3	Non-Preferred Brand			
S5803	166	0		29	10	S5803_166_0	1	4	Specialty			
S5803	166	0		29	10	S5803_166_0	1	2	Preferred Brand			
S5803	166	0		29	10	S5803_166_0	1	1	Generic			
S5803	167	0		29	10	S5803_167_0	1	4	Specialty			
S5803	167	0		29	10	S5803_167_0	1	3	Non-Preferred Brand			
S5803	167	0		29	10	S5803_167_0	1	2	Preferred Brand			
S5803	167	0		29	10	S5803_167_0	1	1	Generic			
S5803	168	0		29	10	S5803_168_0	1	1	Generic			
S5803	168	0		29	10	S5803_168_0	1	2	Preferred Brand			
S5803	168	0		29	10	S5803_168_0	1	4	Specialty			
S5803	168	0		29	10	S5803_168_0	1	3	Non-Preferred Brand			
S5803	169	0		29	10	S5803_169_0	1	1	Generic			
S5803	169	0		29	10	S5803_169_0	1	2	Preferred Brand			
S5803	169	0		29	10	S5803_169_0	1	3	Non-Preferred Brand			
S5803	169	0		29	10	S5803_169_0	1	4	Specialty			
S5803	170	0		29	10	S5803_170_0	1	1	Generic			
S5803	170	0		29	10	S5803_170_0	1	2	Preferred Brand			
S5803	170	0		29	10	S5803_170_0	1	3	Non-Preferred Brand			
S5803	170	0		29	10	S5803_170_0	1	4	Specialty			
S5803	171	0		29	10	S5803_171_0	1	1	Generic			
S5803	171	0		29	10	S5803_171_0	1	2	Preferred Brand			
S5803	171	0		29	10	S5803_171_0	1	3	Non-Preferred Brand			
S5803	171	0		29	10	S5803_171_0	1	4	Specialty			
S5803	210	0		29	10	S5803_210_0	1	1	Generic			
S5803	210	0		29	10	S5803_210_0	1	2	Preferred Brand			
S5803	210	0		29	10	S5803_210_0	1	3	Non-Preferred Brand			
S5803	211	0		29	10	S5803_211_0	1	1	Generic			
S5803	211	0		29	10	S5803_211_0	1	2	Preferred Brand			
S5803	211	0		29	10	S5803_211_0	1	3	Non-Preferred Brand			
S5803	214	0		29	10	S5803_214_0	1	1	Generic			
S5803	214	0		29	10	S5803_214_0	1	2	Preferred Brand			
S5803	214	0		29	10	S5803_214_0	1	3	Non-Preferred Brand			
S5803	214	0		29	10	S5803_214_0	1	4	Specialty			
S5803	215	0		29	10	S5803_215_0	1	1	Generic			
S5803	215	0		29	10	S5803_215_0	1	4	Specialty			
S5803	215	0		29	10	S5803_215_0	1	3	Non-Preferred Brand			
S5803	215	0		29	10	S5803_215_0	1	2	Preferred Brand			
S5803	218	0		29	10	S5803_218_0	1	1	Generic			
S5803	218	0		29	10	S5803_218_0	1	2	Preferred Brand			
S5803	218	0		29	10	S5803_218_0	1	3	Non-Preferred Brand			
S5803	218	0		29	10	S5803_218_0	1	4	Specialty			
S5803	218	0		29	10	S5803_218_0	1	2	Preferred Brand	2		
S5803	218	0		29	10	S5803_218_0	1	3	Non-Preferred Brand	2		
S5803	218	0		29	10	S5803_218_0	1	4	Specialty	2		
S5803	218	0		29	10	S5803_218_0	1	1	Generic	1		1
S5803	219	0		29	10	S5803_219_0	1	1	Generic			
S5803	219	0		29	10	S5803_219_0	1	4	Specialty	2		
S5803	219	0		29	10	S5803_219_0	1	3	Non-Preferred Brand	2		
S5803	219	0		29	10	S5803_219_0	1	2	Preferred Brand	2		
S5803	219	0		29	10	S5803_219_0	1	1	Generic	1		1
S5803	219	0		29	10	S5803_219_0	1	4	Specialty			
S5803	219	0		29	10	S5803_219_0	1	3	Non-Preferred Brand			
S5803	219	0		29	10	S5803_219_0	1	2	Preferred Brand			
S5803	220	0		29	10	S5803_220_0	1	3	Non-Preferred Brand			
S5803	220	0		29	10	S5803_220_0	1	2	Preferred Brand			
S5803	220	0		29	10	S5803_220_0	1	4	Specialty	2		
S5803	220	0		29	10	S5803_220_0	1	3	Non-Preferred Brand	2		
S5803	220	0		29	10	S5803_220_0	1	2	Preferred Brand	2		
S5803	220	0		29	10	S5803_220_0	1	1	Generic	1		1
S5803	220	0		29	10	S5803_220_0	1	4	Specialty			
S5803	220	0		29	10	S5803_220_0	1	1	Generic			
S5803	221	0		29	10	S5803_221_0	1	3	Non-Preferred Brand			
S5803	221	0		29	10	S5803_221_0	1	2	Preferred Brand			
S5803	221	0		29	10	S5803_221_0	1	3	Non-Preferred Brand	2		
S5803	221	0		29	10	S5803_221_0	1	2	Preferred Brand	2		
S5803	221	0		29	10	S5803_221_0	1	1	Generic	1		1
S5803	221	0		29	10	S5803_221_0	1	4	Specialty	2		
S5803	221	0		29	10	S5803_221_0	1	1	Generic			
S5803	221	0		29	10	S5803_221_0	1	4	Specialty			
S5803	222	0		29	10	S5803_222_0	1	3	Non-Preferred Brand			
S5803	222	0		29	10	S5803_222_0	1	2	Preferred Brand			
S5803	222	0		29	10	S5803_222_0	1	1	Generic			
S5803	222	0		29	10	S5803_222_0	1	4	Specialty	2		
S5803	222	0		29	10	S5803_222_0	1	3	Non-Preferred Brand	2		
S5803	222	0		29	10	S5803_222_0	1	2	Preferred Brand	2		
S5803	222	0		29	10	S5803_222_0	1	4	Specialty			
S5803	222	0		29	10	S5803_222_0	1	1	Generic	1		1
S5803	223	0		29	10	S5803_223_0	1	1	Generic			
S5803	223	0		29	10	S5803_223_0	1	2	Preferred Brand			
S5803	223	0		29	10	S5803_223_0	1	3	Non-Preferred Brand			
S5803	223	0		29	10	S5803_223_0	1	4	Specialty			
S5803	223	0		29	10	S5803_223_0	1	1	Generic	1		1
S5803	223	0		29	10	S5803_223_0	1	2	Preferred Brand	2		
S5803	223	0		29	10	S5803_223_0	1	3	Non-Preferred Brand	2		
S5803	223	0		29	10	S5803_223_0	1	4	Specialty	2		
S5803	224	0		29	10	S5803_224_0	1	3	Non-Preferred Brand	2		
S5803	224	0		29	10	S5803_224_0	1	2	Preferred Brand	2		
S5803	224	0		29	10	S5803_224_0	1	4	Specialty	2		
S5803	224	0		29	10	S5803_224_0	1	1	Generic			
S5803	224	0		29	10	S5803_224_0	1	2	Preferred Brand			
S5803	224	0		29	10	S5803_224_0	1	3	Non-Preferred Brand			
S5803	224	0		29	10	S5803_224_0	1	4	Specialty			
S5803	224	0		29	10	S5803_224_0	1	1	Generic	1		1
S5803	225	0		29	10	S5803_225_0	1	1	Generic			
S5803	225	0		29	10	S5803_225_0	1	3	Non-Preferred Brand	2		
S5803	225	0		29	10	S5803_225_0	1	2	Preferred Brand	2		
S5803	225	0		29	10	S5803_225_0	1	1	Generic	1		1
S5803	225	0		29	10	S5803_225_0	1	4	Specialty			
S5803	225	0		29	10	S5803_225_0	1	3	Non-Preferred Brand			
S5803	225	0		29	10	S5803_225_0	1	2	Preferred Brand			
S5803	225	0		29	10	S5803_225_0	1	4	Specialty	2		
S5803	226	0		29	10	S5803_226_0	1	3	Non-Preferred Brand	2		
S5803	226	0		29	10	S5803_226_0	1	2	Preferred Brand	2		
S5803	226	0		29	10	S5803_226_0	1	1	Generic	1		1
S5803	226	0		29	10	S5803_226_0	1	4	Specialty			
S5803	226	0		29	10	S5803_226_0	1	3	Non-Preferred Brand			
S5803	226	0		29	10	S5803_226_0	1	2	Preferred Brand			
S5803	226	0		29	10	S5803_226_0	1	1	Generic			
S5803	226	0		29	10	S5803_226_0	1	4	Specialty	2		
S5803	227	0		29	10	S5803_227_0	1	3	Non-Preferred Brand			
S5803	227	0		29	10	S5803_227_0	1	2	Preferred Brand			
S5803	227	0		29	10	S5803_227_0	1	1	Generic			
S5803	227	0		29	10	S5803_227_0	1	4	Specialty			
S5803	227	0		29	10	S5803_227_0	1	1	Generic	1		1
S5803	227	0		29	10	S5803_227_0	1	2	Preferred Brand	2		
S5803	227	0		29	10	S5803_227_0	1	3	Non-Preferred Brand	2		
S5803	227	0		29	10	S5803_227_0	1	4	Specialty	2		
S5803	228	0		29	10	S5803_228_0	1	3	Non-Preferred Brand			
S5803	228	0		29	10	S5803_228_0	1	2	Preferred Brand			
S5803	228	0		29	10	S5803_228_0	1	1	Generic			
S5803	228	0		29	10	S5803_228_0	1	4	Specialty			
S5803	228	0		29	10	S5803_228_0	1	4	Specialty	2		
S5803	228	0		29	10	S5803_228_0	1	3	Non-Preferred Brand	2		
S5803	228	0		29	10	S5803_228_0	1	2	Preferred Brand	2		
S5803	228	0		29	10	S5803_228_0	1	1	Generic	1		1
S5803	229	0		29	10	S5803_229_0	1	1	Generic			
S5803	229	0		29	10	S5803_229_0	1	2	Preferred Brand			
S5803	229	0		29	10	S5803_229_0	1	3	Non-Preferred Brand			
S5803	229	0		29	10	S5803_229_0	1	3	Non-Preferred Brand	2		
S5803	229	0		29	10	S5803_229_0	1	2	Preferred Brand	2		
S5803	229	0		29	10	S5803_229_0	1	1	Generic	1		1
S5803	229	0		29	10	S5803_229_0	1	4	Specialty			
S5803	229	0		29	10	S5803_229_0	1	4	Specialty	2		
S5803	230	0		29	10	S5803_230_0	1	1	Generic	1		1
S5803	230	0		29	10	S5803_230_0	1	2	Preferred Brand	2		
S5803	230	0		29	10	S5803_230_0	1	3	Non-Preferred Brand	2		
S5803	230	0		29	10	S5803_230_0	1	4	Specialty	2		
S5803	230	0		29	10	S5803_230_0	1	1	Generic			
S5803	230	0		29	10	S5803_230_0	1	2	Preferred Brand			
S5803	230	0		29	10	S5803_230_0	1	3	Non-Preferred Brand			
S5803	230	0		29	10	S5803_230_0	1	4	Specialty			
S5803	231	0		29	10	S5803_231_0	1	3	Non-Preferred Brand			
S5803	231	0		29	10	S5803_231_0	1	2	Preferred Brand			
S5803	231	0		29	10	S5803_231_0	1	1	Generic			
S5803	231	0		29	10	S5803_231_0	1	4	Specialty			
S5803	231	0		29	10	S5803_231_0	1	4	Specialty	2		
S5803	231	0		29	10	S5803_231_0	1	3	Non-Preferred Brand	2		
S5803	231	0		29	10	S5803_231_0	1	2	Preferred Brand	2		
S5803	231	0		29	10	S5803_231_0	1	1	Generic	1		1
S5803	232	0		29	10	S5803_232_0	1	1	Generic			
S5803	232	0		29	10	S5803_232_0	1	2	Preferred Brand			
S5803	232	0		29	10	S5803_232_0	1	3	Non-Preferred Brand			
S5803	232	0		29	10	S5803_232_0	1	3	Non-Preferred Brand	2		
S5803	232	0		29	10	S5803_232_0	1	2	Preferred Brand	2		
S5803	232	0		29	10	S5803_232_0	1	1	Generic	1		1
S5803	232	0		29	10	S5803_232_0	1	4	Specialty			
S5803	232	0		29	10	S5803_232_0	1	4	Specialty	2		
S5803	233	0		29	10	S5803_233_0	1	3	Non-Preferred Brand			
S5803	233	0		29	10	S5803_233_0	1	2	Preferred Brand			
S5803	233	0		29	10	S5803_233_0	1	1	Generic			
S5803	233	0		29	10	S5803_233_0	1	4	Specialty			
S5803	233	0		29	10	S5803_233_0	1	4	Specialty	2		
S5803	233	0		29	10	S5803_233_0	1	3	Non-Preferred Brand	2		
S5803	233	0		29	10	S5803_233_0	1	2	Preferred Brand	2		
S5803	233	0		29	10	S5803_233_0	1	1	Generic	1		1
S5803	234	0		29	10	S5803_234_0	1	3	Non-Preferred Brand			
S5803	234	0		29	10	S5803_234_0	1	2	Preferred Brand			
S5803	234	0		29	10	S5803_234_0	1	1	Generic			
S5803	234	0		29	10	S5803_234_0	1	4	Specialty			
S5803	234	0		29	10	S5803_234_0	1	1	Generic	1		1
S5803	234	0		29	10	S5803_234_0	1	2	Preferred Brand	2		
S5803	234	0		29	10	S5803_234_0	1	3	Non-Preferred Brand	2		
S5803	234	0		29	10	S5803_234_0	1	4	Specialty	2		
S5803	235	0		29	10	S5803_235_0	1	3	Non-Preferred Brand			
S5803	235	0		29	10	S5803_235_0	1	2	Preferred Brand			
S5803	235	0		29	10	S5803_235_0	1	1	Generic			
S5803	235	0		29	10	S5803_235_0	1	4	Specialty			
S5803	235	0		29	10	S5803_235_0	1	4	Specialty	2		
S5803	235	0		29	10	S5803_235_0	1	3	Non-Preferred Brand	2		
S5803	235	0		29	10	S5803_235_0	1	2	Preferred Brand	2		
S5803	235	0		29	10	S5803_235_0	1	1	Generic	1		1
S5803	236	0		29	10	S5803_236_0	1	1	Generic			
S5803	236	0		29	10	S5803_236_0	1	2	Preferred Brand			
S5803	236	0		29	10	S5803_236_0	1	3	Non-Preferred Brand			
S5803	236	0		29	10	S5803_236_0	1	4	Specialty			
S5803	236	0		29	10	S5803_236_0	1	1	Generic	1		1
S5803	236	0		29	10	S5803_236_0	1	2	Preferred Brand	2		
S5803	236	0		29	10	S5803_236_0	1	3	Non-Preferred Brand	2		
S5803	236	0		29	10	S5803_236_0	1	4	Specialty	2		
S5803	237	0		29	10	S5803_237_0	1	1	Generic			
S5803	237	0		29	10	S5803_237_0	1	2	Preferred Brand			
S5803	237	0		29	10	S5803_237_0	1	3	Non-Preferred Brand			
S5803	237	0		29	10	S5803_237_0	1	4	Specialty			
S5803	237	0		29	10	S5803_237_0	1	1	Generic	1		1
S5803	237	0		29	10	S5803_237_0	1	2	Preferred Brand	2		
S5803	237	0		29	10	S5803_237_0	1	3	Non-Preferred Brand	2		
S5803	237	0		29	10	S5803_237_0	1	4	Specialty	2		
S5803	238	0		29	10	S5803_238_0	1	1	Generic	1		1
S5803	238	0		29	10	S5803_238_0	1	2	Preferred Brand	2		
S5803	238	0		29	10	S5803_238_0	1	3	Non-Preferred Brand	2		
S5803	238	0		29	10	S5803_238_0	1	4	Specialty			
S5803	238	0		29	10	S5803_238_0	1	1	Generic			
S5803	238	0		29	10	S5803_238_0	1	2	Preferred Brand			
S5803	238	0		29	10	S5803_238_0	1	3	Non-Preferred Brand			
S5803	238	0		29	10	S5803_238_0	1	4	Specialty	2		
S5803	239	0		29	10	S5803_239_0	1	1	Generic			
S5803	239	0		29	10	S5803_239_0	1	2	Preferred Brand			
S5803	239	0		29	10	S5803_239_0	1	3	Non-Preferred Brand			
S5803	239	0		29	10	S5803_239_0	1	4	Specialty			
S5803	239	0		29	10	S5803_239_0	1	1	Generic	1		1
S5803	239	0		29	10	S5803_239_0	1	2	Preferred Brand	2		
S5803	239	0		29	10	S5803_239_0	1	3	Non-Preferred Brand	2		
S5803	239	0		29	10	S5803_239_0	1	4	Specialty	2		
S5803	240	0		29	10	S5803_240_0	1	1	Generic			
S5803	240	0		29	10	S5803_240_0	1	2	Preferred Brand			
S5803	240	0		29	10	S5803_240_0	1	3	Non-Preferred Brand			
S5803	240	0		29	10	S5803_240_0	1	4	Specialty	2		
S5803	240	0		29	10	S5803_240_0	1	1	Generic	1		1
S5803	240	0		29	10	S5803_240_0	1	2	Preferred Brand	2		
S5803	240	0		29	10	S5803_240_0	1	3	Non-Preferred Brand	2		
S5803	240	0		29	10	S5803_240_0	1	4	Specialty			
S5803	241	0		29	10	S5803_241_0	1	1	Generic			
S5803	241	0		29	10	S5803_241_0	1	2	Preferred Brand			
S5803	241	0		29	10	S5803_241_0	1	3	Non-Preferred Brand			
S5803	241	0		29	10	S5803_241_0	1	4	Specialty	2		
S5803	241	0		29	10	S5803_241_0	1	1	Generic	1		1
S5803	241	0		29	10	S5803_241_0	1	2	Preferred Brand	2		
S5803	241	0		29	10	S5803_241_0	1	3	Non-Preferred Brand	2		
S5803	241	0		29	10	S5803_241_0	1	4	Specialty			
S5803	242	0		29	10	S5803_242_0	1	1	Generic			
S5803	242	0		29	10	S5803_242_0	1	2	Preferred Brand			
S5803	242	0		29	10	S5803_242_0	1	3	Non-Preferred Brand			
S5803	242	0		29	10	S5803_242_0	1	4	Specialty	2		
S5803	242	0		29	10	S5803_242_0	1	1	Generic	1		1
S5803	242	0		29	10	S5803_242_0	1	2	Preferred Brand	2		
S5803	242	0		29	10	S5803_242_0	1	3	Non-Preferred Brand	2		
S5803	242	0		29	10	S5803_242_0	1	4	Specialty			
S5803	243	0		29	10	S5803_243_0	1	1	Generic			
S5803	243	0		29	10	S5803_243_0	1	2	Preferred Brand			
S5803	243	0		29	10	S5803_243_0	1	3	Non-Preferred Brand			
S5803	243	0		29	10	S5803_243_0	1	4	Specialty	2		
S5803	243	0		29	10	S5803_243_0	1	1	Generic	1		1
S5803	243	0		29	10	S5803_243_0	1	2	Preferred Brand	2		
S5803	243	0		29	10	S5803_243_0	1	3	Non-Preferred Brand	2		
S5803	243	0		29	10	S5803_243_0	1	4	Specialty			
S5803	244	0		29	10	S5803_244_0	1	1	Generic			
S5803	244	0		29	10	S5803_244_0	1	2	Preferred Brand			
S5803	244	0		29	10	S5803_244_0	1	3	Non-Preferred Brand			
S5803	244	0		29	10	S5803_244_0	1	4	Specialty	2		
S5803	244	0		29	10	S5803_244_0	1	1	Generic	1		1
S5803	244	0		29	10	S5803_244_0	1	2	Preferred Brand	2		
S5803	244	0		29	10	S5803_244_0	1	3	Non-Preferred Brand	2		
S5803	244	0		29	10	S5803_244_0	1	4	Specialty			
S5803	245	0		29	10	S5803_245_0	1	1	Generic			
S5803	245	0		29	10	S5803_245_0	1	2	Preferred Brand			
S5803	245	0		29	10	S5803_245_0	1	3	Non-Preferred Brand			
S5803	245	0		29	10	S5803_245_0	1	4	Specialty	2		
S5803	245	0		29	10	S5803_245_0	1	1	Generic	1		1
S5803	245	0		29	10	S5803_245_0	1	2	Preferred Brand	2		
S5803	245	0		29	10	S5803_245_0	1	3	Non-Preferred Brand	2		
S5803	245	0		29	10	S5803_245_0	1	4	Specialty			
S5803	246	0		29	10	S5803_246_0	1	1	Generic			
S5803	246	0		29	10	S5803_246_0	1	2	Preferred Brand			
S5803	246	0		29	10	S5803_246_0	1	3	Non-Preferred Brand			
S5803	246	0		29	10	S5803_246_0	1	4	Specialty	2		
S5803	246	0		29	10	S5803_246_0	1	1	Generic	1		1
S5803	246	0		29	10	S5803_246_0	1	2	Preferred Brand	2		
S5803	246	0		29	10	S5803_246_0	1	3	Non-Preferred Brand	2		
S5803	246	0		29	10	S5803_246_0	1	4	Specialty			
S5803	247	0		29	10	S5803_247_0	2	1	Generic			
S5803	247	0		29	10	S5803_247_0	2	2	Preferred Brand			
S5803	247	0		29	10	S5803_247_0	2	3	Non-Preferred Brand			
S5803	247	0		29	10	S5803_247_0	2	4	Specialty	2		
S5803	247	0		29	10	S5803_247_0	2	1	Generic	1		1
S5803	247	0		29	10	S5803_247_0	2	2	Preferred Brand	2		
S5803	247	0		29	10	S5803_247_0	2	3	Non-Preferred Brand	2		
S5803	247	0		29	10	S5803_247_0	2	4	Specialty			
S5803	248	0		29	10	S5803_248_0	1	1	Generic			
S5803	248	0		29	10	S5803_248_0	1	2	Preferred Brand			
S5803	248	0		29	10	S5803_248_0	1	3	Non-Preferred Brand			
S5803	248	0		29	10	S5803_248_0	1	4	Specialty	2		
S5803	248	0		29	10	S5803_248_0	1	1	Generic	1		1
S5803	248	0		29	10	S5803_248_0	1	2	Preferred Brand	2		
S5803	248	0		29	10	S5803_248_0	1	3	Non-Preferred Brand	2		
S5803	248	0		29	10	S5803_248_0	1	4	Specialty			
S5803	249	0		29	10	S5803_249_0	1	1	Generic			
S5803	249	0		29	10	S5803_249_0	1	2	Preferred Brand			
S5803	249	0		29	10	S5803_249_0	1	3	Non-Preferred Brand			
S5803	249	0		29	10	S5803_249_0	1	4	Specialty			
S5803	249	0		29	10	S5803_249_0	1	1	Generic	1		1
S5803	249	0		29	10	S5803_249_0	1	2	Preferred Brand	2		
S5803	249	0		29	10	S5803_249_0	1	3	Non-Preferred Brand	2		
S5803	249	0		29	10	S5803_249_0	1	4	Specialty	2		
S5803	250	0		29	10	S5803_250_0	1	4	Specialty			
S5803	250	0		29	10	S5803_250_0	1	3	Non-Preferred Brand			
S5803	250	0		29	10	S5803_250_0	1	2	Preferred Brand			
S5803	250	0		29	10	S5803_250_0	1	1	Generic			
S5803	250	0		29	10	S5803_250_0	1	1	Generic	1		1
S5803	250	0		29	10	S5803_250_0	1	2	Preferred Brand	2		
S5803	250	0		29	10	S5803_250_0	1	3	Non-Preferred Brand	2		
S5803	250	0		29	10	S5803_250_0	1	4	Specialty	2		
S5803	251	0		29	10	S5803_251_0	1	4	Specialty			
S5803	251	0		29	10	S5803_251_0	1	3	Non-Preferred Brand			
S5803	251	0		29	10	S5803_251_0	1	2	Preferred Brand			
S5803	251	0		29	10	S5803_251_0	1	1	Generic			
S5803	251	0		29	10	S5803_251_0	1	2	Preferred Brand	2		
S5803	251	0		29	10	S5803_251_0	1	4	Specialty	2		
S5803	251	0		29	10	S5803_251_0	1	3	Non-Preferred Brand	2		
S5803	251	0		29	10	S5803_251_0	1	1	Generic	1		1
S5803	252	0		29	10	S5803_252_0	1	3	Non-Preferred Brand	2		
S5803	252	0		29	10	S5803_252_0	1	2	Preferred Brand	2		
S5803	252	0		29	10	S5803_252_0	1	1	Generic	1		1
S5803	252	0		29	10	S5803_252_0	1	4	Specialty	2		
S5803	252	0		29	10	S5803_252_0	1	1	Generic			
S5803	252	0		29	10	S5803_252_0	1	2	Preferred Brand			
S5803	252	0		29	10	S5803_252_0	1	3	Non-Preferred Brand			
S5803	252	0		29	10	S5803_252_0	1	4	Specialty			
S5803	253	0		29	10	S5803_253_0	1	3	Non-Preferred Brand	2		
S5803	253	0		29	10	S5803_253_0	1	2	Preferred Brand	2		
S5803	253	0		29	10	S5803_253_0	1	1	Generic	1		1
S5803	253	0		29	10	S5803_253_0	1	4	Specialty	2		
S5803	253	0		29	10	S5803_253_0	1	4	Specialty			
S5803	253	0		29	10	S5803_253_0	1	3	Non-Preferred Brand			
S5803	253	0		29	10	S5803_253_0	1	2	Preferred Brand			
S5803	253	0		29	10	S5803_253_0	1	1	Generic			
S5805	001	0		29	10	S5805_001_0	3	1	Tier 1-Preferred Generic			
S5805	001	0		29	10	S5805_001_0	3	2	Tier 2 - Generic and Preferred Brand			
S5805	001	0		29	10	S5805_001_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5805	001	0		29	10	S5805_001_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5810	035	0		29	10	S5810_035_0	2	1	Tier 1 - Preferred Generic			
S5810	035	0		29	10	S5810_035_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	035	0		29	10	S5810_035_0	2	5	Tier 5 - Specialty			
S5810	035	0		29	10	S5810_035_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	035	0		29	10	S5810_035_0	2	3	Tier 3 - Preferred Brand			
S5810	036	0		29	10	S5810_036_0	2	3	Tier 3 - Preferred Brand			
S5810	036	0		29	10	S5810_036_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	036	0		29	10	S5810_036_0	2	5	Tier 5 - Specialty			
S5810	036	0		29	10	S5810_036_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	036	0		29	10	S5810_036_0	2	1	Tier 1 - Preferred Generic			
S5810	037	0		29	10	S5810_037_0	2	5	Tier 5 - Specialty			
S5810	037	0		29	10	S5810_037_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	037	0		29	10	S5810_037_0	2	1	Tier 1 - Preferred Generic			
S5810	037	0		29	10	S5810_037_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	037	0		29	10	S5810_037_0	2	3	Tier 3 - Preferred Brand			
S5810	038	0		29	10	S5810_038_0	2	1	Tier 1 - Preferred Generic			
S5810	038	0		29	10	S5810_038_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	038	0		29	10	S5810_038_0	2	5	Tier 5 - Specialty			
S5810	038	0		29	10	S5810_038_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	038	0		29	10	S5810_038_0	2	3	Tier 3 - Preferred Brand			
S5810	039	0		29	10	S5810_039_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	039	0		29	10	S5810_039_0	2	1	Tier 1 - Preferred Generic			
S5810	039	0		29	10	S5810_039_0	2	3	Tier 3 - Preferred Brand			
S5810	039	0		29	10	S5810_039_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	039	0		29	10	S5810_039_0	2	5	Tier 5 - Specialty			
S5810	040	0		29	10	S5810_040_0	3	3	Tier 3 - Preferred Brand			
S5810	040	0		29	10	S5810_040_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	040	0		29	10	S5810_040_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	040	0		29	10	S5810_040_0	3	1	Tier 1 - Preferred Generic			
S5810	040	0		29	10	S5810_040_0	3	5	Tier 5 - Specialty			
S5810	041	0		29	10	S5810_041_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	041	0		29	10	S5810_041_0	2	1	Tier 1 - Preferred Generic			
S5810	041	0		29	10	S5810_041_0	2	3	Tier 3 - Preferred Brand			
S5810	041	0		29	10	S5810_041_0	2	5	Tier 5 - Specialty			
S5810	041	0		29	10	S5810_041_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	042	0		29	10	S5810_042_0	2	1	Tier 1 - Preferred Generic			
S5810	042	0		29	10	S5810_042_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	042	0		29	10	S5810_042_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	042	0		29	10	S5810_042_0	2	3	Tier 3 - Preferred Brand			
S5810	042	0		29	10	S5810_042_0	2	5	Tier 5 - Specialty			
S5810	043	0		29	10	S5810_043_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	043	0		29	10	S5810_043_0	3	3	Tier 3 - Preferred Brand			
S5810	043	0		29	10	S5810_043_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	043	0		29	10	S5810_043_0	3	1	Tier 1 - Preferred Generic			
S5810	043	0		29	10	S5810_043_0	3	5	Tier 5 - Specialty			
S5810	044	0		29	10	S5810_044_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	044	0		29	10	S5810_044_0	2	3	Tier 3 - Preferred Brand			
S5810	044	0		29	10	S5810_044_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	044	0		29	10	S5810_044_0	2	1	Tier 1 - Preferred Generic			
S5810	044	0		29	10	S5810_044_0	2	5	Tier 5 - Specialty			
S5810	045	0		29	10	S5810_045_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	045	0		29	10	S5810_045_0	2	3	Tier 3 - Preferred Brand			
S5810	045	0		29	10	S5810_045_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	045	0		29	10	S5810_045_0	2	1	Tier 1 - Preferred Generic			
S5810	045	0		29	10	S5810_045_0	2	5	Tier 5 - Specialty			
S5810	046	0		29	10	S5810_046_0	2	1	Tier 1 - Preferred Generic			
S5810	046	0		29	10	S5810_046_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	046	0		29	10	S5810_046_0	2	3	Tier 3 - Preferred Brand			
S5810	046	0		29	10	S5810_046_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	046	0		29	10	S5810_046_0	2	5	Tier 5 - Specialty			
S5810	047	0		29	10	S5810_047_0	2	1	Tier 1 - Preferred Generic			
S5810	047	0		29	10	S5810_047_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	047	0		29	10	S5810_047_0	2	3	Tier 3 - Preferred Brand			
S5810	047	0		29	10	S5810_047_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	047	0		29	10	S5810_047_0	2	5	Tier 5 - Specialty			
S5810	048	0		29	10	S5810_048_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	048	0		29	10	S5810_048_0	2	5	Tier 5 - Specialty			
S5810	048	0		29	10	S5810_048_0	2	1	Tier 1 - Preferred Generic			
S5810	048	0		29	10	S5810_048_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	048	0		29	10	S5810_048_0	2	3	Tier 3 - Preferred Brand			
S5810	049	0		29	10	S5810_049_0	2	3	Tier 3 - Preferred Brand			
S5810	049	0		29	10	S5810_049_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	049	0		29	10	S5810_049_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	049	0		29	10	S5810_049_0	2	1	Tier 1 - Preferred Generic			
S5810	049	0		29	10	S5810_049_0	2	5	Tier 5 - Specialty			
S5810	050	0		29	10	S5810_050_0	2	1	Tier 1 - Preferred Generic			
S5810	050	0		29	10	S5810_050_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	050	0		29	10	S5810_050_0	2	3	Tier 3 - Preferred Brand			
S5810	050	0		29	10	S5810_050_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	050	0		29	10	S5810_050_0	2	5	Tier 5 - Specialty			
S5810	051	0		29	10	S5810_051_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	051	0		29	10	S5810_051_0	2	1	Tier 1 - Preferred Generic			
S5810	051	0		29	10	S5810_051_0	2	3	Tier 3 - Preferred Brand			
S5810	051	0		29	10	S5810_051_0	2	5	Tier 5 - Specialty			
S5810	051	0		29	10	S5810_051_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	052	0		29	10	S5810_052_0	2	1	Tier 1 - Preferred Generic			
S5810	052	0		29	10	S5810_052_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	052	0		29	10	S5810_052_0	2	3	Tier 3 - Preferred Brand			
S5810	052	0		29	10	S5810_052_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	052	0		29	10	S5810_052_0	2	5	Tier 5 - Specialty			
S5810	053	0		29	10	S5810_053_0	4	1	Tier 1 - Preferred Generic			
S5810	053	0		29	10	S5810_053_0	4	2	Tier 2 - Non-Preferred Generic			
S5810	053	0		29	10	S5810_053_0	4	4	Tier 4 - Non-Preferred Brand			
S5810	053	0		29	10	S5810_053_0	4	3	Tier 3 - Preferred Brand			
S5810	053	0		29	10	S5810_053_0	4	5	Tier 5 - Specialty			
S5810	054	0		29	10	S5810_054_0	4	4	Tier 4 - Non-Preferred Brand			
S5810	054	0		29	10	S5810_054_0	4	3	Tier 3 - Preferred Brand			
S5810	054	0		29	10	S5810_054_0	4	2	Tier 2 - Non-Preferred Generic			
S5810	054	0		29	10	S5810_054_0	4	1	Tier 1 - Preferred Generic			
S5810	054	0		29	10	S5810_054_0	4	5	Tier 5 - Specialty			
S5810	055	0		29	10	S5810_055_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	055	0		29	10	S5810_055_0	2	3	Tier 3 - Preferred Brand			
S5810	055	0		29	10	S5810_055_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	055	0		29	10	S5810_055_0	2	1	Tier 1 - Preferred Generic			
S5810	055	0		29	10	S5810_055_0	2	5	Tier 5 - Specialty			
S5810	056	0		29	10	S5810_056_0	2	1	Tier 1 - Preferred Generic			
S5810	056	0		29	10	S5810_056_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	056	0		29	10	S5810_056_0	2	3	Tier 3 - Preferred Brand			
S5810	056	0		29	10	S5810_056_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	056	0		29	10	S5810_056_0	2	5	Tier 5 - Specialty			
S5810	057	0		29	10	S5810_057_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	057	0		29	10	S5810_057_0	2	3	Tier 3 - Preferred Brand			
S5810	057	0		29	10	S5810_057_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	057	0		29	10	S5810_057_0	2	1	Tier 1 - Preferred Generic			
S5810	057	0		29	10	S5810_057_0	2	5	Tier 5 - Specialty			
S5810	058	0		29	10	S5810_058_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	058	0		29	10	S5810_058_0	2	1	Tier 1 - Preferred Generic			
S5810	058	0		29	10	S5810_058_0	2	3	Tier 3 - Preferred Brand			
S5810	058	0		29	10	S5810_058_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	058	0		29	10	S5810_058_0	2	5	Tier 5 - Specialty			
S5810	059	0		29	10	S5810_059_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	059	0		29	10	S5810_059_0	2	1	Tier 1 - Preferred Generic			
S5810	059	0		29	10	S5810_059_0	2	3	Tier 3 - Preferred Brand			
S5810	059	0		29	10	S5810_059_0	2	5	Tier 5 - Specialty			
S5810	059	0		29	10	S5810_059_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	060	0		29	10	S5810_060_0	2	1	Tier 1 - Preferred Generic			
S5810	060	0		29	10	S5810_060_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	060	0		29	10	S5810_060_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	060	0		29	10	S5810_060_0	2	3	Tier 3 - Preferred Brand			
S5810	060	0		29	10	S5810_060_0	2	5	Tier 5 - Specialty			
S5810	061	0		29	10	S5810_061_0	2	5	Tier 5 - Specialty			
S5810	061	0		29	10	S5810_061_0	2	1	Tier 1 - Preferred Generic			
S5810	061	0		29	10	S5810_061_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	061	0		29	10	S5810_061_0	2	3	Tier 3 - Preferred Brand			
S5810	061	0		29	10	S5810_061_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	062	0		29	10	S5810_062_0	2	1	Tier 1 - Preferred Generic			
S5810	062	0		29	10	S5810_062_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	062	0		29	10	S5810_062_0	2	3	Tier 3 - Preferred Brand			
S5810	062	0		29	10	S5810_062_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	062	0		29	10	S5810_062_0	2	5	Tier 5 - Specialty			
S5810	063	0		29	10	S5810_063_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	063	0		29	10	S5810_063_0	2	1	Tier 1 - Preferred Generic			
S5810	063	0		29	10	S5810_063_0	2	3	Tier 3 - Preferred Brand			
S5810	063	0		29	10	S5810_063_0	2	5	Tier 5 - Specialty			
S5810	063	0		29	10	S5810_063_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	064	0		29	10	S5810_064_0	2	1	Tier 1 - Preferred Generic			
S5810	064	0		29	10	S5810_064_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	064	0		29	10	S5810_064_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	064	0		29	10	S5810_064_0	2	3	Tier 3 - Preferred Brand			
S5810	064	0		29	10	S5810_064_0	2	5	Tier 5 - Specialty			
S5810	065	0		29	10	S5810_065_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	065	0		29	10	S5810_065_0	2	1	Tier 1 - Preferred Generic			
S5810	065	0		29	10	S5810_065_0	2	3	Tier 3 - Preferred Brand			
S5810	065	0		29	10	S5810_065_0	2	5	Tier 5 - Specialty			
S5810	065	0		29	10	S5810_065_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	066	0		29	10	S5810_066_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	066	0		29	10	S5810_066_0	3	1	Tier 1 - Preferred Generic			
S5810	066	0		29	10	S5810_066_0	3	3	Tier 3 - Preferred Brand			
S5810	066	0		29	10	S5810_066_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	066	0		29	10	S5810_066_0	3	5	Tier 5 - Specialty			
S5810	067	0		29	10	S5810_067_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	067	0		29	10	S5810_067_0	2	1	Tier 1 - Preferred Generic			
S5810	067	0		29	10	S5810_067_0	2	3	Tier 3 - Preferred Brand			
S5810	067	0		29	10	S5810_067_0	2	5	Tier 5 - Specialty			
S5810	067	0		29	10	S5810_067_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	068	0		29	10	S5810_068_0	2	1	Tier 1 - Preferred Generic			
S5810	068	0		29	10	S5810_068_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	068	0		29	10	S5810_068_0	2	3	Tier 3 - Preferred Brand			
S5810	068	0		29	10	S5810_068_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	068	0		29	10	S5810_068_0	2	5	Tier 5 - Specialty			
S5810	137	0		29	10	S5810_137_0	2	1	Tier 1 - Preferred Generic			
S5810	137	0		29	10	S5810_137_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	137	0		29	10	S5810_137_0	2	3	Tier 3 - Preferred Brand			
S5810	137	0		29	10	S5810_137_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	137	0		29	10	S5810_137_0	2	5	Tier 5 - Specialty	2		
S5810	137	0		29	10	S5810_137_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	137	0		29	10	S5810_137_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	137	0		29	10	S5810_137_0	2	3	Tier 3 - Preferred Brand	2		
S5810	137	0		29	10	S5810_137_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	137	0		29	10	S5810_137_0	2	5	Tier 5 - Specialty			
S5810	138	0		29	10	S5810_138_0	2	1	Tier 1 - Preferred Generic			
S5810	138	0		29	10	S5810_138_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	138	0		29	10	S5810_138_0	2	3	Tier 3 - Preferred Brand			
S5810	138	0		29	10	S5810_138_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	138	0		29	10	S5810_138_0	2	5	Tier 5 - Specialty			
S5810	138	0		29	10	S5810_138_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	138	0		29	10	S5810_138_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	138	0		29	10	S5810_138_0	2	3	Tier 3 - Preferred Brand	2		
S5810	138	0		29	10	S5810_138_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	138	0		29	10	S5810_138_0	2	5	Tier 5 - Specialty	2		
S5810	139	0		29	10	S5810_139_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	139	0		29	10	S5810_139_0	3	3	Tier 3 - Preferred Brand	2		
S5810	139	0		29	10	S5810_139_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	139	0		29	10	S5810_139_0	3	5	Tier 5 - Specialty	2		
S5810	139	0		29	10	S5810_139_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	139	0		29	10	S5810_139_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	139	0		29	10	S5810_139_0	3	3	Tier 3 - Preferred Brand			
S5810	139	0		29	10	S5810_139_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	139	0		29	10	S5810_139_0	3	5	Tier 5 - Specialty			
S5810	139	0		29	10	S5810_139_0	3	1	Tier 1 - Preferred Generic			
S5810	140	0		29	10	S5810_140_0	3	3	Tier 3 - Preferred Brand			
S5810	140	0		29	10	S5810_140_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	140	0		29	10	S5810_140_0	3	5	Tier 5 - Specialty	2		
S5810	140	0		29	10	S5810_140_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	140	0		29	10	S5810_140_0	3	3	Tier 3 - Preferred Brand	2		
S5810	140	0		29	10	S5810_140_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	140	0		29	10	S5810_140_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	140	0		29	10	S5810_140_0	3	5	Tier 5 - Specialty			
S5810	140	0		29	10	S5810_140_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	140	0		29	10	S5810_140_0	3	1	Tier 1 - Preferred Generic			
S5810	141	0		29	10	S5810_141_0	2	1	Tier 1 - Preferred Generic			
S5810	141	0		29	10	S5810_141_0	2	3	Tier 3 - Preferred Brand			
S5810	141	0		29	10	S5810_141_0	2	5	Tier 5 - Specialty			
S5810	141	0		29	10	S5810_141_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	141	0		29	10	S5810_141_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	141	0		29	10	S5810_141_0	2	3	Tier 3 - Preferred Brand	2		
S5810	141	0		29	10	S5810_141_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	141	0		29	10	S5810_141_0	2	5	Tier 5 - Specialty	2		
S5810	141	0		29	10	S5810_141_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	141	0		29	10	S5810_141_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	142	0		29	10	S5810_142_0	2	3	Tier 3 - Preferred Brand			
S5810	142	0		29	10	S5810_142_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	142	0		29	10	S5810_142_0	2	1	Tier 1 - Preferred Generic			
S5810	142	0		29	10	S5810_142_0	2	5	Tier 5 - Specialty	2		
S5810	142	0		29	10	S5810_142_0	2	5	Tier 5 - Specialty			
S5810	142	0		29	10	S5810_142_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	142	0		29	10	S5810_142_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	142	0		29	10	S5810_142_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	142	0		29	10	S5810_142_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	142	0		29	10	S5810_142_0	2	3	Tier 3 - Preferred Brand	2		
S5810	143	0		29	10	S5810_143_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	143	0		29	10	S5810_143_0	3	5	Tier 5 - Specialty			
S5810	143	0		29	10	S5810_143_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	143	0		29	10	S5810_143_0	3	3	Tier 3 - Preferred Brand			
S5810	143	0		29	10	S5810_143_0	3	1	Tier 1 - Preferred Generic			
S5810	143	0		29	10	S5810_143_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	143	0		29	10	S5810_143_0	3	5	Tier 5 - Specialty	2		
S5810	143	0		29	10	S5810_143_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	143	0		29	10	S5810_143_0	3	3	Tier 3 - Preferred Brand	2		
S5810	143	0		29	10	S5810_143_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	144	0		29	10	S5810_144_0	2	1	Tier 1 - Preferred Generic			
S5810	144	0		29	10	S5810_144_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	144	0		29	10	S5810_144_0	2	5	Tier 5 - Specialty	2		
S5810	144	0		29	10	S5810_144_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	144	0		29	10	S5810_144_0	2	3	Tier 3 - Preferred Brand	2		
S5810	144	0		29	10	S5810_144_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	144	0		29	10	S5810_144_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	144	0		29	10	S5810_144_0	2	5	Tier 5 - Specialty			
S5810	144	0		29	10	S5810_144_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	144	0		29	10	S5810_144_0	2	3	Tier 3 - Preferred Brand			
S5810	145	0		29	10	S5810_145_0	2	1	Tier 1 - Preferred Generic			
S5810	145	0		29	10	S5810_145_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	145	0		29	10	S5810_145_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	145	0		29	10	S5810_145_0	2	3	Tier 3 - Preferred Brand	2		
S5810	145	0		29	10	S5810_145_0	2	5	Tier 5 - Specialty	2		
S5810	145	0		29	10	S5810_145_0	2	5	Tier 5 - Specialty			
S5810	145	0		29	10	S5810_145_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	145	0		29	10	S5810_145_0	2	3	Tier 3 - Preferred Brand			
S5810	145	0		29	10	S5810_145_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	145	0		29	10	S5810_145_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	146	0		29	10	S5810_146_0	3	1	Tier 1 - Preferred Generic			
S5810	146	0		29	10	S5810_146_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	146	0		29	10	S5810_146_0	3	3	Tier 3 - Preferred Brand			
S5810	146	0		29	10	S5810_146_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	146	0		29	10	S5810_146_0	3	5	Tier 5 - Specialty			
S5810	146	0		29	10	S5810_146_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	146	0		29	10	S5810_146_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	146	0		29	10	S5810_146_0	3	3	Tier 3 - Preferred Brand	2		
S5810	146	0		29	10	S5810_146_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	146	0		29	10	S5810_146_0	3	5	Tier 5 - Specialty	2		
S5810	147	0		29	10	S5810_147_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	147	0		29	10	S5810_147_0	3	3	Tier 3 - Preferred Brand			
S5810	147	0		29	10	S5810_147_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	147	0		29	10	S5810_147_0	3	1	Tier 1 - Preferred Generic			
S5810	147	0		29	10	S5810_147_0	3	5	Tier 5 - Specialty	2		
S5810	147	0		29	10	S5810_147_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	147	0		29	10	S5810_147_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	147	0		29	10	S5810_147_0	3	3	Tier 3 - Preferred Brand	2		
S5810	147	0		29	10	S5810_147_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	147	0		29	10	S5810_147_0	3	5	Tier 5 - Specialty			
S5810	148	0		29	10	S5810_148_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	148	0		29	10	S5810_148_0	2	3	Tier 3 - Preferred Brand			
S5810	148	0		29	10	S5810_148_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	148	0		29	10	S5810_148_0	2	1	Tier 1 - Preferred Generic			
S5810	148	0		29	10	S5810_148_0	2	5	Tier 5 - Specialty			
S5810	148	0		29	10	S5810_148_0	2	5	Tier 5 - Specialty	2		
S5810	148	0		29	10	S5810_148_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	148	0		29	10	S5810_148_0	2	3	Tier 3 - Preferred Brand	2		
S5810	148	0		29	10	S5810_148_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	148	0		29	10	S5810_148_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	149	0		29	10	S5810_149_0	3	1	Tier 1 - Preferred Generic			
S5810	149	0		29	10	S5810_149_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	149	0		29	10	S5810_149_0	3	3	Tier 3 - Preferred Brand			
S5810	149	0		29	10	S5810_149_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	149	0		29	10	S5810_149_0	3	5	Tier 5 - Specialty	2		
S5810	149	0		29	10	S5810_149_0	3	3	Tier 3 - Preferred Brand	2		
S5810	149	0		29	10	S5810_149_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	149	0		29	10	S5810_149_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	149	0		29	10	S5810_149_0	3	5	Tier 5 - Specialty			
S5810	149	0		29	10	S5810_149_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	150	0		29	10	S5810_150_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	150	0		29	10	S5810_150_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	150	0		29	10	S5810_150_0	3	5	Tier 5 - Specialty	2		
S5810	150	0		29	10	S5810_150_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	150	0		29	10	S5810_150_0	3	3	Tier 3 - Preferred Brand	2		
S5810	150	0		29	10	S5810_150_0	3	1	Tier 1 - Preferred Generic			
S5810	150	0		29	10	S5810_150_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	150	0		29	10	S5810_150_0	3	3	Tier 3 - Preferred Brand			
S5810	150	0		29	10	S5810_150_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	150	0		29	10	S5810_150_0	3	5	Tier 5 - Specialty			
S5810	151	0		29	10	S5810_151_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	151	0		29	10	S5810_151_0	2	5	Tier 5 - Specialty			
S5810	151	0		29	10	S5810_151_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	151	0		29	10	S5810_151_0	2	5	Tier 5 - Specialty	2		
S5810	151	0		29	10	S5810_151_0	2	3	Tier 3 - Preferred Brand	2		
S5810	151	0		29	10	S5810_151_0	2	3	Tier 3 - Preferred Brand			
S5810	151	0		29	10	S5810_151_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	151	0		29	10	S5810_151_0	2	1	Tier 1 - Preferred Generic			
S5810	151	0		29	10	S5810_151_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	151	0		29	10	S5810_151_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	152	0		29	10	S5810_152_0	3	3	Tier 3 - Preferred Brand			
S5810	152	0		29	10	S5810_152_0	3	5	Tier 5 - Specialty	2		
S5810	152	0		29	10	S5810_152_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	152	0		29	10	S5810_152_0	3	3	Tier 3 - Preferred Brand	2		
S5810	152	0		29	10	S5810_152_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	152	0		29	10	S5810_152_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	152	0		29	10	S5810_152_0	3	5	Tier 5 - Specialty			
S5810	152	0		29	10	S5810_152_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	152	0		29	10	S5810_152_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	152	0		29	10	S5810_152_0	3	1	Tier 1 - Preferred Generic			
S5810	153	0		29	10	S5810_153_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	153	0		29	10	S5810_153_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	153	0		29	10	S5810_153_0	3	5	Tier 5 - Specialty	2		
S5810	153	0		29	10	S5810_153_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	153	0		29	10	S5810_153_0	3	3	Tier 3 - Preferred Brand	2		
S5810	153	0		29	10	S5810_153_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	153	0		29	10	S5810_153_0	3	3	Tier 3 - Preferred Brand			
S5810	153	0		29	10	S5810_153_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	153	0		29	10	S5810_153_0	3	1	Tier 1 - Preferred Generic			
S5810	153	0		29	10	S5810_153_0	3	5	Tier 5 - Specialty			
S5810	154	0		29	10	S5810_154_0	2	5	Tier 5 - Specialty	2		
S5810	154	0		29	10	S5810_154_0	2	3	Tier 3 - Preferred Brand	2		
S5810	154	0		29	10	S5810_154_0	2	1	Tier 1 - Preferred Generic			
S5810	154	0		29	10	S5810_154_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	154	0		29	10	S5810_154_0	2	3	Tier 3 - Preferred Brand			
S5810	154	0		29	10	S5810_154_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	154	0		29	10	S5810_154_0	2	5	Tier 5 - Specialty			
S5810	154	0		29	10	S5810_154_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	154	0		29	10	S5810_154_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	154	0		29	10	S5810_154_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	155	0		29	10	S5810_155_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	155	0		29	10	S5810_155_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	155	0		29	10	S5810_155_0	2	5	Tier 5 - Specialty			
S5810	155	0		29	10	S5810_155_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	155	0		29	10	S5810_155_0	2	3	Tier 3 - Preferred Brand			
S5810	155	0		29	10	S5810_155_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	155	0		29	10	S5810_155_0	2	1	Tier 1 - Preferred Generic			
S5810	155	0		29	10	S5810_155_0	2	3	Tier 3 - Preferred Brand	2		
S5810	155	0		29	10	S5810_155_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	155	0		29	10	S5810_155_0	2	5	Tier 5 - Specialty	2		
S5810	156	0		29	10	S5810_156_0	2	1	Tier 1 - Preferred Generic			
S5810	156	0		29	10	S5810_156_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	156	0		29	10	S5810_156_0	2	3	Tier 3 - Preferred Brand			
S5810	156	0		29	10	S5810_156_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	156	0		29	10	S5810_156_0	2	5	Tier 5 - Specialty			
S5810	156	0		29	10	S5810_156_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	156	0		29	10	S5810_156_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	156	0		29	10	S5810_156_0	2	3	Tier 3 - Preferred Brand	2		
S5810	156	0		29	10	S5810_156_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	156	0		29	10	S5810_156_0	2	5	Tier 5 - Specialty	2		
S5810	157	0		29	10	S5810_157_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	157	0		29	10	S5810_157_0	2	3	Tier 3 - Preferred Brand			
S5810	157	0		29	10	S5810_157_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	157	0		29	10	S5810_157_0	2	1	Tier 1 - Preferred Generic			
S5810	157	0		29	10	S5810_157_0	2	5	Tier 5 - Specialty	2		
S5810	157	0		29	10	S5810_157_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	157	0		29	10	S5810_157_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	157	0		29	10	S5810_157_0	2	3	Tier 3 - Preferred Brand	2		
S5810	157	0		29	10	S5810_157_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	157	0		29	10	S5810_157_0	2	5	Tier 5 - Specialty			
S5810	158	0		29	10	S5810_158_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	158	0		29	10	S5810_158_0	2	3	Tier 3 - Preferred Brand			
S5810	158	0		29	10	S5810_158_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	158	0		29	10	S5810_158_0	2	1	Tier 1 - Preferred Generic			
S5810	158	0		29	10	S5810_158_0	2	5	Tier 5 - Specialty			
S5810	158	0		29	10	S5810_158_0	2	5	Tier 5 - Specialty	2		
S5810	158	0		29	10	S5810_158_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	158	0		29	10	S5810_158_0	2	3	Tier 3 - Preferred Brand	2		
S5810	158	0		29	10	S5810_158_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	158	0		29	10	S5810_158_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	159	0		29	10	S5810_159_0	2	1	Tier 1 - Preferred Generic			
S5810	159	0		29	10	S5810_159_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	159	0		29	10	S5810_159_0	2	3	Tier 3 - Preferred Brand			
S5810	159	0		29	10	S5810_159_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	159	0		29	10	S5810_159_0	2	5	Tier 5 - Specialty	2		
S5810	159	0		29	10	S5810_159_0	2	3	Tier 3 - Preferred Brand	2		
S5810	159	0		29	10	S5810_159_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	159	0		29	10	S5810_159_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	159	0		29	10	S5810_159_0	2	5	Tier 5 - Specialty			
S5810	159	0		29	10	S5810_159_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	160	0		29	10	S5810_160_0	2	3	Tier 3 - Preferred Brand			
S5810	160	0		29	10	S5810_160_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	160	0		29	10	S5810_160_0	2	1	Tier 1 - Preferred Generic			
S5810	160	0		29	10	S5810_160_0	2	5	Tier 5 - Specialty	2		
S5810	160	0		29	10	S5810_160_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	160	0		29	10	S5810_160_0	2	3	Tier 3 - Preferred Brand	2		
S5810	160	0		29	10	S5810_160_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	160	0		29	10	S5810_160_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	160	0		29	10	S5810_160_0	2	5	Tier 5 - Specialty			
S5810	160	0		29	10	S5810_160_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	161	0		29	10	S5810_161_0	2	3	Tier 3 - Preferred Brand			
S5810	161	0		29	10	S5810_161_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	161	0		29	10	S5810_161_0	2	1	Tier 1 - Preferred Generic			
S5810	161	0		29	10	S5810_161_0	2	5	Tier 5 - Specialty	2		
S5810	161	0		29	10	S5810_161_0	2	5	Tier 5 - Specialty			
S5810	161	0		29	10	S5810_161_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	161	0		29	10	S5810_161_0	2	2	Tier 2 - Non-Preferred Generic	2		
S5810	161	0		29	10	S5810_161_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	161	0		29	10	S5810_161_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	161	0		29	10	S5810_161_0	2	3	Tier 3 - Preferred Brand	2		
S5810	162	0		29	10	S5810_162_0	3	3	Tier 3 - Preferred Brand	2		
S5810	162	0		29	10	S5810_162_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	162	0		29	10	S5810_162_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	162	0		29	10	S5810_162_0	3	5	Tier 5 - Specialty			
S5810	162	0		29	10	S5810_162_0	3	3	Tier 3 - Preferred Brand			
S5810	162	0		29	10	S5810_162_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	162	0		29	10	S5810_162_0	3	5	Tier 5 - Specialty	2		
S5810	162	0		29	10	S5810_162_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	162	0		29	10	S5810_162_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	162	0		29	10	S5810_162_0	3	1	Tier 1 - Preferred Generic			
S5810	163	0		29	10	S5810_163_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	163	0		29	10	S5810_163_0	3	3	Tier 3 - Preferred Brand			
S5810	163	0		29	10	S5810_163_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	163	0		29	10	S5810_163_0	3	1	Tier 1 - Preferred Generic			
S5810	163	0		29	10	S5810_163_0	3	5	Tier 5 - Specialty	2		
S5810	163	0		29	10	S5810_163_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	163	0		29	10	S5810_163_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	163	0		29	10	S5810_163_0	3	3	Tier 3 - Preferred Brand	2		
S5810	163	0		29	10	S5810_163_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	163	0		29	10	S5810_163_0	3	5	Tier 5 - Specialty			
S5810	164	0		29	10	S5810_164_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	164	0		29	10	S5810_164_0	3	3	Tier 3 - Preferred Brand			
S5810	164	0		29	10	S5810_164_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	164	0		29	10	S5810_164_0	3	1	Tier 1 - Preferred Generic			
S5810	164	0		29	10	S5810_164_0	3	5	Tier 5 - Specialty			
S5810	164	0		29	10	S5810_164_0	3	5	Tier 5 - Specialty	2		
S5810	164	0		29	10	S5810_164_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	164	0		29	10	S5810_164_0	3	3	Tier 3 - Preferred Brand	2		
S5810	164	0		29	10	S5810_164_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	164	0		29	10	S5810_164_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	165	0		29	10	S5810_165_0	3	1	Tier 1 - Preferred Generic			
S5810	165	0		29	10	S5810_165_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	165	0		29	10	S5810_165_0	3	3	Tier 3 - Preferred Brand			
S5810	165	0		29	10	S5810_165_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	165	0		29	10	S5810_165_0	3	5	Tier 5 - Specialty	2		
S5810	165	0		29	10	S5810_165_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	165	0		29	10	S5810_165_0	3	3	Tier 3 - Preferred Brand	2		
S5810	165	0		29	10	S5810_165_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	165	0		29	10	S5810_165_0	3	5	Tier 5 - Specialty			
S5810	165	0		29	10	S5810_165_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	166	0		29	10	S5810_166_0	3	1	Tier 1 - Preferred Generic			
S5810	166	0		29	10	S5810_166_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	166	0		29	10	S5810_166_0	3	3	Tier 3 - Preferred Brand			
S5810	166	0		29	10	S5810_166_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	166	0		29	10	S5810_166_0	3	5	Tier 5 - Specialty			
S5810	166	0		29	10	S5810_166_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	166	0		29	10	S5810_166_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	166	0		29	10	S5810_166_0	3	3	Tier 3 - Preferred Brand	2		
S5810	166	0		29	10	S5810_166_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	166	0		29	10	S5810_166_0	3	5	Tier 5 - Specialty	2		
S5810	167	0		29	10	S5810_167_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	167	0		29	10	S5810_167_0	3	3	Tier 3 - Preferred Brand			
S5810	167	0		29	10	S5810_167_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	167	0		29	10	S5810_167_0	3	1	Tier 1 - Preferred Generic			
S5810	167	0		29	10	S5810_167_0	3	5	Tier 5 - Specialty	2		
S5810	167	0		29	10	S5810_167_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	167	0		29	10	S5810_167_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	167	0		29	10	S5810_167_0	3	3	Tier 3 - Preferred Brand	2		
S5810	167	0		29	10	S5810_167_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	167	0		29	10	S5810_167_0	3	5	Tier 5 - Specialty			
S5810	168	0		29	10	S5810_168_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	168	0		29	10	S5810_168_0	3	3	Tier 3 - Preferred Brand			
S5810	168	0		29	10	S5810_168_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	168	0		29	10	S5810_168_0	3	1	Tier 1 - Preferred Generic			
S5810	168	0		29	10	S5810_168_0	3	5	Tier 5 - Specialty			
S5810	168	0		29	10	S5810_168_0	3	5	Tier 5 - Specialty	2		
S5810	168	0		29	10	S5810_168_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	168	0		29	10	S5810_168_0	3	3	Tier 3 - Preferred Brand	2		
S5810	168	0		29	10	S5810_168_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	168	0		29	10	S5810_168_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	169	0		29	10	S5810_169_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	169	0		29	10	S5810_169_0	3	3	Tier 3 - Preferred Brand	2		
S5810	169	0		29	10	S5810_169_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	169	0		29	10	S5810_169_0	3	5	Tier 5 - Specialty	2		
S5810	169	0		29	10	S5810_169_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	169	0		29	10	S5810_169_0	3	5	Tier 5 - Specialty			
S5810	169	0		29	10	S5810_169_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	169	0		29	10	S5810_169_0	3	3	Tier 3 - Preferred Brand			
S5810	169	0		29	10	S5810_169_0	3	1	Tier 1 - Preferred Generic			
S5810	169	0		29	10	S5810_169_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	170	0		29	10	S5810_170_0	3	1	Tier 1 - Preferred Generic			
S5810	170	0		29	10	S5810_170_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	170	0		29	10	S5810_170_0	3	3	Tier 3 - Preferred Brand			
S5810	170	0		29	10	S5810_170_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	170	0		29	10	S5810_170_0	3	5	Tier 5 - Specialty			
S5810	170	0		29	10	S5810_170_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	170	0		29	10	S5810_170_0	3	2	Tier 2 - Non-Preferred Generic	2		
S5810	170	0		29	10	S5810_170_0	3	3	Tier 3 - Preferred Brand	2		
S5810	170	0		29	10	S5810_170_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	170	0		29	10	S5810_170_0	3	5	Tier 5 - Specialty	2		
S5810	171	0		29	10	S5810_171_0	2	3	Tier 3 - Preferred Brand			
S5810	171	0		29	10	S5810_171_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	171	0		29	10	S5810_171_0	2	5	Tier 5 - Specialty	2		
S5810	171	0		29	10	S5810_171_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	171	0		29	10	S5810_171_0	2	3	Tier 3 - Preferred Brand	2		
S5810	171	0		29	10	S5810_171_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	171	0		29	10	S5810_171_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	171	0		29	10	S5810_171_0	2	5	Tier 5 - Specialty			
S5810	171	0		29	10	S5810_171_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	171	0		29	10	S5810_171_0	2	1	Tier 1 - Preferred Generic			
S5810	172	0		29	10	S5810_172_0	2	3	Tier 3 - Preferred Brand	2		
S5810	172	0		29	10	S5810_172_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	172	0		29	10	S5810_172_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	172	0		29	10	S5810_172_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	172	0		29	10	S5810_172_0	2	5	Tier 5 - Specialty			
S5810	172	0		29	10	S5810_172_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	172	0		29	10	S5810_172_0	2	3	Tier 3 - Preferred Brand			
S5810	172	0		29	10	S5810_172_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	172	0		29	10	S5810_172_0	2	1	Tier 1 - Preferred Generic			
S5810	172	0		29	10	S5810_172_0	2	5	Tier 5 - Specialty	2		
S5810	173	0		29	10	S5810_173_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	173	0		29	10	S5810_173_0	2	3	Tier 3 - Preferred Brand	2		
S5810	173	0		29	10	S5810_173_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	173	0		29	10	S5810_173_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	173	0		29	10	S5810_173_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	173	0		29	10	S5810_173_0	2	3	Tier 3 - Preferred Brand			
S5810	173	0		29	10	S5810_173_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	173	0		29	10	S5810_173_0	2	1	Tier 1 - Preferred Generic			
S5810	173	0		29	10	S5810_173_0	2	5	Tier 5 - Specialty	2		
S5810	173	0		29	10	S5810_173_0	2	5	Tier 5 - Specialty			
S5810	174	0		29	10	S5810_174_0	2	3	Tier 3 - Preferred Brand			
S5810	174	0		29	10	S5810_174_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	174	0		29	10	S5810_174_0	2	1	Tier 1 - Preferred Generic			
S5810	174	0		29	10	S5810_174_0	2	5	Tier 5 - Specialty	2		
S5810	174	0		29	10	S5810_174_0	2	5	Tier 5 - Specialty			
S5810	174	0		29	10	S5810_174_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	174	0		29	10	S5810_174_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	174	0		29	10	S5810_174_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	174	0		29	10	S5810_174_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	174	0		29	10	S5810_174_0	2	3	Tier 3 - Preferred Brand	2		
S5810	175	0		29	10	S5810_175_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	175	0		29	10	S5810_175_0	2	5	Tier 5 - Specialty			
S5810	175	0		29	10	S5810_175_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	175	0		29	10	S5810_175_0	2	3	Tier 3 - Preferred Brand			
S5810	175	0		29	10	S5810_175_0	2	1	Tier 1 - Preferred Generic			
S5810	175	0		29	10	S5810_175_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	175	0		29	10	S5810_175_0	2	5	Tier 5 - Specialty	2		
S5810	175	0		29	10	S5810_175_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	175	0		29	10	S5810_175_0	2	3	Tier 3 - Preferred Brand	2		
S5810	175	0		29	10	S5810_175_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	176	0		29	10	S5810_176_0	2	1	Tier 1 - Preferred Generic			
S5810	176	0		29	10	S5810_176_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	176	0		29	10	S5810_176_0	2	3	Tier 3 - Preferred Brand			
S5810	176	0		29	10	S5810_176_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	176	0		29	10	S5810_176_0	2	5	Tier 5 - Specialty	2		
S5810	176	0		29	10	S5810_176_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	176	0		29	10	S5810_176_0	2	3	Tier 3 - Preferred Brand	2		
S5810	176	0		29	10	S5810_176_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	176	0		29	10	S5810_176_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	176	0		29	10	S5810_176_0	2	5	Tier 5 - Specialty			
S5810	177	0		29	10	S5810_177_0	2	1	Tier 1 - Preferred Generic			
S5810	177	0		29	10	S5810_177_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	177	0		29	10	S5810_177_0	2	3	Tier 3 - Preferred Brand			
S5810	177	0		29	10	S5810_177_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	177	0		29	10	S5810_177_0	2	5	Tier 5 - Specialty			
S5810	177	0		29	10	S5810_177_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	177	0		29	10	S5810_177_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	177	0		29	10	S5810_177_0	2	3	Tier 3 - Preferred Brand	2		
S5810	177	0		29	10	S5810_177_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	177	0		29	10	S5810_177_0	2	5	Tier 5 - Specialty	2		
S5810	178	0		29	10	S5810_178_0	2	1	Tier 1 - Preferred Generic			
S5810	178	0		29	10	S5810_178_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	178	0		29	10	S5810_178_0	2	5	Tier 5 - Specialty	2		
S5810	178	0		29	10	S5810_178_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	178	0		29	10	S5810_178_0	2	3	Tier 3 - Preferred Brand	2		
S5810	178	0		29	10	S5810_178_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	178	0		29	10	S5810_178_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	178	0		29	10	S5810_178_0	2	5	Tier 5 - Specialty			
S5810	178	0		29	10	S5810_178_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	178	0		29	10	S5810_178_0	2	3	Tier 3 - Preferred Brand			
S5810	179	0		29	10	S5810_179_0	3	1	Tier 1 - Preferred Generic			
S5810	179	0		29	10	S5810_179_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	179	0		29	10	S5810_179_0	3	3	Tier 3 - Preferred Brand	2		
S5810	179	0		29	10	S5810_179_0	3	2	Tier 2 - Non-Preferred Generic	1		1
S5810	179	0		29	10	S5810_179_0	3	5	Tier 5 - Specialty	2		
S5810	179	0		29	10	S5810_179_0	3	5	Tier 5 - Specialty			
S5810	179	0		29	10	S5810_179_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	179	0		29	10	S5810_179_0	3	3	Tier 3 - Preferred Brand			
S5810	179	0		29	10	S5810_179_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	179	0		29	10	S5810_179_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	180	0		29	10	S5810_180_0	2	3	Tier 3 - Preferred Brand			
S5810	180	0		29	10	S5810_180_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	180	0		29	10	S5810_180_0	2	5	Tier 5 - Specialty	2		
S5810	180	0		29	10	S5810_180_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	180	0		29	10	S5810_180_0	2	3	Tier 3 - Preferred Brand	2		
S5810	180	0		29	10	S5810_180_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	180	0		29	10	S5810_180_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	180	0		29	10	S5810_180_0	2	5	Tier 5 - Specialty			
S5810	180	0		29	10	S5810_180_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	180	0		29	10	S5810_180_0	2	1	Tier 1 - Preferred Generic			
S5810	181	0		29	10	S5810_181_0	2	1	Tier 1 - Preferred Generic			
S5810	181	0		29	10	S5810_181_0	2	3	Tier 3 - Preferred Brand			
S5810	181	0		29	10	S5810_181_0	2	5	Tier 5 - Specialty			
S5810	181	0		29	10	S5810_181_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	181	0		29	10	S5810_181_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	181	0		29	10	S5810_181_0	2	3	Tier 3 - Preferred Brand	2		
S5810	181	0		29	10	S5810_181_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	181	0		29	10	S5810_181_0	2	5	Tier 5 - Specialty	2		
S5810	181	0		29	10	S5810_181_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	181	0		29	10	S5810_181_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	182	0		29	10	S5810_182_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	182	0		29	10	S5810_182_0	2	3	Tier 3 - Preferred Brand	2		
S5810	182	0		29	10	S5810_182_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	182	0		29	10	S5810_182_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	182	0		29	10	S5810_182_0	2	5	Tier 5 - Specialty			
S5810	182	0		29	10	S5810_182_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	182	0		29	10	S5810_182_0	2	3	Tier 3 - Preferred Brand			
S5810	182	0		29	10	S5810_182_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	182	0		29	10	S5810_182_0	2	1	Tier 1 - Preferred Generic			
S5810	182	0		29	10	S5810_182_0	2	5	Tier 5 - Specialty	2		
S5810	183	0		29	10	S5810_183_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	183	0		29	10	S5810_183_0	2	3	Tier 3 - Preferred Brand			
S5810	183	0		29	10	S5810_183_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	183	0		29	10	S5810_183_0	2	1	Tier 1 - Preferred Generic			
S5810	183	0		29	10	S5810_183_0	2	5	Tier 5 - Specialty	2		
S5810	183	0		29	10	S5810_183_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	183	0		29	10	S5810_183_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	183	0		29	10	S5810_183_0	2	3	Tier 3 - Preferred Brand	2		
S5810	183	0		29	10	S5810_183_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	183	0		29	10	S5810_183_0	2	5	Tier 5 - Specialty			
S5810	184	0		29	10	S5810_184_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	184	0		29	10	S5810_184_0	2	3	Tier 3 - Preferred Brand			
S5810	184	0		29	10	S5810_184_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	184	0		29	10	S5810_184_0	2	1	Tier 1 - Preferred Generic			
S5810	184	0		29	10	S5810_184_0	2	5	Tier 5 - Specialty			
S5810	184	0		29	10	S5810_184_0	2	5	Tier 5 - Specialty	2		
S5810	184	0		29	10	S5810_184_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	184	0		29	10	S5810_184_0	2	3	Tier 3 - Preferred Brand	2		
S5810	184	0		29	10	S5810_184_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	184	0		29	10	S5810_184_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	185	0		29	10	S5810_185_0	2	1	Tier 1 - Preferred Generic			
S5810	185	0		29	10	S5810_185_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	185	0		29	10	S5810_185_0	2	3	Tier 3 - Preferred Brand			
S5810	185	0		29	10	S5810_185_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	185	0		29	10	S5810_185_0	2	5	Tier 5 - Specialty	2		
S5810	185	0		29	10	S5810_185_0	2	3	Tier 3 - Preferred Brand	2		
S5810	185	0		29	10	S5810_185_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	185	0		29	10	S5810_185_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	185	0		29	10	S5810_185_0	2	5	Tier 5 - Specialty			
S5810	185	0		29	10	S5810_185_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	186	0		29	10	S5810_186_0	2	1	Tier 1 - Preferred Generic			
S5810	186	0		29	10	S5810_186_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	186	0		29	10	S5810_186_0	2	3	Tier 3 - Preferred Brand			
S5810	186	0		29	10	S5810_186_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	186	0		29	10	S5810_186_0	2	5	Tier 5 - Specialty			
S5810	186	0		29	10	S5810_186_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	186	0		29	10	S5810_186_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	186	0		29	10	S5810_186_0	2	3	Tier 3 - Preferred Brand	2		
S5810	186	0		29	10	S5810_186_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	186	0		29	10	S5810_186_0	2	5	Tier 5 - Specialty	2		
S5810	187	0		29	10	S5810_187_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	187	0		29	10	S5810_187_0	2	5	Tier 5 - Specialty	2		
S5810	187	0		29	10	S5810_187_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	187	0		29	10	S5810_187_0	2	5	Tier 5 - Specialty			
S5810	187	0		29	10	S5810_187_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	187	0		29	10	S5810_187_0	2	3	Tier 3 - Preferred Brand			
S5810	187	0		29	10	S5810_187_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	187	0		29	10	S5810_187_0	2	3	Tier 3 - Preferred Brand	2		
S5810	187	0		29	10	S5810_187_0	2	1	Tier 1 - Preferred Generic			
S5810	187	0		29	10	S5810_187_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	188	0		29	10	S5810_188_0	2	5	Tier 5 - Specialty	2		
S5810	188	0		29	10	S5810_188_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	188	0		29	10	S5810_188_0	2	3	Tier 3 - Preferred Brand	2		
S5810	188	0		29	10	S5810_188_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	188	0		29	10	S5810_188_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	188	0		29	10	S5810_188_0	2	5	Tier 5 - Specialty			
S5810	188	0		29	10	S5810_188_0	2	3	Tier 3 - Preferred Brand			
S5810	188	0		29	10	S5810_188_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	188	0		29	10	S5810_188_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	188	0		29	10	S5810_188_0	2	1	Tier 1 - Preferred Generic			
S5810	189	0		29	10	S5810_189_0	3	2	Tier 2 - Non-Preferred Generic	1		1
S5810	189	0		29	10	S5810_189_0	3	3	Tier 3 - Preferred Brand	2		
S5810	189	0		29	10	S5810_189_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	189	0		29	10	S5810_189_0	3	5	Tier 5 - Specialty	2		
S5810	189	0		29	10	S5810_189_0	3	3	Tier 3 - Preferred Brand			
S5810	189	0		29	10	S5810_189_0	3	1	Tier 1 - Preferred Generic			
S5810	189	0		29	10	S5810_189_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	189	0		29	10	S5810_189_0	3	5	Tier 5 - Specialty			
S5810	189	0		29	10	S5810_189_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	189	0		29	10	S5810_189_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	190	0		29	10	S5810_190_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	190	0		29	10	S5810_190_0	2	3	Tier 3 - Preferred Brand	2		
S5810	190	0		29	10	S5810_190_0	2	5	Tier 5 - Specialty	2		
S5810	190	0		29	10	S5810_190_0	2	1	Tier 1 - Preferred Generic			
S5810	190	0		29	10	S5810_190_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	190	0		29	10	S5810_190_0	2	3	Tier 3 - Preferred Brand			
S5810	190	0		29	10	S5810_190_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	190	0		29	10	S5810_190_0	2	5	Tier 5 - Specialty			
S5810	190	0		29	10	S5810_190_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	190	0		29	10	S5810_190_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	191	0		29	10	S5810_191_0	2	1	Tier 1 - Preferred Generic			
S5810	191	0		29	10	S5810_191_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	191	0		29	10	S5810_191_0	2	3	Tier 3 - Preferred Brand	2		
S5810	191	0		29	10	S5810_191_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	191	0		29	10	S5810_191_0	2	5	Tier 5 - Specialty	2		
S5810	191	0		29	10	S5810_191_0	2	5	Tier 5 - Specialty			
S5810	191	0		29	10	S5810_191_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	191	0		29	10	S5810_191_0	2	3	Tier 3 - Preferred Brand			
S5810	191	0		29	10	S5810_191_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	191	0		29	10	S5810_191_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	192	0		29	10	S5810_192_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	192	0		29	10	S5810_192_0	2	3	Tier 3 - Preferred Brand	2		
S5810	192	0		29	10	S5810_192_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	192	0		29	10	S5810_192_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	192	0		29	10	S5810_192_0	2	5	Tier 5 - Specialty			
S5810	192	0		29	10	S5810_192_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	192	0		29	10	S5810_192_0	2	3	Tier 3 - Preferred Brand			
S5810	192	0		29	10	S5810_192_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	192	0		29	10	S5810_192_0	2	1	Tier 1 - Preferred Generic			
S5810	192	0		29	10	S5810_192_0	2	5	Tier 5 - Specialty	2		
S5810	193	0		29	10	S5810_193_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	193	0		29	10	S5810_193_0	2	3	Tier 3 - Preferred Brand			
S5810	193	0		29	10	S5810_193_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	193	0		29	10	S5810_193_0	2	1	Tier 1 - Preferred Generic			
S5810	193	0		29	10	S5810_193_0	2	5	Tier 5 - Specialty	2		
S5810	193	0		29	10	S5810_193_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	193	0		29	10	S5810_193_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	193	0		29	10	S5810_193_0	2	3	Tier 3 - Preferred Brand	2		
S5810	193	0		29	10	S5810_193_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	193	0		29	10	S5810_193_0	2	5	Tier 5 - Specialty			
S5810	194	0		29	10	S5810_194_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	194	0		29	10	S5810_194_0	2	3	Tier 3 - Preferred Brand			
S5810	194	0		29	10	S5810_194_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	194	0		29	10	S5810_194_0	2	1	Tier 1 - Preferred Generic			
S5810	194	0		29	10	S5810_194_0	2	5	Tier 5 - Specialty			
S5810	194	0		29	10	S5810_194_0	2	5	Tier 5 - Specialty	2		
S5810	194	0		29	10	S5810_194_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	194	0		29	10	S5810_194_0	2	3	Tier 3 - Preferred Brand	2		
S5810	194	0		29	10	S5810_194_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	194	0		29	10	S5810_194_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	195	0		29	10	S5810_195_0	2	1	Tier 1 - Preferred Generic			
S5810	195	0		29	10	S5810_195_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	195	0		29	10	S5810_195_0	2	3	Tier 3 - Preferred Brand			
S5810	195	0		29	10	S5810_195_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	195	0		29	10	S5810_195_0	2	5	Tier 5 - Specialty	2		
S5810	195	0		29	10	S5810_195_0	2	3	Tier 3 - Preferred Brand	2		
S5810	195	0		29	10	S5810_195_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	195	0		29	10	S5810_195_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	195	0		29	10	S5810_195_0	2	5	Tier 5 - Specialty			
S5810	195	0		29	10	S5810_195_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	196	0		29	10	S5810_196_0	2	5	Tier 5 - Specialty			
S5810	196	0		29	10	S5810_196_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	196	0		29	10	S5810_196_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	196	0		29	10	S5810_196_0	2	3	Tier 3 - Preferred Brand	2		
S5810	196	0		29	10	S5810_196_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	196	0		29	10	S5810_196_0	2	5	Tier 5 - Specialty	2		
S5810	196	0		29	10	S5810_196_0	2	1	Tier 1 - Preferred Generic			
S5810	196	0		29	10	S5810_196_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	196	0		29	10	S5810_196_0	2	3	Tier 3 - Preferred Brand			
S5810	196	0		29	10	S5810_196_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	197	0		29	10	S5810_197_0	3	4	Tier 4 - Non-Preferred Brand			
S5810	197	0		29	10	S5810_197_0	3	3	Tier 3 - Preferred Brand			
S5810	197	0		29	10	S5810_197_0	3	2	Tier 2 - Non-Preferred Generic			
S5810	197	0		29	10	S5810_197_0	3	1	Tier 1 - Preferred Generic			
S5810	197	0		29	10	S5810_197_0	3	5	Tier 5 - Specialty	2		
S5810	197	0		29	10	S5810_197_0	3	1	Tier 1 - Preferred Generic	1		1
S5810	197	0		29	10	S5810_197_0	3	2	Tier 2 - Non-Preferred Generic	1		1
S5810	197	0		29	10	S5810_197_0	3	3	Tier 3 - Preferred Brand	2		
S5810	197	0		29	10	S5810_197_0	3	4	Tier 4 - Non-Preferred Brand	2		
S5810	197	0		29	10	S5810_197_0	3	5	Tier 5 - Specialty			
S5810	198	0		29	10	S5810_198_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	198	0		29	10	S5810_198_0	2	3	Tier 3 - Preferred Brand			
S5810	198	0		29	10	S5810_198_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	198	0		29	10	S5810_198_0	2	1	Tier 1 - Preferred Generic			
S5810	198	0		29	10	S5810_198_0	2	5	Tier 5 - Specialty			
S5810	198	0		29	10	S5810_198_0	2	5	Tier 5 - Specialty	2		
S5810	198	0		29	10	S5810_198_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	198	0		29	10	S5810_198_0	2	3	Tier 3 - Preferred Brand	2		
S5810	198	0		29	10	S5810_198_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	198	0		29	10	S5810_198_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	199	0		29	10	S5810_199_0	2	1	Tier 1 - Preferred Generic			
S5810	199	0		29	10	S5810_199_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	199	0		29	10	S5810_199_0	2	3	Tier 3 - Preferred Brand			
S5810	199	0		29	10	S5810_199_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	199	0		29	10	S5810_199_0	2	5	Tier 5 - Specialty	2		
S5810	199	0		29	10	S5810_199_0	2	3	Tier 3 - Preferred Brand	2		
S5810	199	0		29	10	S5810_199_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	199	0		29	10	S5810_199_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	199	0		29	10	S5810_199_0	2	5	Tier 5 - Specialty			
S5810	199	0		29	10	S5810_199_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	200	0		29	10	S5810_200_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	200	0		29	10	S5810_200_0	2	3	Tier 3 - Preferred Brand	2		
S5810	200	0		29	10	S5810_200_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	200	0		29	10	S5810_200_0	2	5	Tier 5 - Specialty	2		
S5810	200	0		29	10	S5810_200_0	2	1	Tier 1 - Preferred Generic			
S5810	200	0		29	10	S5810_200_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	200	0		29	10	S5810_200_0	2	3	Tier 3 - Preferred Brand			
S5810	200	0		29	10	S5810_200_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	200	0		29	10	S5810_200_0	2	5	Tier 5 - Specialty			
S5810	200	0		29	10	S5810_200_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	201	0		29	10	S5810_201_0	2	5	Tier 5 - Specialty	2		
S5810	201	0		29	10	S5810_201_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	201	0		29	10	S5810_201_0	2	3	Tier 3 - Preferred Brand	2		
S5810	201	0		29	10	S5810_201_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	201	0		29	10	S5810_201_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	201	0		29	10	S5810_201_0	2	5	Tier 5 - Specialty			
S5810	201	0		29	10	S5810_201_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	201	0		29	10	S5810_201_0	2	3	Tier 3 - Preferred Brand			
S5810	201	0		29	10	S5810_201_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	201	0		29	10	S5810_201_0	2	1	Tier 1 - Preferred Generic			
S5810	202	0		29	10	S5810_202_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	202	0		29	10	S5810_202_0	2	5	Tier 5 - Specialty			
S5810	202	0		29	10	S5810_202_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	202	0		29	10	S5810_202_0	2	3	Tier 3 - Preferred Brand			
S5810	202	0		29	10	S5810_202_0	2	5	Tier 5 - Specialty	2		
S5810	202	0		29	10	S5810_202_0	2	1	Tier 1 - Preferred Generic			
S5810	202	0		29	10	S5810_202_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	202	0		29	10	S5810_202_0	2	3	Tier 3 - Preferred Brand	2		
S5810	202	0		29	10	S5810_202_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	202	0		29	10	S5810_202_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	203	0		29	10	S5810_203_0	2	5	Tier 5 - Specialty	2		
S5810	203	0		29	10	S5810_203_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	203	0		29	10	S5810_203_0	2	3	Tier 3 - Preferred Brand	2		
S5810	203	0		29	10	S5810_203_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	203	0		29	10	S5810_203_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	203	0		29	10	S5810_203_0	2	5	Tier 5 - Specialty			
S5810	203	0		29	10	S5810_203_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	203	0		29	10	S5810_203_0	2	3	Tier 3 - Preferred Brand			
S5810	203	0		29	10	S5810_203_0	2	2	Tier 2 - Non-Preferred Generic			
S5810	203	0		29	10	S5810_203_0	2	1	Tier 1 - Preferred Generic			
S5810	204	0		29	10	S5810_204_0	2	1	Tier 1 - Preferred Generic	1		1
S5810	204	0		29	10	S5810_204_0	2	5	Tier 5 - Specialty			
S5810	204	0		29	10	S5810_204_0	2	4	Tier 4 - Non-Preferred Brand			
S5810	204	0		29	10	S5810_204_0	2	3	Tier 3 - Preferred Brand			
S5810	204	0		29	10	S5810_204_0	2	5	Tier 5 - Specialty	2		
S5810	204	0		29	10	S5810_204_0	2	1	Tier 1 - Preferred Generic			
S5810	204	0		29	10	S5810_204_0	2	2	Tier 2 - Non-Preferred Generic	1		1
S5810	204	0		29	10	S5810_204_0	2	3	Tier 3 - Preferred Brand	2		
S5810	204	0		29	10	S5810_204_0	2	4	Tier 4 - Non-Preferred Brand	2		
S5810	204	0		29	10	S5810_204_0	2	2	Tier 2 - Non-Preferred Generic			
S5820	001	0		29	10	S5820_001_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	001	0		29	10	S5820_001_0	3	2	Tier 2 - Generic and Preferred Brand			
S5820	001	0		29	10	S5820_001_0	3	1	Tier 1-Preferred Generic			
S5820	001	0		29	10	S5820_001_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5820	002	0		29	10	S5820_002_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	002	0		29	10	S5820_002_0	4	2	Tier 2 - Generic and Preferred Brand			
S5820	002	0		29	10	S5820_002_0	4	1	Tier 1-Preferred Generic			
S5820	002	0		29	10	S5820_002_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5820	003	0		29	10	S5820_003_0	4	1	Tier 1-Preferred Generic			
S5820	003	0		29	10	S5820_003_0	4	2	Tier 2 - Generic and Preferred Brand			
S5820	003	0		29	10	S5820_003_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	003	0		29	10	S5820_003_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5820	004	0		29	10	S5820_004_0	4	1	Tier 1-Preferred Generic			
S5820	004	0		29	10	S5820_004_0	4	2	Tier 2 - Generic and Preferred Brand			
S5820	004	0		29	10	S5820_004_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	004	0		29	10	S5820_004_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5820	005	0		29	10	S5820_005_0	4	1	Tier 1-Preferred Generic			
S5820	005	0		29	10	S5820_005_0	4	2	Tier 2 - Generic and Preferred Brand			
S5820	005	0		29	10	S5820_005_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5820	005	0		29	10	S5820_005_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	006	0		29	10	S5820_006_0	2	1	Tier 1-Preferred Generic			
S5820	006	0		29	10	S5820_006_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	006	0		29	10	S5820_006_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	006	0		29	10	S5820_006_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	007	0		29	10	S5820_007_0	2	1	Tier 1-Preferred Generic			
S5820	007	0		29	10	S5820_007_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	007	0		29	10	S5820_007_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	007	0		29	10	S5820_007_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	008	0		29	10	S5820_008_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	008	0		29	10	S5820_008_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	008	0		29	10	S5820_008_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	008	0		29	10	S5820_008_0	2	1	Tier 1-Preferred Generic			
S5820	009	0		29	10	S5820_009_0	2	1	Tier 1-Preferred Generic			
S5820	009	0		29	10	S5820_009_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	009	0		29	10	S5820_009_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	009	0		29	10	S5820_009_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	010	0		29	10	S5820_010_0	2	1	Tier 1-Preferred Generic			
S5820	010	0		29	10	S5820_010_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	010	0		29	10	S5820_010_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	010	0		29	10	S5820_010_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	011	0		29	10	S5820_011_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	011	0		29	10	S5820_011_0	3	2	Tier 2 - Generic and Preferred Brand			
S5820	011	0		29	10	S5820_011_0	3	1	Tier 1-Preferred Generic			
S5820	011	0		29	10	S5820_011_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5820	012	0		29	10	S5820_012_0	2	1	Tier 1-Preferred Generic			
S5820	012	0		29	10	S5820_012_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	012	0		29	10	S5820_012_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	012	0		29	10	S5820_012_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	013	0		29	10	S5820_013_0	2	1	Tier 1-Preferred Generic			
S5820	013	0		29	10	S5820_013_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	013	0		29	10	S5820_013_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	013	0		29	10	S5820_013_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	014	0		29	10	S5820_014_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	014	0		29	10	S5820_014_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	014	0		29	10	S5820_014_0	2	1	Tier 1-Preferred Generic			
S5820	014	0		29	10	S5820_014_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	015	0		29	10	S5820_015_0	2	1	Tier 1-Preferred Generic			
S5820	015	0		29	10	S5820_015_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	015	0		29	10	S5820_015_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	015	0		29	10	S5820_015_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	016	0		29	10	S5820_016_0	2	1	Tier 1-Preferred Generic			
S5820	016	0		29	10	S5820_016_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	016	0		29	10	S5820_016_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	016	0		29	10	S5820_016_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	017	0		29	10	S5820_017_0	2	1	Tier 1-Preferred Generic			
S5820	017	0		29	10	S5820_017_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	017	0		29	10	S5820_017_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	017	0		29	10	S5820_017_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	018	0		29	10	S5820_018_0	2	1	Tier 1-Preferred Generic			
S5820	018	0		29	10	S5820_018_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	018	0		29	10	S5820_018_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	018	0		29	10	S5820_018_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	019	0		29	10	S5820_019_0	2	1	Tier 1-Preferred Generic			
S5820	019	0		29	10	S5820_019_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	019	0		29	10	S5820_019_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	019	0		29	10	S5820_019_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	020	0		29	10	S5820_020_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	020	0		29	10	S5820_020_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	020	0		29	10	S5820_020_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	020	0		29	10	S5820_020_0	2	1	Tier 1-Preferred Generic			
S5820	021	0		29	10	S5820_021_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	021	0		29	10	S5820_021_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	021	0		29	10	S5820_021_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	021	0		29	10	S5820_021_0	2	1	Tier 1-Preferred Generic			
S5820	022	0		29	10	S5820_022_0	2	1	Tier 1-Preferred Generic			
S5820	022	0		29	10	S5820_022_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	022	0		29	10	S5820_022_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	022	0		29	10	S5820_022_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	023	0		29	10	S5820_023_0	2	1	Tier 1-Preferred Generic			
S5820	023	0		29	10	S5820_023_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	023	0		29	10	S5820_023_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	023	0		29	10	S5820_023_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	024	0		29	10	S5820_024_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	024	0		29	10	S5820_024_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	024	0		29	10	S5820_024_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	024	0		29	10	S5820_024_0	2	1	Tier 1-Preferred Generic			
S5820	025	0		29	10	S5820_025_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	025	0		29	10	S5820_025_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	025	0		29	10	S5820_025_0	2	1	Tier 1-Preferred Generic			
S5820	025	0		29	10	S5820_025_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	026	0		29	10	S5820_026_0	2	1	Tier 1-Preferred Generic			
S5820	026	0		29	10	S5820_026_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	026	0		29	10	S5820_026_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	026	0		29	10	S5820_026_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	027	0		29	10	S5820_027_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	027	0		29	10	S5820_027_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	027	0		29	10	S5820_027_0	2	1	Tier 1-Preferred Generic			
S5820	027	0		29	10	S5820_027_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	028	0		29	10	S5820_028_0	3	1	Tier 1-Preferred Generic			
S5820	028	0		29	10	S5820_028_0	3	2	Tier 2 - Generic and Preferred Brand			
S5820	028	0		29	10	S5820_028_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	028	0		29	10	S5820_028_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5820	029	0		29	10	S5820_029_0	2	1	Tier 1-Preferred Generic			
S5820	029	0		29	10	S5820_029_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	029	0		29	10	S5820_029_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	029	0		29	10	S5820_029_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	030	0		29	10	S5820_030_0	2	1	Tier 1-Preferred Generic			
S5820	030	0		29	10	S5820_030_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	030	0		29	10	S5820_030_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	030	0		29	10	S5820_030_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	031	0		29	10	S5820_031_0	2	1	Tier 1-Preferred Generic			
S5820	031	0		29	10	S5820_031_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	031	0		29	10	S5820_031_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	031	0		29	10	S5820_031_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	032	0		29	10	S5820_032_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	032	0		29	10	S5820_032_0	3	2	Tier 2 - Generic and Preferred Brand			
S5820	032	0		29	10	S5820_032_0	3	1	Tier 1-Preferred Generic			
S5820	032	0		29	10	S5820_032_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5820	033	0		29	10	S5820_033_0	2	1	Tier 1-Preferred Generic			
S5820	033	0		29	10	S5820_033_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	033	0		29	10	S5820_033_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	033	0		29	10	S5820_033_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	034	0		29	10	S5820_034_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	034	0		29	10	S5820_034_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	034	0		29	10	S5820_034_0	2	1	Tier 1-Preferred Generic			
S5820	034	0		29	10	S5820_034_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	035	0		29	10	S5820_035_0	2	1	Tier 1-Preferred Generic			
S5820	035	0		29	10	S5820_035_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	035	0		29	10	S5820_035_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	035	0		29	10	S5820_035_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	036	0		29	10	S5820_036_0	2	1	Tier 1-Preferred Generic			
S5820	036	0		29	10	S5820_036_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	036	0		29	10	S5820_036_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	036	0		29	10	S5820_036_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	037	0		29	10	S5820_037_0	4	1	Tier 1-Preferred Generic			
S5820	037	0		29	10	S5820_037_0	4	2	Tier 2 - Generic and Preferred Brand			
S5820	037	0		29	10	S5820_037_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	037	0		29	10	S5820_037_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5820	038	0		29	10	S5820_038_0	4	1	Tier 1-Preferred Generic			
S5820	038	0		29	10	S5820_038_0	4	2	Tier 2 - Generic and Preferred Brand			
S5820	038	0		29	10	S5820_038_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	038	0		29	10	S5820_038_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5820	142	0		29	10	S5820_142_0	2	1	Tier 1 - Preferred Generic			
S5820	142	0		29	10	S5820_142_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	142	0		29	10	S5820_142_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	142	0		29	10	S5820_142_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	142	0		29	10	S5820_142_0	2	1	Tier 1 - Preferred Generic	1		1
S5820	142	0		29	10	S5820_142_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5820	142	0		29	10	S5820_142_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5820	142	0		29	10	S5820_142_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5820	143	0		29	10	S5820_143_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5820	143	0		29	10	S5820_143_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5820	143	0		29	10	S5820_143_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5820	143	0		29	10	S5820_143_0	2	1	Tier 1 - Preferred Generic	1		1
S5820	143	0		29	10	S5820_143_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	143	0		29	10	S5820_143_0	2	1	Tier 1 - Preferred Generic			
S5820	143	0		29	10	S5820_143_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	143	0		29	10	S5820_143_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	144	0		29	10	S5820_144_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5820	144	0		29	10	S5820_144_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5820	144	0		29	10	S5820_144_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5820	144	0		29	10	S5820_144_0	2	1	Tier 1 - Preferred Generic	1		1
S5820	144	0		29	10	S5820_144_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	144	0		29	10	S5820_144_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	144	0		29	10	S5820_144_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	144	0		29	10	S5820_144_0	2	1	Tier 1 - Preferred Generic			
S5820	145	0		29	10	S5820_145_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5820	145	0		29	10	S5820_145_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5820	145	0		29	10	S5820_145_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5820	145	0		29	10	S5820_145_0	2	1	Tier 1 - Preferred Generic	1		1
S5820	145	0		29	10	S5820_145_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	145	0		29	10	S5820_145_0	2	1	Tier 1 - Preferred Generic			
S5820	145	0		29	10	S5820_145_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	145	0		29	10	S5820_145_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	146	0		29	10	S5820_146_0	3	4	Tier 4 - Specialty (Generic, Brand)	2		
S5820	146	0		29	10	S5820_146_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5820	146	0		29	10	S5820_146_0	3	2	Tier 2 - Generic and Preferred Brand	2		
S5820	146	0		29	10	S5820_146_0	3	1	Tier 1 - Preferred Generic			
S5820	146	0		29	10	S5820_146_0	3	2	Tier 2 - Generic and Preferred Brand			
S5820	146	0		29	10	S5820_146_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	146	0		29	10	S5820_146_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5820	146	0		29	10	S5820_146_0	3	1	Tier 1 - Preferred Generic	1		1
S5820	147	0		29	10	S5820_147_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	147	0		29	10	S5820_147_0	2	1	Tier 1 - Preferred Generic			
S5820	147	0		29	10	S5820_147_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	147	0		29	10	S5820_147_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	148	0		29	10	S5820_148_0	2	1	Tier 1 - Preferred Generic			
S5820	148	0		29	10	S5820_148_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	148	0		29	10	S5820_148_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	148	0		29	10	S5820_148_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	149	0		29	10	S5820_149_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	149	0		29	10	S5820_149_0	2	1	Tier 1 - Preferred Generic			
S5820	149	0		29	10	S5820_149_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	149	0		29	10	S5820_149_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	150	0		29	10	S5820_150_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5820	150	0		29	10	S5820_150_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	150	0		29	10	S5820_150_0	2	2	Tier 2 - Generic and Preferred Brand			
S5820	150	0		29	10	S5820_150_0	2	1	Tier 1 - Preferred Generic			
S5820	151	0		29	10	S5820_151_0	3	1	Tier 1 - Preferred Generic			
S5820	151	0		29	10	S5820_151_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5820	151	0		29	10	S5820_151_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5820	151	0		29	10	S5820_151_0	3	2	Tier 2 - Generic and Preferred Brand			
S5825	017	0		29	10	S5825_017_0	1	2	Brand			
S5825	017	0		29	10	S5825_017_0	1	1	Generic			
S5825	017	0		29	10	S5825_017_0	1	3	Specialty			
S5825	085	0		29	10	S5825_085_0	1	1	Generic	1		1
S5825	085	0		29	10	S5825_085_0	1	2	Brand	2		
S5825	085	0		29	10	S5825_085_0	1	3	Specialty			
S5825	085	0		29	10	S5825_085_0	1	3	Specialty	2		
S5825	085	0		29	10	S5825_085_0	1	1	Generic			
S5825	085	0		29	10	S5825_085_0	1	2	Brand			
S5840	002	0		29	10	S5840_002_0	6	2	Preferred Brand			
S5840	002	0		29	10	S5840_002_0	6	3	Non-Preferred Brand			
S5840	002	0		29	10	S5840_002_0	6	4	Specialty Tier Brand			
S5840	002	0		29	10	S5840_002_0	6	1	Generic			
S5840	002	0		29	10	S5840_002_0	6	2	Preferred Brand	2		
S5840	002	0		29	10	S5840_002_0	6	3	Non-Preferred Brand	2		
S5840	002	0		29	10	S5840_002_0	6	4	Specialty Tier Brand	2		
S5840	002	0		29	10	S5840_002_0	6	1	Generic	1		1
S5857	001	0		29	10	S5857_001_0	3	1	Generic Drugs			
S5857	001	0		29	10	S5857_001_0	3	4	Specialty Tier			
S5857	001	0		29	10	S5857_001_0	3	3	Non-Preferred Brand			
S5857	001	0		29	10	S5857_001_0	3	2	Preferred Brand on Formulary			
S5860	001	0		29	10	S5860_001_0	13	1	Generic drugs			
S5860	001	0		29	10	S5860_001_0	13	2	Preferred brand drugs			
S5860	001	0		29	10	S5860_001_0	13	3	Non-preferred brand drugs			
S5860	001	0		29	10	S5860_001_0	13	4	Specialty drugs			
S5860	003	0		29	10	S5860_003_0	13	1	Generic drugs			
S5860	003	0		29	10	S5860_003_0	13	2	Preferred brand drugs			
S5860	003	0		29	10	S5860_003_0	13	3	Non-preferred brand drugs			
S5860	003	0		29	10	S5860_003_0	13	4	Specialty drugs			
S5877	004	0		29	10	S5877_004_0	1	1	Generic			
S5877	004	0		29	10	S5877_004_0	1	2	Preferred Brand			
S5877	004	0		29	10	S5877_004_0	1	3	Non-Preferred Brand			
S5877	004	0		29	10	S5877_004_0	1	4	Specialty			
S5877	007	0		29	10	S5877_007_0	1	1	Generic			
S5877	007	0		29	10	S5877_007_0	1	2	Preferred Brand			
S5877	007	0		29	10	S5877_007_0	1	3	Non-Preferred Brand			
S5877	007	0		29	10	S5877_007_0	1	4	Specialty			
S5884	001	0		29	10	S5884_001_0	2	3	Non-Preferred Brand			
S5884	001	0		29	10	S5884_001_0	2	4	Specialty			
S5884	001	0		29	10	S5884_001_0	2	2	Preferred Brand			
S5884	001	0		29	10	S5884_001_0	2	1	Preferred Generic			
S5884	002	0		29	10	S5884_002_0	2	3	Non-Preferred Brand			
S5884	002	0		29	10	S5884_002_0	2	4	Specialty			
S5884	002	0		29	10	S5884_002_0	2	1	Preferred Generic			
S5884	002	0		29	10	S5884_002_0	2	2	Preferred Brand			
S5884	003	0		29	10	S5884_003_0	2	3	Non-Preferred Brand			
S5884	003	0		29	10	S5884_003_0	2	4	Specialty			
S5884	003	0		29	10	S5884_003_0	2	1	Preferred Generic			
S5884	003	0		29	10	S5884_003_0	2	2	Preferred Brand			
S5884	004	0		29	10	S5884_004_0	2	4	Specialty			
S5884	004	0		29	10	S5884_004_0	2	3	Non-Preferred Brand			
S5884	004	0		29	10	S5884_004_0	2	1	Preferred Generic			
S5884	004	0		29	10	S5884_004_0	2	2	Preferred Brand			
S5884	005	0		29	10	S5884_005_0	2	3	Non-Preferred Brand			
S5884	005	0		29	10	S5884_005_0	2	4	Specialty			
S5884	005	0		29	10	S5884_005_0	2	2	Preferred Brand			
S5884	005	0		29	10	S5884_005_0	2	1	Preferred Generic			
S5884	006	0		29	10	S5884_006_0	2	4	Specialty			
S5884	006	0		29	10	S5884_006_0	2	3	Non-Preferred Brand			
S5884	006	0		29	10	S5884_006_0	2	1	Preferred Generic			
S5884	006	0		29	10	S5884_006_0	2	2	Preferred Brand			
S5884	007	0		29	10	S5884_007_0	2	1	Preferred Generic			
S5884	007	0		29	10	S5884_007_0	2	2	Preferred Brand			
S5884	007	0		29	10	S5884_007_0	2	4	Specialty			
S5884	007	0		29	10	S5884_007_0	2	3	Non-Preferred Brand			
S5884	008	0		29	10	S5884_008_0	2	1	Preferred Generic			
S5884	008	0		29	10	S5884_008_0	2	3	Non-Preferred Brand			
S5884	008	0		29	10	S5884_008_0	2	2	Preferred Brand			
S5884	008	0		29	10	S5884_008_0	2	4	Specialty			
S5884	009	0		29	10	S5884_009_0	2	1	Preferred Generic			
S5884	009	0		29	10	S5884_009_0	2	2	Preferred Brand			
S5884	009	0		29	10	S5884_009_0	2	3	Non-Preferred Brand			
S5884	009	0		29	10	S5884_009_0	2	4	Specialty			
S5884	010	0		29	10	S5884_010_0	2	1	Preferred Generic			
S5884	010	0		29	10	S5884_010_0	2	2	Preferred Brand			
S5884	010	0		29	10	S5884_010_0	2	3	Non-Preferred Brand			
S5884	010	0		29	10	S5884_010_0	2	4	Specialty			
S5884	011	0		29	10	S5884_011_0	2	3	Non-Preferred Brand			
S5884	011	0		29	10	S5884_011_0	2	2	Preferred Brand			
S5884	011	0		29	10	S5884_011_0	2	1	Preferred Generic			
S5884	011	0		29	10	S5884_011_0	2	4	Specialty			
S5884	012	0		29	10	S5884_012_0	2	1	Preferred Generic			
S5884	012	0		29	10	S5884_012_0	2	2	Preferred Brand			
S5884	012	0		29	10	S5884_012_0	2	3	Non-Preferred Brand			
S5884	012	0		29	10	S5884_012_0	2	4	Specialty			
S5884	013	0		29	10	S5884_013_0	2	1	Preferred Generic			
S5884	013	0		29	10	S5884_013_0	2	2	Preferred Brand			
S5884	013	0		29	10	S5884_013_0	2	3	Non-Preferred Brand			
S5884	013	0		29	10	S5884_013_0	2	4	Specialty			
S5884	014	0		29	10	S5884_014_0	2	3	Non-Preferred Brand			
S5884	014	0		29	10	S5884_014_0	2	2	Preferred Brand			
S5884	014	0		29	10	S5884_014_0	2	1	Preferred Generic			
S5884	014	0		29	10	S5884_014_0	2	4	Specialty			
S5884	015	0		29	10	S5884_015_0	2	1	Preferred Generic			
S5884	015	0		29	10	S5884_015_0	2	2	Preferred Brand			
S5884	015	0		29	10	S5884_015_0	2	3	Non-Preferred Brand			
S5884	015	0		29	10	S5884_015_0	2	4	Specialty			
S5884	016	0		29	10	S5884_016_0	2	1	Preferred Generic			
S5884	016	0		29	10	S5884_016_0	2	2	Preferred Brand			
S5884	016	0		29	10	S5884_016_0	2	3	Non-Preferred Brand			
S5884	016	0		29	10	S5884_016_0	2	4	Specialty			
S5884	017	0		29	10	S5884_017_0	2	1	Preferred Generic			
S5884	017	0		29	10	S5884_017_0	2	2	Preferred Brand			
S5884	017	0		29	10	S5884_017_0	2	4	Specialty			
S5884	017	0		29	10	S5884_017_0	2	3	Non-Preferred Brand			
S5884	018	0		29	10	S5884_018_0	2	1	Preferred Generic			
S5884	018	0		29	10	S5884_018_0	2	2	Preferred Brand			
S5884	018	0		29	10	S5884_018_0	2	3	Non-Preferred Brand			
S5884	018	0		29	10	S5884_018_0	2	4	Specialty			
S5884	019	0		29	10	S5884_019_0	2	1	Preferred Generic			
S5884	019	0		29	10	S5884_019_0	2	3	Non-Preferred Brand			
S5884	019	0		29	10	S5884_019_0	2	2	Preferred Brand			
S5884	019	0		29	10	S5884_019_0	2	4	Specialty			
S5884	020	0		29	10	S5884_020_0	2	1	Preferred Generic			
S5884	020	0		29	10	S5884_020_0	2	3	Non-Preferred Brand			
S5884	020	0		29	10	S5884_020_0	2	2	Preferred Brand			
S5884	020	0		29	10	S5884_020_0	2	4	Specialty			
S5884	021	0		29	10	S5884_021_0	2	4	Specialty			
S5884	021	0		29	10	S5884_021_0	2	3	Non-Preferred Brand			
S5884	021	0		29	10	S5884_021_0	2	1	Preferred Generic			
S5884	021	0		29	10	S5884_021_0	2	2	Preferred Brand			
S5884	022	0		29	10	S5884_022_0	2	2	Preferred Brand			
S5884	022	0		29	10	S5884_022_0	2	3	Non-Preferred Brand			
S5884	022	0		29	10	S5884_022_0	2	4	Specialty			
S5884	022	0		29	10	S5884_022_0	2	1	Preferred Generic			
S5884	023	0		29	10	S5884_023_0	2	1	Preferred Generic			
S5884	023	0		29	10	S5884_023_0	2	2	Preferred Brand			
S5884	023	0		29	10	S5884_023_0	2	3	Non-Preferred Brand			
S5884	023	0		29	10	S5884_023_0	2	4	Specialty			
S5884	024	0		29	10	S5884_024_0	2	2	Preferred Brand			
S5884	024	0		29	10	S5884_024_0	2	3	Non-Preferred Brand			
S5884	024	0		29	10	S5884_024_0	2	4	Specialty			
S5884	024	0		29	10	S5884_024_0	2	1	Preferred Generic			
S5884	025	0		29	10	S5884_025_0	2	1	Preferred Generic			
S5884	025	0		29	10	S5884_025_0	2	4	Specialty			
S5884	025	0		29	10	S5884_025_0	2	2	Preferred Brand			
S5884	025	0		29	10	S5884_025_0	2	3	Non-Preferred Brand			
S5884	026	0		29	10	S5884_026_0	2	4	Specialty			
S5884	026	0		29	10	S5884_026_0	2	3	Non-Preferred Brand			
S5884	026	0		29	10	S5884_026_0	2	2	Preferred Brand			
S5884	026	0		29	10	S5884_026_0	2	1	Preferred Generic			
S5884	027	0		29	10	S5884_027_0	2	2	Preferred Brand			
S5884	027	0		29	10	S5884_027_0	2	3	Non-Preferred Brand			
S5884	027	0		29	10	S5884_027_0	2	4	Specialty			
S5884	027	0		29	10	S5884_027_0	2	1	Preferred Generic			
S5884	028	0		29	10	S5884_028_0	2	3	Non-Preferred Brand			
S5884	028	0		29	10	S5884_028_0	2	1	Preferred Generic			
S5884	028	0		29	10	S5884_028_0	2	2	Preferred Brand			
S5884	028	0		29	10	S5884_028_0	2	4	Specialty			
S5884	029	0		29	10	S5884_029_0	2	2	Preferred Brand			
S5884	029	0		29	10	S5884_029_0	2	1	Preferred Generic			
S5884	029	0		29	10	S5884_029_0	2	3	Non-Preferred Brand			
S5884	029	0		29	10	S5884_029_0	2	4	Specialty			
S5884	030	0		29	10	S5884_030_0	2	2	Preferred Brand			
S5884	030	0		29	10	S5884_030_0	2	1	Preferred Generic			
S5884	030	0		29	10	S5884_030_0	2	4	Specialty			
S5884	030	0		29	10	S5884_030_0	2	3	Non-Preferred Brand			
S5884	031	0		29	10	S5884_031_0	2	4	Specialty			
S5884	031	0		29	10	S5884_031_0	2	1	Preferred Generic	1		1
S5884	031	0		29	10	S5884_031_0	2	2	Preferred Brand	2		
S5884	031	0		29	10	S5884_031_0	2	3	Non-Preferred Brand			
S5884	031	0		29	10	S5884_031_0	2	2	Preferred Brand			
S5884	031	0		29	10	S5884_031_0	2	3	Non-Preferred Brand	2		
S5884	031	0		29	10	S5884_031_0	2	4	Specialty	2		
S5884	031	0		29	10	S5884_031_0	2	1	Preferred Generic			
S5884	032	0		29	10	S5884_032_0	2	2	Preferred Brand			
S5884	032	0		29	10	S5884_032_0	2	1	Preferred Generic			
S5884	032	0		29	10	S5884_032_0	2	4	Specialty	2		
S5884	032	0		29	10	S5884_032_0	2	3	Non-Preferred Brand	2		
S5884	032	0		29	10	S5884_032_0	2	2	Preferred Brand	2		
S5884	032	0		29	10	S5884_032_0	2	1	Preferred Generic	1		1
S5884	032	0		29	10	S5884_032_0	2	4	Specialty			
S5884	032	0		29	10	S5884_032_0	2	3	Non-Preferred Brand			
S5884	033	0		29	10	S5884_033_0	2	1	Preferred Generic			
S5884	033	0		29	10	S5884_033_0	2	3	Non-Preferred Brand	2		
S5884	033	0		29	10	S5884_033_0	2	2	Preferred Brand	2		
S5884	033	0		29	10	S5884_033_0	2	1	Preferred Generic	1		1
S5884	033	0		29	10	S5884_033_0	2	4	Specialty			
S5884	033	0		29	10	S5884_033_0	2	3	Non-Preferred Brand			
S5884	033	0		29	10	S5884_033_0	2	2	Preferred Brand			
S5884	033	0		29	10	S5884_033_0	2	4	Specialty	2		
S5884	034	0		29	10	S5884_034_0	2	3	Non-Preferred Brand			
S5884	034	0		29	10	S5884_034_0	2	4	Specialty			
S5884	034	0		29	10	S5884_034_0	2	1	Preferred Generic	1		1
S5884	034	0		29	10	S5884_034_0	2	2	Preferred Brand	2		
S5884	034	0		29	10	S5884_034_0	2	3	Non-Preferred Brand	2		
S5884	034	0		29	10	S5884_034_0	2	4	Specialty	2		
S5884	034	0		29	10	S5884_034_0	2	1	Preferred Generic			
S5884	034	0		29	10	S5884_034_0	2	2	Preferred Brand			
S5884	035	0		29	10	S5884_035_0	2	1	Preferred Generic			
S5884	035	0		29	10	S5884_035_0	2	3	Non-Preferred Brand	2		
S5884	035	0		29	10	S5884_035_0	2	3	Non-Preferred Brand			
S5884	035	0		29	10	S5884_035_0	2	4	Specialty			
S5884	035	0		29	10	S5884_035_0	2	1	Preferred Generic	1		1
S5884	035	0		29	10	S5884_035_0	2	2	Preferred Brand	2		
S5884	035	0		29	10	S5884_035_0	2	2	Preferred Brand			
S5884	035	0		29	10	S5884_035_0	2	4	Specialty	2		
S5884	036	0		29	10	S5884_036_0	2	2	Preferred Brand	2		
S5884	036	0		29	10	S5884_036_0	2	1	Preferred Generic	1		1
S5884	036	0		29	10	S5884_036_0	2	4	Specialty			
S5884	036	0		29	10	S5884_036_0	2	3	Non-Preferred Brand			
S5884	036	0		29	10	S5884_036_0	2	2	Preferred Brand			
S5884	036	0		29	10	S5884_036_0	2	1	Preferred Generic			
S5884	036	0		29	10	S5884_036_0	2	3	Non-Preferred Brand	2		
S5884	036	0		29	10	S5884_036_0	2	4	Specialty	2		
S5884	037	0		29	10	S5884_037_0	2	4	Specialty	2		
S5884	037	0		29	10	S5884_037_0	2	3	Non-Preferred Brand	2		
S5884	037	0		29	10	S5884_037_0	2	2	Preferred Brand	2		
S5884	037	0		29	10	S5884_037_0	2	1	Preferred Generic	1		1
S5884	037	0		29	10	S5884_037_0	2	4	Specialty			
S5884	037	0		29	10	S5884_037_0	2	3	Non-Preferred Brand			
S5884	037	0		29	10	S5884_037_0	2	2	Preferred Brand			
S5884	037	0		29	10	S5884_037_0	2	1	Preferred Generic			
S5884	038	0		29	10	S5884_038_0	2	4	Specialty	2		
S5884	038	0		29	10	S5884_038_0	2	3	Non-Preferred Brand	2		
S5884	038	0		29	10	S5884_038_0	2	1	Preferred Generic			
S5884	038	0		29	10	S5884_038_0	2	2	Preferred Brand			
S5884	038	0		29	10	S5884_038_0	2	3	Non-Preferred Brand			
S5884	038	0		29	10	S5884_038_0	2	4	Specialty			
S5884	038	0		29	10	S5884_038_0	2	1	Preferred Generic	1		1
S5884	038	0		29	10	S5884_038_0	2	2	Preferred Brand	2		
S5884	039	0		29	10	S5884_039_0	2	1	Preferred Generic			
S5884	039	0		29	10	S5884_039_0	2	1	Preferred Generic	1		1
S5884	039	0		29	10	S5884_039_0	2	2	Preferred Brand	2		
S5884	039	0		29	10	S5884_039_0	2	3	Non-Preferred Brand	2		
S5884	039	0		29	10	S5884_039_0	2	4	Specialty	2		
S5884	039	0		29	10	S5884_039_0	2	3	Non-Preferred Brand			
S5884	039	0		29	10	S5884_039_0	2	2	Preferred Brand			
S5884	039	0		29	10	S5884_039_0	2	4	Specialty			
S5884	040	0		29	10	S5884_040_0	2	1	Preferred Generic			
S5884	040	0		29	10	S5884_040_0	2	2	Preferred Brand			
S5884	040	0		29	10	S5884_040_0	2	4	Specialty	2		
S5884	040	0		29	10	S5884_040_0	2	3	Non-Preferred Brand	2		
S5884	040	0		29	10	S5884_040_0	2	2	Preferred Brand	2		
S5884	040	0		29	10	S5884_040_0	2	1	Preferred Generic	1		1
S5884	040	0		29	10	S5884_040_0	2	4	Specialty			
S5884	040	0		29	10	S5884_040_0	2	3	Non-Preferred Brand			
S5884	041	0		29	10	S5884_041_0	2	1	Preferred Generic			
S5884	041	0		29	10	S5884_041_0	2	3	Non-Preferred Brand	2		
S5884	041	0		29	10	S5884_041_0	2	2	Preferred Brand	2		
S5884	041	0		29	10	S5884_041_0	2	1	Preferred Generic	1		1
S5884	041	0		29	10	S5884_041_0	2	4	Specialty			
S5884	041	0		29	10	S5884_041_0	2	3	Non-Preferred Brand			
S5884	041	0		29	10	S5884_041_0	2	2	Preferred Brand			
S5884	041	0		29	10	S5884_041_0	2	4	Specialty	2		
S5884	042	0		29	10	S5884_042_0	2	3	Non-Preferred Brand			
S5884	042	0		29	10	S5884_042_0	2	4	Specialty			
S5884	042	0		29	10	S5884_042_0	2	1	Preferred Generic	1		1
S5884	042	0		29	10	S5884_042_0	2	2	Preferred Brand	2		
S5884	042	0		29	10	S5884_042_0	2	3	Non-Preferred Brand	2		
S5884	042	0		29	10	S5884_042_0	2	4	Specialty	2		
S5884	042	0		29	10	S5884_042_0	2	1	Preferred Generic			
S5884	042	0		29	10	S5884_042_0	2	2	Preferred Brand			
S5884	043	0		29	10	S5884_043_0	2	1	Preferred Generic			
S5884	043	0		29	10	S5884_043_0	2	2	Preferred Brand			
S5884	043	0		29	10	S5884_043_0	2	4	Specialty	2		
S5884	043	0		29	10	S5884_043_0	2	3	Non-Preferred Brand	2		
S5884	043	0		29	10	S5884_043_0	2	2	Preferred Brand	2		
S5884	043	0		29	10	S5884_043_0	2	1	Preferred Generic	1		1
S5884	043	0		29	10	S5884_043_0	2	4	Specialty			
S5884	043	0		29	10	S5884_043_0	2	3	Non-Preferred Brand			
S5884	044	0		29	10	S5884_044_0	2	1	Preferred Generic			
S5884	044	0		29	10	S5884_044_0	2	2	Preferred Brand			
S5884	044	0		29	10	S5884_044_0	2	4	Specialty	2		
S5884	044	0		29	10	S5884_044_0	2	3	Non-Preferred Brand	2		
S5884	044	0		29	10	S5884_044_0	2	2	Preferred Brand	2		
S5884	044	0		29	10	S5884_044_0	2	1	Preferred Generic	1		1
S5884	044	0		29	10	S5884_044_0	2	4	Specialty			
S5884	044	0		29	10	S5884_044_0	2	3	Non-Preferred Brand			
S5884	045	0		29	10	S5884_045_0	2	3	Non-Preferred Brand			
S5884	045	0		29	10	S5884_045_0	2	1	Preferred Generic	1		1
S5884	045	0		29	10	S5884_045_0	2	4	Specialty			
S5884	045	0		29	10	S5884_045_0	2	2	Preferred Brand			
S5884	045	0		29	10	S5884_045_0	2	1	Preferred Generic			
S5884	045	0		29	10	S5884_045_0	2	2	Preferred Brand	2		
S5884	045	0		29	10	S5884_045_0	2	3	Non-Preferred Brand	2		
S5884	045	0		29	10	S5884_045_0	2	4	Specialty	2		
S5884	046	0		29	10	S5884_046_0	2	1	Preferred Generic			
S5884	046	0		29	10	S5884_046_0	2	1	Preferred Generic	1		1
S5884	046	0		29	10	S5884_046_0	2	2	Preferred Brand	2		
S5884	046	0		29	10	S5884_046_0	2	3	Non-Preferred Brand	2		
S5884	046	0		29	10	S5884_046_0	2	4	Specialty	2		
S5884	046	0		29	10	S5884_046_0	2	2	Preferred Brand			
S5884	046	0		29	10	S5884_046_0	2	3	Non-Preferred Brand			
S5884	046	0		29	10	S5884_046_0	2	4	Specialty			
S5884	047	0		29	10	S5884_047_0	2	1	Preferred Generic	1		1
S5884	047	0		29	10	S5884_047_0	2	2	Preferred Brand	2		
S5884	047	0		29	10	S5884_047_0	2	1	Preferred Generic			
S5884	047	0		29	10	S5884_047_0	2	3	Non-Preferred Brand	2		
S5884	047	0		29	10	S5884_047_0	2	3	Non-Preferred Brand			
S5884	047	0		29	10	S5884_047_0	2	4	Specialty			
S5884	047	0		29	10	S5884_047_0	2	2	Preferred Brand			
S5884	047	0		29	10	S5884_047_0	2	4	Specialty	2		
S5884	048	0		29	10	S5884_048_0	2	2	Preferred Brand			
S5884	048	0		29	10	S5884_048_0	2	1	Preferred Generic			
S5884	048	0		29	10	S5884_048_0	2	2	Preferred Brand	2		
S5884	048	0		29	10	S5884_048_0	2	3	Non-Preferred Brand	2		
S5884	048	0		29	10	S5884_048_0	2	4	Specialty	2		
S5884	048	0		29	10	S5884_048_0	2	1	Preferred Generic	1		1
S5884	048	0		29	10	S5884_048_0	2	4	Specialty			
S5884	048	0		29	10	S5884_048_0	2	3	Non-Preferred Brand			
S5884	049	0		29	10	S5884_049_0	2	4	Specialty			
S5884	049	0		29	10	S5884_049_0	2	2	Preferred Brand	2		
S5884	049	0		29	10	S5884_049_0	2	1	Preferred Generic			
S5884	049	0		29	10	S5884_049_0	2	1	Preferred Generic	1		1
S5884	049	0		29	10	S5884_049_0	2	3	Non-Preferred Brand	2		
S5884	049	0		29	10	S5884_049_0	2	4	Specialty	2		
S5884	049	0		29	10	S5884_049_0	2	2	Preferred Brand			
S5884	049	0		29	10	S5884_049_0	2	3	Non-Preferred Brand			
S5884	050	0		29	10	S5884_050_0	2	2	Preferred Brand			
S5884	050	0		29	10	S5884_050_0	2	3	Non-Preferred Brand			
S5884	050	0		29	10	S5884_050_0	2	4	Specialty			
S5884	050	0		29	10	S5884_050_0	2	1	Preferred Generic	1		1
S5884	050	0		29	10	S5884_050_0	2	1	Preferred Generic			
S5884	050	0		29	10	S5884_050_0	2	4	Specialty	2		
S5884	050	0		29	10	S5884_050_0	2	3	Non-Preferred Brand	2		
S5884	050	0		29	10	S5884_050_0	2	2	Preferred Brand	2		
S5884	051	0		29	10	S5884_051_0	2	1	Preferred Generic			
S5884	051	0		29	10	S5884_051_0	2	2	Preferred Brand			
S5884	051	0		29	10	S5884_051_0	2	3	Non-Preferred Brand			
S5884	051	0		29	10	S5884_051_0	2	1	Preferred Generic	1		1
S5884	051	0		29	10	S5884_051_0	2	4	Specialty			
S5884	051	0		29	10	S5884_051_0	2	4	Specialty	2		
S5884	051	0		29	10	S5884_051_0	2	3	Non-Preferred Brand	2		
S5884	051	0		29	10	S5884_051_0	2	2	Preferred Brand	2		
S5884	052	0		29	10	S5884_052_0	2	2	Preferred Brand	2		
S5884	052	0		29	10	S5884_052_0	2	3	Non-Preferred Brand			
S5884	052	0		29	10	S5884_052_0	2	4	Specialty			
S5884	052	0		29	10	S5884_052_0	2	1	Preferred Generic			
S5884	052	0		29	10	S5884_052_0	2	3	Non-Preferred Brand	2		
S5884	052	0		29	10	S5884_052_0	2	4	Specialty	2		
S5884	052	0		29	10	S5884_052_0	2	2	Preferred Brand			
S5884	052	0		29	10	S5884_052_0	2	1	Preferred Generic	1		1
S5884	053	0		29	10	S5884_053_0	2	1	Preferred Generic			
S5884	053	0		29	10	S5884_053_0	2	4	Specialty	2		
S5884	053	0		29	10	S5884_053_0	2	3	Non-Preferred Brand	2		
S5884	053	0		29	10	S5884_053_0	2	2	Preferred Brand	2		
S5884	053	0		29	10	S5884_053_0	2	1	Preferred Generic	1		1
S5884	053	0		29	10	S5884_053_0	2	4	Specialty			
S5884	053	0		29	10	S5884_053_0	2	3	Non-Preferred Brand			
S5884	053	0		29	10	S5884_053_0	2	2	Preferred Brand			
S5884	054	0		29	10	S5884_054_0	2	4	Specialty			
S5884	054	0		29	10	S5884_054_0	2	3	Non-Preferred Brand			
S5884	054	0		29	10	S5884_054_0	2	2	Preferred Brand			
S5884	054	0		29	10	S5884_054_0	2	1	Preferred Generic			
S5884	054	0		29	10	S5884_054_0	2	4	Specialty	2		
S5884	054	0		29	10	S5884_054_0	2	3	Non-Preferred Brand	2		
S5884	054	0		29	10	S5884_054_0	2	2	Preferred Brand	2		
S5884	054	0		29	10	S5884_054_0	2	1	Preferred Generic	1		1
S5884	055	0		29	10	S5884_055_0	2	1	Preferred Generic	1		1
S5884	055	0		29	10	S5884_055_0	2	4	Specialty	2		
S5884	055	0		29	10	S5884_055_0	2	3	Non-Preferred Brand	2		
S5884	055	0		29	10	S5884_055_0	2	1	Preferred Generic			
S5884	055	0		29	10	S5884_055_0	2	2	Preferred Brand			
S5884	055	0		29	10	S5884_055_0	2	3	Non-Preferred Brand			
S5884	055	0		29	10	S5884_055_0	2	4	Specialty			
S5884	055	0		29	10	S5884_055_0	2	2	Preferred Brand	2		
S5884	056	0		29	10	S5884_056_0	2	1	Preferred Generic			
S5884	056	0		29	10	S5884_056_0	2	3	Non-Preferred Brand			
S5884	056	0		29	10	S5884_056_0	2	4	Specialty			
S5884	056	0		29	10	S5884_056_0	2	1	Preferred Generic	1		1
S5884	056	0		29	10	S5884_056_0	2	2	Preferred Brand			
S5884	056	0		29	10	S5884_056_0	2	2	Preferred Brand	2		
S5884	056	0		29	10	S5884_056_0	2	4	Specialty	2		
S5884	056	0		29	10	S5884_056_0	2	3	Non-Preferred Brand	2		
S5884	057	0		29	10	S5884_057_0	2	3	Non-Preferred Brand	2		
S5884	057	0		29	10	S5884_057_0	2	4	Specialty	2		
S5884	057	0		29	10	S5884_057_0	2	1	Preferred Generic			
S5884	057	0		29	10	S5884_057_0	2	2	Preferred Brand			
S5884	057	0		29	10	S5884_057_0	2	3	Non-Preferred Brand			
S5884	057	0		29	10	S5884_057_0	2	4	Specialty			
S5884	057	0		29	10	S5884_057_0	2	1	Preferred Generic	1		1
S5884	057	0		29	10	S5884_057_0	2	2	Preferred Brand	2		
S5884	058	0		29	10	S5884_058_0	2	1	Preferred Generic			
S5884	058	0		29	10	S5884_058_0	2	2	Preferred Brand			
S5884	058	0		29	10	S5884_058_0	2	4	Specialty	2		
S5884	058	0		29	10	S5884_058_0	2	3	Non-Preferred Brand	2		
S5884	058	0		29	10	S5884_058_0	2	2	Preferred Brand	2		
S5884	058	0		29	10	S5884_058_0	2	1	Preferred Generic	1		1
S5884	058	0		29	10	S5884_058_0	2	4	Specialty			
S5884	058	0		29	10	S5884_058_0	2	3	Non-Preferred Brand			
S5884	059	0		29	10	S5884_059_0	2	1	Preferred Generic			
S5884	059	0		29	10	S5884_059_0	2	3	Non-Preferred Brand	2		
S5884	059	0		29	10	S5884_059_0	2	2	Preferred Brand	2		
S5884	059	0		29	10	S5884_059_0	2	1	Preferred Generic	1		1
S5884	059	0		29	10	S5884_059_0	2	4	Specialty			
S5884	059	0		29	10	S5884_059_0	2	3	Non-Preferred Brand			
S5884	059	0		29	10	S5884_059_0	2	2	Preferred Brand			
S5884	059	0		29	10	S5884_059_0	2	4	Specialty	2		
S5884	060	0		29	10	S5884_060_0	2	1	Preferred Generic			
S5884	060	0		29	10	S5884_060_0	2	2	Preferred Brand			
S5884	060	0		29	10	S5884_060_0	2	3	Non-Preferred Brand			
S5884	060	0		29	10	S5884_060_0	2	4	Specialty			
S5884	060	0		29	10	S5884_060_0	2	1	Preferred Generic	1		1
S5884	060	0		29	10	S5884_060_0	2	2	Preferred Brand	2		
S5884	060	0		29	10	S5884_060_0	2	3	Non-Preferred Brand	2		
S5884	060	0		29	10	S5884_060_0	2	4	Specialty	2		
S5884	061	0		29	10	S5884_061_0	2	1	Preferred Generic			
S5884	061	0		29	10	S5884_061_0	2	2	Preferred Brand			
S5884	061	0		29	10	S5884_061_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	062	0		29	10	S5884_062_0	2	1	Preferred Generic			
S5884	062	0		29	10	S5884_062_0	2	2	Preferred Brand			
S5884	062	0		29	10	S5884_062_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	063	0		29	10	S5884_063_0	2	1	Preferred Generic			
S5884	063	0		29	10	S5884_063_0	2	2	Preferred Brand			
S5884	063	0		29	10	S5884_063_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	064	0		29	10	S5884_064_0	2	2	Preferred Brand			
S5884	064	0		29	10	S5884_064_0	2	1	Preferred Generic			
S5884	064	0		29	10	S5884_064_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	065	0		29	10	S5884_065_0	2	1	Preferred Generic			
S5884	065	0		29	10	S5884_065_0	2	2	Preferred Brand			
S5884	065	0		29	10	S5884_065_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	066	0		29	10	S5884_066_0	2	2	Preferred Brand			
S5884	066	0		29	10	S5884_066_0	2	1	Preferred Generic			
S5884	066	0		29	10	S5884_066_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	067	0		29	10	S5884_067_0	2	2	Preferred Brand			
S5884	067	0		29	10	S5884_067_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	067	0		29	10	S5884_067_0	2	1	Preferred Generic			
S5884	068	0		29	10	S5884_068_0	2	2	Preferred Brand			
S5884	068	0		29	10	S5884_068_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	068	0		29	10	S5884_068_0	2	1	Preferred Generic			
S5884	069	0		29	10	S5884_069_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	069	0		29	10	S5884_069_0	2	2	Preferred Brand			
S5884	069	0		29	10	S5884_069_0	2	1	Preferred Generic			
S5884	070	0		29	10	S5884_070_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	070	0		29	10	S5884_070_0	2	2	Preferred Brand			
S5884	070	0		29	10	S5884_070_0	2	1	Preferred Generic			
S5884	071	0		29	10	S5884_071_0	1	1	Preferred Generic			
S5884	071	0		29	10	S5884_071_0	1	2	Preferred Brand			
S5884	071	0		29	10	S5884_071_0	1	3	Other - Non-Preferred (Gen/Brand)			
S5884	072	0		29	10	S5884_072_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	072	0		29	10	S5884_072_0	2	2	Preferred Brand			
S5884	072	0		29	10	S5884_072_0	2	1	Preferred Generic			
S5884	073	0		29	10	S5884_073_0	2	2	Preferred Brand			
S5884	073	0		29	10	S5884_073_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	073	0		29	10	S5884_073_0	2	1	Preferred Generic			
S5884	074	0		29	10	S5884_074_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	074	0		29	10	S5884_074_0	2	1	Preferred Generic			
S5884	074	0		29	10	S5884_074_0	2	2	Preferred Brand			
S5884	075	0		29	10	S5884_075_0	1	1	Preferred Generic			
S5884	075	0		29	10	S5884_075_0	1	2	Preferred Brand			
S5884	075	0		29	10	S5884_075_0	1	3	Other - Non-Preferred (Gen/Brand)			
S5884	076	0		29	10	S5884_076_0	2	1	Preferred Generic			
S5884	076	0		29	10	S5884_076_0	2	2	Preferred Brand			
S5884	076	0		29	10	S5884_076_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	077	0		29	10	S5884_077_0	2	2	Preferred Brand			
S5884	077	0		29	10	S5884_077_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	077	0		29	10	S5884_077_0	2	1	Preferred Generic			
S5884	078	0		29	10	S5884_078_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	078	0		29	10	S5884_078_0	2	2	Preferred Brand			
S5884	078	0		29	10	S5884_078_0	2	1	Preferred Generic			
S5884	079	0		29	10	S5884_079_0	2	1	Preferred Generic			
S5884	079	0		29	10	S5884_079_0	2	2	Preferred Brand			
S5884	079	0		29	10	S5884_079_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	080	0		29	10	S5884_080_0	2	1	Preferred Generic			
S5884	080	0		29	10	S5884_080_0	2	2	Preferred Brand			
S5884	080	0		29	10	S5884_080_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	081	0		29	10	S5884_081_0	2	1	Preferred Generic			
S5884	081	0		29	10	S5884_081_0	2	2	Preferred Brand			
S5884	081	0		29	10	S5884_081_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	082	0		29	10	S5884_082_0	1	3	Other - Non-Preferred (Gen/Brand)			
S5884	082	0		29	10	S5884_082_0	1	1	Preferred Generic			
S5884	082	0		29	10	S5884_082_0	1	2	Preferred Brand			
S5884	083	0		29	10	S5884_083_0	1	1	Preferred Generic			
S5884	083	0		29	10	S5884_083_0	1	2	Preferred Brand			
S5884	083	0		29	10	S5884_083_0	1	3	Other - Non-Preferred (Gen/Brand)			
S5884	084	0		29	10	S5884_084_0	2	1	Preferred Generic			
S5884	084	0		29	10	S5884_084_0	2	2	Preferred Brand			
S5884	084	0		29	10	S5884_084_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	085	0		29	10	S5884_085_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	085	0		29	10	S5884_085_0	2	1	Preferred Generic			
S5884	085	0		29	10	S5884_085_0	2	2	Preferred Brand			
S5884	086	0		29	10	S5884_086_0	1	3	Other - Non-Preferred (Gen/Brand)			
S5884	086	0		29	10	S5884_086_0	1	2	Preferred Brand			
S5884	086	0		29	10	S5884_086_0	1	1	Preferred Generic			
S5884	087	0		29	10	S5884_087_0	2	1	Preferred Generic			
S5884	087	0		29	10	S5884_087_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	087	0		29	10	S5884_087_0	2	2	Preferred Brand			
S5884	088	0		29	10	S5884_088_0	1	1	Preferred Generic			
S5884	088	0		29	10	S5884_088_0	1	3	Other - Non-Preferred (Gen/Brand)			
S5884	088	0		29	10	S5884_088_0	1	2	Preferred Brand			
S5884	089	0		29	10	S5884_089_0	1	1	Preferred Generic			
S5884	089	0		29	10	S5884_089_0	1	3	Other - Non-Preferred (Gen/Brand)			
S5884	089	0		29	10	S5884_089_0	1	2	Preferred Brand			
S5884	090	0		29	10	S5884_090_0	2	1	Preferred Generic			
S5884	090	0		29	10	S5884_090_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	090	0		29	10	S5884_090_0	2	2	Preferred Brand			
S5884	092	0		29	10	S5884_092_0	2	1	Preferred Generic			
S5884	092	0		29	10	S5884_092_0	2	2	Preferred Brand			
S5884	092	0		29	10	S5884_092_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	093	0		29	10	S5884_093_0	3	2	Preferred Brand			
S5884	093	0		29	10	S5884_093_0	3	1	Preferred Generic			
S5884	093	0		29	10	S5884_093_0	3	3	Other - Non-Preferred (Gen/Brand)			
S5884	094	0		29	10	S5884_094_0	2	2	Preferred Brand			
S5884	094	0		29	10	S5884_094_0	2	1	Preferred Generic			
S5884	094	0		29	10	S5884_094_0	2	3	Other - Non-Preferred (Gen/Brand)			
S5884	095	0		29	10	S5884_095_0	2	2	Preferred Brand			
S5884	095	0		29	10	S5884_095_0	2	3	Non-Preferred Brand			
S5884	095	0		29	10	S5884_095_0	2	4	Specialty			
S5884	095	0		29	10	S5884_095_0	2	1	Preferred Generic			
S5884	096	0		29	10	S5884_096_0	2	4	Specialty			
S5884	096	0		29	10	S5884_096_0	2	3	Non-Preferred Brand			
S5884	096	0		29	10	S5884_096_0	2	2	Preferred Brand			
S5884	096	0		29	10	S5884_096_0	2	1	Preferred Generic			
S5884	097	0		29	10	S5884_097_0	2	4	Specialty			
S5884	097	0		29	10	S5884_097_0	2	3	Non-Preferred Brand			
S5884	097	0		29	10	S5884_097_0	2	2	Preferred Brand			
S5884	097	0		29	10	S5884_097_0	2	1	Preferred Generic			
S5884	098	0		29	10	S5884_098_0	2	4	Specialty	2		
S5884	098	0		29	10	S5884_098_0	2	3	Non-Preferred Brand	2		
S5884	098	0		29	10	S5884_098_0	2	2	Preferred Brand	2		
S5884	098	0		29	10	S5884_098_0	2	1	Preferred Generic	1		1
S5884	098	0		29	10	S5884_098_0	2	4	Specialty			
S5884	098	0		29	10	S5884_098_0	2	2	Preferred Brand			
S5884	098	0		29	10	S5884_098_0	2	1	Preferred Generic			
S5884	098	0		29	10	S5884_098_0	2	3	Non-Preferred Brand			
S5884	099	0		29	10	S5884_099_0	2	1	Preferred Generic			
S5884	099	0		29	10	S5884_099_0	2	4	Specialty	2		
S5884	099	0		29	10	S5884_099_0	2	3	Non-Preferred Brand			
S5884	099	0		29	10	S5884_099_0	2	4	Specialty			
S5884	099	0		29	10	S5884_099_0	2	1	Preferred Generic	1		1
S5884	099	0		29	10	S5884_099_0	2	2	Preferred Brand	2		
S5884	099	0		29	10	S5884_099_0	2	3	Non-Preferred Brand	2		
S5884	099	0		29	10	S5884_099_0	2	2	Preferred Brand			
S5884	100	0		29	10	S5884_100_0	2	1	Preferred Generic			
S5884	100	0		29	10	S5884_100_0	2	2	Preferred Brand			
S5884	100	0		29	10	S5884_100_0	2	3	Non-Preferred Brand			
S5884	100	0		29	10	S5884_100_0	2	4	Specialty	2		
S5884	100	0		29	10	S5884_100_0	2	1	Preferred Generic	1		1
S5884	100	0		29	10	S5884_100_0	2	2	Preferred Brand	2		
S5884	100	0		29	10	S5884_100_0	2	3	Non-Preferred Brand	2		
S5884	100	0		29	10	S5884_100_0	2	4	Specialty			
S5904	001	0		29	10	S5904_001_0	4	1	Tier 1 - Covered Generic			
S5904	001	0		29	10	S5904_001_0	4	2	Tier 2 - Covered Preferred Brand			
S5904	001	0		29	10	S5904_001_0	4	3	Tier 3 - Covered Brand			
S5904	001	0		29	10	S5904_001_0	4	4	Tier S - Covered Specialty			
S5904	002	0		29	10	S5904_002_0	4	2	Tier 2 - Covered Preferred Brand			
S5904	002	0		29	10	S5904_002_0	4	1	Tier 1 - Covered Generic			
S5904	002	0		29	10	S5904_002_0	4	2	Tier 2 - Covered Preferred Brand	2		
S5904	002	0		29	10	S5904_002_0	4	1	Tier 1 - Covered Generic	1		1
S5904	002	0		29	10	S5904_002_0	4	3	Tier 3 - Covered Brand	2		
S5904	002	0		29	10	S5904_002_0	4	3	Tier 3 - Covered Brand			
S5904	002	0		29	10	S5904_002_0	4	4	Tier S - Covered Specialty			
S5904	002	0		29	10	S5904_002_0	4	4	Tier S - Covered Specialty	2		
S5904	003	0		29	10	S5904_003_0	5	2	Tier 2 - Covered Preferred Brand			
S5904	003	0		29	10	S5904_003_0	5	1	Tier 1 - Covered Generic			
S5904	003	0		29	10	S5904_003_0	5	3	Tier 3 - Covered Brand			
S5904	003	0		29	10	S5904_003_0	5	4	Tier S - Covered Specialty			
S5907	001	0		29	10	S5907_001_0	4	5	Tier 5/ Nivel 5			
S5907	001	0		29	10	S5907_001_0	4	4	Tier 4/ Nivel 4			
S5907	001	0		29	10	S5907_001_0	4	3	Tier 3/ Nivel 3			
S5907	001	0		29	10	S5907_001_0	4	1	Tier 1/ Nivel 1			
S5907	001	0		29	10	S5907_001_0	4	2	Tier 2/ Nivel 2			
S5907	002	0		29	10	S5907_002_0	4	1	Tier 1/ Nivel 1			
S5907	002	0		29	10	S5907_002_0	4	2	Tier 2/ Nivel 2			
S5907	002	0		29	10	S5907_002_0	4	3	Tier 3/ Nivel 3			
S5907	002	0		29	10	S5907_002_0	4	4	Tier 4/ Nivel 4			
S5907	002	0		29	10	S5907_002_0	4	5	Tier 5/ Nivel 5			
S5907	003	0		29	10	S5907_003_0	4	4	Tier 4/ Nivel 4			
S5907	003	0		29	10	S5907_003_0	4	3	Tier 3/ Nivel 3			
S5907	003	0		29	10	S5907_003_0	4	2	Tier 2/ Nivel 2			
S5907	003	0		29	10	S5907_003_0	4	1	Tier 1/ Nivel 1			
S5907	003	0		29	10	S5907_003_0	4	5	Tier 5/ Nivel 5			
S5907	003	0		29	10	S5907_003_0	4	1	Tier 1/ Nivel 1	1		1
S5907	003	0		29	10	S5907_003_0	4	2	Tier 2/ Nivel 2	2		
S5907	003	0		29	10	S5907_003_0	4	5	Tier 5/ Nivel 5	2		
S5907	003	0		29	10	S5907_003_0	4	4	Tier 4/ Nivel 4	2		
S5907	003	0		29	10	S5907_003_0	4	3	Tier 3/ Nivel 3	2		
S5915	002	0		29	10	S5915_002_0	4	1	Preferred Generic			
S5915	002	0		29	10	S5915_002_0	4	2	Preferred Brand			
S5915	002	0		29	10	S5915_002_0	4	3	Non-Preferred Brand or Generic			
S5915	002	0		29	10	S5915_002_0	4	4	Specialty	2		
S5915	002	0		29	10	S5915_002_0	4	3	Non-Preferred Brand or Generic	2		
S5915	002	0		29	10	S5915_002_0	4	2	Preferred Brand	2		
S5915	002	0		29	10	S5915_002_0	4	1	Preferred Generic	1		1
S5915	002	0		29	10	S5915_002_0	4	4	Specialty			
S5915	003	0		29	10	S5915_003_0	4	1	Preferred Generic			
S5915	003	0		29	10	S5915_003_0	4	3	Non-Preferred Brand or Generic			
S5915	003	0		29	10	S5915_003_0	4	2	Preferred Brand			
S5915	004	0		29	10	S5915_004_0	5	2	Preferred Brand			
S5915	004	0		29	10	S5915_004_0	5	3	Non-Preferred Brand or Generic			
S5915	004	0		29	10	S5915_004_0	5	1	Preferred Generic			
S5915	004	0		29	10	S5915_004_0	5	4	Specialty			
S5916	001	0		29	10	S5916_001_0	2	5	Specialty			
S5916	001	0		29	10	S5916_001_0	2	4	Miscellaneous Injectables			
S5916	001	0		29	10	S5916_001_0	2	2	Preferred Brand			
S5916	001	0		29	10	S5916_001_0	2	1	Generic			
S5916	001	0		29	10	S5916_001_0	2	3	Non-Preferred Brand			
S5916	002	0		29	10	S5916_002_0	2	5	Specialty Medications	2		
S5916	002	0		29	10	S5916_002_0	2	3	Non-Preferred Brand	2		
S5916	002	0		29	10	S5916_002_0	2	2	Preferred Brand	2		
S5916	002	0		29	10	S5916_002_0	2	1	Generic	1		1
S5916	002	0		29	10	S5916_002_0	2	5	Specialty Medications			
S5916	002	0		29	10	S5916_002_0	2	4	Miscellaneous Injectables			
S5916	002	0		29	10	S5916_002_0	2	3	Non-Preferred Brand			
S5916	002	0		29	10	S5916_002_0	2	2	Preferred Brand			
S5916	002	0		29	10	S5916_002_0	2	1	Generic			
S5916	002	0		29	10	S5916_002_0	2	4	Miscellaneous Injectables	2		
S5917	001	0		29	10	S5917_001_0	4	2	Brand			
S5917	001	0		29	10	S5917_001_0	4	1	Generic			
S5917	001	0		29	10	S5917_001_0	4	3	Specialty			
S5917	002	0		29	10	S5917_002_0	4	1	Generic			
S5917	002	0		29	10	S5917_002_0	4	2	Brand			
S5917	002	0		29	10	S5917_002_0	4	3	Specialty			
S5917	003	0		29	10	S5917_003_0	4	1	Generic			
S5917	003	0		29	10	S5917_003_0	4	2	Brand			
S5917	003	0		29	10	S5917_003_0	4	3	Specialty			
S5917	004	0		29	10	S5917_004_0	4	2	Brand			
S5917	004	0		29	10	S5917_004_0	4	1	Generic			
S5917	004	0		29	10	S5917_004_0	4	3	Specialty			
S5917	005	0		29	10	S5917_005_0	4	2	Brand			
S5917	005	0		29	10	S5917_005_0	4	1	Generic			
S5917	005	0		29	10	S5917_005_0	4	3	Specialty			
S5917	006	0		29	10	S5917_006_0	4	2	Brand			
S5917	006	0		29	10	S5917_006_0	4	1	Generic			
S5917	006	0		29	10	S5917_006_0	4	3	Specialty			
S5917	007	0		29	10	S5917_007_0	4	1	Generic			
S5917	007	0		29	10	S5917_007_0	4	2	Brand			
S5917	007	0		29	10	S5917_007_0	4	3	Specialty			
S5917	008	0		29	10	S5917_008_0	4	1	Generic			
S5917	008	0		29	10	S5917_008_0	4	2	Brand			
S5917	008	0		29	10	S5917_008_0	4	3	Specialty			
S5921	001	0		29	10	S5921_001_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	001	0		29	10	S5921_001_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	001	0		29	10	S5921_001_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	001	0		29	10	S5921_001_0	2	1	Tier 1 - Preferred Generic			
S5921	002	0		29	10	S5921_002_0	4	2	Tier 2 - Generic and Preferred Brand			
S5921	002	0		29	10	S5921_002_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5921	002	0		29	10	S5921_002_0	4	1	Tier 1-Preferred Generic			
S5921	002	0		29	10	S5921_002_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	003	0		29	10	S5921_003_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	003	0		29	10	S5921_003_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	003	0		29	10	S5921_003_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	003	0		29	10	S5921_003_0	2	1	Tier 1 - Preferred Generic			
S5921	003	0		29	10	S5921_003_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	003	0		29	10	S5921_003_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	003	0		29	10	S5921_003_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	003	0		29	10	S5921_003_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	011	0		29	10	S5921_011_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	011	0		29	10	S5921_011_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	011	0		29	10	S5921_011_0	2	1	Tier 1 - Preferred Generic			
S5921	011	0		29	10	S5921_011_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	012	0		29	10	S5921_012_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	012	0		29	10	S5921_012_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	012	0		29	10	S5921_012_0	2	1	Tier 1-Preferred Generic			
S5921	012	0		29	10	S5921_012_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	013	0		29	10	S5921_013_0	2	1	Tier 1 - Preferred Generic			
S5921	013	0		29	10	S5921_013_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	013	0		29	10	S5921_013_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	013	0		29	10	S5921_013_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	013	0		29	10	S5921_013_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	013	0		29	10	S5921_013_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	013	0		29	10	S5921_013_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	013	0		29	10	S5921_013_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	021	0		29	10	S5921_021_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	021	0		29	10	S5921_021_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	021	0		29	10	S5921_021_0	2	1	Tier 1 - Preferred Generic			
S5921	021	0		29	10	S5921_021_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	022	0		29	10	S5921_022_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	022	0		29	10	S5921_022_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	022	0		29	10	S5921_022_0	2	1	Tier 1-Preferred Generic			
S5921	022	0		29	10	S5921_022_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	023	0		29	10	S5921_023_0	2	1	Tier 1 - Preferred Generic			
S5921	023	0		29	10	S5921_023_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	023	0		29	10	S5921_023_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	023	0		29	10	S5921_023_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	023	0		29	10	S5921_023_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	023	0		29	10	S5921_023_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	023	0		29	10	S5921_023_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	023	0		29	10	S5921_023_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	031	0		29	10	S5921_031_0	2	1	Tier 1 - Preferred Generic			
S5921	031	0		29	10	S5921_031_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	031	0		29	10	S5921_031_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	031	0		29	10	S5921_031_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	032	0		29	10	S5921_032_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	032	0		29	10	S5921_032_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	032	0		29	10	S5921_032_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	032	0		29	10	S5921_032_0	2	1	Tier 1-Preferred Generic			
S5921	033	0		29	10	S5921_033_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	033	0		29	10	S5921_033_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	033	0		29	10	S5921_033_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	033	0		29	10	S5921_033_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	033	0		29	10	S5921_033_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	033	0		29	10	S5921_033_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	033	0		29	10	S5921_033_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	033	0		29	10	S5921_033_0	2	1	Tier 1 - Preferred Generic			
S5921	041	0		29	10	S5921_041_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	041	0		29	10	S5921_041_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	041	0		29	10	S5921_041_0	2	1	Tier 1 - Preferred Generic			
S5921	041	0		29	10	S5921_041_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	042	0		29	10	S5921_042_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	042	0		29	10	S5921_042_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	042	0		29	10	S5921_042_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	042	0		29	10	S5921_042_0	2	1	Tier 1-Preferred Generic			
S5921	043	0		29	10	S5921_043_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	043	0		29	10	S5921_043_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	043	0		29	10	S5921_043_0	2	1	Tier 1 - Preferred Generic			
S5921	043	0		29	10	S5921_043_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	043	0		29	10	S5921_043_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	043	0		29	10	S5921_043_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	043	0		29	10	S5921_043_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	043	0		29	10	S5921_043_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	051	0		29	10	S5921_051_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	051	0		29	10	S5921_051_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	051	0		29	10	S5921_051_0	2	1	Tier 1 - Preferred Generic			
S5921	051	0		29	10	S5921_051_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	052	0		29	10	S5921_052_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	052	0		29	10	S5921_052_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	052	0		29	10	S5921_052_0	2	1	Tier 1-Preferred Generic			
S5921	052	0		29	10	S5921_052_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	053	0		29	10	S5921_053_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	053	0		29	10	S5921_053_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	053	0		29	10	S5921_053_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	053	0		29	10	S5921_053_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	053	0		29	10	S5921_053_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	053	0		29	10	S5921_053_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	053	0		29	10	S5921_053_0	2	1	Tier 1 - Preferred Generic			
S5921	053	0		29	10	S5921_053_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	061	0		29	10	S5921_061_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	061	0		29	10	S5921_061_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	061	0		29	10	S5921_061_0	2	1	Tier 1 - Preferred Generic			
S5921	061	0		29	10	S5921_061_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	062	0		29	10	S5921_062_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	062	0		29	10	S5921_062_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	062	0		29	10	S5921_062_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	062	0		29	10	S5921_062_0	2	1	Tier 1-Preferred Generic			
S5921	063	0		29	10	S5921_063_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	063	0		29	10	S5921_063_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	063	0		29	10	S5921_063_0	2	1	Tier 1 - Preferred Generic			
S5921	063	0		29	10	S5921_063_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	063	0		29	10	S5921_063_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	063	0		29	10	S5921_063_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	063	0		29	10	S5921_063_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	063	0		29	10	S5921_063_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	071	0		29	10	S5921_071_0	2	1	Tier 1 - Preferred Generic			
S5921	071	0		29	10	S5921_071_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	071	0		29	10	S5921_071_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	071	0		29	10	S5921_071_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	072	0		29	10	S5921_072_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	072	0		29	10	S5921_072_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	072	0		29	10	S5921_072_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	072	0		29	10	S5921_072_0	2	1	Tier 1-Preferred Generic			
S5921	073	0		29	10	S5921_073_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	073	0		29	10	S5921_073_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	073	0		29	10	S5921_073_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	073	0		29	10	S5921_073_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	073	0		29	10	S5921_073_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	073	0		29	10	S5921_073_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	073	0		29	10	S5921_073_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	073	0		29	10	S5921_073_0	2	1	Tier 1 - Preferred Generic			
S5921	081	0		29	10	S5921_081_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	081	0		29	10	S5921_081_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	081	0		29	10	S5921_081_0	2	1	Tier 1 - Preferred Generic			
S5921	081	0		29	10	S5921_081_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	082	0		29	10	S5921_082_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	082	0		29	10	S5921_082_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	082	0		29	10	S5921_082_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	082	0		29	10	S5921_082_0	2	1	Tier 1-Preferred Generic			
S5921	083	0		29	10	S5921_083_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	083	0		29	10	S5921_083_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	083	0		29	10	S5921_083_0	2	1	Tier 1 - Preferred Generic			
S5921	083	0		29	10	S5921_083_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	083	0		29	10	S5921_083_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	083	0		29	10	S5921_083_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	083	0		29	10	S5921_083_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	083	0		29	10	S5921_083_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	091	0		29	10	S5921_091_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	091	0		29	10	S5921_091_0	3	2	Tier 2 - Generic and Preferred Brand			
S5921	091	0		29	10	S5921_091_0	3	1	Tier 1 - Preferred Generic			
S5921	091	0		29	10	S5921_091_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5921	092	0		29	10	S5921_092_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	092	0		29	10	S5921_092_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	092	0		29	10	S5921_092_0	2	1	Tier 1-Preferred Generic			
S5921	092	0		29	10	S5921_092_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	093	0		29	10	S5921_093_0	2	1	Tier 1 - Preferred Generic			
S5921	093	0		29	10	S5921_093_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	093	0		29	10	S5921_093_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	093	0		29	10	S5921_093_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	093	0		29	10	S5921_093_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	093	0		29	10	S5921_093_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	093	0		29	10	S5921_093_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	093	0		29	10	S5921_093_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	101	0		29	10	S5921_101_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	101	0		29	10	S5921_101_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	101	0		29	10	S5921_101_0	2	1	Tier 1 - Preferred Generic			
S5921	101	0		29	10	S5921_101_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	102	0		29	10	S5921_102_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	102	0		29	10	S5921_102_0	4	2	Tier 2 - Generic and Preferred Brand			
S5921	102	0		29	10	S5921_102_0	4	1	Tier 1-Preferred Generic			
S5921	102	0		29	10	S5921_102_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5921	103	0		29	10	S5921_103_0	2	1	Tier 1 - Preferred Generic			
S5921	103	0		29	10	S5921_103_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	103	0		29	10	S5921_103_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	103	0		29	10	S5921_103_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	103	0		29	10	S5921_103_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	103	0		29	10	S5921_103_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	103	0		29	10	S5921_103_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	103	0		29	10	S5921_103_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	111	0		29	10	S5921_111_0	2	1	Tier 1 - Preferred Generic			
S5921	111	0		29	10	S5921_111_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	111	0		29	10	S5921_111_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	111	0		29	10	S5921_111_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	112	0		29	10	S5921_112_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	112	0		29	10	S5921_112_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	112	0		29	10	S5921_112_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	112	0		29	10	S5921_112_0	2	1	Tier 1-Preferred Generic			
S5921	113	0		29	10	S5921_113_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	113	0		29	10	S5921_113_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	113	0		29	10	S5921_113_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	113	0		29	10	S5921_113_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	113	0		29	10	S5921_113_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	113	0		29	10	S5921_113_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	113	0		29	10	S5921_113_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	113	0		29	10	S5921_113_0	2	1	Tier 1 - Preferred Generic			
S5921	121	0		29	10	S5921_121_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	121	0		29	10	S5921_121_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	121	0		29	10	S5921_121_0	2	1	Tier 1 - Preferred Generic			
S5921	121	0		29	10	S5921_121_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	122	0		29	10	S5921_122_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	122	0		29	10	S5921_122_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	122	0		29	10	S5921_122_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	122	0		29	10	S5921_122_0	2	1	Tier 1-Preferred Generic			
S5921	123	0		29	10	S5921_123_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	123	0		29	10	S5921_123_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	123	0		29	10	S5921_123_0	2	1	Tier 1 - Preferred Generic			
S5921	123	0		29	10	S5921_123_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	123	0		29	10	S5921_123_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	123	0		29	10	S5921_123_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	123	0		29	10	S5921_123_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	123	0		29	10	S5921_123_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	131	0		29	10	S5921_131_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	131	0		29	10	S5921_131_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	131	0		29	10	S5921_131_0	2	1	Tier 1 - Preferred Generic			
S5921	131	0		29	10	S5921_131_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	132	0		29	10	S5921_132_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	132	0		29	10	S5921_132_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	132	0		29	10	S5921_132_0	2	1	Tier 1-Preferred Generic			
S5921	132	0		29	10	S5921_132_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	133	0		29	10	S5921_133_0	2	1	Tier 1 - Preferred Generic			
S5921	133	0		29	10	S5921_133_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	133	0		29	10	S5921_133_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	133	0		29	10	S5921_133_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	133	0		29	10	S5921_133_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	133	0		29	10	S5921_133_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	133	0		29	10	S5921_133_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	133	0		29	10	S5921_133_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	141	0		29	10	S5921_141_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	141	0		29	10	S5921_141_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	141	0		29	10	S5921_141_0	2	1	Tier 1 - Preferred Generic			
S5921	141	0		29	10	S5921_141_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	142	0		29	10	S5921_142_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	142	0		29	10	S5921_142_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	142	0		29	10	S5921_142_0	2	1	Tier 1-Preferred Generic			
S5921	142	0		29	10	S5921_142_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	143	0		29	10	S5921_143_0	2	1	Tier 1 - Preferred Generic			
S5921	143	0		29	10	S5921_143_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	143	0		29	10	S5921_143_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	143	0		29	10	S5921_143_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	143	0		29	10	S5921_143_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	143	0		29	10	S5921_143_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	143	0		29	10	S5921_143_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	143	0		29	10	S5921_143_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	151	0		29	10	S5921_151_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	151	0		29	10	S5921_151_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	151	0		29	10	S5921_151_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	151	0		29	10	S5921_151_0	2	1	Tier 1 - Preferred Generic			
S5921	152	0		29	10	S5921_152_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	152	0		29	10	S5921_152_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	152	0		29	10	S5921_152_0	2	1	Tier 1-Preferred Generic			
S5921	152	0		29	10	S5921_152_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	153	0		29	10	S5921_153_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	153	0		29	10	S5921_153_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	153	0		29	10	S5921_153_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	153	0		29	10	S5921_153_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	153	0		29	10	S5921_153_0	2	1	Tier 1 - Preferred Generic			
S5921	153	0		29	10	S5921_153_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	153	0		29	10	S5921_153_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	153	0		29	10	S5921_153_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	161	0		29	10	S5921_161_0	2	1	Tier 1 - Preferred Generic			
S5921	161	0		29	10	S5921_161_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	161	0		29	10	S5921_161_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	161	0		29	10	S5921_161_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	162	0		29	10	S5921_162_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	162	0		29	10	S5921_162_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	162	0		29	10	S5921_162_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	162	0		29	10	S5921_162_0	2	1	Tier 1-Preferred Generic			
S5921	163	0		29	10	S5921_163_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	163	0		29	10	S5921_163_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	163	0		29	10	S5921_163_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	163	0		29	10	S5921_163_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	163	0		29	10	S5921_163_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	163	0		29	10	S5921_163_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	163	0		29	10	S5921_163_0	2	1	Tier 1 - Preferred Generic			
S5921	163	0		29	10	S5921_163_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	171	0		29	10	S5921_171_0	2	1	Tier 1 - Preferred Generic			
S5921	171	0		29	10	S5921_171_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	171	0		29	10	S5921_171_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	171	0		29	10	S5921_171_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	172	0		29	10	S5921_172_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	172	0		29	10	S5921_172_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	172	0		29	10	S5921_172_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	172	0		29	10	S5921_172_0	2	1	Tier 1-Preferred Generic			
S5921	173	0		29	10	S5921_173_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	173	0		29	10	S5921_173_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	173	0		29	10	S5921_173_0	2	1	Tier 1 - Preferred Generic			
S5921	173	0		29	10	S5921_173_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	173	0		29	10	S5921_173_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	173	0		29	10	S5921_173_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	173	0		29	10	S5921_173_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	173	0		29	10	S5921_173_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	181	0		29	10	S5921_181_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	181	0		29	10	S5921_181_0	2	1	Tier 1 - Preferred Generic			
S5921	181	0		29	10	S5921_181_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	181	0		29	10	S5921_181_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	182	0		29	10	S5921_182_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	182	0		29	10	S5921_182_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	182	0		29	10	S5921_182_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	182	0		29	10	S5921_182_0	2	1	Tier 1-Preferred Generic			
S5921	183	0		29	10	S5921_183_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	183	0		29	10	S5921_183_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	183	0		29	10	S5921_183_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	183	0		29	10	S5921_183_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	183	0		29	10	S5921_183_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	183	0		29	10	S5921_183_0	2	1	Tier 1 - Preferred Generic			
S5921	183	0		29	10	S5921_183_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	183	0		29	10	S5921_183_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	191	0		29	10	S5921_191_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	191	0		29	10	S5921_191_0	2	1	Tier 1 - Preferred Generic			
S5921	191	0		29	10	S5921_191_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	191	0		29	10	S5921_191_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	192	0		29	10	S5921_192_0	2	1	Tier 1-Preferred Generic			
S5921	192	0		29	10	S5921_192_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	192	0		29	10	S5921_192_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	192	0		29	10	S5921_192_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	193	0		29	10	S5921_193_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	193	0		29	10	S5921_193_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	193	0		29	10	S5921_193_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	193	0		29	10	S5921_193_0	2	1	Tier 1 - Preferred Generic			
S5921	193	0		29	10	S5921_193_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	193	0		29	10	S5921_193_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	193	0		29	10	S5921_193_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	193	0		29	10	S5921_193_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	201	0		29	10	S5921_201_0	4	1	Tier 1 - Preferred Generic			
S5921	201	0		29	10	S5921_201_0	4	2	Tier 2 - Generic and Preferred Brand			
S5921	201	0		29	10	S5921_201_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	201	0		29	10	S5921_201_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5921	202	0		29	10	S5921_202_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	202	0		29	10	S5921_202_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	202	0		29	10	S5921_202_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	202	0		29	10	S5921_202_0	2	1	Tier 1-Preferred Generic			
S5921	203	0		29	10	S5921_203_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	203	0		29	10	S5921_203_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	203	0		29	10	S5921_203_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	203	0		29	10	S5921_203_0	2	1	Tier 1 - Preferred Generic			
S5921	207	0		29	10	S5921_207_0	4	1	Tier 1-Preferred Generic			
S5921	207	0		29	10	S5921_207_0	4	2	Tier 2 - Generic and Preferred Brand			
S5921	207	0		29	10	S5921_207_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	207	0		29	10	S5921_207_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5921	213	0		29	10	S5921_213_0	2	1	Tier 1 - Preferred Generic			
S5921	213	0		29	10	S5921_213_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	213	0		29	10	S5921_213_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	213	0		29	10	S5921_213_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	213	0		29	10	S5921_213_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	213	0		29	10	S5921_213_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	213	0		29	10	S5921_213_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	213	0		29	10	S5921_213_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	221	0		29	10	S5921_221_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	221	0		29	10	S5921_221_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	221	0		29	10	S5921_221_0	2	1	Tier 1 - Preferred Generic			
S5921	221	0		29	10	S5921_221_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	222	0		29	10	S5921_222_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	222	0		29	10	S5921_222_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	222	0		29	10	S5921_222_0	2	1	Tier 1-Preferred Generic			
S5921	222	0		29	10	S5921_222_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	223	0		29	10	S5921_223_0	2	1	Tier 1 - Preferred Generic			
S5921	223	0		29	10	S5921_223_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	223	0		29	10	S5921_223_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	223	0		29	10	S5921_223_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	223	0		29	10	S5921_223_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	223	0		29	10	S5921_223_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	223	0		29	10	S5921_223_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	223	0		29	10	S5921_223_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	231	0		29	10	S5921_231_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	231	0		29	10	S5921_231_0	2	1	Tier 1 - Preferred Generic			
S5921	231	0		29	10	S5921_231_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	231	0		29	10	S5921_231_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	232	0		29	10	S5921_232_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	232	0		29	10	S5921_232_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	232	0		29	10	S5921_232_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	232	0		29	10	S5921_232_0	2	1	Tier 1-Preferred Generic			
S5921	233	0		29	10	S5921_233_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	233	0		29	10	S5921_233_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	233	0		29	10	S5921_233_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	233	0		29	10	S5921_233_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	233	0		29	10	S5921_233_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	233	0		29	10	S5921_233_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	233	0		29	10	S5921_233_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	233	0		29	10	S5921_233_0	2	1	Tier 1 - Preferred Generic			
S5921	235	0		29	10	S5921_235_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	235	0		29	10	S5921_235_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	235	0		29	10	S5921_235_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	235	0		29	10	S5921_235_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	235	0		29	10	S5921_235_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	235	0		29	10	S5921_235_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	235	0		29	10	S5921_235_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	235	0		29	10	S5921_235_0	2	1	Tier 1 - Preferred Generic			
S5921	237	0		29	10	S5921_237_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	237	0		29	10	S5921_237_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	237	0		29	10	S5921_237_0	2	1	Tier 1 - Preferred Generic			
S5921	237	0		29	10	S5921_237_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	238	0		29	10	S5921_238_0	2	1	Tier 1-Preferred Generic			
S5921	238	0		29	10	S5921_238_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	238	0		29	10	S5921_238_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	238	0		29	10	S5921_238_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	239	0		29	10	S5921_239_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	239	0		29	10	S5921_239_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	239	0		29	10	S5921_239_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	239	0		29	10	S5921_239_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	239	0		29	10	S5921_239_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	239	0		29	10	S5921_239_0	2	1	Tier 1 - Preferred Generic			
S5921	239	0		29	10	S5921_239_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	239	0		29	10	S5921_239_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	247	0		29	10	S5921_247_0	2	1	Tier 1 - Preferred Generic			
S5921	247	0		29	10	S5921_247_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	247	0		29	10	S5921_247_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	247	0		29	10	S5921_247_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	248	0		29	10	S5921_248_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	248	0		29	10	S5921_248_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	248	0		29	10	S5921_248_0	2	1	Tier 1-Preferred Generic			
S5921	248	0		29	10	S5921_248_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	249	0		29	10	S5921_249_0	2	1	Tier 1 - Preferred Generic			
S5921	249	0		29	10	S5921_249_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	249	0		29	10	S5921_249_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	249	0		29	10	S5921_249_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	249	0		29	10	S5921_249_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	249	0		29	10	S5921_249_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	249	0		29	10	S5921_249_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	249	0		29	10	S5921_249_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	261	0		29	10	S5921_261_0	2	1	Tier 1 - Preferred Generic			
S5921	261	0		29	10	S5921_261_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	261	0		29	10	S5921_261_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	261	0		29	10	S5921_261_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	262	0		29	10	S5921_262_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5921	262	0		29	10	S5921_262_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	262	0		29	10	S5921_262_0	3	2	Tier 2 - Generic and Preferred Brand			
S5921	262	0		29	10	S5921_262_0	3	1	Tier 1-Preferred Generic			
S5921	263	0		29	10	S5921_263_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	263	0		29	10	S5921_263_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	263	0		29	10	S5921_263_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	263	0		29	10	S5921_263_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	263	0		29	10	S5921_263_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	263	0		29	10	S5921_263_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	263	0		29	10	S5921_263_0	2	1	Tier 1 - Preferred Generic			
S5921	263	0		29	10	S5921_263_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	265	0		29	10	S5921_265_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	265	0		29	10	S5921_265_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	265	0		29	10	S5921_265_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	265	0		29	10	S5921_265_0	2	1	Tier 1 - Preferred Generic			
S5921	266	0		29	10	S5921_266_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5921	266	0		29	10	S5921_266_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	266	0		29	10	S5921_266_0	3	2	Tier 2 - Generic and Preferred Brand			
S5921	266	0		29	10	S5921_266_0	3	1	Tier 1-Preferred Generic			
S5921	273	0		29	10	S5921_273_0	2	1	Tier 1 - Preferred Generic			
S5921	273	0		29	10	S5921_273_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	273	0		29	10	S5921_273_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	273	0		29	10	S5921_273_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	273	0		29	10	S5921_273_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	273	0		29	10	S5921_273_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	273	0		29	10	S5921_273_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	273	0		29	10	S5921_273_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	281	0		29	10	S5921_281_0	2	1	Tier 1 - Preferred Generic			
S5921	281	0		29	10	S5921_281_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	281	0		29	10	S5921_281_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	281	0		29	10	S5921_281_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	282	0		29	10	S5921_282_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	282	0		29	10	S5921_282_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	282	0		29	10	S5921_282_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	282	0		29	10	S5921_282_0	2	1	Tier 1-Preferred Generic			
S5921	283	0		29	10	S5921_283_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	283	0		29	10	S5921_283_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	283	0		29	10	S5921_283_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	283	0		29	10	S5921_283_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	283	0		29	10	S5921_283_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	283	0		29	10	S5921_283_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	283	0		29	10	S5921_283_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	283	0		29	10	S5921_283_0	2	1	Tier 1 - Preferred Generic			
S5921	286	0		29	10	S5921_286_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	286	0		29	10	S5921_286_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	286	0		29	10	S5921_286_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	286	0		29	10	S5921_286_0	2	1	Tier 1 - Preferred Generic			
S5921	288	0		29	10	S5921_288_0	3	1	Tier 1-Preferred Generic			
S5921	288	0		29	10	S5921_288_0	3	2	Tier 2 - Generic and Preferred Brand			
S5921	288	0		29	10	S5921_288_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	288	0		29	10	S5921_288_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5921	293	0		29	10	S5921_293_0	2	1	Tier 1 - Preferred Generic			
S5921	293	0		29	10	S5921_293_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	293	0		29	10	S5921_293_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	293	0		29	10	S5921_293_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	293	0		29	10	S5921_293_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	293	0		29	10	S5921_293_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	293	0		29	10	S5921_293_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	293	0		29	10	S5921_293_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	301	0		29	10	S5921_301_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	301	0		29	10	S5921_301_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	301	0		29	10	S5921_301_0	2	1	Tier 1 - Preferred Generic			
S5921	301	0		29	10	S5921_301_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	302	0		29	10	S5921_302_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	302	0		29	10	S5921_302_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	302	0		29	10	S5921_302_0	2	1	Tier 1-Preferred Generic			
S5921	302	0		29	10	S5921_302_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	303	0		29	10	S5921_303_0	2	1	Tier 1 - Preferred Generic			
S5921	303	0		29	10	S5921_303_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	303	0		29	10	S5921_303_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	303	0		29	10	S5921_303_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	303	0		29	10	S5921_303_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	303	0		29	10	S5921_303_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	303	0		29	10	S5921_303_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	303	0		29	10	S5921_303_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	311	0		29	10	S5921_311_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	311	0		29	10	S5921_311_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	311	0		29	10	S5921_311_0	2	1	Tier 1 - Preferred Generic			
S5921	311	0		29	10	S5921_311_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	312	0		29	10	S5921_312_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	312	0		29	10	S5921_312_0	3	2	Tier 2 - Generic and Preferred Brand			
S5921	312	0		29	10	S5921_312_0	3	1	Tier 1-Preferred Generic			
S5921	312	0		29	10	S5921_312_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5921	313	0		29	10	S5921_313_0	2	1	Tier 1 - Preferred Generic			
S5921	313	0		29	10	S5921_313_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	313	0		29	10	S5921_313_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	313	0		29	10	S5921_313_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	313	0		29	10	S5921_313_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	313	0		29	10	S5921_313_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	313	0		29	10	S5921_313_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	313	0		29	10	S5921_313_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	321	0		29	10	S5921_321_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	321	0		29	10	S5921_321_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	321	0		29	10	S5921_321_0	2	1	Tier 1 - Preferred Generic			
S5921	321	0		29	10	S5921_321_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	322	0		29	10	S5921_322_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	322	0		29	10	S5921_322_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	322	0		29	10	S5921_322_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	322	0		29	10	S5921_322_0	2	1	Tier 1-Preferred Generic			
S5921	323	0		29	10	S5921_323_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	323	0		29	10	S5921_323_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	323	0		29	10	S5921_323_0	2	1	Tier 1 - Preferred Generic			
S5921	323	0		29	10	S5921_323_0	2	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	323	0		29	10	S5921_323_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	323	0		29	10	S5921_323_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	323	0		29	10	S5921_323_0	2	1	Tier 1 - Preferred Generic	1		1
S5921	323	0		29	10	S5921_323_0	2	2	Tier 2 - Generic and Preferred Brand	2		
S5921	331	0		29	10	S5921_331_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	331	0		29	10	S5921_331_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	331	0		29	10	S5921_331_0	2	1	Tier 1 - Preferred Generic			
S5921	331	0		29	10	S5921_331_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	332	0		29	10	S5921_332_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	332	0		29	10	S5921_332_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	332	0		29	10	S5921_332_0	2	1	Tier 1-Preferred Generic			
S5921	332	0		29	10	S5921_332_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	333	0		29	10	S5921_333_0	3	1	Tier 1 - Preferred Generic			
S5921	333	0		29	10	S5921_333_0	3	2	Tier 2 - Generic and Preferred Brand			
S5921	333	0		29	10	S5921_333_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	333	0		29	10	S5921_333_0	3	4	Tier 4 - Specialty (Generic, Brand)			
S5921	333	0		29	10	S5921_333_0	3	1	Tier 1 - Preferred Generic	1		1
S5921	333	0		29	10	S5921_333_0	3	2	Tier 2 - Generic and Preferred Brand	2		
S5921	333	0		29	10	S5921_333_0	3	3	Tier 3 - Other Non Preferred (Generic, Brand)	2		
S5921	333	0		29	10	S5921_333_0	3	4	Tier 4 - Specialty (Generic, Brand)	2		
S5921	343	0		29	10	S5921_343_0	2	1	Tier 1-Preferred Generic			
S5921	343	0		29	10	S5921_343_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	343	0		29	10	S5921_343_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	343	0		29	10	S5921_343_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	344	0		29	10	S5921_344_0	2	1	Tier 1-Preferred Generic			
S5921	344	0		29	10	S5921_344_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	344	0		29	10	S5921_344_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	344	0		29	10	S5921_344_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	345	0		29	10	S5921_345_0	2	1	Tier 1-Preferred Generic			
S5921	345	0		29	10	S5921_345_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	345	0		29	10	S5921_345_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	345	0		29	10	S5921_345_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5921	346	0		29	10	S5921_346_0	4	1	Tier 1-Preferred Generic			
S5921	346	0		29	10	S5921_346_0	4	4	Tier 4 - Specialty (Generic, Brand)			
S5921	346	0		29	10	S5921_346_0	4	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	346	0		29	10	S5921_346_0	4	2	Tier 2 - Generic and Preferred Brand			
S5921	347	0		29	10	S5921_347_0	2	1	Tier 1-Preferred Generic			
S5921	347	0		29	10	S5921_347_0	2	2	Tier 2 - Generic and Preferred Brand			
S5921	347	0		29	10	S5921_347_0	2	3	Tier 3 - Other Non Preferred (Generic, Brand)			
S5921	347	0		29	10	S5921_347_0	2	4	Tier 4 - Specialty (Generic, Brand)			
S5937	001	0		29	10	S5937_001_0	3	1	Generic			
S5937	001	0		29	10	S5937_001_0	3	4	Specialty			
S5937	001	0		29	10	S5937_001_0	3	3	Non-Preferred Brand			
S5937	001	0		29	10	S5937_001_0	3	2	Preferred Brand			
S5946	003	0		29	10	S5946_003_0	1	1	Preferred Generic			
S5946	003	0		29	10	S5946_003_0	1	2	Preferred Brand			
S5946	003	0		29	10	S5946_003_0	1	3	Brand			
S5946	003	0		29	10	S5946_003_0	1	4	Specialty			
S5946	004	0		29	10	S5946_004_0	1	1	Preferred Generic			
S5946	004	0		29	10	S5946_004_0	1	2	Preferred Brand			
S5946	004	0		29	10	S5946_004_0	1	3	Brand			
S5946	004	0		29	10	S5946_004_0	1	4	Specialty			
S5953	001	0		29	10	S5953_001_0	2	1	Generic			
S5953	001	0		29	10	S5953_001_0	2	3	Specialty			
S5953	001	0		29	10	S5953_001_0	2	2	Brand			
S5953	002	0		29	10	S5953_002_0	2	4	Specialty			
S5953	002	0		29	10	S5953_002_0	2	1	Generic	1		1
S5953	002	0		29	10	S5953_002_0	2	2	Preferred Brand	2		
S5953	002	0		29	10	S5953_002_0	2	3	Non-Preferred Brand	2		
S5953	002	0		29	10	S5953_002_0	2	4	Specialty	2		
S5953	002	0		29	10	S5953_002_0	2	2	Preferred Brand			
S5953	002	0		29	10	S5953_002_0	2	1	Generic			
S5953	002	0		29	10	S5953_002_0	2	3	Non-Preferred Brand			
S5954	004	0		29	10	S5954_004_0	2	3	Tier 3			
S5954	004	0		29	10	S5954_004_0	2	2	Tier 2			
S5954	004	0		29	10	S5954_004_0	2	1	Tier 1			
S5954	005	0		29	10	S5954_005_0	4	3	Tier 3			
S5954	005	0		29	10	S5954_005_0	4	4	Tier 4			
S5954	005	0		29	10	S5954_005_0	4	1	Tier 1			
S5954	005	0		29	10	S5954_005_0	4	4	Tier 4	2		
S5954	005	0		29	10	S5954_005_0	4	1	Tier 1	1		1
S5954	005	0		29	10	S5954_005_0	4	2	Tier 2			
S5954	005	0		29	10	S5954_005_0	4	2	Tier 2	2		
S5954	005	0		29	10	S5954_005_0	4	3	Tier 3	2		
S5954	007	0		29	10	S5954_007_0	3	4	Tier 4			
S5954	007	0		29	10	S5954_007_0	3	3	Tier 3			
S5954	007	0		29	10	S5954_007_0	3	1	Tier 1			
S5954	007	0		29	10	S5954_007_0	3	2	Tier 2			
S5960	003	0		29	10	S5960_003_0	3	3	Tier 3 Non-Preferred Brand or Generic			
S5960	003	0		29	10	S5960_003_0	3	2	Tier 2 Preferred Brand			
S5960	003	0		29	10	S5960_003_0	3	5	Tier 5 Specialty			
S5960	003	0		29	10	S5960_003_0	3	4	Tier 4 Non-Specialty Injectable			
S5960	003	0		29	10	S5960_003_0	3	1	Tier 1 Preferred Generic			
S5960	004	0		29	10	S5960_004_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	004	0		29	10	S5960_004_0	2	1	Tier 1 Preferred Generic			
S5960	004	0		29	10	S5960_004_0	2	5	Tier 5 Specialty			
S5960	004	0		29	10	S5960_004_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	004	0		29	10	S5960_004_0	2	2	Tier 2 Preferred Brand			
S5960	005	0		29	10	S5960_005_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	005	0		29	10	S5960_005_0	2	1	Tier 1 Preferred Generic			
S5960	005	0		29	10	S5960_005_0	2	5	Tier 5 Specialty			
S5960	005	0		29	10	S5960_005_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	005	0		29	10	S5960_005_0	2	2	Tier 2 Preferred Brand			
S5960	006	0		29	10	S5960_006_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	006	0		29	10	S5960_006_0	2	1	Tier 1 Preferred Generic			
S5960	006	0		29	10	S5960_006_0	2	5	Tier 5 Specialty			
S5960	006	0		29	10	S5960_006_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	006	0		29	10	S5960_006_0	2	2	Tier 2 Preferred Brand			
S5960	008	0		29	10	S5960_008_0	2	2	Tier 2 Preferred Brand			
S5960	008	0		29	10	S5960_008_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	008	0		29	10	S5960_008_0	2	5	Tier 5 Specialty			
S5960	008	0		29	10	S5960_008_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	008	0		29	10	S5960_008_0	2	1	Tier 1 Preferred Generic			
S5960	009	0		29	10	S5960_009_0	2	5	Tier 5 Specialty			
S5960	009	0		29	10	S5960_009_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	009	0		29	10	S5960_009_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	009	0		29	10	S5960_009_0	2	1	Tier 1 Preferred Generic			
S5960	009	0		29	10	S5960_009_0	2	2	Tier 2 Preferred Brand			
S5960	011	0		29	10	S5960_011_0	2	2	Tier 2 Preferred Brand			
S5960	011	0		29	10	S5960_011_0	2	1	Tier 1 Preferred Generic			
S5960	011	0		29	10	S5960_011_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	011	0		29	10	S5960_011_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	011	0		29	10	S5960_011_0	2	5	Tier 5 Specialty			
S5960	012	0		29	10	S5960_012_0	2	1	Tier 1 Preferred Generic			
S5960	012	0		29	10	S5960_012_0	2	2	Tier 2 Preferred Brand			
S5960	012	0		29	10	S5960_012_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	012	0		29	10	S5960_012_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	012	0		29	10	S5960_012_0	2	5	Tier 5 Specialty			
S5960	013	0		29	10	S5960_013_0	2	2	Tier 2 Preferred Brand			
S5960	013	0		29	10	S5960_013_0	2	1	Tier 1 Preferred Generic			
S5960	013	0		29	10	S5960_013_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	013	0		29	10	S5960_013_0	2	5	Tier 5 Specialty			
S5960	013	0		29	10	S5960_013_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	017	0		29	10	S5960_017_0	2	1	Tier 1 Preferred Generic			
S5960	017	0		29	10	S5960_017_0	2	2	Tier 2 Preferred Brand			
S5960	017	0		29	10	S5960_017_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	017	0		29	10	S5960_017_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	017	0		29	10	S5960_017_0	2	5	Tier 5 Specialty			
S5960	019	0		29	10	S5960_019_0	2	1	Tier 1 Preferred Generic			
S5960	019	0		29	10	S5960_019_0	2	2	Tier 2 Preferred Brand			
S5960	019	0		29	10	S5960_019_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	019	0		29	10	S5960_019_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	019	0		29	10	S5960_019_0	2	5	Tier 5 Specialty			
S5960	020	0		29	10	S5960_020_0	2	2	Tier 2 Preferred Brand			
S5960	020	0		29	10	S5960_020_0	2	1	Tier 1 Preferred Generic			
S5960	020	0		29	10	S5960_020_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	020	0		29	10	S5960_020_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	020	0		29	10	S5960_020_0	2	5	Tier 5 Specialty			
S5960	021	0		29	10	S5960_021_0	2	2	Tier 2 Preferred Brand			
S5960	021	0		29	10	S5960_021_0	2	1	Tier 1 Preferred Generic			
S5960	021	0		29	10	S5960_021_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	021	0		29	10	S5960_021_0	2	5	Tier 5 Specialty			
S5960	021	0		29	10	S5960_021_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	022	0		29	10	S5960_022_0	2	1	Tier 1 Preferred Generic			
S5960	022	0		29	10	S5960_022_0	2	2	Tier 2 Preferred Brand			
S5960	022	0		29	10	S5960_022_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	022	0		29	10	S5960_022_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	022	0		29	10	S5960_022_0	2	5	Tier 5 Specialty			
S5960	023	0		29	10	S5960_023_0	2	1	Tier 1 Preferred Generic			
S5960	023	0		29	10	S5960_023_0	2	2	Tier 2 Preferred Brand			
S5960	023	0		29	10	S5960_023_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	023	0		29	10	S5960_023_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	023	0		29	10	S5960_023_0	2	5	Tier 5 Specialty			
S5960	025	0		29	10	S5960_025_0	2	1	Tier 1 Preferred Generic			
S5960	025	0		29	10	S5960_025_0	2	2	Tier 2 Preferred Brand			
S5960	025	0		29	10	S5960_025_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	025	0		29	10	S5960_025_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	025	0		29	10	S5960_025_0	2	5	Tier 5 Specialty			
S5960	026	0		29	10	S5960_026_0	2	2	Tier 2 Preferred Brand			
S5960	026	0		29	10	S5960_026_0	2	1	Tier 1 Preferred Generic			
S5960	026	0		29	10	S5960_026_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	026	0		29	10	S5960_026_0	2	5	Tier 5 Specialty			
S5960	026	0		29	10	S5960_026_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	028	0		29	10	S5960_028_0	2	1	Tier 1 Preferred Generic			
S5960	028	0		29	10	S5960_028_0	2	2	Tier 2 Preferred Brand			
S5960	028	0		29	10	S5960_028_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	028	0		29	10	S5960_028_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	028	0		29	10	S5960_028_0	2	5	Tier 5 Specialty			
S5960	030	0		29	10	S5960_030_0	2	2	Tier 2 Preferred Brand			
S5960	030	0		29	10	S5960_030_0	2	1	Tier 1 Preferred Generic			
S5960	030	0		29	10	S5960_030_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	030	0		29	10	S5960_030_0	2	5	Tier 5 Specialty			
S5960	030	0		29	10	S5960_030_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	031	0		29	10	S5960_031_0	2	2	Tier 2 Preferred Brand			
S5960	031	0		29	10	S5960_031_0	2	1	Tier 1 Preferred Generic			
S5960	031	0		29	10	S5960_031_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	031	0		29	10	S5960_031_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	031	0		29	10	S5960_031_0	2	5	Tier 5 Specialty			
S5960	033	0		29	10	S5960_033_0	2	2	Tier 2 Preferred Brand			
S5960	033	0		29	10	S5960_033_0	2	1	Tier 1 Preferred Generic			
S5960	033	0		29	10	S5960_033_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	033	0		29	10	S5960_033_0	2	5	Tier 5 Specialty			
S5960	033	0		29	10	S5960_033_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	034	0		29	10	S5960_034_0	2	1	Tier 1 Preferred Generic			
S5960	034	0		29	10	S5960_034_0	2	2	Tier 2 Preferred Brand			
S5960	034	0		29	10	S5960_034_0	2	3	Tier 3 Non-Preferred Brand or Generic			
S5960	034	0		29	10	S5960_034_0	2	4	Tier 4 Non-Specialty Injectable			
S5960	034	0		29	10	S5960_034_0	2	5	Tier 5 Specialty			
S5967	035	0		29	10	S5967_035_0	3	4	Tier 4			
S5967	035	0		29	10	S5967_035_0	3	3	Tier 3			
S5967	035	0		29	10	S5967_035_0	3	1	Tier 1			
S5967	035	0		29	10	S5967_035_0	3	2	Tier 2			
S5967	036	0		29	10	S5967_036_0	2	1	Tier 1			
S5967	036	0		29	10	S5967_036_0	2	3	Tier 3			
S5967	036	0		29	10	S5967_036_0	2	4	Tier 4			
S5967	036	0		29	10	S5967_036_0	2	2	Tier 2			
S5967	037	0		29	10	S5967_037_0	2	2	Tier 2			
S5967	037	0		29	10	S5967_037_0	2	3	Tier 3			
S5967	037	0		29	10	S5967_037_0	2	4	Tier 4			
S5967	037	0		29	10	S5967_037_0	2	1	Tier 1			
S5967	038	0		29	10	S5967_038_0	2	2	Tier 2			
S5967	038	0		29	10	S5967_038_0	2	4	Tier 4			
S5967	038	0		29	10	S5967_038_0	2	3	Tier 3			
S5967	038	0		29	10	S5967_038_0	2	1	Tier 1			
S5967	039	0		29	10	S5967_039_0	2	3	Tier 3			
S5967	039	0		29	10	S5967_039_0	2	4	Tier 4			
S5967	039	0		29	10	S5967_039_0	2	2	Tier 2			
S5967	039	0		29	10	S5967_039_0	2	1	Tier 1			
S5967	040	0		29	10	S5967_040_0	2	2	Tier 2			
S5967	040	0		29	10	S5967_040_0	2	4	Tier 4			
S5967	040	0		29	10	S5967_040_0	2	3	Tier 3			
S5967	040	0		29	10	S5967_040_0	2	1	Tier 1			
S5967	041	0		29	10	S5967_041_0	2	3	Tier 3			
S5967	041	0		29	10	S5967_041_0	2	4	Tier 4			
S5967	041	0		29	10	S5967_041_0	2	2	Tier 2			
S5967	041	0		29	10	S5967_041_0	2	1	Tier 1			
S5967	042	0		29	10	S5967_042_0	2	2	Tier 2			
S5967	042	0		29	10	S5967_042_0	2	4	Tier 4			
S5967	042	0		29	10	S5967_042_0	2	3	Tier 3			
S5967	042	0		29	10	S5967_042_0	2	1	Tier 1			
S5967	043	0		29	10	S5967_043_0	2	3	Tier 3			
S5967	043	0		29	10	S5967_043_0	2	4	Tier 4			
S5967	043	0		29	10	S5967_043_0	2	2	Tier 2			
S5967	043	0		29	10	S5967_043_0	2	1	Tier 1			
S5967	044	0		29	10	S5967_044_0	2	2	Tier 2			
S5967	044	0		29	10	S5967_044_0	2	4	Tier 4			
S5967	044	0		29	10	S5967_044_0	2	3	Tier 3			
S5967	044	0		29	10	S5967_044_0	2	1	Tier 1			
S5967	045	0		29	10	S5967_045_0	2	3	Tier 3			
S5967	045	0		29	10	S5967_045_0	2	4	Tier 4			
S5967	045	0		29	10	S5967_045_0	2	2	Tier 2			
S5967	045	0		29	10	S5967_045_0	2	1	Tier 1			
S5967	046	0		29	10	S5967_046_0	2	2	Tier 2			
S5967	046	0		29	10	S5967_046_0	2	3	Tier 3			
S5967	046	0		29	10	S5967_046_0	2	4	Tier 4			
S5967	046	0		29	10	S5967_046_0	2	1	Tier 1			
S5967	047	0		29	10	S5967_047_0	2	2	Tier 2			
S5967	047	0		29	10	S5967_047_0	2	1	Tier 1			
S5967	047	0		29	10	S5967_047_0	2	3	Tier 3			
S5967	047	0		29	10	S5967_047_0	2	4	Tier 4			
S5967	048	0		29	10	S5967_048_0	2	4	Tier 4			
S5967	048	0		29	10	S5967_048_0	2	1	Tier 1			
S5967	048	0		29	10	S5967_048_0	2	2	Tier 2			
S5967	048	0		29	10	S5967_048_0	2	3	Tier 3			
S5967	049	0		29	10	S5967_049_0	2	1	Tier 1			
S5967	049	0		29	10	S5967_049_0	2	4	Tier 4			
S5967	049	0		29	10	S5967_049_0	2	3	Tier 3			
S5967	049	0		29	10	S5967_049_0	2	2	Tier 2			
S5967	050	0		29	10	S5967_050_0	2	1	Tier 1			
S5967	050	0		29	10	S5967_050_0	2	4	Tier 4			
S5967	050	0		29	10	S5967_050_0	2	2	Tier 2			
S5967	050	0		29	10	S5967_050_0	2	3	Tier 3			
S5967	051	0		29	10	S5967_051_0	2	3	Tier 3			
S5967	051	0		29	10	S5967_051_0	2	1	Tier 1			
S5967	051	0		29	10	S5967_051_0	2	4	Tier 4			
S5967	051	0		29	10	S5967_051_0	2	2	Tier 2			
S5967	052	0		29	10	S5967_052_0	2	3	Tier 3			
S5967	052	0		29	10	S5967_052_0	2	1	Tier 1			
S5967	052	0		29	10	S5967_052_0	2	4	Tier 4			
S5967	052	0		29	10	S5967_052_0	2	2	Tier 2			
S5967	053	0		29	10	S5967_053_0	2	3	Tier 3			
S5967	053	0		29	10	S5967_053_0	2	1	Tier 1			
S5967	053	0		29	10	S5967_053_0	2	4	Tier 4			
S5967	053	0		29	10	S5967_053_0	2	2	Tier 2			
S5967	054	0		29	10	S5967_054_0	2	3	Tier 3			
S5967	054	0		29	10	S5967_054_0	2	1	Tier 1			
S5967	054	0		29	10	S5967_054_0	2	4	Tier 4			
S5967	054	0		29	10	S5967_054_0	2	2	Tier 2			
S5967	055	0		29	10	S5967_055_0	2	3	Tier 3			
S5967	055	0		29	10	S5967_055_0	2	1	Tier 1			
S5967	055	0		29	10	S5967_055_0	2	4	Tier 4			
S5967	055	0		29	10	S5967_055_0	2	2	Tier 2			
S5967	056	0		29	10	S5967_056_0	2	3	Tier 3			
S5967	056	0		29	10	S5967_056_0	2	1	Tier 1			
S5967	056	0		29	10	S5967_056_0	2	4	Tier 4			
S5967	056	0		29	10	S5967_056_0	2	2	Tier 2			
S5967	057	0		29	10	S5967_057_0	2	2	Tier 2			
S5967	057	0		29	10	S5967_057_0	2	1	Tier 1			
S5967	057	0		29	10	S5967_057_0	2	3	Tier 3			
S5967	057	0		29	10	S5967_057_0	2	4	Tier 4			
S5967	058	0		29	10	S5967_058_0	2	3	Tier 3			
S5967	058	0		29	10	S5967_058_0	2	2	Tier 2			
S5967	058	0		29	10	S5967_058_0	2	1	Tier 1			
S5967	058	0		29	10	S5967_058_0	2	4	Tier 4			
S5967	059	0		29	10	S5967_059_0	2	3	Tier 3			
S5967	059	0		29	10	S5967_059_0	2	4	Tier 4			
S5967	059	0		29	10	S5967_059_0	2	1	Tier 1			
S5967	059	0		29	10	S5967_059_0	2	2	Tier 2			
S5967	060	0		29	10	S5967_060_0	2	1	Tier 1			
S5967	060	0		29	10	S5967_060_0	2	2	Tier 2			
S5967	060	0		29	10	S5967_060_0	2	3	Tier 3			
S5967	060	0		29	10	S5967_060_0	2	4	Tier 4			
S5967	061	0		29	10	S5967_061_0	2	1	Tier 1			
S5967	061	0		29	10	S5967_061_0	2	2	Tier 2			
S5967	061	0		29	10	S5967_061_0	2	4	Tier 4			
S5967	061	0		29	10	S5967_061_0	2	3	Tier 3			
S5967	062	0		29	10	S5967_062_0	2	1	Tier 1			
S5967	062	0		29	10	S5967_062_0	2	4	Tier 4			
S5967	062	0		29	10	S5967_062_0	2	2	Tier 2			
S5967	062	0		29	10	S5967_062_0	2	3	Tier 3			
S5967	063	0		29	10	S5967_063_0	2	4	Tier 4			
S5967	063	0		29	10	S5967_063_0	2	3	Tier 3			
S5967	063	0		29	10	S5967_063_0	2	2	Tier 2			
S5967	063	0		29	10	S5967_063_0	2	1	Tier 1			
S5967	064	0		29	10	S5967_064_0	2	3	Tier 3			
S5967	064	0		29	10	S5967_064_0	2	2	Tier 2			
S5967	064	0		29	10	S5967_064_0	2	1	Tier 1			
S5967	064	0		29	10	S5967_064_0	2	4	Tier 4			
S5967	065	0		29	10	S5967_065_0	2	4	Tier 4			
S5967	065	0		29	10	S5967_065_0	2	3	Tier 3			
S5967	065	0		29	10	S5967_065_0	2	2	Tier 2			
S5967	065	0		29	10	S5967_065_0	2	1	Tier 1			
S5967	066	0		29	10	S5967_066_0	2	3	Tier 3			
S5967	066	0		29	10	S5967_066_0	2	4	Tier 4			
S5967	066	0		29	10	S5967_066_0	2	1	Tier 1			
S5967	066	0		29	10	S5967_066_0	2	2	Tier 2			
S5967	067	0		29	10	S5967_067_0	2	1	Tier 1			
S5967	067	0		29	10	S5967_067_0	2	2	Tier 2			
S5967	067	0		29	10	S5967_067_0	2	3	Tier 3			
S5967	067	0		29	10	S5967_067_0	2	4	Tier 4			
S5967	068	0		29	10	S5967_068_0	2	1	Tier 1			
S5967	068	0		29	10	S5967_068_0	2	2	Tier 2			
S5967	068	0		29	10	S5967_068_0	2	3	Tier 3			
S5967	068	0		29	10	S5967_068_0	2	4	Tier 4			
S5967	138	0		29	10	S5967_138_0	2	1	Tier 1			
S5967	138	0		29	10	S5967_138_0	2	2	Tier 2			
S5967	138	0		29	10	S5967_138_0	2	4	Tier 4			
S5967	138	0		29	10	S5967_138_0	2	3	Tier 3			
S5967	139	0		29	10	S5967_139_0	2	4	Tier 4			
S5967	139	0		29	10	S5967_139_0	2	3	Tier 3			
S5967	139	0		29	10	S5967_139_0	2	2	Tier 2			
S5967	139	0		29	10	S5967_139_0	2	1	Tier 1			
S5967	140	0		29	10	S5967_140_0	2	2	Tier 2			
S5967	140	0		29	10	S5967_140_0	2	4	Tier 4			
S5967	140	0		29	10	S5967_140_0	2	3	Tier 3			
S5967	140	0		29	10	S5967_140_0	2	1	Tier 1			
S5967	141	0		29	10	S5967_141_0	2	4	Tier 4			
S5967	141	0		29	10	S5967_141_0	2	3	Tier 3			
S5967	141	0		29	10	S5967_141_0	2	2	Tier 2			
S5967	141	0		29	10	S5967_141_0	2	1	Tier 1			
S5967	142	0		29	10	S5967_142_0	2	4	Tier 4			
S5967	142	0		29	10	S5967_142_0	2	1	Tier 1			
S5967	142	0		29	10	S5967_142_0	2	2	Tier 2			
S5967	142	0		29	10	S5967_142_0	2	3	Tier 3			
S5967	143	0		29	10	S5967_143_0	2	1	Tier 1			
S5967	143	0		29	10	S5967_143_0	2	2	Tier 2			
S5967	143	0		29	10	S5967_143_0	2	3	Tier 3			
S5967	143	0		29	10	S5967_143_0	2	4	Tier 4			
S5967	144	0		29	10	S5967_144_0	2	2	Tier 2			
S5967	144	0		29	10	S5967_144_0	2	1	Tier 1			
S5967	144	0		29	10	S5967_144_0	2	3	Tier 3			
S5967	144	0		29	10	S5967_144_0	2	4	Tier 4			
S5967	145	0		29	10	S5967_145_0	2	3	Tier 3			
S5967	145	0		29	10	S5967_145_0	2	4	Tier 4			
S5967	145	0		29	10	S5967_145_0	2	1	Tier 1			
S5967	145	0		29	10	S5967_145_0	2	2	Tier 2			
S5967	146	0		29	10	S5967_146_0	2	4	Tier 4			
S5967	146	0		29	10	S5967_146_0	2	1	Tier 1			
S5967	146	0		29	10	S5967_146_0	2	2	Tier 2			
S5967	146	0		29	10	S5967_146_0	2	3	Tier 3			
S5967	147	0		29	10	S5967_147_0	2	1	Tier 1			
S5967	147	0		29	10	S5967_147_0	2	2	Tier 2			
S5967	147	0		29	10	S5967_147_0	2	4	Tier 4			
S5967	147	0		29	10	S5967_147_0	2	3	Tier 3			
S5967	148	0		29	10	S5967_148_0	2	1	Tier 1			
S5967	148	0		29	10	S5967_148_0	2	3	Tier 3			
S5967	148	0		29	10	S5967_148_0	2	2	Tier 2			
S5967	148	0		29	10	S5967_148_0	2	4	Tier 4			
S5967	149	0		29	10	S5967_149_0	2	3	Tier 3			
S5967	149	0		29	10	S5967_149_0	2	4	Tier 4			
S5967	149	0		29	10	S5967_149_0	2	2	Tier 2			
S5967	149	0		29	10	S5967_149_0	2	1	Tier 1			
S5967	150	0		29	10	S5967_150_0	2	4	Tier 4			
S5967	150	0		29	10	S5967_150_0	2	3	Tier 3			
S5967	150	0		29	10	S5967_150_0	2	2	Tier 2			
S5967	150	0		29	10	S5967_150_0	2	1	Tier 1			
S5967	151	0		29	10	S5967_151_0	2	3	Tier 3			
S5967	151	0		29	10	S5967_151_0	2	1	Tier 1			
S5967	151	0		29	10	S5967_151_0	2	2	Tier 2			
S5967	151	0		29	10	S5967_151_0	2	4	Tier 4			
S5967	152	0		29	10	S5967_152_0	2	1	Tier 1			
S5967	152	0		29	10	S5967_152_0	2	2	Tier 2			
S5967	152	0		29	10	S5967_152_0	2	3	Tier 3			
S5967	152	0		29	10	S5967_152_0	2	4	Tier 4			
S5967	153	0		29	10	S5967_153_0	2	1	Tier 1			
S5967	153	0		29	10	S5967_153_0	2	3	Tier 3			
S5967	153	0		29	10	S5967_153_0	2	4	Tier 4			
S5967	153	0		29	10	S5967_153_0	2	2	Tier 2			
S5967	154	0		29	10	S5967_154_0	2	1	Tier 1			
S5967	154	0		29	10	S5967_154_0	2	2	Tier 2			
S5967	154	0		29	10	S5967_154_0	2	3	Tier 3			
S5967	154	0		29	10	S5967_154_0	2	4	Tier 4			
S5967	155	0		29	10	S5967_155_0	2	1	Tier 1			
S5967	155	0		29	10	S5967_155_0	2	2	Tier 2			
S5967	155	0		29	10	S5967_155_0	2	3	Tier 3			
S5967	155	0		29	10	S5967_155_0	2	4	Tier 4			
S5967	156	0		29	10	S5967_156_0	2	1	Tier 1			
S5967	156	0		29	10	S5967_156_0	2	2	Tier 2			
S5967	156	0		29	10	S5967_156_0	2	3	Tier 3			
S5967	156	0		29	10	S5967_156_0	2	4	Tier 4			
S5967	157	0		29	10	S5967_157_0	2	1	Tier 1			
S5967	157	0		29	10	S5967_157_0	2	2	Tier 2			
S5967	157	0		29	10	S5967_157_0	2	4	Tier 4			
S5967	157	0		29	10	S5967_157_0	2	3	Tier 3			
S5967	158	0		29	10	S5967_158_0	2	1	Tier 1			
S5967	158	0		29	10	S5967_158_0	2	2	Tier 2			
S5967	158	0		29	10	S5967_158_0	2	3	Tier 3			
S5967	158	0		29	10	S5967_158_0	2	4	Tier 4			
S5967	159	0		29	10	S5967_159_0	2	1	Tier 1			
S5967	159	0		29	10	S5967_159_0	2	3	Tier 3			
S5967	159	0		29	10	S5967_159_0	2	2	Tier 2			
S5967	159	0		29	10	S5967_159_0	2	4	Tier 4			
S5967	160	0		29	10	S5967_160_0	2	1	Tier 1			
S5967	160	0		29	10	S5967_160_0	2	2	Tier 2			
S5967	160	0		29	10	S5967_160_0	2	4	Tier 4			
S5967	160	0		29	10	S5967_160_0	2	3	Tier 3			
S5967	161	0		29	10	S5967_161_0	2	4	Tier 4			
S5967	161	0		29	10	S5967_161_0	2	3	Tier 3			
S5967	161	0		29	10	S5967_161_0	2	2	Tier 2			
S5967	161	0		29	10	S5967_161_0	2	1	Tier 1			
S5967	162	0		29	10	S5967_162_0	2	3	Tier 3			
S5967	162	0		29	10	S5967_162_0	2	2	Tier 2			
S5967	162	0		29	10	S5967_162_0	2	4	Tier 4			
S5967	162	0		29	10	S5967_162_0	2	1	Tier 1			
S5967	163	0		29	10	S5967_163_0	2	1	Tier 1			
S5967	163	0		29	10	S5967_163_0	2	2	Tier 2			
S5967	163	0		29	10	S5967_163_0	2	3	Tier 3			
S5967	163	0		29	10	S5967_163_0	2	4	Tier 4			
S5967	164	0		29	10	S5967_164_0	2	1	Tier 1			
S5967	164	0		29	10	S5967_164_0	2	2	Tier 2			
S5967	164	0		29	10	S5967_164_0	2	4	Tier 4			
S5967	164	0		29	10	S5967_164_0	2	3	Tier 3			
S5967	165	0		29	10	S5967_165_0	2	1	Tier 1			
S5967	165	0		29	10	S5967_165_0	2	3	Tier 3			
S5967	165	0		29	10	S5967_165_0	2	2	Tier 2			
S5967	165	0		29	10	S5967_165_0	2	4	Tier 4			
S5967	166	0		29	10	S5967_166_0	2	4	Tier 4			
S5967	166	0		29	10	S5967_166_0	2	3	Tier 3			
S5967	166	0		29	10	S5967_166_0	2	1	Tier 1			
S5967	166	0		29	10	S5967_166_0	2	2	Tier 2			
S5967	167	0		29	10	S5967_167_0	2	4	Tier 4			
S5967	167	0		29	10	S5967_167_0	2	1	Tier 1			
S5967	167	0		29	10	S5967_167_0	2	2	Tier 2			
S5967	167	0		29	10	S5967_167_0	2	3	Tier 3			
S5967	168	0		29	10	S5967_168_0	2	3	Tier 3			
S5967	168	0		29	10	S5967_168_0	2	1	Tier 1			
S5967	168	0		29	10	S5967_168_0	2	2	Tier 2			
S5967	168	0		29	10	S5967_168_0	2	4	Tier 4			
S5967	169	0		29	10	S5967_169_0	2	4	Tier 4			
S5967	169	0		29	10	S5967_169_0	2	1	Tier 1			
S5967	169	0		29	10	S5967_169_0	2	2	Tier 2			
S5967	169	0		29	10	S5967_169_0	2	3	Tier 3			
S5967	170	0		29	10	S5967_170_0	2	1	Tier 1			
S5967	170	0		29	10	S5967_170_0	2	2	Tier 2			
S5967	170	0		29	10	S5967_170_0	2	3	Tier 3			
S5967	170	0		29	10	S5967_170_0	2	4	Tier 4			
S5967	171	0		29	10	S5967_171_0	2	1	Tier 1			
S5967	171	0		29	10	S5967_171_0	2	2	Tier 2			
S5967	171	0		29	10	S5967_171_0	2	3	Tier 3			
S5967	171	0		29	10	S5967_171_0	2	4	Tier 4			
S5983	001	0		29	10	S5983_001_0	3	2	Preferred Brand			
S5983	001	0		29	10	S5983_001_0	3	1	Generic			
S5983	001	0		29	10	S5983_001_0	3	4	Specialty			
S5983	001	0		29	10	S5983_001_0	3	3	Non-Preferred Brand			
S5983	004	0		29	10	S5983_004_0	2	3	Non-Preferred Brand			
S5983	004	0		29	10	S5983_004_0	2	2	Preferred Brand			
S5983	004	0		29	10	S5983_004_0	2	1	Generic			
S5983	004	0		29	10	S5983_004_0	2	4	Specialty			
S5983	005	0		29	10	S5983_005_0	3	1	Generic			
S5983	005	0		29	10	S5983_005_0	3	2	Preferred Brand			
S5983	005	0		29	10	S5983_005_0	3	3	Non-Preferred Brand			
S5983	005	0		29	10	S5983_005_0	3	4	Specialty			
S5983	005	0		29	10	S5983_005_0	3	1	Generic	1		1
S5983	005	0		29	10	S5983_005_0	3	2	Preferred Brand	2		
S5983	005	0		29	10	S5983_005_0	3	3	Non-Preferred Brand	2		
S5983	005	0		29	10	S5983_005_0	3	4	Specialty	2		
S5993	001	0		29	10	S5993_001_0	4	3	Non-Preferred Brand			
S5993	001	0		29	10	S5993_001_0	4	2	Preferred Brand			
S5993	001	0		29	10	S5993_001_0	4	1	Generic			
S5993	001	0		29	10	S5993_001_0	4	4	Specialty			
S5993	003	0		29	10	S5993_003_0	2	1	Generic	1		1
S5993	003	0		29	10	S5993_003_0	2	2	Preferred Brand	2		
S5993	003	0		29	10	S5993_003_0	2	3	Non-Preferred Brand	2		
S5993	003	0		29	10	S5993_003_0	2	4	Specialty			
S5993	003	0		29	10	S5993_003_0	2	3	Non-Preferred Brand			
S5993	003	0		29	10	S5993_003_0	2	4	Specialty	2		
S5993	003	0		29	10	S5993_003_0	2	1	Generic			
S5993	003	0		29	10	S5993_003_0	2	2	Preferred Brand			
S7694	001	0		29	10	S7694_001_0	3	4	Tier 4 NonPreferred Brand			
S7694	001	0		29	10	S7694_001_0	3	3	Tier 3 Preferred Brand			
S7694	001	0		29	10	S7694_001_0	3	1	Tier 1 Preferred Generic			
S7694	001	0		29	10	S7694_001_0	3	2	Tier 2 Non Preferred Generics			
S7694	001	0		29	10	S7694_001_0	3	5	Tier 5 Specialty Drugs			
S7694	002	0		29	10	S7694_002_0	3	4	Tier 4 NonPreferred Brand			
S7694	002	0		29	10	S7694_002_0	3	3	Tier 3 Preferred Brand			
S7694	002	0		29	10	S7694_002_0	3	2	Tier 2 Non Preferred Generics			
S7694	002	0		29	10	S7694_002_0	3	1	Tier 1 Preferred Generic			
S7694	002	0		29	10	S7694_002_0	3	5	Tier 5 Specialty Drugs			
S7694	003	0		29	10	S7694_003_0	3	1	Tier 1 Preferred Generic			
S7694	003	0		29	10	S7694_003_0	3	2	Tier 2 Non Preferred Generics			
S7694	003	0		29	10	S7694_003_0	3	3	Tier 3 Preferred Brand			
S7694	003	0		29	10	S7694_003_0	3	4	Tier 4 NonPreferred Brand			
S7694	003	0		29	10	S7694_003_0	3	5	Tier 5 Specialty Drugs			
S7694	004	0		29	10	S7694_004_0	3	1	Tier 1 Preferred Generic			
S7694	004	0		29	10	S7694_004_0	3	2	Tier 2 Non Preferred Generics			
S7694	004	0		29	10	S7694_004_0	3	3	Tier 3 Preferred Brand			
S7694	004	0		29	10	S7694_004_0	3	4	Tier 4 NonPreferred Brand			
S7694	004	0		29	10	S7694_004_0	3	5	Tier 5 Specialty Drugs			
S7694	005	0		29	10	S7694_005_0	3	2	Tier 2 Non Preferred Generics			
S7694	005	0		29	10	S7694_005_0	3	1	Tier 1 Preferred Generic			
S7694	005	0		29	10	S7694_005_0	3	3	Tier 3 Preferred Brand			
S7694	005	0		29	10	S7694_005_0	3	5	Tier 5 Specialty Drugs			
S7694	005	0		29	10	S7694_005_0	3	4	Tier 4 NonPreferred Brand			
S7694	006	0		29	10	S7694_006_0	3	4	Tier 4 NonPreferred Brand			
S7694	006	0		29	10	S7694_006_0	3	3	Tier 3 Preferred Brand			
S7694	006	0		29	10	S7694_006_0	3	2	Tier 2 Non Preferred Generics			
S7694	006	0		29	10	S7694_006_0	3	1	Tier 1 Preferred Generic			
S7694	006	0		29	10	S7694_006_0	3	5	Tier 5 Specialty Drugs			
S7694	007	0		29	10	S7694_007_0	3	4	Tier 4 NonPreferred Brand			
S7694	007	0		29	10	S7694_007_0	3	3	Tier 3 Preferred Brand			
S7694	007	0		29	10	S7694_007_0	3	2	Tier 2 Non Preferred Generics			
S7694	007	0		29	10	S7694_007_0	3	1	Tier 1 Preferred Generic			
S7694	007	0		29	10	S7694_007_0	3	5	Tier 5 Specialty Drugs			
S7694	008	0		29	10	S7694_008_0	3	1	Tier 1 Preferred Generic			
S7694	008	0		29	10	S7694_008_0	3	2	Tier 2 Non Preferred Generics			
S7694	008	0		29	10	S7694_008_0	3	3	Tier 3 Preferred Brand			
S7694	008	0		29	10	S7694_008_0	3	4	Tier 4 NonPreferred Brand			
S7694	008	0		29	10	S7694_008_0	3	5	Tier 5 Specialty Drugs			
S7694	009	0		29	10	S7694_009_0	3	1	Tier 1 Preferred Generic			
S7694	009	0		29	10	S7694_009_0	3	2	Tier 2 Non Preferred Generics			
S7694	009	0		29	10	S7694_009_0	3	4	Tier 4 NonPreferred Brand			
S7694	009	0		29	10	S7694_009_0	3	3	Tier 3 Preferred Brand			
S7694	009	0		29	10	S7694_009_0	3	5	Tier 5 Specialty Drugs			
S7694	010	0		29	10	S7694_010_0	3	1	Tier 1 Preferred Generic			
S7694	010	0		29	10	S7694_010_0	3	2	Tier 2 Non Preferred Generics			
S7694	010	0		29	10	S7694_010_0	3	5	Tier 5 Specialty Drugs			
S7694	010	0		29	10	S7694_010_0	3	4	Tier 4 NonPreferred Brand			
S7694	010	0		29	10	S7694_010_0	3	3	Tier 3 Preferred Brand			
S7694	011	0		29	10	S7694_011_0	3	3	Tier 3 Preferred Brand			
S7694	011	0		29	10	S7694_011_0	3	5	Tier 5 Specialty Drugs			
S7694	011	0		29	10	S7694_011_0	3	4	Tier 4 NonPreferred Brand			
S7694	011	0		29	10	S7694_011_0	3	2	Tier 2 Non Preferred Generics			
S7694	011	0		29	10	S7694_011_0	3	1	Tier 1 Preferred Generic			
S7694	012	0		29	10	S7694_012_0	3	4	Tier 4 NonPreferred Brand			
S7694	012	0		29	10	S7694_012_0	3	5	Tier 5 Specialty Drugs			
S7694	012	0		29	10	S7694_012_0	3	3	Tier 3 Preferred Brand			
S7694	012	0		29	10	S7694_012_0	3	2	Tier 2 Non Preferred Generics			
S7694	012	0		29	10	S7694_012_0	3	1	Tier 1 Preferred Generic			
S7694	013	0		29	10	S7694_013_0	3	4	Tier 4 NonPreferred Brand			
S7694	013	0		29	10	S7694_013_0	3	5	Tier 5 Specialty Drugs			
S7694	013	0		29	10	S7694_013_0	3	2	Tier 2 Non Preferred Generics			
S7694	013	0		29	10	S7694_013_0	3	3	Tier 3 Preferred Brand			
S7694	013	0		29	10	S7694_013_0	3	1	Tier 1 Preferred Generic			
S7694	014	0		29	10	S7694_014_0	3	1	Tier 1 Preferred Generic			
S7694	014	0		29	10	S7694_014_0	3	2	Tier 2 Non Preferred Generics			
S7694	014	0		29	10	S7694_014_0	3	5	Tier 5 Specialty Drugs			
S7694	014	0		29	10	S7694_014_0	3	4	Tier 4 NonPreferred Brand			
S7694	014	0		29	10	S7694_014_0	3	3	Tier 3 Preferred Brand			
S7694	015	0		29	10	S7694_015_0	3	5	Tier 5 Specialty Drugs			
S7694	015	0		29	10	S7694_015_0	3	4	Tier 4 NonPreferred Brand			
S7694	015	0		29	10	S7694_015_0	3	3	Tier 3 Preferred Brand			
S7694	015	0		29	10	S7694_015_0	3	1	Tier 1 Preferred Generic			
S7694	015	0		29	10	S7694_015_0	3	2	Tier 2 Non Preferred Generics			
S7694	016	0		29	10	S7694_016_0	3	3	Tier 3 Preferred Brand			
S7694	016	0		29	10	S7694_016_0	3	4	Tier 4 NonPreferred Brand			
S7694	016	0		29	10	S7694_016_0	3	2	Tier 2 Non Preferred Generics			
S7694	016	0		29	10	S7694_016_0	3	1	Tier 1 Preferred Generic			
S7694	016	0		29	10	S7694_016_0	3	5	Tier 5 Specialty Drugs			
S7694	017	0		29	10	S7694_017_0	3	2	Tier 2 Non Preferred Generics			
S7694	017	0		29	10	S7694_017_0	3	1	Tier 1 Preferred Generic			
S7694	017	0		29	10	S7694_017_0	3	3	Tier 3 Preferred Brand			
S7694	017	0		29	10	S7694_017_0	3	5	Tier 5 Specialty Drugs			
S7694	017	0		29	10	S7694_017_0	3	4	Tier 4 NonPreferred Brand			
S7694	018	0		29	10	S7694_018_0	3	1	Tier 1 Preferred Generic			
S7694	018	0		29	10	S7694_018_0	3	2	Tier 2 Non Preferred Generics			
S7694	018	0		29	10	S7694_018_0	3	4	Tier 4 NonPreferred Brand			
S7694	018	0		29	10	S7694_018_0	3	3	Tier 3 Preferred Brand			
S7694	018	0		29	10	S7694_018_0	3	5	Tier 5 Specialty Drugs			
S7694	019	0		29	10	S7694_019_0	3	4	Tier 4 NonPreferred Brand			
S7694	019	0		29	10	S7694_019_0	3	3	Tier 3 Preferred Brand			
S7694	019	0		29	10	S7694_019_0	3	2	Tier 2 Non Preferred Generics			
S7694	019	0		29	10	S7694_019_0	3	1	Tier 1 Preferred Generic			
S7694	019	0		29	10	S7694_019_0	3	5	Tier 5 Specialty Drugs			
S7694	020	0		29	10	S7694_020_0	3	2	Tier 2 Non Preferred Generics			
S7694	020	0		29	10	S7694_020_0	3	1	Tier 1 Preferred Generic			
S7694	020	0		29	10	S7694_020_0	3	4	Tier 4 NonPreferred Brand			
S7694	020	0		29	10	S7694_020_0	3	5	Tier 5 Specialty Drugs			
S7694	020	0		29	10	S7694_020_0	3	3	Tier 3 Preferred Brand			
S7694	021	0		29	10	S7694_021_0	3	1	Tier 1 Preferred Generic			
S7694	021	0		29	10	S7694_021_0	3	2	Tier 2 Non Preferred Generics			
S7694	021	0		29	10	S7694_021_0	3	4	Tier 4 NonPreferred Brand			
S7694	021	0		29	10	S7694_021_0	3	5	Tier 5 Specialty Drugs			
S7694	021	0		29	10	S7694_021_0	3	3	Tier 3 Preferred Brand			
S7694	022	0		29	10	S7694_022_0	3	3	Tier 3 Preferred Brand			
S7694	022	0		29	10	S7694_022_0	3	5	Tier 5 Specialty Drugs			
S7694	022	0		29	10	S7694_022_0	3	4	Tier 4 NonPreferred Brand			
S7694	022	0		29	10	S7694_022_0	3	2	Tier 2 Non Preferred Generics			
S7694	022	0		29	10	S7694_022_0	3	1	Tier 1 Preferred Generic			
S7694	023	0		29	10	S7694_023_0	3	4	Tier 4 NonPreferred Brand			
S7694	023	0		29	10	S7694_023_0	3	5	Tier 5 Specialty Drugs			
S7694	023	0		29	10	S7694_023_0	3	3	Tier 3 Preferred Brand			
S7694	023	0		29	10	S7694_023_0	3	2	Tier 2 Non Preferred Generics			
S7694	023	0		29	10	S7694_023_0	3	1	Tier 1 Preferred Generic			
S7694	024	0		29	10	S7694_024_0	3	3	Tier 3 Preferred Brand			
S7694	024	0		29	10	S7694_024_0	3	5	Tier 5 Specialty Drugs			
S7694	024	0		29	10	S7694_024_0	3	4	Tier 4 NonPreferred Brand			
S7694	024	0		29	10	S7694_024_0	3	2	Tier 2 Non Preferred Generics			
S7694	024	0		29	10	S7694_024_0	3	1	Tier 1 Preferred Generic			
S7694	025	0		29	10	S7694_025_0	3	4	Tier 4 NonPreferred Brand			
S7694	025	0		29	10	S7694_025_0	3	5	Tier 5 Specialty Drugs			
S7694	025	0		29	10	S7694_025_0	3	3	Tier 3 Preferred Brand			
S7694	025	0		29	10	S7694_025_0	3	2	Tier 2 Non Preferred Generics			
S7694	025	0		29	10	S7694_025_0	3	1	Tier 1 Preferred Generic			
S7694	026	0		29	10	S7694_026_0	3	4	Tier 4 NonPreferred Brand			
S7694	026	0		29	10	S7694_026_0	3	5	Tier 5 Specialty Drugs			
S7694	026	0		29	10	S7694_026_0	3	2	Tier 2 Non Preferred Generics			
S7694	026	0		29	10	S7694_026_0	3	3	Tier 3 Preferred Brand			
S7694	026	0		29	10	S7694_026_0	3	1	Tier 1 Preferred Generic			
S7694	027	0		29	10	S7694_027_0	3	1	Tier 1 Preferred Generic			
S7694	027	0		29	10	S7694_027_0	3	2	Tier 2 Non Preferred Generics			
S7694	027	0		29	10	S7694_027_0	3	5	Tier 5 Specialty Drugs			
S7694	027	0		29	10	S7694_027_0	3	4	Tier 4 NonPreferred Brand			
S7694	027	0		29	10	S7694_027_0	3	3	Tier 3 Preferred Brand			
S7694	028	0		29	10	S7694_028_0	3	5	Tier 5 Specialty Drugs			
S7694	028	0		29	10	S7694_028_0	3	4	Tier 4 NonPreferred Brand			
S7694	028	0		29	10	S7694_028_0	3	3	Tier 3 Preferred Brand			
S7694	028	0		29	10	S7694_028_0	3	2	Tier 2 Non Preferred Generics			
S7694	028	0		29	10	S7694_028_0	3	1	Tier 1 Preferred Generic			
S7694	029	0		29	10	S7694_029_0	3	5	Tier 5 Specialty Drugs			
S7694	029	0		29	10	S7694_029_0	3	2	Tier 2 Non Preferred Generics			
S7694	029	0		29	10	S7694_029_0	3	3	Tier 3 Preferred Brand			
S7694	029	0		29	10	S7694_029_0	3	4	Tier 4 NonPreferred Brand			
S7694	029	0		29	10	S7694_029_0	3	1	Tier 1 Preferred Generic			
S7694	030	0		29	10	S7694_030_0	3	1	Tier 1 Preferred Generic			
S7694	030	0		29	10	S7694_030_0	3	2	Tier 2 Non Preferred Generics			
S7694	030	0		29	10	S7694_030_0	3	5	Tier 5 Specialty Drugs			
S7694	030	0		29	10	S7694_030_0	3	4	Tier 4 NonPreferred Brand			
S7694	030	0		29	10	S7694_030_0	3	3	Tier 3 Preferred Brand			
S7694	031	0		29	10	S7694_031_0	3	1	Tier 1 Preferred Generic			
S7694	031	0		29	10	S7694_031_0	3	2	Tier 2 Non Preferred Generics			
S7694	031	0		29	10	S7694_031_0	3	3	Tier 3 Preferred Brand			
S7694	031	0		29	10	S7694_031_0	3	4	Tier 4 NonPreferred Brand			
S7694	031	0		29	10	S7694_031_0	3	5	Tier 5 Specialty Drugs			
S7694	032	0		29	10	S7694_032_0	3	3	Tier 3 Preferred Brand			
S7694	032	0		29	10	S7694_032_0	3	4	Tier 4 NonPreferred Brand			
S7694	032	0		29	10	S7694_032_0	3	2	Tier 2 Non Preferred Generics			
S7694	032	0		29	10	S7694_032_0	3	1	Tier 1 Preferred Generic			
S7694	032	0		29	10	S7694_032_0	3	5	Tier 5 Specialty Drugs			
S7694	033	0		29	10	S7694_033_0	3	2	Tier 2 Non Preferred Generics			
S7694	033	0		29	10	S7694_033_0	3	1	Tier 1 Preferred Generic			
S7694	033	0		29	10	S7694_033_0	3	3	Tier 3 Preferred Brand			
S7694	033	0		29	10	S7694_033_0	3	5	Tier 5 Specialty Drugs			
S7694	033	0		29	10	S7694_033_0	3	4	Tier 4 NonPreferred Brand			
S7694	034	0		29	10	S7694_034_0	4	1	Tier 1 Preferred Generic			
S7694	034	0		29	10	S7694_034_0	4	2	Tier 2 Non Preferred Generics			
S7694	034	0		29	10	S7694_034_0	4	4	Tier 4 NonPreferred Brand			
S7694	034	0		29	10	S7694_034_0	4	3	Tier 3 Preferred Brand			
S7694	034	0		29	10	S7694_034_0	4	5	Tier 5 Specialty Drugs			
S7694	035	0		29	10	S7694_035_0	3	4	Tier 4 NonPreferred Brand			
S7694	035	0		29	10	S7694_035_0	3	3	Tier 3 Preferred Brand			
S7694	035	0		29	10	S7694_035_0	3	2	Tier 2 NonPreferred Generic			
S7694	035	0		29	10	S7694_035_0	3	1	Tier 1 Preferred Generics			
S7694	035	0		29	10	S7694_035_0	3	5	Tier 5 Specialty			
S7694	036	0		29	10	S7694_036_0	3	4	Tier 4 NonPreferred Brand			
S7694	036	0		29	10	S7694_036_0	3	3	Tier 3 Preferred Brand			
S7694	036	0		29	10	S7694_036_0	3	2	Tier 2 NonPreferred Generic			
S7694	036	0		29	10	S7694_036_0	3	1	Tier 1 Preferred Generics			
S7694	036	0		29	10	S7694_036_0	3	5	Tier 5 Specialty			
S7694	037	0		29	10	S7694_037_0	3	4	Tier 4 NonPreferred Brand			
S7694	037	0		29	10	S7694_037_0	3	3	Tier 3 Preferred Brand			
S7694	037	0		29	10	S7694_037_0	3	2	Tier 2 NonPreferred Generic			
S7694	037	0		29	10	S7694_037_0	3	1	Tier 1 Preferred Generics			
S7694	037	0		29	10	S7694_037_0	3	5	Tier 5 Specialty			
S7694	038	0		29	10	S7694_038_0	3	1	Tier 1 Preferred Generics			
S7694	038	0		29	10	S7694_038_0	3	2	Tier 2 NonPreferred Generic			
S7694	038	0		29	10	S7694_038_0	3	3	Tier 3 Preferred Brand			
S7694	038	0		29	10	S7694_038_0	3	4	Tier 4 NonPreferred Brand			
S7694	038	0		29	10	S7694_038_0	3	5	Tier 5 Specialty			
S7694	039	0		29	10	S7694_039_0	3	1	Tier 1 Preferred Generics			
S7694	039	0		29	10	S7694_039_0	3	2	Tier 2 NonPreferred Generic			
S7694	039	0		29	10	S7694_039_0	3	3	Tier 3 Preferred Brand			
S7694	039	0		29	10	S7694_039_0	3	4	Tier 4 NonPreferred Brand			
S7694	039	0		29	10	S7694_039_0	3	5	Tier 5 Specialty			
S7694	040	0		29	10	S7694_040_0	3	2	Tier 2 NonPreferred Generic			
S7694	040	0		29	10	S7694_040_0	3	1	Tier 1 Preferred Generics			
S7694	040	0		29	10	S7694_040_0	3	4	Tier 4 NonPreferred Brand			
S7694	040	0		29	10	S7694_040_0	3	5	Tier 5 Specialty			
S7694	040	0		29	10	S7694_040_0	3	3	Tier 3 Preferred Brand			
S7694	041	0		29	10	S7694_041_0	3	5	Tier 5 Specialty			
S7694	041	0		29	10	S7694_041_0	3	4	Tier 4 NonPreferred Brand			
S7694	041	0		29	10	S7694_041_0	3	3	Tier 3 Preferred Brand			
S7694	041	0		29	10	S7694_041_0	3	2	Tier 2 NonPreferred Generic			
S7694	041	0		29	10	S7694_041_0	3	1	Tier 1 Preferred Generics			
S7694	042	0		29	10	S7694_042_0	3	1	Tier 1 Preferred Generics			
S7694	042	0		29	10	S7694_042_0	3	2	Tier 2 NonPreferred Generic			
S7694	042	0		29	10	S7694_042_0	3	3	Tier 3 Preferred Brand			
S7694	042	0		29	10	S7694_042_0	3	4	Tier 4 NonPreferred Brand			
S7694	042	0		29	10	S7694_042_0	3	5	Tier 5 Specialty			
S7694	043	0		29	10	S7694_043_0	3	1	Tier 1 Preferred Generics			
S7694	043	0		29	10	S7694_043_0	3	2	Tier 2 NonPreferred Generic			
S7694	043	0		29	10	S7694_043_0	3	3	Tier 3 Preferred Brand			
S7694	043	0		29	10	S7694_043_0	3	4	Tier 4 NonPreferred Brand			
S7694	043	0		29	10	S7694_043_0	3	5	Tier 5 Specialty			
S7694	044	0		29	10	S7694_044_0	3	4	Tier 4 NonPreferred Brand			
S7694	044	0		29	10	S7694_044_0	3	3	Tier 3 Preferred Brand			
S7694	044	0		29	10	S7694_044_0	3	2	Tier 2 NonPreferred Generic			
S7694	044	0		29	10	S7694_044_0	3	1	Tier 1 Preferred Generics			
S7694	044	0		29	10	S7694_044_0	3	5	Tier 5 Specialty			
S7694	045	0		29	10	S7694_045_0	3	2	Tier 2 NonPreferred Generic			
S7694	045	0		29	10	S7694_045_0	3	1	Tier 1 Preferred Generics			
S7694	045	0		29	10	S7694_045_0	3	3	Tier 3 Preferred Brand			
S7694	045	0		29	10	S7694_045_0	3	4	Tier 4 NonPreferred Brand			
S7694	045	0		29	10	S7694_045_0	3	5	Tier 5 Specialty			
S7694	046	0		29	10	S7694_046_0	2	1	Tier 1 Preferred Generics			
S7694	046	0		29	10	S7694_046_0	2	2	Tier 2 NonPreferred Generic			
S7694	046	0		29	10	S7694_046_0	2	3	Tier 3 Preferred Brand			
S7694	046	0		29	10	S7694_046_0	2	4	Tier 4 NonPreferred Brand			
S7694	046	0		29	10	S7694_046_0	2	5	Tier 5 Specialty			
S7694	047	0		29	10	S7694_047_0	3	2	Tier 2 NonPreferred Generic			
S7694	047	0		29	10	S7694_047_0	3	1	Tier 1 Preferred Generics			
S7694	047	0		29	10	S7694_047_0	3	3	Tier 3 Preferred Brand			
S7694	047	0		29	10	S7694_047_0	3	5	Tier 5 Specialty			
S7694	047	0		29	10	S7694_047_0	3	4	Tier 4 NonPreferred Brand			
S7694	048	0		29	10	S7694_048_0	3	1	Tier 1 Preferred Generics			
S7694	048	0		29	10	S7694_048_0	3	2	Tier 2 NonPreferred Generic			
S7694	048	0		29	10	S7694_048_0	3	3	Tier 3 Preferred Brand			
S7694	048	0		29	10	S7694_048_0	3	4	Tier 4 NonPreferred Brand			
S7694	048	0		29	10	S7694_048_0	3	5	Tier 5 Specialty			
S7694	049	0		29	10	S7694_049_0	3	1	Tier 1 Preferred Generics			
S7694	049	0		29	10	S7694_049_0	3	2	Tier 2 NonPreferred Generic			
S7694	049	0		29	10	S7694_049_0	3	4	Tier 4 NonPreferred Brand			
S7694	049	0		29	10	S7694_049_0	3	3	Tier 3 Preferred Brand			
S7694	049	0		29	10	S7694_049_0	3	5	Tier 5 Specialty			
S7694	050	0		29	10	S7694_050_0	3	2	Tier 2 NonPreferred Generic			
S7694	050	0		29	10	S7694_050_0	3	1	Tier 1 Preferred Generics			
S7694	050	0		29	10	S7694_050_0	3	4	Tier 4 NonPreferred Brand			
S7694	050	0		29	10	S7694_050_0	3	5	Tier 5 Specialty			
S7694	050	0		29	10	S7694_050_0	3	3	Tier 3 Preferred Brand			
S7694	051	0		29	10	S7694_051_0	3	1	Tier 1 Preferred Generics			
S7694	051	0		29	10	S7694_051_0	3	2	Tier 2 NonPreferred Generic			
S7694	051	0		29	10	S7694_051_0	3	4	Tier 4 NonPreferred Brand			
S7694	051	0		29	10	S7694_051_0	3	5	Tier 5 Specialty			
S7694	051	0		29	10	S7694_051_0	3	3	Tier 3 Preferred Brand			
S7694	052	0		29	10	S7694_052_0	3	4	Tier 4 NonPreferred Brand			
S7694	052	0		29	10	S7694_052_0	3	5	Tier 5 Specialty			
S7694	052	0		29	10	S7694_052_0	3	2	Tier 2 NonPreferred Generic			
S7694	052	0		29	10	S7694_052_0	3	3	Tier 3 Preferred Brand			
S7694	052	0		29	10	S7694_052_0	3	1	Tier 1 Preferred Generics			
S7694	053	0		29	10	S7694_053_0	3	1	Tier 1 Preferred Generics			
S7694	053	0		29	10	S7694_053_0	3	2	Tier 2 NonPreferred Generic			
S7694	053	0		29	10	S7694_053_0	3	4	Tier 4 NonPreferred Brand			
S7694	053	0		29	10	S7694_053_0	3	5	Tier 5 Specialty			
S7694	053	0		29	10	S7694_053_0	3	3	Tier 3 Preferred Brand			
S7694	054	0		29	10	S7694_054_0	3	4	Tier 4 NonPreferred Brand			
S7694	054	0		29	10	S7694_054_0	3	3	Tier 3 Preferred Brand			
S7694	054	0		29	10	S7694_054_0	3	2	Tier 2 NonPreferred Generic			
S7694	054	0		29	10	S7694_054_0	3	1	Tier 1 Preferred Generics			
S7694	054	0		29	10	S7694_054_0	3	5	Tier 5 Specialty			
S7694	055	0		29	10	S7694_055_0	3	2	Tier 2 NonPreferred Generic			
S7694	055	0		29	10	S7694_055_0	3	1	Tier 1 Preferred Generics			
S7694	055	0		29	10	S7694_055_0	3	3	Tier 3 Preferred Brand			
S7694	055	0		29	10	S7694_055_0	3	4	Tier 4 NonPreferred Brand			
S7694	055	0		29	10	S7694_055_0	3	5	Tier 5 Specialty			
S7694	056	0		29	10	S7694_056_0	3	1	Tier 1 Preferred Generics			
S7694	056	0		29	10	S7694_056_0	3	2	Tier 2 NonPreferred Generic			
S7694	056	0		29	10	S7694_056_0	3	3	Tier 3 Preferred Brand			
S7694	056	0		29	10	S7694_056_0	3	4	Tier 4 NonPreferred Brand			
S7694	056	0		29	10	S7694_056_0	3	5	Tier 5 Specialty			
S7694	057	0		29	10	S7694_057_0	3	2	Tier 2 NonPreferred Generic			
S7694	057	0		29	10	S7694_057_0	3	1	Tier 1 Preferred Generics			
S7694	057	0		29	10	S7694_057_0	3	3	Tier 3 Preferred Brand			
S7694	057	0		29	10	S7694_057_0	3	5	Tier 5 Specialty			
S7694	057	0		29	10	S7694_057_0	3	4	Tier 4 NonPreferred Brand			
S7694	058	0		29	10	S7694_058_0	3	1	Tier 1 Preferred Generics			
S7694	058	0		29	10	S7694_058_0	3	2	Tier 2 NonPreferred Generic			
S7694	058	0		29	10	S7694_058_0	3	3	Tier 3 Preferred Brand			
S7694	058	0		29	10	S7694_058_0	3	4	Tier 4 NonPreferred Brand			
S7694	058	0		29	10	S7694_058_0	3	5	Tier 5 Specialty			
S7694	059	0		29	10	S7694_059_0	3	1	Tier 1 Preferred Generics			
S7694	059	0		29	10	S7694_059_0	3	2	Tier 2 NonPreferred Generic			
S7694	059	0		29	10	S7694_059_0	3	4	Tier 4 NonPreferred Brand			
S7694	059	0		29	10	S7694_059_0	3	3	Tier 3 Preferred Brand			
S7694	059	0		29	10	S7694_059_0	3	5	Tier 5 Specialty			
S7694	060	0		29	10	S7694_060_0	3	2	Tier 2 NonPreferred Generic			
S7694	060	0		29	10	S7694_060_0	3	3	Tier 3 Preferred Brand			
S7694	060	0		29	10	S7694_060_0	3	4	Tier 4 NonPreferred Brand			
S7694	060	0		29	10	S7694_060_0	3	5	Tier 5 Specialty			
S7694	060	0		29	10	S7694_060_0	3	1	Tier 1 Preferred Generics			
S7694	061	0		29	10	S7694_061_0	3	5	Tier 5 Specialty			
S7694	061	0		29	10	S7694_061_0	3	4	Tier 4 NonPreferred Brand			
S7694	061	0		29	10	S7694_061_0	3	3	Tier 3 Preferred Brand			
S7694	061	0		29	10	S7694_061_0	3	2	Tier 2 NonPreferred Generic			
S7694	061	0		29	10	S7694_061_0	3	1	Tier 1 Preferred Generics			
S7694	062	0		29	10	S7694_062_0	3	2	Tier 2 NonPreferred Generic			
S7694	062	0		29	10	S7694_062_0	3	1	Tier 1 Preferred Generics			
S7694	062	0		29	10	S7694_062_0	3	4	Tier 4 NonPreferred Brand			
S7694	062	0		29	10	S7694_062_0	3	5	Tier 5 Specialty			
S7694	062	0		29	10	S7694_062_0	3	3	Tier 3 Preferred Brand			
S7694	063	0		29	10	S7694_063_0	3	5	Tier 5 Specialty			
S7694	063	0		29	10	S7694_063_0	3	4	Tier 4 NonPreferred Brand			
S7694	063	0		29	10	S7694_063_0	3	3	Tier 3 Preferred Brand			
S7694	063	0		29	10	S7694_063_0	3	2	Tier 2 NonPreferred Generic			
S7694	063	0		29	10	S7694_063_0	3	1	Tier 1 Preferred Generics			
S7694	064	0		29	10	S7694_064_0	3	5	Tier 5 Specialty			
S7694	064	0		29	10	S7694_064_0	3	4	Tier 4 NonPreferred Brand			
S7694	064	0		29	10	S7694_064_0	3	3	Tier 3 Preferred Brand			
S7694	064	0		29	10	S7694_064_0	3	2	Tier 2 NonPreferred Generic			
S7694	064	0		29	10	S7694_064_0	3	1	Tier 1 Preferred Generics			
S7694	065	0		29	10	S7694_065_0	3	5	Tier 5 Specialty			
S7694	065	0		29	10	S7694_065_0	3	4	Tier 4 NonPreferred Brand			
S7694	065	0		29	10	S7694_065_0	3	3	Tier 3 Preferred Brand			
S7694	065	0		29	10	S7694_065_0	3	2	Tier 2 NonPreferred Generic			
S7694	065	0		29	10	S7694_065_0	3	1	Tier 1 Preferred Generics			
S7694	066	0		29	10	S7694_066_0	3	2	Tier 2 NonPreferred Generic			
S7694	066	0		29	10	S7694_066_0	3	3	Tier 3 Preferred Brand			
S7694	066	0		29	10	S7694_066_0	3	4	Tier 4 NonPreferred Brand			
S7694	066	0		29	10	S7694_066_0	3	5	Tier 5 Specialty			
S7694	066	0		29	10	S7694_066_0	3	1	Tier 1 Preferred Generics			
S7694	067	0		29	10	S7694_067_0	3	1	Tier 1 Preferred Generics			
S7694	067	0		29	10	S7694_067_0	3	2	Tier 2 NonPreferred Generic			
S7694	067	0		29	10	S7694_067_0	3	3	Tier 3 Preferred Brand			
S7694	067	0		29	10	S7694_067_0	3	5	Tier 5 Specialty			
S7694	067	0		29	10	S7694_067_0	3	4	Tier 4 NonPreferred Brand			
S7694	068	0		29	10	S7694_068_0	3	1	Tier 1 Preferred Generics			
S7694	068	0		29	10	S7694_068_0	3	2	Tier 2 NonPreferred Generic			
S7694	068	0		29	10	S7694_068_0	3	3	Tier 3 Preferred Brand			
S7694	068	0		29	10	S7694_068_0	3	4	Tier 4 NonPreferred Brand			
S7694	068	0		29	10	S7694_068_0	3	5	Tier 5 Specialty			
S8067	001	0		29	10	S8067_001_0	5	2	Formulary Brand Drugs			
S8067	001	0		29	10	S8067_001_0	5	3	Specialty Drugs			
S8067	001	0		29	10	S8067_001_0	5	1	Generic Drugs			
S8067	003	0		29	10	S8067_003_0	7	1	Generic Drugs	1		1
S8067	003	0		29	10	S8067_003_0	7	1	Generic Drugs			
S8067	003	0		29	10	S8067_003_0	7	2	Preferred Brand Drugs			
S8067	003	0		29	10	S8067_003_0	7	3	Non-preferred Brand Drugs			
S8067	003	0		29	10	S8067_003_0	7	4	Specialty Drugs	2		
S8067	003	0		29	10	S8067_003_0	7	3	Non-preferred Brand Drugs	2		
S8067	003	0		29	10	S8067_003_0	7	2	Preferred Brand Drugs	2		
S8067	003	0		29	10	S8067_003_0	7	4	Specialty Drugs			
S8201	001	0		29	10	S8201_001_0	3	1	Generic			
S8201	001	0		29	10	S8201_001_0	3	2	Preferred Brand			
S8201	001	0		29	10	S8201_001_0	3	3	Non-Preferred Brand			
S8201	001	0		29	10	S8201_001_0	3	4	Specialty			
S8465	001	0		29	10	S8465_001_0	2	5	Tier 5 - Specialty			
S8465	001	0		29	10	S8465_001_0	2	4	Tier 4 - Brands			
S8465	001	0		29	10	S8465_001_0	2	3	Tier 3 - Preferred Brands			
S8465	001	0		29	10	S8465_001_0	2	1	Preferred Generics			
S8465	001	0		29	10	S8465_001_0	2	2	Tier 2 - Generics			
S8465	002	0		29	10	S8465_002_0	4	4	Tier 4 - Brands			
S8465	002	0		29	10	S8465_002_0	4	3	Tier 3 - Preferred Brands			
S8465	002	0		29	10	S8465_002_0	4	2	Tier 2 - Generics			
S8465	002	0		29	10	S8465_002_0	4	1	Tier 1 - Preferred Generics			
S8465	002	0		29	10	S8465_002_0	4	5	Tier 5 - Specialty	2		
S8465	002	0		29	10	S8465_002_0	4	1	Tier 1 - Preferred Generics	1		1
S8465	002	0		29	10	S8465_002_0	4	2	Tier 2 - Generics	2		
S8465	002	0		29	10	S8465_002_0	4	3	Tier 3 - Preferred Brands	2		
S8465	002	0		29	10	S8465_002_0	4	4	Tier 4 - Brands	2		
S8465	002	0		29	10	S8465_002_0	4	5	Tier 5 - Specialty			
S8475	001	0		29	10	S8475_001_0	3	1	Tier 1			
S8475	001	0		29	10	S8475_001_0	3	5	Tier 5			
S8475	001	0		29	10	S8475_001_0	3	3	Tier 3			
S8475	001	0		29	10	S8475_001_0	3	4	Tier 4			
S8475	001	0		29	10	S8475_001_0	3	2	Tier 2			
S8475	002	0		29	10	S8475_002_0	3	4	Tier 4	2		
S8475	002	0		29	10	S8475_002_0	3	3	Tier 3	2		
S8475	002	0		29	10	S8475_002_0	3	2	Tier 2	2		
S8475	002	0		29	10	S8475_002_0	3	1	Tier 1	1		1
S8475	002	0		29	10	S8475_002_0	3	5	Tier 5	2		
S8475	002	0		29	10	S8475_002_0	3	4	Tier 4			
S8475	002	0		29	10	S8475_002_0	3	3	Tier 3			
S8475	002	0		29	10	S8475_002_0	3	2	Tier 2			
S8475	002	0		29	10	S8475_002_0	3	1	Tier 1			
S8475	002	0		29	10	S8475_002_0	3	5	Tier 5			
