pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	mrx_tier_post_id	mrx_tier_post_benefit_type	mrx_tier_post_type_id	mrx_tier_post_lbl	mrx_tier_post_drug_type	mrx_tier_post_includes	mrx_tier_post_spec_yn	mrx_tier_post_ref_prcng_yn	mrx_tier_post_cost_struct	mrx_tier_post_coins_pct	mrx_tier_post_copay_amt
H0524	002	0	2	01	01	H0524_002_0	6	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	002	0	2	01	01	H0524_002_0	6	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	002	0	2	01	01	H0524_002_0	6	1	4	2	Generic	010000	1	2	2	2		4.00
H0524	003	0	1	01	01	H0524_003_0	7	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	003	0	1	01	01	H0524_003_0	7	1	4	2	Generic	010000	1	2	2	2		4.00
H0524	003	0	1	01	01	H0524_003_0	7	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	008	0	1	01	01	H0524_008_0	9	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	008	0	1	01	01	H0524_008_0	9	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	008	0	1	01	01	H0524_008_0	9	1	4	2	Generic	010000	1	2	2	2		5.00
H0524	010	0	2	01	01	H0524_010_0	5	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	010	0	2	01	01	H0524_010_0	5	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	010	0	2	01	01	H0524_010_0	5	1	4	2	Generic	010000	1	2	2	2		5.00
H0524	013	0	1	01	01	H0524_013_0	5	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	013	0	1	01	01	H0524_013_0	5	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	013	0	1	01	01	H0524_013_0	5	1	4	2	Generic	010000	1	2	2	2		5.00
H0524	015	0	1	01	01	H0524_015_0	5	1	4	2	Generic	010000	1	2	2	2		4.00
H0524	015	0	1	01	01	H0524_015_0	5	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	015	0	1	01	01	H0524_015_0	5	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	029	0	1	01	01	H0524_029_0	5	2	3	2	Brand	000010		2	2	2		12.00
H0524	029	0	1	01	01	H0524_029_0	5	3	3	2	Specialty	000010		1	2	2		12.00
H0524	029	0	1	01	01	H0524_029_0	5	1	3	2	Generic	010000		2	2	2		5.00
H0524	030	0	1	01	01	H0524_030_0	5	3	3	2	Specialty	000010		1	2	2		12.00
H0524	030	0	1	01	01	H0524_030_0	5	2	3	2	Brand	000010		2	2	2		12.00
H0524	030	0	1	01	01	H0524_030_0	5	1	3	2	Generic	010000		2	2	2		5.00
H0524	031	0	1	01	01	H0524_031_0	5	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	031	0	1	01	01	H0524_031_0	5	1	4	2	Generic	010000	1	2	2	2		5.00
H0524	031	0	1	01	01	H0524_031_0	5	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	032	0	1	01	01	H0524_032_0	5	1	4	2	Generic	010000	1	2	2	2		5.00
H0524	032	0	1	01	01	H0524_032_0	5	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	032	0	1	01	01	H0524_032_0	5	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	033	0	1	01	01	H0524_033_0	5	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	033	0	1	01	01	H0524_033_0	5	1	4	2	Generic	010000	1	2	2	2		5.00
H0524	033	0	1	01	01	H0524_033_0	5	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	034	0	1	01	01	H0524_034_0	6	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	034	0	1	01	01	H0524_034_0	6	1	4	2	Generic	010000	1	2	2	2		4.00
H0524	034	0	1	01	01	H0524_034_0	6	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	035	0	1	01	01	H0524_035_0	5	2	4	2	Brand	000010	1	2	2	2		12.00
H0524	035	0	1	01	01	H0524_035_0	5	3	4	2	Specialty	000010	1	1	2	2		12.00
H0524	035	0	1	01	01	H0524_035_0	5	1	4	2	Generic	010000	1	2	2	2		4.00
H0630	013	0	1	01	01	H0630_013_0	8	3	4	2	Specialty Drugs	000010	1	1	2	2		10.00
H0630	013	0	1	01	01	H0630_013_0	8	2	4	2	Brand Drugs	000010	1	2	2	2		10.00
H0630	013	0	1	01	01	H0630_013_0	8	1	4	2	Generic Drugs	010000	1	2	2	2		5.00
H0630	015	0	1	01	01	H0630_015_0	6	1	4	2	Generic Drugs	010000	1	2	2	2		5.00
H0630	015	0	1	01	01	H0630_015_0	6	2	4	2	Brand Drugs	000010	1	2	2	2		10.00
H0630	015	0	1	01	01	H0630_015_0	6	3	4	2	Specialty Drugs	000010	1	1	2	2		10.00
H0630	016	0	1	01	01	H0630_016_0	7	3	4	2	Specialty Drugs	000010	1	1	2	2		10.00
H0630	016	0	1	01	01	H0630_016_0	7	2	4	2	Brand Drugs	000010	1	2	2	2		10.00
H0630	016	0	1	01	01	H0630_016_0	7	1	4	2	Generic Drugs	010000	1	2	2	2		5.00
H0630	017	0	1	01	01	H0630_017_0	8	1	4	2	Generic Drugs	010000	1	2	2	2		5.00
H0630	017	0	1	01	01	H0630_017_0	8	2	4	2	Brand Drugs	000010	1	2	2	2		10.00
H0630	017	0	1	01	01	H0630_017_0	8	3	4	2	Specialty Drugs	000010	1	1	2	2		10.00
H0630	018	0	1	01	01	H0630_018_0	5	1	4	2	Generic Drugs	010000	1	2	2	2		5.00
H0630	018	0	1	01	01	H0630_018_0	5	2	4	2	Brand Drugs	000010	1	2	2	2		10.00
H0630	018	0	1	01	01	H0630_018_0	5	3	4	2	Specialty Drugs	000010	1	1	2	2		10.00
H1170	002	0	1	01	01	H1170_002_0	11	1	4	2	Generic	010000	1	2	2	2		2.00
H1170	002	0	1	01	01	H1170_002_0	11	2	4	2	Brand	000010	1	2	2	2		10.00
H1170	002	0	1	01	01	H1170_002_0	11	3	4	2	Specialty	000010	1	1	2	2		10.00
H1170	008	0	1	01	01	H1170_008_0	12	1	3	2	Generic	010000		2	2	2		5.00
H1170	008	0	1	01	01	H1170_008_0	12	2	3	2	Brand	000010		2	2	2		15.00
H1170	008	0	1	01	01	H1170_008_0	12	3	3	2	Specialty	000010		1	2	2		15.00
H1170	009	0	1	01	01	H1170_009_0	9	1	4	2	Generic	010000	1	2	2	2		2.00
H1170	009	0	1	01	01	H1170_009_0	9	2	4	2	Brand	000010	1	2	2	2		10.00
H1170	009	0	1	01	01	H1170_009_0	9	3	4	2	Specialty	000010	1	1	2	2		10.00
H1230	001	0	1	01	01	H1230_001_0	11	3	4	2	Specialty	000010	1	1	2	2		10.00
H1230	001	0	1	01	01	H1230_001_0	11	2	4	2	Brand	000010	1	2	2	2		10.00
H1230	001	0	1	01	01	H1230_001_0	11	1	4	2	Generic	010000	1	2	2	2		4.00
H1230	003	0	1	01	01	H1230_003_0	11	2	4	2	Brand	000010	1	2	2	2		10.00
H1230	003	0	1	01	01	H1230_003_0	11	3	4	2	Specialty	000010	1	1	2	2		10.00
H1230	003	0	1	01	01	H1230_003_0	11	1	4	2	Generic	010000	1	2	2	2		4.00
H1251	003	0	1	18	06	H1251_003_0	5	1	2	2	Generic	010000		2	2	2		0.00
H1251	003	0	1	18	06	H1251_003_0	5	2	2	2	Preferred Brand	000001		2	2	2		2.40
H1251	003	0	1	18	06	H1251_003_0	5	3	2	2	Other Brand	100000		2	1	2		6.00
H1251	003	0	1	18	06	H1251_003_0	5	4	2	2	Injectables	100000		2	2	1	5	
H1251	003	0	1	18	06	H1251_003_0	5	5	2	2	Specialty Drugs	100000		1	2	1	5	
H1251	004	0	1	18	06	H1251_004_0	5	1	2	2	Generic	010000		2	2	2		0.00
H1251	004	0	1	18	06	H1251_004_0	5	5	2	2	Specialty Drugs	100000		1	2	1	5	
H1251	004	0	1	18	06	H1251_004_0	5	4	2	2	Injectables	100000		2	2	1	5	
H1251	004	0	1	18	06	H1251_004_0	5	3	2	2	Other Brand	100000		2	1	2		6.00
H1251	004	0	1	18	06	H1251_004_0	5	2	2	2	Preferred Brand	000001		2	2	2		2.40
H1251	011	0	1	18	06	H1251_011_0	5	3	2	2	Other Brand	100000		2	1	2		6.00
H1251	011	0	1	18	06	H1251_011_0	5	4	2	2	Injectables	100000		2	2	1	5	
H1251	011	0	1	18	06	H1251_011_0	5	2	2	2	Preferred Brand	000001		2	2	2		2.40
H1251	011	0	1	18	06	H1251_011_0	5	1	2	2	Generic	010000		2	2	2		0.00
H1251	011	0	1	18	06	H1251_011_0	5	5	2	2	Specialty Drugs	100000		1	2	1	5	
H2150	002	0	1	18	06	H2150_002_0	7	2	4	2	Brand	000010	1	2	2	2		12.00
H2150	002	0	1	18	06	H2150_002_0	7	3	4	2	Specialty	000010	1	1	2	2		12.00
H2150	002	0	1	18	06	H2150_002_0	7	1	4	2	Generic	010000	1	2	2	2		4.00
H2150	009	0	1	18	06	H2150_009_0	8	3	4	2	Specialty	000010	1	1	2	2		15.00
H2150	009	0	1	18	06	H2150_009_0	8	2	4	2	Brand	000010	1	2	2	2		15.00
H2150	009	0	1	18	06	H2150_009_0	8	1	4	2	Generic	010000	1	2	2	2		5.00
H2150	028	0	2	18	06	H2150_028_0	11	2	4	2	Brand	000010	1	2	2	2		12.00
H2150	028	0	2	18	06	H2150_028_0	11	1	4	2	Generic	010000	1	2	2	2		4.00
H2150	028	0	2	18	06	H2150_028_0	11	3	4	2	Specialty	000010	1	1	2	2		12.00
H2150	029	0	2	18	06	H2150_029_0	11	2	4	2	Brand	000010	1	2	2	2		15.00
H2150	029	0	2	18	06	H2150_029_0	11	1	4	2	Generic	010000	1	2	2	2		5.00
H2150	029	0	2	18	06	H2150_029_0	11	3	4	2	Specialty	000010	1	1	2	2		15.00
H2229	028	0	1	04	01	H2229_028_0	6	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2229	028	0	1	04	01	H2229_028_0	6	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2229	028	0	1	04	01	H2229_028_0	6	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2229	029	0	1	04	01	H2229_029_0	6	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2229	029	0	1	04	01	H2229_029_0	6	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2229	029	0	1	04	01	H2229_029_0	6	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	001	1	1	01	01	H2256_001_1	8	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	001	1	1	01	01	H2256_001_1	8	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	001	1	1	01	01	H2256_001_1	8	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	001	2	1	01	01	H2256_001_2	9	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	001	2	1	01	01	H2256_001_2	9	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	001	2	1	01	01	H2256_001_2	9	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	015	1	1	01	01	H2256_015_1	8	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	015	1	1	01	01	H2256_015_1	8	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	015	1	1	01	01	H2256_015_1	8	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	015	2	1	01	01	H2256_015_2	8	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	015	2	1	01	01	H2256_015_2	8	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	015	2	1	01	01	H2256_015_2	8	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	017	1	1	01	01	H2256_017_1	8	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	017	1	1	01	01	H2256_017_1	8	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	017	1	1	01	01	H2256_017_1	8	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	017	7	1	01	01	H2256_017_7	8	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	017	7	1	01	01	H2256_017_7	8	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	017	7	1	01	01	H2256_017_7	8	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	018	1	1	01	01	H2256_018_1	8	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	018	1	1	01	01	H2256_018_1	8	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	018	1	1	01	01	H2256_018_1	8	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	018	7	1	01	01	H2256_018_7	7	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	018	7	1	01	01	H2256_018_7	7	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	018	7	1	01	01	H2256_018_7	7	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	023	0	1	01	01	H2256_023_0	5	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	023	0	1	01	01	H2256_023_0	5	1	4	2	Tier 1	010000	3	2	2	2		2.00
H2256	023	0	1	01	01	H2256_023_0	5	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	024	0	1	01	01	H2256_024_0	5	2	4	2	Tier 2	000010	1	2	2	2		8.00
H2256	024	0	1	01	01	H2256_024_0	5	3	4	2	Tier 3	000010	3	2	2	2		14.00
H2256	024	0	1	01	01	H2256_024_0	5	1	4	2	Tier 1	010000	3	2	2	2		2.00
H3057	001	1	1	09	04	H3057_001_1	4	2	4	2	Tier 2	000010	1	2	2	2		8.00
H3057	001	1	1	09	04	H3057_001_1	4	1	4	2	Tier 1	010000	3	2	2	2		2.00
H3057	001	1	1	09	04	H3057_001_1	4	3	4	2	Tier 3	000010	3	2	2	2		14.00
H3057	001	2	1	09	04	H3057_001_2	4	3	4	2	Tier 3	000010	3	2	2	2		14.00
H3057	001	2	1	09	04	H3057_001_2	4	1	4	2	Tier 1	010000	3	2	2	2		2.00
H3057	001	2	1	09	04	H3057_001_2	4	2	4	2	Tier 2	000010	1	2	2	2		8.00
H3057	002	1	1	09	04	H3057_002_1	4	3	4	2	Tier 3	000010	3	2	2	2		14.00
H3057	002	1	1	09	04	H3057_002_1	4	1	4	2	Tier 1	010000	3	2	2	2		2.00
H3057	002	1	1	09	04	H3057_002_1	4	2	4	2	Tier 2	000010	1	2	2	2		8.00
H3057	002	2	1	09	04	H3057_002_2	4	1	4	2	Tier 1	010000	3	2	2	2		2.00
H3057	002	2	1	09	04	H3057_002_2	4	2	4	2	Tier 2	000010	1	2	2	2		8.00
H3057	002	2	1	09	04	H3057_002_2	4	3	4	2	Tier 3	000010	3	2	2	2		14.00
H3057	007	0	1	09	04	H3057_007_0	4	3	4	2	Tier 3	000010	3	2	2	2		14.00
H3057	007	0	1	09	04	H3057_007_0	4	2	4	2	Tier 2	000010	1	2	2	2		8.00
H3057	007	0	1	09	04	H3057_007_0	4	1	4	2	Tier 1	010000	3	2	2	2		2.00
H3057	008	0	1	09	04	H3057_008_0	4	2	4	2	Tier 2	000010	1	2	2	2		8.00
H3057	008	0	1	09	04	H3057_008_0	4	3	4	2	Tier 3	000010	3	2	2	2		14.00
H3057	008	0	1	09	04	H3057_008_0	4	1	4	2	Tier 1	010000	3	2	2	2		2.00
H3815	001	0	1	01	01	H3815_001_0	9	1	4	2	Formulary Generic	010000	1	2	2	1	5	
H3815	001	0	1	01	01	H3815_001_0	9	2	4	2	Formulary Preferred Brand	000001	1	2	2	1	5	
H3815	001	0	1	01	01	H3815_001_0	9	3	4	2	Formulary Non-Preferred Brand	100000	1	2	2	1	5	
H3815	001	0	1	01	01	H3815_001_0	9	4	4	2	Formulary Specialty	110001	1	1	2	1	5	
H4011	004	0	1	04	01	H4011_004_0	9	3	4	2	Non-Preferred Brand	100000	1	2	2	1	5	
H4011	004	0	1	04	01	H4011_004_0	9	2	4	2	Preferred Brand	000001	1	2	2	1	5	
H4011	004	0	1	04	01	H4011_004_0	9	1	4	2	Generic	010000	1	2	2	1	5	
H4011	004	0	1	04	01	H4011_004_0	9	4	4	2	Specialty Tier Brand	010011	1	1	2	1	5	
H4012	003	0	1	01	01	H4012_003_0	7	4	4	2	Tier 4/ Nivel 4	100000	3	2	1	4	5	10.00
H4012	003	0	1	01	01	H4012_003_0	7	3	4	2	Tier 3/ Nivel 3	000010	3	2	1	2		.50
H4012	003	0	1	01	01	H4012_003_0	7	2	4	2	Tier 2/ Nivel 2	000001	3	2	1	2		.50
H4012	003	0	1	01	01	H4012_003_0	7	1	4	2	Tier 1/ Nivel 1	010000	3	2	1	2		0.00
H4012	003	0	1	01	01	H4012_003_0	7	5	4	2	Tier 5/ Nivel 5	010010	3	1	2	2		0.00
H4012	004	0	1	01	01	H4012_004_0	6	1	4	2	Tier 1/ Nivel 1	010000	3	2	2	2		0.00
H4012	004	0	1	01	01	H4012_004_0	6	5	4	2	Tier 5/ Nivel 5	010010	3	1	2	2		0.00
H4012	004	0	1	01	01	H4012_004_0	6	4	4	2	Tier 4/ Nivel 4	100000	3	2	2	4	5	10.00
H4012	004	0	1	01	01	H4012_004_0	6	3	4	2	Tier 3/ Nivel 3	000010	3	2	2	2		.50
H4012	004	0	1	01	01	H4012_004_0	6	2	4	2	Tier 2/ Nivel 2	000001	3	2	2	2		.50
H4012	005	0	1	01	01	H4012_005_0	7	4	4	2	Tier 4/ Nivel 4	100000	3	2	2	4	5	10.00
H4012	005	0	1	01	01	H4012_005_0	7	3	4	2	Tier 3/ Nivel 3	000010	3	2	2	2		.50
H4012	005	0	1	01	01	H4012_005_0	7	2	4	2	Tier 2/ Nivel 2	000001	3	2	2	2		.50
H4012	005	0	1	01	01	H4012_005_0	7	1	4	2	Tier 1/ Nivel 1	010000	3	2	2	2		0.00
H4012	005	0	1	01	01	H4012_005_0	7	5	4	2	Tier 5/ Nivel 5	010010	3	1	2	2		0.00
H5420	001	0	1	05	01	H5420_001_0	6	2	4	2	Preferred Brand	000001	1	2	2	3	5	2.40
H5420	001	0	1	05	01	H5420_001_0	6	4	4	2	Non-Preferred Brand	000010	1	2	2	3	5	6.00
H5420	001	0	1	05	01	H5420_001_0	6	3	4	2	Formulary Brand	000010	3	2	2	3	5	2.40
H5420	001	0	1	05	01	H5420_001_0	6	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5420	001	0	1	05	01	H5420_001_0	6	1	4	2	Generic	010000	3	2	2	3	5	2.40
H5420	003	0	1	05	01	H5420_003_0	6	4	4	2	Non-Preferred Brand	000010	1	2	2	3	5	6.00
H5420	003	0	1	05	01	H5420_003_0	6	3	4	2	Formulary Brand	000010	3	2	2	3	5	2.40
H5420	003	0	1	05	01	H5420_003_0	6	2	4	2	Preferred Brand	000001	1	2	2	3	5	2.40
H5420	003	0	1	05	01	H5420_003_0	6	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5420	003	0	1	05	01	H5420_003_0	6	1	4	2	Generic	010000	3	2	2	3	5	2.40
H5420	004	0	1	05	01	H5420_004_0	5	1	4	2	Generic	010000	3	2	2	3	5	2.40
H5420	004	0	1	05	01	H5420_004_0	5	3	4	2	Formulary Brand	000010	3	2	2	3	5	2.40
H5420	004	0	1	05	01	H5420_004_0	5	4	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5420	004	0	1	05	01	H5420_004_0	5	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5420	004	0	1	05	01	H5420_004_0	5	2	4	2	Preferred Brand	000001	1	2	2	3	5	2.40
H5420	005	0	1	05	01	H5420_005_0	5	2	4	2	Preferred Brand	000001	1	2	2	3	5	2.40
H5420	005	0	1	05	01	H5420_005_0	5	3	4	2	Formulary Brand	000010	3	2	2	3	5	2.40
H5420	005	0	1	05	01	H5420_005_0	5	4	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5420	005	0	1	05	01	H5420_005_0	5	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5420	005	0	1	05	01	H5420_005_0	5	1	4	2	Generic	010000	3	2	2	3	5	2.40
H5420	006	0	1	05	01	H5420_006_0	5	1	4	2	Generic	010001	3	2	2	3	5	2.40
H5420	006	0	1	05	01	H5420_006_0	5	2	4	2	Brand	000010	1	2	2	3	5	6.00
H5420	006	0	1	05	01	H5420_006_0	5	3	4	2	Specialty	010010	1	1	2	3	5	6.00
H5420	009	0	1	05	01	H5420_009_0	5	4	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5420	009	0	1	05	01	H5420_009_0	5	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5420	009	0	1	05	01	H5420_009_0	5	3	4	2	Formulary Brand	000010	3	2	2	3	5	2.40
H5420	009	0	1	05	01	H5420_009_0	5	2	4	2	Preferred Brand	000001	1	2	2	3	5	2.40
H5420	009	0	1	05	01	H5420_009_0	5	1	4	2	Generic	010000	3	2	2	3	5	2.40
H5427	053	0	1	02	01	H5427_053_0	11	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	053	0	1	02	01	H5427_053_0	11	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	053	0	1	02	01	H5427_053_0	11	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	053	0	1	02	01	H5427_053_0	11	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	054	0	1	02	01	H5427_054_0	11	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	054	0	1	02	01	H5427_054_0	11	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	054	0	1	02	01	H5427_054_0	11	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	054	0	1	02	01	H5427_054_0	11	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	056	0	1	02	01	H5427_056_0	11	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	056	0	1	02	01	H5427_056_0	11	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	056	0	1	02	01	H5427_056_0	11	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	056	0	1	02	01	H5427_056_0	11	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	059	0	1	02	01	H5427_059_0	9	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	059	0	1	02	01	H5427_059_0	9	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	059	0	1	02	01	H5427_059_0	9	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	059	0	1	02	01	H5427_059_0	9	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	060	0	1	02	01	H5427_060_0	9	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	060	0	1	02	01	H5427_060_0	9	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	060	0	1	02	01	H5427_060_0	9	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	060	0	1	02	01	H5427_060_0	9	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	062	0	1	02	01	H5427_062_0	8	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	062	0	1	02	01	H5427_062_0	8	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	062	0	1	02	01	H5427_062_0	8	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	062	0	1	02	01	H5427_062_0	8	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	070	0	1	01	01	H5427_070_0	8	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	070	0	1	01	01	H5427_070_0	8	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	070	0	1	01	01	H5427_070_0	8	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	070	0	1	01	01	H5427_070_0	8	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	072	0	1	01	01	H5427_072_0	11	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	072	0	1	01	01	H5427_072_0	11	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5427	072	0	1	01	01	H5427_072_0	11	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	072	0	1	01	01	H5427_072_0	11	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	075	0	1	02	01	H5427_075_0	11	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5427	075	0	1	02	01	H5427_075_0	11	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5427	075	0	1	02	01	H5427_075_0	11	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5427	075	0	1	02	01	H5427_075_0	11	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5431	001	0	1	01	01	H5431_001_0	7	1	4	2	Preferred Generic	001000	3	2	2	3	5	2.40
H5431	001	0	1	01	01	H5431_001_0	7	4	4	2	Non-Preferred Brand	100010	1	2	1	3	5	6.00
H5431	001	0	1	01	01	H5431_001_0	7	3	4	2	Preferred Brand	000010	3	2	2	3	5	6.00
H5431	001	0	1	01	01	H5431_001_0	7	2	4	2	Non-Preferred Generic	000100	3	2	1	3	5	6.00
H5431	001	0	1	01	01	H5431_001_0	7	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5431	002	0	1	01	01	H5431_002_0	6	1	4	2	Preferred Generic	001000	3	2	2	3	5	2.40
H5431	002	0	1	01	01	H5431_002_0	6	2	4	2	Non-Preferred Generic	000100	3	2	1	3	5	6.00
H5431	002	0	1	01	01	H5431_002_0	6	3	4	2	Preferred Brand	000010	3	2	2	3	5	6.00
H5431	002	0	1	01	01	H5431_002_0	6	4	4	2	Non-Preferred Brand	100010	1	2	2	3	5	6.00
H5431	002	0	1	01	01	H5431_002_0	6	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5431	005	0	1	01	01	H5431_005_0	8	1	4	2	Preferred Generic	001000	3	2	2	3	5	2.40
H5431	005	0	1	01	01	H5431_005_0	8	2	4	2	Non-Preferred Generic	000100	3	2	1	3	5	6.00
H5431	005	0	1	01	01	H5431_005_0	8	5	4	2	Specialty	010010	1	1	2	3	5	6.00
H5431	005	0	1	01	01	H5431_005_0	8	4	4	2	Non-Preferred Brand	100010	1	2	1	3	5	6.00
H5431	005	0	1	01	01	H5431_005_0	8	3	4	2	Preferred Brand	000010	3	2	2	3	5	6.00
H5554	001	0	1	01	01	H5554_001_0	5	1	4	2	Generics	010000	1	2	2	2		0.00
H5554	001	0	1	01	01	H5554_001_0	5	2	4	2	Brand	000010	1	2	2	2		5.60
H5594	001	0	1	02	01	H5594_001_0	8	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5594	001	0	1	02	01	H5594_001_0	8	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5594	001	0	1	02	01	H5594_001_0	8	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5594	001	0	1	02	01	H5594_001_0	8	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5594	002	0	1	02	01	H5594_002_0	8	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5594	002	0	1	02	01	H5594_002_0	8	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5594	002	0	1	02	01	H5594_002_0	8	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5594	002	0	1	02	01	H5594_002_0	8	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5594	005	0	1	02	01	H5594_005_0	8	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5594	005	0	1	02	01	H5594_005_0	8	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5594	005	0	1	02	01	H5594_005_0	8	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5594	005	0	1	02	01	H5594_005_0	8	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5594	006	0	1	02	01	H5594_006_0	8	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5594	006	0	1	02	01	H5594_006_0	8	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5594	006	0	1	02	01	H5594_006_0	8	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5594	006	0	1	02	01	H5594_006_0	8	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5594	007	0	1	02	01	H5594_007_0	9	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5594	007	0	1	02	01	H5594_007_0	9	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5594	007	0	1	02	01	H5594_007_0	9	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5594	007	0	1	02	01	H5594_007_0	9	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5594	008	0	1	02	01	H5594_008_0	9	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5594	008	0	1	02	01	H5594_008_0	9	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5594	008	0	1	02	01	H5594_008_0	9	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5594	008	0	1	02	01	H5594_008_0	9	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5594	009	0	1	02	01	H5594_009_0	10	3	4	2	Tier 3	100000	3	2	2	3	5	6.00
H5594	009	0	1	02	01	H5594_009_0	10	4	4	2	Tier 4	010010	1	1	2	3	5	6.00
H5594	009	0	1	02	01	H5594_009_0	10	1	4	2	Tier 1	010000	3	2	2	3	5	2.40
H5594	009	0	1	02	01	H5594_009_0	10	2	4	2	Tier 2	000001	3	2	2	3	5	6.00
H5696	001	0	1	01	01	H5696_001_0	9	1	4	2	Generic	010000	1	2	2	3	5	2.40
H5696	001	0	1	01	01	H5696_001_0	9	2	4	2	Preferred Brand	000001	1	2	2	3	5	6.00
H5696	001	0	1	01	01	H5696_001_0	9	3	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5696	001	0	1	01	01	H5696_001_0	9	4	4	2	Injectable  Specialty	010010	1	1	2	3	5	6.00
H5696	002	0	1	01	01	H5696_002_0	10	1	4	2	Generic	010000	1	2	2	3	5	2.40
H5696	002	0	1	01	01	H5696_002_0	10	2	4	2	Preferred Brand	000001	1	2	2	3	5	6.00
H5696	002	0	1	01	01	H5696_002_0	10	3	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5696	002	0	1	01	01	H5696_002_0	10	4	4	2	Injectable  Specialty	010010	1	1	2	3	5	6.00
H5696	003	0	1	01	01	H5696_003_0	8	1	4	2	Generic	010000	1	2	2	3	5	2.40
H5696	003	0	1	01	01	H5696_003_0	8	2	4	2	Preferred Brand	000001	1	2	2	3	5	6.00
H5696	003	0	1	01	01	H5696_003_0	8	4	4	2	Injectable  Specialty	010010	1	1	2	3	5	6.00
H5696	003	0	1	01	01	H5696_003_0	8	3	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5696	004	0	1	01	01	H5696_004_0	9	1	4	2	Generic	010000	1	2	2	3	5	2.40
H5696	004	0	1	01	01	H5696_004_0	9	2	4	2	Preferred Brand	000001	1	2	2	3	5	6.00
H5696	004	0	1	01	01	H5696_004_0	9	3	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5696	004	0	1	01	01	H5696_004_0	9	4	4	2	Injectable  Specialty	010010	1	1	2	3	5	6.00
H5696	022	0	1	01	01	H5696_022_0	12	1	4	2	Generic	010000	1	2	2	3	5	2.40
H5696	022	0	1	01	01	H5696_022_0	12	3	4	2	Non-Preferred Brand	100000	1	2	2	3	5	6.00
H5696	022	0	1	01	01	H5696_022_0	12	2	4	2	Preferred Brand	000001	1	2	2	3	5	6.00
H5696	022	0	1	01	01	H5696_022_0	12	4	4	2	Injectable and Specialty	010010	1	1	2	3	5	6.00
H5821	015	0	1	02	01	H5821_015_0	6	4	4	2	Specialty Drugs	000010	1	1	2	3	5	6.00
H5821	015	0	1	02	01	H5821_015_0	6	1	4	2	Generic Drugs	010000	1	2	2	2		0.00
H5821	015	0	1	02	01	H5821_015_0	6	2	4	2	Preferred Brand Drugs	000001	3	2	2	3	5	6.00
H5821	015	0	1	02	01	H5821_015_0	6	3	4	2	Non-Preferred Brand Drugs	100000	1	2	2	3	5	6.00
H5887	001	0	1	01	01	H5887_001_0	10	3	4	2	Non-Preferred Brand	100000	1	2	2	1	5	
H5887	001	0	1	01	01	H5887_001_0	10	2	4	2	Preferred Brand	000001	1	2	2	1	5	
H5887	001	0	1	01	01	H5887_001_0	10	1	4	2	Generic	010000	1	2	2	1	5	
H5887	001	0	1	01	01	H5887_001_0	10	4	4	2	Specialty Tier Brand	010011	1	1	2	1	5	
H5887	006	0	1	01	01	H5887_006_0	10	3	4	2	Non-Preferred Brand	100000	1	2	2	1	5	
H5887	006	0	1	01	01	H5887_006_0	10	2	4	2	Preferred Brand	000001	1	2	2	1	5	
H5887	006	0	1	01	01	H5887_006_0	10	1	4	2	Generic	010000	1	2	2	1	5	
H5887	006	0	1	01	01	H5887_006_0	10	4	4	2	Specialty Tier Brand	010011	1	1	2	1	5	
H5887	007	0	1	01	01	H5887_007_0	10	1	4	2	Generic	010000	1	2	2	1	5	
H5887	007	0	1	01	01	H5887_007_0	10	2	4	2	Preferred Brand	000001	1	2	2	1	5	
H5887	007	0	1	01	01	H5887_007_0	10	3	4	2	Non-Preferred Brand	100000	1	2	2	1	5	
H5887	007	0	1	01	01	H5887_007_0	10	4	4	2	Specialty Tier Brand	010011	1	1	2	1	5	
H6360	001	0	1	18	06	H6360_001_0	7	2	4	2	Brand-Name	000010	1	2	2	2		15.00
H6360	001	0	1	18	06	H6360_001_0	7	1	4	2	Generic	010000	1	2	2	2		5.00
H6360	001	0	1	18	06	H6360_001_0	7	3	4	2	Specialty	000010	1	1	2	2		15.00
H6360	002	0	1	18	06	H6360_002_0	6	2	4	2	Brand-Name	000010	1	2	2	2		15.00
H6360	002	0	1	18	06	H6360_002_0	6	1	4	2	Generic	010000	1	2	2	2		5.00
H6360	002	0	1	18	06	H6360_002_0	6	3	4	2	Specialty	000010	1	1	2	2		15.00
H6360	006	0	1	18	06	H6360_006_0	7	1	4	2	Generic	010000	1	2	2	2		7.00
H6360	006	0	1	18	06	H6360_006_0	7	2	4	2	Brand-Name	000010	1	2	2	2		15.00
H6360	006	0	1	18	06	H6360_006_0	7	3	4	2	Specialty	000010	1	1	2	2		15.00
H6360	009	0	2	18	06	H6360_009_0	5	1	4	2	Generic	010000	1	2	2	2		5.00
H6360	009	0	2	18	06	H6360_009_0	5	2	4	2	Brand-Name	000010	1	2	2	2		15.00
H6360	009	0	2	18	06	H6360_009_0	5	3	4	2	Specialty	000010	1	1	2	2		15.00
H9003	001	0	1	01	01	H9003_001_0	7	3	4	2	Specialty	000010	1	1	2	2		15.00
H9003	001	0	1	01	01	H9003_001_0	7	1	4	2	Generic	010000	1	2	2	2		5.00
H9003	001	0	1	01	01	H9003_001_0	7	2	4	2	Brand	000010	1	2	2	2		15.00
H9003	006	0	1	01	01	H9003_006_0	3	2	4	2	Brand	000010	1	2	2	2		15.00
H9003	006	0	1	01	01	H9003_006_0	3	1	4	2	Generic	010000	1	2	2	2		5.00
H9003	006	0	1	01	01	H9003_006_0	3	3	4	2	Specialty	000010	1	1	2	2		15.00
H9103	001	0	1	01	01	H9103_001_0	4	3	4	2	Specialty	000010	1	1	2	2		10.00
H9103	001	0	1	01	01	H9103_001_0	4	1	4	2	Generic	010000	1	2	2	2		5.00
H9103	001	0	1	01	01	H9103_001_0	4	2	4	2	Brand	000010	1	2	2	2		10.00
