pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_c_pos_outpt_group_num_id	pbp_c_pos_group_lbl	pbp_c_pos_outpt_bendesc_cats	pbp_c_pos_outpt_coins_yn	pbp_c_pos_outpt_coins_min_pct	pbp_c_pos_outpt_coins_max_pct	pbp_c_pos_outpt_copay_yn	pbp_c_pos_outpt_copay_min_amt	pbp_c_pos_outpt_copay_max_amt	pbp_c_pos_outpt_maxplan_yn	pbp_c_pos_outpt_maxplan_amt	pbp_c_pos_outpt_maxplan_per	pbp_c_pos_outpt_deduct_yn	pbp_c_pos_outpt_deduct_amt
H0108	006	0	1	02	01	H0108_006_0	4	2		01001011111110000000100000000000000000000000000	2			1	35.00	35.00	2			2	
H0108	006	0	1	02	01	H0108_006_0	4	1		00010000000000000000000000100000111111110000000	2			1	0.00	0.00	2			2	
H0108	006	0	1	02	01	H0108_006_0	4	3		00000000000001111001000000000000000000000000000	1	20	25	1	35.00	35.00	2			2	
H0108	006	0	1	02	01	H0108_006_0	4	4		00000000000000000000000000000000000000001000000	1	25	25	1	35.00	35.00	2			2	
H0108	006	0	1	02	01	H0108_006_0	4	7		00000000000000000000000001000000000000000000000	1	20	20	2			2			2	
H0108	006	0	1	02	01	H0108_006_0	4	6		00100000000000000000000000000000000000000000000	2			1	100.00	100.00	2			2	
H0108	006	0	1	02	01	H0108_006_0	4	5		00000000000000000000000010000000000000000000000	1	25	25	1	0.00	0.00	2			2	
H0108	006	0	1	02	01	H0108_006_0	4	8		00000000000000000110000000000000000000000000000	1	25	25	2			2			2	
H0307	009	0	1	02	01	H0307_009_0	6	1		00000000000000000100000000000000000000000000000	1	15	15	2			2			2	
H0307	010	0	1	02	01	H0307_010_0	3	7		00000000000001000000000000000000000000000000000	1	25	25	1	40.00	40.00	2			2	
H0307	010	0	1	02	01	H0307_010_0	3	1		00001101111100000000000000000000010000000011010	2			1	40.00	40.00	2			2	
H0307	010	0	1	02	01	H0307_010_0	3	2		00000010000010110001100000000000000000000000000	1	20	25	1	40.00	40.00	2			2	
H0307	010	0	1	02	01	H0307_010_0	3	3		01100000000000000010000001000000000000000000000	1	20	20	2			2			2	
H0307	010	0	1	02	01	H0307_010_0	3	4		00000000000000000000010000000000000000000000000	2			1	100.00	100.00	2			2	
H0307	010	0	1	02	01	H0307_010_0	3	6		00000000000000000000000000100000101111111000000	2			1	0.00	0.00	2			2	
H0307	010	0	1	02	01	H0307_010_0	3	5		00000000000000000000000010000000000000000000000	1	20	40	2			2			2	
H0307	805	0	1	02	01	H0307_805_0	5	1		00000000000000000100000000000000000000000000000	1	20	20	2			2			2	
H0307	806	0	1	02	01	H0307_806_0	4	1		00000000000000000100000000000000000000000000000	1	20	20	2			2			2	
H0307	807	0	1	02	01	H0307_807_0	4	1		00000000000000000100000000000000000000000000000	1	20	20	2			2			2	
H0316	014	0	1	02	01	H0316_014_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H0316	014	0	1	02	01	H0316_014_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	45.00	2			2	
H0316	014	0	1	02	01	H0316_014_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H0320	007	0	1	02	01	H0320_007_0	7	1		00110000001001101110110001100001111111111000000	1	20	20	2			2			2	
H0320	007	0	1	02	01	H0320_007_0	7	2		00001111011010000000000000000000000000000011010	2			1	40.00	40.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	10	Group 10	00000000000000000110000000000000000000000000000	1	20	20	2			2			2	
H0401	002	0	1	02	01	H0401_002_0	3	11	Group 11	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	20.00	30.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	30.00	30.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	4	Group 4	00010000000000000000000111000000001111111000100	1	20	20	2			2			2	
H0401	002	0	1	02	01	H0401_002_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	20	20	1	10.00	10.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H0401	002	0	1	02	01	H0401_002_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H0408	002	0	1	02	01	H0408_002_0	3	3	Group 3	00000000000000000000000000000000000000000000100	2			1	0.00	0.00	2			2	
H0408	002	0	1	02	01	H0408_002_0	3	4	Group 4	00000000000000000000000000000001000000000000000	1	0	30	2			2			2	
H0408	002	0	1	02	01	H0408_002_0	3	1	Group 1	01110111111111111111110111100000111111111011010	1	30	30	2			2			2	
H0408	002	0	1	02	01	H0408_002_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H0410	001	0	1	37	05	H0410_001_0	4	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H0410	001	0	1	37	05	H0410_001_0	4	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H0410	001	0	1	37	05	H0410_001_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H0410	002	0	1	37	05	H0410_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H0410	002	0	1	37	05	H0410_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H0410	002	0	1	37	05	H0410_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H0410	003	0	1	37	05	H0410_003_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H0410	003	0	1	37	05	H0410_003_0	4	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H0410	003	0	1	37	05	H0410_003_0	4	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H0410	004	0	1	37	05	H0410_004_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H0410	004	0	1	37	05	H0410_004_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	20.00	2			2	
H0410	004	0	1	37	05	H0410_004_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			1	0.00	0.00	2			2	
H0624	004	0	1	02	01	H0624_004_0	3	1	Group 1	01110111111111111111110111100000111111111001010	1	30	30	2			2			2	
H0624	004	0	1	02	01	H0624_004_0	3	5	Group 5	00000000000000000000001000000000000000000000000	1	50	50	2			2			2	
H0624	004	0	1	02	01	H0624_004_0	3	4	Group 4	00000000000000000000000000000001000000000010000	1	0	30	2			2			2	
H0624	004	0	1	02	01	H0624_004_0	3	3	Group 3	00000000000000000000000000000000000000000100101	2			1	0.00	0.00	2			2	
H0624	004	0	1	02	01	H0624_004_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	10.00	2			2	
H0630	019	0	1	02	01	H0630_019_0	4	1	OON Benefits	00001011111111111101100110100000111111100001010	1	30	30	2			1	1000.00	3	2	
H0712	001	0	1	02	01	H0712_001_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H0712	018	0	1	02	01	H0712_018_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H0755	020	0	1	02	01	H0755_020_0	7	4	Group 4 - $0	00000000000000000000000000000000101111111000100	2			2			2			2	
H0755	020	0	1	02	01	H0755_020_0	7	5	Group 5 - $100  - $200	00000000000000000110000000000000000000000000000	2			1	100.00	200.00	2			2	
H0755	020	0	1	02	01	H0755_020_0	7	6	Group 6 - $200	00000000000000100000000000000000000000000000000	2			1	200.00	200.00	2			2	
H0755	020	0	1	02	01	H0755_020_0	7	3	Group 3 - $125	00000000000000000000010000000000000000000000000	2			1	125.00	125.00	2			2	
H0755	020	0	1	02	01	H0755_020_0	7	1	Group 1 - 20%	00000000000000000000000111100000000000000000000	1	20	20	2			2			2	
H0755	020	0	1	02	01	H0755_020_0	7	2	Group 2 - $45	01001111011011011000100000000000010000000011010	2			1	45.00	45.00	2			2	
H0755	029	0	1	02	01	H0755_029_0	7	4	Group 4 - $0	00000000000000000000000000000000101111111000100	2			1	0.00	0.00	2			2	
H0755	029	0	1	02	01	H0755_029_0	7	2	Group 2 - $50	00001001001000000000000000000000010000000011010	2			1	50.00	50.00	2			1	1200.00
H0755	029	0	1	02	01	H0755_029_0	7	3	Group 3 - $150	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			1	1200.00
H0755	029	0	1	02	01	H0755_029_0	7	1	Group 1 - 20%	01000110010011111110100111100000000000000000000	1	20	20	2			2			1	1200.00
H0806	001	0	1	02	01	H0806_001_0	10	3	Dental	00000000000000000000000000000000000000000100000	2			2			1	750.00	3	1	50.00
H0806	001	0	1	02	01	H0806_001_0	10	1		01011011011011111110100111100000111111111001010	1	30	30	2			2			2	
H0806	001	0	1	02	01	H0806_001_0	10	2	Ambulance	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1013	021	0	1	02	01	H1013_021_0	6	2	Preventive Services	00000000000000000000000000000000111111100000000	1	20	20	2			2			2	
H1013	021	0	1	02	01	H1013_021_0	6	1	Health Care Professional Services	00001101111100000000000000000000000000000000000	1	20	20	2			2			2	
H1032	002	0	1	02	01	H1032_002_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	012	0	1	02	01	H1032_012_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	014	0	1	02	01	H1032_014_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	025	0	1	02	01	H1032_025_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	032	0	1	02	01	H1032_032_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	035	0	1	02	01	H1032_035_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	061	0	1	02	01	H1032_061_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	073	0	1	02	01	H1032_073_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	091	0	1	02	01	H1032_091_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	101	0	1	02	01	H1032_101_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	106	0	1	02	01	H1032_106_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	113	0	1	02	01	H1032_113_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	131	0	1	02	01	H1032_131_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	132	0	1	02	01	H1032_132_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1032	133	0	1	02	01	H1032_133_0	6	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1035	002	0	1	02	01	H1035_002_0	5	1	POS - Medical	01111011101111111111110111100001111111111000000	1	20	20	2			2			2	
H1035	006	0	1	02	01	H1035_006_0	5	1	POS - Medical	01111011101111111111110111100001111111111000000	1	20	20	2			2			2	
H1035	007	0	1	02	01	H1035_007_0	4	1	POS - Medical	01111011101111111111110111100001111111111000000	1	20	20	2			2			2	
H1045	010	0	1	02	01	H1045_010_0	9	1		00000001000001111110100000100000101111100000000	1	20	20	2			2			2	
H1080	004	0	1	02	01	H1080_004_0	4	3	Group 3	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1080	004	0	1	02	01	H1080_004_0	4	4	Group 4	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1080	004	0	1	02	01	H1080_004_0	4	5	Group 5	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1080	004	0	1	02	01	H1080_004_0	4	7	Group 7	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1080	004	0	1	02	01	H1080_004_0	4	1	Group 1	01001111011010000000100000000000010000000111010	2			1	40.00	40.00	2			2	
H1080	004	0	1	02	01	H1080_004_0	4	6	Group 6	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1080	004	0	1	02	01	H1080_004_0	4	2	Group 2	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H1080	004	0	1	02	01	H1080_004_0	4	8	Group 8	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H1099	001	0	1	02	01	H1099_001_0	6	1		01111111111111111111110111100000111111111001010	1	20	20	2			1	500000.00	3	2	
H1099	804	0	1	02	01	H1099_804_0	1	1		01111111111111111111110111100000111111111001010	1	20	20	2			2			2	
H1111	002	0	1	02	01	H1111_002_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	35.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1111	002	0	1	02	01	H1111_002_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H1111	002	0	1	02	01	H1111_002_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H1111	004	0	1	02	01	H1111_004_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H1111	004	0	1	02	01	H1111_004_0	3	3	Group 3	00000000000000000000000000000000000000000000100	2			1	0.00	0.00	2			2	
H1111	004	0	1	02	01	H1111_004_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H1111	005	0	1	02	01	H1111_005_0	4	4	Group 4	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1111	005	0	1	02	01	H1111_005_0	4	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1111	005	0	1	02	01	H1111_005_0	4	2	Group 2	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1111	005	0	1	02	01	H1111_005_0	4	5	Group 5	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1111	005	0	1	02	01	H1111_005_0	4	7	Group 7	00000000000000000000000000000000100000000000000	2			1	0.00	0.00	2			2	
H1111	005	0	1	02	01	H1111_005_0	4	1	Group 1	01011111011010000110100111100000011111111011110	1	30	30	2			2			2	
H1111	005	0	1	02	01	H1111_005_0	4	6	Group 6	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1216	001	0	1	02	01	H1216_001_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1264	004	0	1	02	01	H1264_004_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1264	008	0	1	02	01	H1264_008_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1264	014	0	1	02	01	H1264_014_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1286	002	0	1	02	01	H1286_002_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	40.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	11	Group 11	00000000000000000110000000000000000000000000000	2			1	200.00	200.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	4	Group 4	00010000000000000000000111000000001111111000100	1	30	30	2			2			2	
H1286	002	0	1	02	01	H1286_002_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	40.00	40.00	2			2	
H1286	002	0	1	02	01	H1286_002_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	11	Group 11	00000000000000000110000000000000000000000000000	2			1	175.00	175.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	30.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	3	Group 3	01000110010010000000100000000000000000000011010	2			1	30.00	30.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	4	Group 4	00010000000000000000000111000000001111111000100	1	30	30	2			2			2	
H1286	003	0	1	02	01	H1286_003_0	2	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1286	003	0	1	02	01	H1286_003_0	2	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H1286	004	0	1	02	01	H1286_004_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	40.00	40.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1286	004	0	1	02	01	H1286_004_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	40.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	11		00000000000000000110000000000000000000000000000	2			1	250.00	250.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	1	Group 1	00001001000000000000000000000000000000000000000	2			1	20.00	40.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	2	Group 2	00000000001000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	3	Group 3	01000110010010000000100000000000000000000011010	2			1	40.00	40.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	4	Group 4	00010000000000000000000111000000001111111000100	1	30	30	2			2			2	
H1286	008	0	1	02	01	H1286_008_0	6	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1286	008	0	1	02	01	H1286_008_0	6	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H1286	801	0	1	02	01	H1286_801_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H1286	801	0	1	02	01	H1286_801_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H1286	801	0	1	02	01	H1286_801_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H1286	801	0	1	02	01	H1286_801_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H1286	803	0	1	02	01	H1286_803_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H1286	803	0	1	02	01	H1286_803_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H1286	803	0	1	02	01	H1286_803_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H1286	803	0	1	02	01	H1286_803_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H1286	804	0	1	02	01	H1286_804_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H1286	804	0	1	02	01	H1286_804_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H1286	804	0	1	02	01	H1286_804_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H1286	804	0	1	02	01	H1286_804_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H1416	009	0	1	02	01	H1416_009_0	5	1		01010111011011111110110111100000101111111000000	1	25	25	2			2			2	
H1416	018	0	1	02	01	H1416_018_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1416	019	0	1	02	01	H1416_019_0	5	1		01010111011011111110110111100000101111111000000	1	25	25	2			2			2	
H1416	020	0	1	02	01	H1416_020_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1657	002	0	1	02	01	H1657_002_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1657	008	0	1	02	01	H1657_008_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H1903	022	0	1	02	01	H1903_022_0	5	1		01010111011011111110110111100000101111111000000	1	30	30	2			2			2	
H1944	001	0	1	02	01	H1944_001_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H1944	001	0	1	02	01	H1944_001_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	35.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H1944	001	0	1	02	01	H1944_001_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H1944	801	0	1	02	01	H1944_801_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H1944	801	0	1	02	01	H1944_801_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H1944	801	0	1	02	01	H1944_801_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H1944	801	0	1	02	01	H1944_801_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H1944	802	0	1	02	01	H1944_802_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H1944	802	0	1	02	01	H1944_802_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H1944	802	0	1	02	01	H1944_802_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H1944	802	0	1	02	01	H1944_802_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H1944	803	0	1	02	01	H1944_803_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H1944	803	0	1	02	01	H1944_803_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H1944	803	0	1	02	01	H1944_803_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H1944	803	0	1	02	01	H1944_803_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H1961	002	0	1	02	01	H1961_002_0	5	3	Ambulance	00000000000000000000010000000000000000000000000	2			1	100.00	100.00	2			2	
H1961	002	0	1	02	01	H1961_002_0	5	2	Dental	00000000000000000000000000000000000000000110000	2			1	0.00	140.00	2			1	50.00
H1961	002	0	1	02	01	H1961_002_0	5	1	Choice 3 medical benefits	01111111111111111111100111100001111111111001110	1	20	20	2			2			2	
H1961	007	0	1	02	01	H1961_007_0	6	1	Choice 3 medical benefits	01111111111111111111100111100001111111111001110	1	20	20	2			2			2	
H1961	007	0	1	02	01	H1961_007_0	6	2	Dental	00000000000000000000000000000000000000000110000	2			1	0.00	140.00	2			1	50.00
H1961	007	0	1	02	01	H1961_007_0	6	3	Ambulance	00000000000000000000010000000000000000000000000	2			1	100.00	100.00	2			2	
H1961	801	0	1	02	01	H1961_801_0	3	1	POS benefits	01111111111111111111111111111111111111111111111	1	20	20	2			2			2	
H1961	802	0	1	02	01	H1961_802_0	3	1	POS Benefits	01111111111111111111110111100001111111111111111	1	20	20	2			2			2	
H2108	026	0	1	02	01	H2108_026_0	2	1	Group 1	00011111000011111110010000100000111111111000000	1	20	20	2			2			2	
H2182	001	0	1	02	01	H2182_001_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H2182	001	0	1	02	01	H2182_001_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	35.00	2			2	
H2182	001	0	1	02	01	H2182_001_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H2320	007	0	1	02	01	H2320_007_0	6	5	$25 Copay	01000010000010100000000000000000000000000000000	2			1	25.00	25.00	2			2	
H2320	007	0	1	02	01	H2320_007_0	6	4	$35 Copay	00001101011000000000000000000000000000000001010	2			1	35.00	35.00	2			2	
H2320	007	0	1	02	01	H2320_007_0	6	3	30% Coinsurance	00000000000000000000000110000000000000000000000	1	30	30	2			2			2	
H2320	007	0	1	02	01	H2320_007_0	6	2	$50 Copay	00000000100100000001010000000000000000000000000	2			1	50.00	50.00	2			2	
H2320	007	0	1	02	01	H2320_007_0	6	1	$75 Copay	00000000000000000110000000000000000000000000000	2			1	75.00	75.00	2			2	
H2320	007	0	1	02	01	H2320_007_0	6	12	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			2			2	
H2320	007	0	1	02	01	H2320_007_0	6	7	$15 Copay	00000000000000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H2320	007	0	1	02	01	H2320_007_0	6	8	$10 Copay	00000000000000000000100001000000101111111000000	2			1	10.00	10.00	2			2	
H2320	007	0	1	02	01	H2320_007_0	6	9	40% Coinsurance	00100000000000000000000000000000000000000000000	1	40	40	2			2			2	
H2320	007	0	1	02	01	H2320_007_0	6	10	$0 Copay	00010000000000000000000000100010000000000000000	2			2			2			2	
H2320	007	0	1	02	01	H2320_007_0	6	11	Eye Wear	00000000000000000000000000000000000000000000100	2			2			2			2	
H2320	007	0	1	02	01	H2320_007_0	6	6	$20 Copay	00000000000001011000000000000000000000000000000	2			1	20.00	20.00	2			2	
H2320	008	0	1	02	01	H2320_008_0	6	5	$25 Copay	01000010000010100000000000000000000000000000000	2			1	25.00	25.00	2			2	
H2320	008	0	1	02	01	H2320_008_0	6	4	$35 Copay	00001101011000000000000000000000000000000001010	2			1	35.00	35.00	2			2	
H2320	008	0	1	02	01	H2320_008_0	6	3	30% Coinsurance	00000000000000000000000110000000000000000000000	1	30	30	2			2			2	
H2320	008	0	1	02	01	H2320_008_0	6	2	$50 Copay	00000000100100000001010000000000000000000000000	2			1	50.00	50.00	2			2	
H2320	008	0	1	02	01	H2320_008_0	6	1	$75 Copay	00000000000000000110000000000000000000000000000	2			1	75.00	75.00	2			2	
H2320	008	0	1	02	01	H2320_008_0	6	6	$20 Copay	00000000000001011000000000000000000000000000000	2			1	20.00	20.00	2			2	
H2320	008	0	1	02	01	H2320_008_0	6	12	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			2			2	
H2320	008	0	1	02	01	H2320_008_0	6	11	Eye Wear	00000000000000000000000000000000000000000000100	2			2			2			2	
H2320	008	0	1	02	01	H2320_008_0	6	10	$0 Copay	00010000000000000000000000100010000000000000000	2			2			2			2	
H2320	008	0	1	02	01	H2320_008_0	6	9	40% Coinsurance	00100000000000000000000000000000000000000000000	1	40	40	2			2			2	
H2320	008	0	1	02	01	H2320_008_0	6	8	$10 Copay	00000000000000000000100001000000101111111000000	2			1	10.00	10.00	2			2	
H2320	008	0	1	02	01	H2320_008_0	6	7	$15 Copay	00000000000000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	1	$75 Copay	00000000000000000110000000000000000000000000000	2			1	75.00	75.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	2	$50 Copay	00000000100100000001010000000000000000000000000	2			1	50.00	50.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	3	30% Coinsurance	00000000000000000000000110000000000000000000000	1	30	30	2			2			2	
H2320	009	0	1	02	01	H2320_009_0	6	4	$35 Copay	00001101011000000000000000000000000000000001010	2			1	35.00	35.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	5	$25 Copay	01000010000010100000000000000000000000000000000	2			1	25.00	25.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	12	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			2			2	
H2320	009	0	1	02	01	H2320_009_0	6	10	$0 Copay	00010000000000000000000000100010000000000000000	2			2			2			2	
H2320	009	0	1	02	01	H2320_009_0	6	9	40% Coinsurance	00100000000000000000000000000000000000000000000	1	40	40	2			2			2	
H2320	009	0	1	02	01	H2320_009_0	6	8	$10 Copay	00000000000000000000100001000000101111111000000	2			1	10.00	10.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	7	Routine Physical Exams	00000000000000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	6	$20 Copay	00000000000001011000000000000000000000000000000	2			1	20.00	20.00	2			2	
H2320	009	0	1	02	01	H2320_009_0	6	11	Eye Wear	00000000000000000000000000000000000000000000100	2			2			2			2	
H2320	010	0	1	02	01	H2320_010_0	6	5	$25 Copay	01000010000010100000000000000000000000000000000	2			1	25.00	25.00	2			2	
H2320	010	0	1	02	01	H2320_010_0	6	4	$35 Copay	00001101011000000000000000000000000000000001010	2			1	35.00	35.00	2			2	
H2320	010	0	1	02	01	H2320_010_0	6	12	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			2			2	
H2320	010	0	1	02	01	H2320_010_0	6	11	Eye Wear	00000000000000000000000000000000000000000000100	2			2			2			2	
H2320	010	0	1	02	01	H2320_010_0	6	10	$0 Copay	00010000000000000000000000100010000000000000000	2			2			2			2	
H2320	010	0	1	02	01	H2320_010_0	6	9	40% Coinsurance	00100000000000000000000000000000000000000000000	1	40	40	2			2			2	
H2320	010	0	1	02	01	H2320_010_0	6	8	$10 Copay	00000000000000000000100001000000101111111000000	2			1	10.00	10.00	2			2	
H2320	010	0	1	02	01	H2320_010_0	6	7	Routine Physical Exams	00000000000000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H2320	010	0	1	02	01	H2320_010_0	6	6	$20 Copay	00000000000001011000000000000000000000000000000	2			1	20.00	20.00	2			2	
H2320	010	0	1	02	01	H2320_010_0	6	1	$75 Copay	00000000000000000110000000000000000000000000000	2			1	75.00	75.00	2			2	
H2320	010	0	1	02	01	H2320_010_0	6	2	$50 Copay	00000000100100000001010000000000000000000000000	2			1	50.00	50.00	2			2	
H2320	010	0	1	02	01	H2320_010_0	6	3	30% Coinsurance	00000000000000000000000110000000000000000000000	1	30	30	2			2			2	
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H2654	010	0	1	02	01	H2654_010_0	5	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H2654	010	0	1	02	01	H2654_010_0	5	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H2654	010	0	1	02	01	H2654_010_0	5	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H2654	010	0	1	02	01	H2654_010_0	5	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H2654	010	0	1	02	01	H2654_010_0	5	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H2654	010	0	1	02	01	H2654_010_0	5	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H2654	010	0	1	02	01	H2654_010_0	5	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H2654	013	0	1	02	01	H2654_013_0	4	4	Group 4	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H2654	013	0	1	02	01	H2654_013_0	4	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H2654	013	0	1	02	01	H2654_013_0	4	2	Group 2	00000000000001110000000000000000000000000000000	1	35	35	1	10.00	10.00	2			2	
H2654	013	0	1	02	01	H2654_013_0	4	1	Group 1	01000010000010000110100000000000000000000000000	1	35	35	2			2			2	
H2654	022	0	1	02	01	H2654_022_0	3	2	Group 2	00000000000001110000000000000000000000000000000	1	35	35	1	10.00	10.00	2			2	
H2654	022	0	1	02	01	H2654_022_0	3	1	Group 1	01000010000010000110100000000000000000000000000	1	35	35	2			2			2	
H2654	022	0	1	02	01	H2654_022_0	3	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H2654	022	0	1	02	01	H2654_022_0	3	4	Group 4	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	23.00	43.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	43.00	43.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	25	25	2			2			2	
H2802	001	0	1	02	01	H2802_001_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	25	25	1	10.00	10.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H2802	001	0	1	02	01	H2802_001_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	23.00	23.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	43.00	43.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	23.00	43.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	23.00	23.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	25	25	2			2			2	
H2803	001	0	1	02	01	H2803_001_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	25	25	1	10.00	10.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H2803	001	0	1	02	01	H2803_001_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	23.00	43.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	25	25	1	10.00	10.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	25	25	2			2			2	
H2803	002	0	1	02	01	H2803_002_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	43.00	43.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	23.00	23.00	2			2	
H2803	002	0	1	02	01	H2803_002_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H2803	010	0	1	02	01	H2803_010_0	4	3	Group 3	00000000000000000000000000000001100000000000000	2			1	0.00	0.00	2			2	
H2803	010	0	1	02	01	H2803_010_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H2803	010	0	1	02	01	H2803_010_0	4	1	Group 1	01110111111111111111110111100000011111111011110	1	30	30	2			2			2	
H2803	012	0	1	02	01	H2803_012_0	3	3	Group 3	00000000000000000000000000000001100000000000000	2			1	0.00	0.00	2			2	
H2803	012	0	1	02	01	H2803_012_0	3	1	Group 1	01110111111111111111110111100000011111111011110	1	30	30	2			2			2	
H2803	012	0	1	02	01	H2803_012_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H2803	801	0	1	02	01	H2803_801_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H2803	801	0	1	02	01	H2803_801_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H2803	801	0	1	02	01	H2803_801_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H2803	801	0	1	02	01	H2803_801_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H2803	803	0	1	02	01	H2803_803_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H2803	803	0	1	02	01	H2803_803_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H2803	803	0	1	02	01	H2803_803_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H2803	803	0	1	02	01	H2803_803_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H2803	804	0	1	02	01	H2803_804_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H2803	804	0	1	02	01	H2803_804_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H2803	804	0	1	02	01	H2803_804_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H2803	804	0	1	02	01	H2803_804_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H2931	002	0	1	02	01	H2931_002_0	9	2	$35 Copayment Group	00001111111110000001100000000000011110011011010	2			1	35.00	35.00	2			2	
H2931	002	0	1	02	01	H2931_002_0	9	1	20% Coinsurance Group	01110000000000000110010000100000100011100000100	1	20	20	2			2			2	
H2931	002	0	1	02	01	H2931_002_0	9	3	30% Group	00000000000001111000000111000000000010000000000	1	30	30	2			2			2	
H2931	002	0	1	02	01	H2931_002_0	9	4	Genetic Testing	00000000000001000000000000000000000000000000000	1	50	50	2			2			2	
H2961	002	0	1	02	01	H2961_002_0	13	2	$35 Copayment Group	00001111111110000001100000000000011110011011010	2			1	35.00	35.00	2			2	
H2961	002	0	1	02	01	H2961_002_0	13	1	20% Coinsurance Group	01110000000000000110010001100000100011100000100	1	20	20	2			2			2	
H2961	002	0	1	02	01	H2961_002_0	13	3	30% Group	00000000000001111000000110000000000010000000000	1	30	30	2			2			2	
H2961	002	0	1	02	01	H2961_002_0	13	4	Genetic Testing	00000000000001000000000000000000000000000000000	1	50	50	2			2			2	
H2961	011	0	1	02	01	H2961_011_0	10	1	$35 Group	00001010101110000001100000000000011110011000000	2			1	35.00	35.00	2			2	
H2961	011	0	1	02	01	H2961_011_0	10	2	$45 Group	00000101011000000000000000000000000010011011010	2			1	45.00	45.00	2			2	
H2961	011	0	1	02	01	H2961_011_0	10	3	30% Group	00000000000001111000010111000000000011100000000	1	30	30	2			2			2	
H2961	011	0	1	02	01	H2961_011_0	10	4	20% Group	01110000000000000110000000100000100010000000100	1	20	20	2			2			2	
H2961	011	0	1	02	01	H2961_011_0	10	5	50% Group	00000000000001000000000000000000000000000000000	1	50	50	2			2			2	
H3044	004	0	1	02	01	H3044_004_0	4	2	Primary Doctor	00001000000000000000000000000000000000000000000	2			1	25.00	25.00	2			2	
H3044	004	0	1	02	01	H3044_004_0	4	1	Outpatient Services	01110010100111111111110111100000111111100000000	1	20	20	2			2			2	
H3044	004	0	1	02	01	H3044_004_0	4	3	Specialists	00000101011000000000000000000000000000000000000	2			1	35.00	35.00	2			2	
H3044	801	0	1	02	01	H3044_801_0	1	1		01111111111111111111110111100000111111100000000	1	20	20	2			2			2	
H3044	802	0	1	02	01	H3044_802_0	1	1		01111111111111111111110111100000111111100000000	1	20	20	2			2			2	
H3044	803	0	1	02	01	H3044_803_0	1	1		01111111111111111111110111100000111111100000000	1	20	20	2			2			2	
H3044	804	0	1	02	01	H3044_804_0	1	1		01111111111111111111110111100000111111100000000	1	20	20	2			2			2	
H3107	004	0	1	02	01	H3107_004_0	4	4	Group 4	00000000000000000000000000000000000000000001100	1	0	30	2			2			2	
H3107	004	0	1	02	01	H3107_004_0	4	3	Group 3	00000000100100000000000000000000000000000000000	1	50	50	2			2			2	
H3107	004	0	1	02	01	H3107_004_0	4	1	Group 1	00001101011000111000000000000000011111111010010	1	30	30	2			2			2	
H3107	004	0	1	02	01	H3107_004_0	4	2	Group 2	00000000000000000000000000000001100000000000000	2			1	0.00	0.00	2			2	
H3107	005	0	1	02	01	H3107_005_0	5	4	Group 4	00000000000000000000000000000000000000000001100	1	0	30	2			2			2	
H3107	005	0	1	02	01	H3107_005_0	5	3	Group 3	00000000100100000000000000000000000000000000000	1	50	50	2			2			2	
H3107	005	0	1	02	01	H3107_005_0	5	1	Group 1	00001101011000111000000000000000011111111010010	1	30	30	2			2			2	
H3107	005	0	1	02	01	H3107_005_0	5	2	Group 2	00000000000000000000000000000001100000000000000	2			1	0.00	0.00	2			2	
H3107	008	0	1	02	01	H3107_008_0	3	4	Group 4	00000000000000000000000000000000000000000001100	1	0	30	2			2			2	
H3107	008	0	1	02	01	H3107_008_0	3	3	Group 3	00000000100100000000000000000000000000000000000	1	50	50	2			2			2	
H3107	008	0	1	02	01	H3107_008_0	3	2	Group 2	00000000000000000000000000000001100000000000000	2			1	0.00	0.00	2			2	
H3107	008	0	1	02	01	H3107_008_0	3	1	Group 1	00001101011000111000000000000000011111111010010	1	30	30	2			2			2	
H3154	005	0	1	02	01	H3154_005_0	3	1		01111111111111111111100111100001111111110001111	1	35	35	2			2			2	
H3154	006	0	1	02	01	H3154_006_0	5	1		01111111111111111111100111100001111111110001111	1	35	35	2			2			2	
H3154	012	0	1	02	01	H3154_012_0	5	1		01111111111111111111100111100001111111110001111	1	35	35	2			2			2	
H3154	801	0	1	02	01	H3154_801_0	3	1		01111111111111111111100111100001111111110001111	1	35	35	2			2			2	
H3154	802	0	1	02	01	H3154_802_0	3	1		01111111111111111111100111100001111111110001111	1	35	35	2			2			2	
H3154	805	0	1	02	01	H3154_805_0	3	1		01111111111111111111100111100001111111110001111	1	35	35	2			2			2	
H3327	022	0	1	02	01	H3327_022_0	5	1	Non-Inpatient	01111111111111111111110111100000101111111000000	1	20	20	2			2			2	
H3327	023	0	1	02	01	H3327_023_0	6	1	Non-Inpatient	01111111111111111111110111100000101111111000000	1	20	20	2			2			2	
H3327	805	0	1	02	01	H3327_805_0	1	1	Non-Inpatient	01111111111111111111110111100000101111111000000	1	20	20	2			2			2	
H3327	806	0	1	02	01	H3327_806_0	1	1	Non-Inpatient	01111111111111111111110111100000101111111000000	1	20	20	2			2			2	
H3327	807	0	1	02	01	H3327_807_0	1	1	Non-Inpatient	01111111111111111111110111100000101111111000000	1	20	20	2			2			2	
H3347	010	0	1	02	01	H3347_010_0	4	1	POS	00010111111111001001000000000000101111111000000	1	20	20	2			1	5000.00	3	2	
H3361	043	0	1	02	01	H3361_043_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H3361	098	0	1	02	01	H3361_098_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H3361	099	0	1	02	01	H3361_099_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H3361	106	0	1	02	01	H3361_106_0	5	1		01010111011011111110110111100000101111111000000	1	20	20	2			2			2	
H3362	807	0	1	02	01	H3362_807_0	1	2	45%	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H3362	807	0	1	02	01	H3362_807_0	1	1	20% coinsurance	01001111011011111111110111100001111111111011110	1	20	20	2			2			1	146.00
H3362	817	0	1	02	01	H3362_817_0	1	2	45%	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H3362	817	0	1	02	01	H3362_817_0	1	1	20% coinsurance	01001111011011111111110111100001111111111011110	1	20	20	2			2			1	146.00
H3362	819	0	1	02	01	H3362_819_0	1	1	20% coinsurance	01001111011011111111110111100001111111111011110	1	20	20	2			2			1	146.00
H3362	819	0	1	02	01	H3362_819_0	1	2	45%	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H3435	001	0	1	37	05	H3435_001_0	4	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H3435	001	0	1	37	05	H3435_001_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H3435	001	0	1	37	05	H3435_001_0	4	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H3435	002	0	1	37	05	H3435_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H3435	002	0	1	37	05	H3435_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H3435	002	0	1	37	05	H3435_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H3435	003	0	1	37	05	H3435_003_0	4	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H3435	003	0	1	37	05	H3435_003_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H3435	003	0	1	37	05	H3435_003_0	4	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H3456	001	0	1	02	01	H3456_001_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H3456	001	0	1	02	01	H3456_001_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H3456	001	0	1	02	01	H3456_001_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	40.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H3456	020	0	1	02	01	H3456_020_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	40.00	40.00	2			2	
H3456	020	0	1	02	01	H3456_020_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H3456	023	0	1	02	01	H3456_023_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H3456	023	0	1	02	01	H3456_023_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H3528	006	0	1	02	01	H3528_006_0	6	3	$100 copayment	00000000000000000000010000000000000000000000000	2			1	100.00	100.00	2			2	
H3528	006	0	1	02	01	H3528_006_0	6	1	$0 copayment	00000000000000000000100000100000111111100000000	2			2			2			2	
H3528	006	0	1	02	01	H3528_006_0	6	4	20% coinsurance	00000000000001111110000110000000000000000000000	1	20	20	2			2			2	
H3528	006	0	1	02	01	H3528_006_0	6	2	$40 copayment	01001111011010000000000000000000000000000001010	2			1	40.00	40.00	2			2	
H3528	007	0	1	02	01	H3528_007_0	4	1	$0 copayment	00000000000000000000100000100000111111100000000	2			2			2			2	
H3528	007	0	1	02	01	H3528_007_0	4	2	$40 copayment	01001111011010000000000000000000000000000001010	2			1	40.00	40.00	2			2	
H3528	007	0	1	02	01	H3528_007_0	4	3	$100 copayment	00000000000000000000010000000000000000000000000	2			1	100.00	100.00	2			2	
H3528	007	0	1	02	01	H3528_007_0	4	4	20% coinsurance	00000000000001111110000110000000000000000000000	1	20	20	2			2			2	
H3528	806	0	1	02	01	H3528_806_0	2	1	20%	01001111011011111110110110100000111111100001010	1	20	20	2			2			2	
H3528	807	0	1	02	01	H3528_807_0	2	1	20%	01001111011011111110110110100000111111100001010	1	20	20	2			2			2	
H3659	001	0	1	02	01	H3659_001_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	32.00	45.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	32.00	32.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H3659	001	0	1	02	01	H3659_001_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H3659	001	0	1	02	01	H3659_001_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H3659	058	0	1	02	01	H3659_058_0	3	4	Group 4	00000000000000000000000000000001000000000000000	1	0	30	2			2			2	
H3659	058	0	1	02	01	H3659_058_0	3	3	Group 3	00000000000000000000000000000000000000000000100	2			1	0.00	0.00	2			2	
H3659	058	0	1	02	01	H3659_058_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H3659	058	0	1	02	01	H3659_058_0	3	1	Group 1	01110111111111111111110111100000111111111011010	1	30	30	2			2			2	
H3660	028	0	1	02	01	H3660_028_0	7	3	Group 3 $40 Copay	01100111110110000001100000000000000000000011010	2			1	40.00	40.00	2			2	
H3660	028	0	1	02	01	H3660_028_0	7	4	Grou 4 $200 Copay	00000000000000000000010000000000000000000000000	2			1	200.00	200.00	2			2	
H3660	028	0	1	02	01	H3660_028_0	7	5	Group 5 30% Coinsurance	00000000000000000000000111000000000000000000000	1	30	30	2			2			2	
H3660	028	0	1	02	01	H3660_028_0	7	1	Group 1 20% Coinsurance	00010000000001111110000000000000000000000000000	1	20	20	2			2			2	
H3660	028	0	1	02	01	H3660_028_0	7	2	Group 2 $15 Copay	00001000000000000000000000000000111111111000000	2			1	15.00	15.00	2			2	
H3660	029	0	1	02	01	H3660_029_0	7	5	Group 5 $200 Copay	00000000000000000000010000000000000000000000000	2			1	200.00	200.00	2			2	
H3660	029	0	1	02	01	H3660_029_0	7	4	Group 4 30 % Coinsurance	00000000000000000000000111000000000000000000000	1	30	30	2			2			2	
H3660	029	0	1	02	01	H3660_029_0	7	2	Group 2 $15 Copay	00001000000000000000000000000000111111111000000	2			1	15.00	15.00	2			2	
H3660	029	0	1	02	01	H3660_029_0	7	1	Group 1 20% Coinsurance	00010000000001111110000000000000000000000000000	1	20	20	2			2			2	
H3660	029	0	1	02	01	H3660_029_0	7	3	Group 3 $45 Copay	01100111110110000001100000000000000000000011010	2			1	45.00	45.00	2			2	
H3660	032	0	1	02	01	H3660_032_0	7	2	Group 2 $15 Copay	00001000000000000000000000000000111111111000000	2			1	15.00	15.00	2			2	
H3660	032	0	1	02	01	H3660_032_0	7	3	Group 3 $35 Copay	01100111110110000001100000000000000000000011010	2			1	35.00	35.00	2			2	
H3660	032	0	1	02	01	H3660_032_0	7	4	Group 4 $150 Copay	00000000000000000110010000000000000000000000000	2			1	150.00	150.00	2			2	
H3660	032	0	1	02	01	H3660_032_0	7	1	Group 1 20% Coinsurance	00010000000001111000000111000000000000000000000	1	20	20	2			2			2	
H3660	043	0	1	02	01	H3660_043_0	4	2	Group 2 $15 Copay	00001000000000000000000000000000111111110000000	2			1	15.00	15.00	2			2	
H3660	043	0	1	02	01	H3660_043_0	4	1	Group 1 20% Coinsurance	00010000000001111110000000000000000000000000000	1	20	20	2			2			2	
H3660	043	0	1	02	01	H3660_043_0	4	3	Group 3 $45 Copay	01100111110110000001100000000000000000000011010	2			1	45.00	45.00	2			2	
H3660	043	0	1	02	01	H3660_043_0	4	4	Group 4 30 Coinsurane	00000000000000000000000111000000000000000000000	1	30	30	2			2			2	
H3660	043	0	1	02	01	H3660_043_0	4	5	Group 5 $200 Copay	00000000000000000000010000000000000000000000000	2			1	0.00	200.00	2			2	
H3660	805	0	1	02	01	H3660_805_0	4	2	Group 2 20%	00010000000001111110000000000000000000000000000	1	20	20	2			2			2	
H3660	805	0	1	02	01	H3660_805_0	4	3	Group 3 $35 Copay	00001000000000000000000000000000111111111000000	2			1	35.00	35.00	2			2	
H3660	805	0	1	02	01	H3660_805_0	4	4	Group 4 $55 Copay	01100111110110000001010000000000000000000011010	2			1	55.00	55.00	2			2	
H3660	805	0	1	02	01	H3660_805_0	4	5	Group 5 30% Coinsurance	00000000000000000000000111000000000000000000000	1	30	30	2			2			2	
H3660	805	0	1	02	01	H3660_805_0	4	1	Group 1 $200 Copay	00000000000000000000010000000000000000000000000	2			1	200.00	200.00	2			2	
H3660	806	0	1	02	01	H3660_806_0	4	2	Group 2 20%	00010000000001111110000000000000000000000000000	1	20	20	2			2			2	
H3660	806	0	1	02	01	H3660_806_0	4	1	Group 1 $200 Copay	00000000000000000000010000000000000000000000000	2			1	200.00	200.00	2			2	
H3660	806	0	1	02	01	H3660_806_0	4	3	Group 3 $35 Copay	00001000000000000000000000000000111111111000000	2			1	35.00	35.00	2			2	
H3660	806	0	1	02	01	H3660_806_0	4	4	Group 4 $55 Copay	01100111110110000001100000000000000000000011010	2			1	55.00	55.00	2			2	
H3660	806	0	1	02	01	H3660_806_0	4	5	Group 5 30% Coinsurance	00000000000000000000000111000000000000000000000	1	30	30	2			2			2	
H3664	012	0	1	02	01	H3664_012_0	2	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3664	012	0	1	02	01	H3664_012_0	2	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	012	0	1	02	01	H3664_012_0	2	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	014	0	1	02	01	H3664_014_0	2	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	014	0	1	02	01	H3664_014_0	2	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	014	0	1	02	01	H3664_014_0	2	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3664	017	0	1	02	01	H3664_017_0	2	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	017	0	1	02	01	H3664_017_0	2	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	017	0	1	02	01	H3664_017_0	2	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3664	801	0	1	02	01	H3664_801_0	1	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3664	801	0	1	02	01	H3664_801_0	1	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	801	0	1	02	01	H3664_801_0	1	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	802	0	1	02	01	H3664_802_0	1	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	802	0	1	02	01	H3664_802_0	1	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3664	802	0	1	02	01	H3664_802_0	1	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	803	0	1	02	01	H3664_803_0	1	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	803	0	1	02	01	H3664_803_0	1	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	803	0	1	02	01	H3664_803_0	1	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3664	805	0	2	02	01	H3664_805_0	1	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3664	805	0	2	02	01	H3664_805_0	1	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	805	0	2	02	01	H3664_805_0	1	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	806	0	2	02	01	H3664_806_0	1	3	Hearing Aids	00000000000000000000000000000000000000000000001	2			2			1	500.00	1	2	
H3664	806	0	2	02	01	H3664_806_0	1	2	Eye Wear	00000000000000000000000000000000000000000000100	2			2			1	70.00	2	2	
H3664	806	0	2	02	01	H3664_806_0	1	1	Preventive Dental	00000000000000000000000000000000000000000100000	2			2			1	125.00	3	2	
H3814	015	0	1	02	01	H3814_015_0	7	5	Outpatient/ASC	00000000000000000110000000000000000000000000000	2			1	200.00	200.00	2			2	
H3814	015	0	1	02	01	H3814_015_0	7	4	Diagnostice Tests	00000000000001111000000000000000000000000000000	1	0	15	2			2			2	
H3814	015	0	1	02	01	H3814_015_0	7	3	Preventive/Other	00010000000000000000000001100001111111111000000	2			1	0.00	0.00	2			2	
H3814	015	0	1	02	01	H3814_015_0	7	6	DME/Prosthetics	00000000000000000000000110000000000000000000000	1	35	35	2			2			2	
H3814	015	0	1	02	01	H3814_015_0	7	1	Specialists	01100111110110000001100000000000000000000011010	2			1	30.00	30.00	2			2	
H3814	015	0	1	02	01	H3814_015_0	7	2	Primary Care	00001000000000000000000000000000000000000000000	2			1	25.00	25.00	2			2	
H3814	021	0	1	02	01	H3814_021_0	7	6	DME/Prosthetics	00000000000000000000000110000000000000000000000	1	35	35	2			2			2	
H3814	021	0	1	02	01	H3814_021_0	7	1	Specialists	01100111110110000001100000000000000000000011010	2			1	30.00	30.00	2			2	
H3814	021	0	1	02	01	H3814_021_0	7	2	Primary Care	00001000000000000000000000000000000000000000000	2			1	25.00	25.00	2			2	
H3814	021	0	1	02	01	H3814_021_0	7	3	Preventive/Other	00010000000000000000000001100001111111111000000	2			1	0.00	0.00	2			2	
H3814	021	0	1	02	01	H3814_021_0	7	4	Diagnostice Tests	00000000000001111000000000000000000000000000000	1	0	15	2			2			2	
H3814	021	0	1	02	01	H3814_021_0	7	5	Outpatient/ASC	00000000000000000110000000000000000000000000000	2			1	200.00	200.00	2			2	
H3814	026	0	1	02	01	H3814_026_0	7	1	Specialists	01100111110110000001100000000000000000000011010	2			1	40.00	40.00	2			2	
H3814	026	0	1	02	01	H3814_026_0	7	2	Primary Care	00001000000000000000000000000000000000000000000	2			1	30.00	30.00	2			2	
H3814	026	0	1	02	01	H3814_026_0	7	3	Preventive/Other	00010000000000000000000001100001111111111000000	2			1	0.00	0.00	2			2	
H3814	026	0	1	02	01	H3814_026_0	7	4	Diagnostice Tests	00000000000001111000000000000000000000000000000	1	20	20	2			2			2	
H3814	026	0	1	02	01	H3814_026_0	7	5	Outpatient/ASC	00000000000000000110000000000000000000000000000	2			1	400.00	400.00	2			2	
H3814	026	0	1	02	01	H3814_026_0	7	6	DME/Prosthetics	00000000000000000000000110000000000000000000000	1	35	35	2			2			2	
H3814	027	0	1	02	01	H3814_027_0	7	1	Specialists	01100111110110000001100000000000000000000011010	2			1	40.00	40.00	2			2	
H3814	027	0	1	02	01	H3814_027_0	7	2	Primary Care	00001000000000000000000000000000000000000000000	2			1	30.00	30.00	2			2	
H3814	027	0	1	02	01	H3814_027_0	7	3	Preventive/Other	00010000000000000000000001100001111111111000000	2			1	0.00	0.00	2			2	
H3814	027	0	1	02	01	H3814_027_0	7	4	Diagnostice Tests	00000000000001111000000000000000000000000000000	1	20	20	2			2			2	
H3814	027	0	1	02	01	H3814_027_0	7	5	Outpatient/ASC	00000000000000000110000000000000000000000000000	2			1	400.00	400.00	2			2	
H3814	027	0	1	02	01	H3814_027_0	7	6	DME/Prosthetics	00000000000000000000000110000000000000000000000	1	35	35	2			2			2	
H3864	001	0	1	02	01	H3864_001_0	3	1	Physician office visits and diagnostics	00001001100001000000000000000000000000000000000	1	10	10	2			2			2	
H3864	007	0	1	02	01	H3864_007_0	5	1	Physician office visits and diagnostics	00001001100001000000000000000000000000000000000	1	10	10	2			2			2	
H3887	001	0	1	02	01	H3887_001_0	3	5	Group 5	00000000000000000000001000000000000000000000000	1	50	50	2			2			2	
H3887	001	0	1	02	01	H3887_001_0	3	1	Group 1	01110111111111111111110111100000111111111011010	1	30	30	2			2			2	
H3887	001	0	1	02	01	H3887_001_0	3	4	Group 4	00000000000000000000000000000001000000000000000	1	0	30	2			2			2	
H3887	001	0	1	02	01	H3887_001_0	3	3	Group 3	00000000000000000000000000000000000000000000100	2			1	0.00	0.00	2			2	
H3887	001	0	1	02	01	H3887_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H3887	002	0	1	02	01	H3887_002_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H3887	002	0	1	02	01	H3887_002_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H3887	002	0	1	02	01	H3887_002_0	3	3	Group 3	00000000000000000000000000000000000000000000100	2			1	0.00	0.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H3887	003	0	1	02	01	H3887_003_0	6	3	Group 3	01000110010010000000100000000000000000000011010	2			1	50.00	50.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H3887	003	0	1	02	01	H3887_003_0	6	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	50.00	2			2	
H3887	005	0	1	02	01	H3887_005_0	6	1	Group 1	01011111011010000110100111100000011111111011110	1	30	30	2			2			2	
H3887	005	0	1	02	01	H3887_005_0	6	7	Group 7	00000000000000000000000000000000100000000000000	2			1	0.00	0.00	2			2	
H3887	005	0	1	02	01	H3887_005_0	6	6	Group 6	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H3887	005	0	1	02	01	H3887_005_0	6	5	Group 5	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H3887	005	0	1	02	01	H3887_005_0	6	4	Group 4	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H3887	005	0	1	02	01	H3887_005_0	6	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H3887	005	0	1	02	01	H3887_005_0	6	2	Group 2	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H3887	801	0	1	02	01	H3887_801_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H3887	801	0	1	02	01	H3887_801_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H3887	801	0	1	02	01	H3887_801_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H3887	801	0	1	02	01	H3887_801_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H3887	802	0	1	02	01	H3887_802_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H3887	802	0	1	02	01	H3887_802_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H3887	802	0	1	02	01	H3887_802_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H3887	802	0	1	02	01	H3887_802_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H3887	803	0	1	02	01	H3887_803_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H3887	803	0	1	02	01	H3887_803_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H3887	803	0	1	02	01	H3887_803_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H3887	803	0	1	02	01	H3887_803_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H4102	001	0	1	02	01	H4102_001_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H4102	001	0	1	02	01	H4102_001_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	50.00	50.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	30.00	30.00	2			2	
H4102	001	0	1	02	01	H4102_001_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	30.00	50.00	2			2	
H4152	007	0	1	02	01	H4152_007_0	8	1		01011111111111111111100111100000111111111001010	1	20	20	2			2			2	
H4152	815	0	1	02	01	H4152_815_0	7	1		01011111111111111111100111100000111111111001010	1	20	20	2			2			2	
H4152	821	0	1	02	01	H4152_821_0	7	1		01011111111111111111100111100000111111111001010	1	20	20	2			2			2	
H4270	001	0	1	02	01	H4270_001_0	5	1	All Other POS Benefits	01111011111111111111110111100000111111111001010	1	20	20	2			2			2	
H4270	002	0	1	02	01	H4270_002_0	8	1	All Other POS Benefits	01111011111111111111110111100000111111111001010	1	20	20	2			2			2	
H4270	003	0	1	02	01	H4270_003_0	7	1	All Other POS Benefits	01111011111111111111110111100000111111111001010	1	20	20	2			2			2	
H4270	801	0	1	02	01	H4270_801_0	6	1	All Other POS Benefits	01111011111111111111110111100000111111111001010	1	20	20	2			2			2	
H4270	802	0	1	02	01	H4270_802_0	6	1	All Other POS Benefits	01111011111111111111110111100000111111111001010	1	20	20	2			2			2	
H4406	001	0	1	02	01	H4406_001_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H4406	001	0	1	02	01	H4406_001_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4406	001	0	1	02	01	H4406_001_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	1	Group 1	00001001000000000000000000000000000000000000000	2			1	20.00	35.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	2	Group 2	00000000001000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H4456	026	0	1	02	01	H4456_026_0	5	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4456	026	0	1	02	01	H4456_026_0	5	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	10	Group 10	00000000000000000110000000000000000000000000000	2			1	140.00	140.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	11	Group 11	00000000000000000000000000100000100000000000000	2			1	0.00	0.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	30.00	35.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	30.00	30.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H4456	027	0	1	02	01	H4456_027_0	3	4	Group 4	00010000000000000000000111000000001111111000100	1	30	30	2			2			2	
H4456	027	0	1	02	01	H4456_027_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	0.00	0.00	2			2	
H4528	001	0	1	02	01	H4528_001_0	3	1	Group 1	00011111000011111110010000100000111111111000000	1	20	20	2			2			2	
H4528	005	0	1	02	01	H4528_005_0	3	1	Group 1	00011111000011111110010000100000111111111000000	1	20	20	2			2			2	
H4529	002	0	1	02	01	H4529_002_0	10	1		00110001001001101110110011100001111111111000000	1	20	20	2			2			2	
H4529	002	0	1	02	01	H4529_002_0	10	2		00001110011010000000000000000000000000000011010	2			1	40.00	40.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H4604	003	0	1	02	01	H4604_003_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4604	003	0	1	02	01	H4604_003_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H4604	005	0	1	02	01	H4604_005_0	2	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4604	005	0	1	02	01	H4604_005_0	2	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4604	008	0	1	02	01	H4604_008_0	4	7	Group 7	00000000000000000000000000000000100000000000000	2			1	0.00	0.00	2			2	
H4604	008	0	1	02	01	H4604_008_0	4	1	Group 1	01011111011010000110100111100000011111111011110	1	30	30	2			2			2	
H4604	008	0	1	02	01	H4604_008_0	4	2	Group 2	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H4604	008	0	1	02	01	H4604_008_0	4	6	Group 6	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4604	008	0	1	02	01	H4604_008_0	4	5	Group 5	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4604	008	0	1	02	01	H4604_008_0	4	4	Group 4	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4604	008	0	1	02	01	H4604_008_0	4	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4779	001	0	1	37	05	H4779_001_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H4779	001	0	1	37	05	H4779_001_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H4779	001	0	1	37	05	H4779_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H4779	002	0	1	37	05	H4779_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H4779	002	0	1	37	05	H4779_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H4779	002	0	1	37	05	H4779_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H4779	003	0	1	37	05	H4779_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H4779	003	0	1	37	05	H4779_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H4779	003	0	1	37	05	H4779_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H4971	001	0	1	02	01	H4971_001_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	25	25	1	10.00	10.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	4	Group 4	00010000000000000110000000000000001111111000000	1	25	25	2			2			2	
H4971	001	0	1	02	01	H4971_001_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	30.00	30.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	20.00	30.00	2			2	
H4971	001	0	1	02	01	H4971_001_0	4	11	Group 11	00000000000000000000000111000000000000000000100	1	30	30	2			2			2	
H4971	801	0	1	02	01	H4971_801_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H4971	801	0	1	02	01	H4971_801_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H4971	801	0	1	02	01	H4971_801_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H4971	801	0	1	02	01	H4971_801_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H4971	802	0	1	02	01	H4971_802_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H4971	802	0	1	02	01	H4971_802_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H4971	802	0	1	02	01	H4971_802_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H4971	802	0	1	02	01	H4971_802_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H4971	803	0	1	02	01	H4971_803_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H4971	803	0	1	02	01	H4971_803_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H4971	803	0	1	02	01	H4971_803_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H4971	803	0	1	02	01	H4971_803_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H5211	001	0	1	02	01	H5211_001_0	7	2	No Copay and 20% Coinsurance	01010010000011011110100111100000111111111000000	1	20	20	2			2			2	
H5211	001	0	1	02	01	H5211_001_0	7	1	$15 Copay and 20% Coinsurance	00101101111100000001000000000000000000000001010	1	20	20	1	15.00	15.00	2			2	
H5211	001	0	1	02	01	H5211_001_0	7	3	$0 to $100 Copay and 20% Coinsurance	00000000000000100000000000000000000000000000000	1	20	20	1	0.00	100.00	2			2	
H5211	002	0	1	02	01	H5211_002_0	5	4	$0 to $100 Copay and 20% Coinsurance	00000000000000100000000000000000000000000000000	1	20	20	1	0.00	100.00	2			2	
H5211	002	0	1	02	01	H5211_002_0	5	3	No Copay and 20% Coinsurance	01010010000011011000100111100000111111111000000	1	20	20	2			2			2	
H5211	002	0	1	02	01	H5211_002_0	5	2	$0 to $250 Copay and 20% Coinsurance	00000000000000000110000000000000000000000000000	1	20	20	1	0.00	250.00	2			2	
H5211	002	0	1	02	01	H5211_002_0	5	1	$20 Copay and 20% Coinsurance	00101101111100000001000000000000000000000001010	1	20	20	1	20.00	20.00	2			2	
H5211	003	0	1	02	01	H5211_003_0	5	3	No Copay and 20% Coinsurance	01010010000011011000100111100000111111111000000	1	20	20	2			2			2	
H5211	003	0	1	02	01	H5211_003_0	5	4	$0 to $100 Copay and 20% Coinsurance	00000000000000100000000000000000000000000000000	1	20	20	1	0.00	100.00	2			2	
H5211	003	0	1	02	01	H5211_003_0	5	2	$0-$250 Copay and 20% Coinsurance	00000000000000000110000000000000000000000000000	1	20	20	1	0.00	250.00	2			2	
H5211	003	0	1	02	01	H5211_003_0	5	1	$20 Copay and 20% Coinsurance	00101101111100000001000000000000000000000001010	1	20	20	1	20.00	20.00	2			2	
H5211	004	0	1	02	01	H5211_004_0	5	3	$0 to $100 Copay and 20% Coinsurance	00000000000000100000000000000000000000000000000	1	20	20	1	0.00	100.00	2			2	
H5211	004	0	1	02	01	H5211_004_0	5	1	$15 Copay and 20% Coinsurance	00101101111100000001000000000000000000000001010	1	20	20	1	15.00	15.00	2			2	
H5211	004	0	1	02	01	H5211_004_0	5	2	No Copay and 20% Coinsurance	01010010000011011110100111100000111111111000000	1	20	20	2			2			2	
H5211	005	0	1	02	01	H5211_005_0	5	1		01111111111111111111100111100000111111111001010	1	20	20	2			2			2	
H5211	006	0	1	02	01	H5211_006_0	5	1		01111111111111111111100111100000111111111001010	1	20	20	2			2			2	
H5253	004	0	1	02	01	H5253_004_0	5	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H5253	004	0	1	02	01	H5253_004_0	5	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5253	004	0	1	02	01	H5253_004_0	5	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H5253	007	0	1	02	01	H5253_007_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H5253	007	0	1	02	01	H5253_007_0	3	1	Group 1	01110111111111111111110111100000111111111011010	1	30	30	2			2			2	
H5253	007	0	1	02	01	H5253_007_0	3	3	Group 3	00000000000000000000000000000000000000000000100	2			1	0.00	0.00	2			2	
H5253	007	0	1	02	01	H5253_007_0	3	4	Group 4	00000000000000000000000000000001000000000000000	1	0	30	2			2			2	
H5253	011	0	1	02	01	H5253_011_0	5	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	1	Group 1	00001001000000000000000000000000000000000000000	2			1	20.00	30.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	4	Group 4	00000000000000000000000111000000000000000000100	1	30	30	2			2			2	
H5253	011	0	1	02	01	H5253_011_0	5	3	Group 3	01000110010010000000100000000000000000000011010	2			1	30.00	30.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	2	Group 2	00000000001000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H5253	011	0	1	02	01	H5253_011_0	5	11	Group 11	00010000000000000110000000000000001111111000000	1	25	25	2			2			2	
H5253	011	0	1	02	01	H5253_011_0	5	5	Group 5	00000000000001110000000000000000000000000000000	1	25	30	1	10.00	10.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H5253	021	0	1	02	01	H5253_021_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H5253	021	0	1	02	01	H5253_021_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H5253	027	0	1	02	01	H5253_027_0	4	1	Group 1	01011111011010000110100111100000011111111011110	1	30	30	2			2			2	
H5253	027	0	1	02	01	H5253_027_0	4	2	Group 2	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H5253	027	0	1	02	01	H5253_027_0	4	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H5253	027	0	1	02	01	H5253_027_0	4	4	Group 4	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5253	027	0	1	02	01	H5253_027_0	4	5	Group 5	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H5253	027	0	1	02	01	H5253_027_0	4	6	Group 6	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H5253	027	0	1	02	01	H5253_027_0	4	7	Group 7	00000000000000000000000000000000100000000000000	2			1	0.00	0.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	20.00	35.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H5253	028	0	1	02	01	H5253_028_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H5253	028	0	1	02	01	H5253_028_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5253	029	0	1	02	01	H5253_029_0	4	1	Group 1	01011111011010000110100111100000011111111011110	1	30	30	2			2			2	
H5253	029	0	1	02	01	H5253_029_0	4	2	Group 2	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H5253	029	0	1	02	01	H5253_029_0	4	7	Group 7	00000000000000000000000000000000100000000000000	2			1	0.00	0.00	2			2	
H5253	029	0	1	02	01	H5253_029_0	4	6	Group 6	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H5253	029	0	1	02	01	H5253_029_0	4	5	Group 5	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H5253	029	0	1	02	01	H5253_029_0	4	4	Group 4	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5253	029	0	1	02	01	H5253_029_0	4	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H5302	003	0	1	02	01	H5302_003_0	10	1	pos categories of service	01111111111111111111100111100000101111111000000	1	20	20	2			2			2	
H5302	004	0	1	02	01	H5302_004_0	10	1	pos categories of service	01111111111111111111100111100000111111111000000	1	20	20	2			2			2	
H5302	005	0	1	02	01	H5302_005_0	8	2	pos copay services	00001101010000000000000000000000111111100000000	2			1	30.00	50.00	2			2	
H5302	005	0	1	02	01	H5302_005_0	8	1	pos coinsurance categories of service	01110010101111111111100111100000000000011001010	1	30	30	2			2			2	
H5302	006	0	1	02	01	H5302_006_0	10	1	pos categories of service	01111111111111111111100111100000111111111000000	1	20	20	2			2			2	
H5378	174	0	1	04	01	H5378_174_0	4	1		01111111111111111111110111100001111111111111110	1	20	20	2			2			2	
H5404	086	0	1	02	01	H5404_086_0	6	1	POS Group 1	01111111111111111111110111100000111111111100000	1	0	25	1	0.00	300.00	2			2	
H5407	001	0	1	02	01	H5407_001_0	6	1		01111111111111111111110111100000111111111000000	1	20	20	2			1	50000.00	3	2	
H5407	004	0	1	02	01	H5407_004_0	6	1		01111111111111111111110111100000111111111000000	1	20	20	2			1	50000.00	3	2	
H5407	005	0	1	02	01	H5407_005_0	6	1		01111111111111111111110111100000111111111000000	1	20	20	2			1	50000.00	3	2	
H5407	009	0	1	02	01	H5407_009_0	7	1		01111111111111111111110111100000111111111000000	1	20	20	2			1	50000.00	3	2	
H5407	014	0	1	02	01	H5407_014_0	6	1		01111111111111111111110111100000111111111000000	1	20	20	2			1	50000.00	3	2	
H5407	016	0	1	02	01	H5407_016_0	8	1		01111111111111111111110111100000111111111000000	1	20	20	2			1	50000.00	3	2	
H5416	029	0	1	02	01	H5416_029_0	7	2		00001111011010000000000000000000000000000011010	2			1	40.00	40.00	2			2	
H5416	029	0	1	02	01	H5416_029_0	7	1		00110000001001101110110011100001111111111000000	1	25	25	2			2			2	
H5416	030	0	1	02	01	H5416_030_0	7	2		00001111011010000000000000000000000000000011010	2			1	40.00	40.00	2			2	
H5416	030	0	1	02	01	H5416_030_0	7	1		00110000001001101110110011100001111111111000000	1	25	25	2			2			2	
H5426	001	0	1	02	01	H5426_001_0	5	1		00001001010000000110000000000000011110000000000	1	20	20	2			2			2	
H5426	002	0	1	02	01	H5426_002_0	7	1		00001001010000000110000000000000011110000000000	1	20	20	2			2			2	
H5426	008	0	1	02	01	H5426_008_0	8	1		00001001010000000110000000000000011110000000000	1	30	30	2			2			2	
H5591	001	0	1	02	01	H5591_001_0	3	4	Group 4	00000000000000000000000000100000000000000000000	2			2			2			2	
H5591	001	0	1	02	01	H5591_001_0	3	3	Group 3	00000000000000010000000111000000000000000000000	1	20	30	2			2			2	
H5591	001	0	1	02	01	H5591_001_0	3	2	Group 2	00000000000000000110000000000000000000000000000	2			1	125.00	125.00	2			2	
H5591	001	0	1	02	01	H5591_001_0	3	1	Group 1	00001111110110000001000000000000000000000001010	2			1	20.00	30.00	2			2	
H5591	001	0	1	02	01	H5591_001_0	3	5	Group 5	00000000000001101000000000000000000000000000000	1	0	30	2			2			2	
H5652	001	0	1	37	05	H5652_001_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5652	001	0	1	37	05	H5652_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5652	001	0	1	37	05	H5652_001_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5652	002	0	1	37	05	H5652_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5652	002	0	1	37	05	H5652_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5652	002	0	1	37	05	H5652_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5652	003	0	1	37	05	H5652_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			1	0.00	0.00	2			2	
H5652	003	0	1	37	05	H5652_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5652	003	0	1	37	05	H5652_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	20.00	2			2	
H5652	004	0	1	37	05	H5652_004_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5652	004	0	1	37	05	H5652_004_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5652	004	0	1	37	05	H5652_004_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5678	001	0	1	37	05	H5678_001_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5678	001	0	1	37	05	H5678_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5678	001	0	1	37	05	H5678_001_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5678	002	0	1	37	05	H5678_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5678	002	0	1	37	05	H5678_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5678	002	0	1	37	05	H5678_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5678	003	0	1	37	05	H5678_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			1	0.00	0.00	2			2	
H5678	003	0	1	37	05	H5678_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	20.00	2			2	
H5678	003	0	1	37	05	H5678_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5678	004	0	1	37	05	H5678_004_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5678	004	0	1	37	05	H5678_004_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5678	004	0	1	37	05	H5678_004_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5697	001	0	1	37	05	H5697_001_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5697	001	0	1	37	05	H5697_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5697	001	0	1	37	05	H5697_001_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5697	002	0	1	37	05	H5697_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5697	002	0	1	37	05	H5697_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5697	002	0	1	37	05	H5697_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5697	003	0	1	37	05	H5697_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5697	003	0	1	37	05	H5697_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5697	003	0	1	37	05	H5697_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5697	004	0	1	37	05	H5697_004_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			1	0.00	0.00	2			2	
H5697	004	0	1	37	05	H5697_004_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	20.00	2			2	
H5697	004	0	1	37	05	H5697_004_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5700	025	0	1	02	01	H5700_025_0	9	1		00110000001001101110110001100001111111111000000	1	25	25	2			2			2	
H5700	025	0	1	02	01	H5700_025_0	9	2		00001111011010000000000000000000000000000011010	2			1	40.00	40.00	2			2	
H5746	012	0	1	02	01	H5746_012_0	8	1	Specialist Physician Services	00000111111110000000000000000000000000000011010	2			1	35.00	35.00	2			2	
H5746	012	0	1	02	01	H5746_012_0	8	2	Diagnostic Imaging	00000000000000101000000000000000000000000000000	2			1	100.00	100.00	2			2	
H5746	012	0	1	02	01	H5746_012_0	8	3	Ambulatory Surgery	00000000000000000010000000000000000000000000000	2			1	200.00	200.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	30.00	30.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	30.00	45.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H5749	001	0	1	02	01	H5749_001_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H5749	801	0	1	02	01	H5749_801_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H5749	801	0	1	02	01	H5749_801_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H5749	801	0	1	02	01	H5749_801_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H5749	801	0	1	02	01	H5749_801_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H5749	802	0	1	02	01	H5749_802_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H5749	802	0	1	02	01	H5749_802_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H5749	802	0	1	02	01	H5749_802_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H5749	802	0	1	02	01	H5749_802_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H5749	803	0	1	02	01	H5749_803_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H5749	803	0	1	02	01	H5749_803_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H5749	803	0	1	02	01	H5749_803_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H5749	803	0	1	02	01	H5749_803_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H5754	001	0	1	37	05	H5754_001_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5754	001	0	1	37	05	H5754_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5754	001	0	1	37	05	H5754_001_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5754	002	0	1	37	05	H5754_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5754	002	0	1	37	05	H5754_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5754	002	0	1	37	05	H5754_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5754	003	0	1	37	05	H5754_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5754	003	0	1	37	05	H5754_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	20.00	2			2	
H5754	003	0	1	37	05	H5754_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			1	0.00	0.00	2			2	
H5754	004	0	1	37	05	H5754_004_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5754	004	0	1	37	05	H5754_004_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5754	004	0	1	37	05	H5754_004_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5826	011	0	1	02	01	H5826_011_0	6	1	POS Out of Network Cost Share	01100111111110000111100111000000000000011011110	1	25	25	2			2			2	
H5850	017	0	1	02	01	H5850_017_0	7	1	Health Care Professional Services	01101111111111111111100000000000000000000000000	1	20	20	2			2			2	
H5850	017	0	1	02	01	H5850_017_0	7	2	Preventive Services	00000000000000000000000000000000111111101000000	1	20	20	2			2			2	
H5896	012	0	1	02	01	H5896_012_0	6	1	Specialist Physician Services	00000111111110000000000000000000000000000011010	2			1	55.00	55.00	2			2	
H5896	012	0	1	02	01	H5896_012_0	6	2	Diagnostic Imaging	00000000000000100000000000000000000000000000000	2			1	250.00	250.00	2			2	
H5896	012	0	1	02	01	H5896_012_0	6	4	Outpatient X rays	00000000000000001000000000000000000000000000000	2			1	75.00	75.00	2			2	
H5896	012	0	1	02	01	H5896_012_0	6	3	Ambulatory Surgery	00000000000000000010000000000000000000000000000	2			1	300.00	300.00	2			2	
H5918	001	0	1	37	05	H5918_001_0	4	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5918	001	0	1	37	05	H5918_001_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5918	001	0	1	37	05	H5918_001_0	4	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5918	002	0	1	37	05	H5918_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5918	002	0	1	37	05	H5918_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5918	002	0	1	37	05	H5918_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5918	003	0	1	37	05	H5918_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			1	0.00	0.00	2			2	
H5918	003	0	1	37	05	H5918_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	20.00	2			2	
H5918	003	0	1	37	05	H5918_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H5918	004	0	1	37	05	H5918_004_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H5918	004	0	1	37	05	H5918_004_0	4	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H5918	004	0	1	37	05	H5918_004_0	4	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H6228	001	0	1	37	05	H6228_001_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H6228	001	0	1	37	05	H6228_001_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H6228	001	0	1	37	05	H6228_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H6228	002	0	1	37	05	H6228_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H6228	002	0	1	37	05	H6228_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H6228	002	0	1	37	05	H6228_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H6228	003	0	1	37	05	H6228_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H6228	003	0	1	37	05	H6228_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H6228	003	0	1	37	05	H6228_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H6642	001	0	1	02	01	H6642_001_0	3	1	POS Group	01111111111111111111110111100000111111111000000	1	30	30	2			2			2	
H6642	002	0	1	02	01	H6642_002_0	3	1	POS Group	01111111111111111111110111100000111111111000000	1	30	30	2			2			2	
H6642	003	0	1	02	01	H6642_003_0	3	1	POS Group	01111111111111111111110111100000111111111000000	1	30	30	2			2			2	
H6642	004	0	1	02	01	H6642_004_0	2	1	POS Group	01111111111111111111110111100000111111111000000	1	30	30	2			2			2	
H6793	001	0	1	37	05	H6793_001_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H6793	001	0	1	37	05	H6793_001_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H6793	001	0	1	37	05	H6793_001_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H6793	002	0	1	37	05	H6793_002_0	2	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H6793	002	0	1	37	05	H6793_002_0	2	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H6793	002	0	1	37	05	H6793_002_0	2	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H6793	003	0	1	37	05	H6793_003_0	3	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H6793	003	0	1	37	05	H6793_003_0	3	2	Group 2	00001000000000000000000000000000000000000000000	1	0	30	1	0.00	30.00	2			2	
H6793	003	0	1	37	05	H6793_003_0	3	3	Group 3	00000000000000000000000000000000000000000000101	2			2			2			2	
H7179	009	0	1	02	01	H7179_009_0	8	1		00110000001001101110110011100001111111111000000	1	30	30	2			2			2	
H7179	009	0	1	02	01	H7179_009_0	8	2		00001111011010000000000000000000000000000011010	2			1	40.00	40.00	2			2	
H7187	001	0	1	02	01	H7187_001_0	4	4	Group 4	00000000000000000000000000000001000000000010000	1	0	30	2			2			2	
H7187	001	0	1	02	01	H7187_001_0	4	3	Group 3	00000000000000000000000000000000000000000100101	2			1	0.00	0.00	2			2	
H7187	001	0	1	02	01	H7187_001_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H7187	001	0	1	02	01	H7187_001_0	4	1	Group 1	01110111111111111111110111100000111111111001010	1	30	30	2			2			2	
H7187	002	0	1	02	01	H7187_002_0	4	3	Group 3	00000000000000000000000000000000000000000000100	2			1	0.00	0.00	2			2	
H7187	002	0	1	02	01	H7187_002_0	4	2	Group 2	00001000000000000000000000000000000000000000000	1	20	30	2			2			2	
H7187	002	0	1	02	01	H7187_002_0	4	1	Group 1	01110111111111111111110111100001111111111011010	1	30	30	2			2			2	
H7187	003	0	1	02	01	H7187_003_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	35.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H7187	003	0	1	02	01	H7187_003_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H7187	008	0	1	02	01	H7187_008_0	3	6	Group 6	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H7187	008	0	1	02	01	H7187_008_0	3	7	Group 7	00000000000000000000000000000000100000000000000	2			1	0.00	0.00	2			2	
H7187	008	0	1	02	01	H7187_008_0	3	5	Group 5	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H7187	008	0	1	02	01	H7187_008_0	3	4	Group 4	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H7187	008	0	1	02	01	H7187_008_0	3	3	Group 3	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H7187	008	0	1	02	01	H7187_008_0	3	2	Group 2	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H7187	008	0	1	02	01	H7187_008_0	3	1	Group 1	01011111011010000110100111100001011111111011110	1	30	30	2			2			2	
H7187	009	0	1	02	01	H7187_009_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H7187	009	0	1	02	01	H7187_009_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	35.00	2			2	
H7187	009	0	1	02	01	H7187_009_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H7187	801	0	1	02	01	H7187_801_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H7187	801	0	1	02	01	H7187_801_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H7187	801	0	1	02	01	H7187_801_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H7187	801	0	1	02	01	H7187_801_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H7187	803	0	1	02	01	H7187_803_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H7187	803	0	1	02	01	H7187_803_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H7187	803	0	1	02	01	H7187_803_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H7187	803	0	1	02	01	H7187_803_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H7187	804	0	1	02	01	H7187_804_0	3	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H7187	804	0	1	02	01	H7187_804_0	3	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H7187	804	0	1	02	01	H7187_804_0	3	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H7187	804	0	1	02	01	H7187_804_0	3	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H7220	004	0	1	02	01	H7220_004_0	8	1	Out of Network benefits	01011111111111111111110111000000000000011000000	1	20	20	2			1	10000.00	3	2	
H7281	001	0	1	02	01	H7281_001_0	3	1	Group 1	00011111000011111110010000100000111111111000000	1	20	20	2			2			2	
H7281	002	0	1	02	01	H7281_002_0	2	1	Group 1	00011111000011111110010000100000111111111000000	1	20	20	2			2			2	
H8050	001	0	1	02	01	H8050_001_0	5	1	Physician Services	01111111111111111111110111100000111111110011010	1	30	30	2			2			2	
H8050	006	0	1	02	01	H8050_006_0	5	1	Physician Services	01111111111111111111110111100000111111110011010	1	30	30	2			2			2	
H8578	010	0	1	02	01	H8578_010_0	3	1	CORF	01000000000000000000000000000000000000000000000	2			1	20.00	20.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	2	Partial Hospitalization	00100000000000000000000000000000000000000000000	2			1	20.00	20.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	3	Home Health Services	00010000000000000000100000000000000000000000000	2			1	0.00	0.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	4		00001111111110000001000000000000010000000000000	2			1	20.00	20.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	5		00000000000001111000000000000000000000000000000	2			1	0.00	100.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	6		00000000000000000010000000000000000000000000000	2			1	200.00	200.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	14		00000000000000000000000000000000000000000001100	2			1	20.00	20.00	1	100.00	2	2	
H8578	010	0	1	02	01	H8578_010_0	3	8		00000000000000000000000110000000000000000000000	1	20	20	2			2			2	
H8578	010	0	1	02	01	H8578_010_0	3	9		00000000000000000000000001000000000000011000000	2			1	0.00	0.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	10		00000000000000000000000000000001000000000000000	2			2			1	150.00	3	2	
H8578	010	0	1	02	01	H8578_010_0	3	11		00000000000000000000000000000000101111100000000	2			1	0.00	0.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	12		00000000000000000000000000000000000000000000010	2			1	20.00	20.00	2			2	
H8578	010	0	1	02	01	H8578_010_0	3	13		00000000000000000000000000000000000000000110000	2			2			1	150.00	3	2	
H8578	010	0	1	02	01	H8578_010_0	3	7		00000000000000000000010000000000000000000000000	2			1	50.00	50.00	2			2	
H8649	002	0	1	02	01	H8649_002_0	9	1		01011011011011111110100111100000111111111001010	1	30	30	2			2			2	
H8649	002	0	1	02	01	H8649_002_0	9	2	Ambulance	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H8649	002	0	1	02	01	H8649_002_0	9	3	Dental	00000000000000000000000000000000000000000100000	2			2			1	750.00	3	1	50.00
H8649	003	0	1	02	01	H8649_003_0	9	1		01011011011011111110100111100000111111111001010	1	30	30	2			2			2	
H8649	003	0	1	02	01	H8649_003_0	9	2	Ambulance	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H8649	003	0	1	02	01	H8649_003_0	9	3	Dental	00000000000000000000000000000000000000000100000	2			2			1	750.00	3	1	50.00
H8649	801	0	1	02	01	H8649_801_0	1	6		00000000000000000000000000000000000100000000000	2			2			2			2	
H8649	801	0	1	02	01	H8649_801_0	1	5		00000000000000000000000000000000001000000000000	2			2			2			2	
H8649	801	0	1	02	01	H8649_801_0	1	4		00000000000000000000000000000000100000000000000	2			2			2			2	
H8649	801	0	1	02	01	H8649_801_0	1	3		00000000000001000000000000000000000000000000000	2			2			2			2	
H8649	801	0	1	02	01	H8649_801_0	1	1		01001011011010111110110011000000010011111011110	1	20	20	2			2			2	
H8649	801	0	1	02	01	H8649_801_0	1	2	Home Health Services	00010000000000000000000000000000000000000000000	2			2			2			2	
H8649	802	0	1	02	01	H8649_802_0	1	1		01001011011010111110110011000000010011111011110	1	20	20	2			2			2	
H8649	802	0	1	02	01	H8649_802_0	1	2	Home Health Services	00010000000000000000000000000000000000000000000	2			2			2			2	
H8649	802	0	1	02	01	H8649_802_0	1	3		00000000000001000000000000000000000000000000000	2			2			2			2	
H8649	802	0	1	02	01	H8649_802_0	1	4		00000000000000000000000000000000100000000000000	2			2			2			2	
H8649	802	0	1	02	01	H8649_802_0	1	5		00000000000000000000000000000000001000000000000	2			2			2			2	
H8649	802	0	1	02	01	H8649_802_0	1	6		00000000000000000000000000000000000100000000000	2			2			2			2	
H8649	803	0	1	02	01	H8649_803_0	2	5		00000000000000000000000000000000001000000000000	2			2			2			2	
H8649	803	0	1	02	01	H8649_803_0	2	4		00000000000000000000000000000000100000000000000	2			2			2			2	
H8649	803	0	1	02	01	H8649_803_0	2	3		00000000000001000000000000000000000000000000000	2			2			2			2	
H8649	803	0	1	02	01	H8649_803_0	2	2	Home Health Services	00010000000000000000000000000000000000000000000	2			2			2			2	
H8649	803	0	1	02	01	H8649_803_0	2	1		01001011011010111110110011000000010011111011110	1	20	20	2			2			2	
H8649	803	0	1	02	01	H8649_803_0	2	6		00000000000000000000000000000000000100000000000	2			2			2			2	
H8748	001	0	1	02	01	H8748_001_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	45.00	45.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H8748	001	0	1	02	01	H8748_001_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H8748	001	0	1	02	01	H8748_001_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	45.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H8748	002	0	1	02	01	H8748_002_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	35.00	2			2	
H8748	002	0	1	02	01	H8748_002_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H8748	003	0	1	02	01	H8748_003_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	35.00	35.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	15.00	15.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	15.00	35.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H8748	003	0	1	02	01	H8748_003_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	3	Group 3	01000110010010000000100000000000000000000011010	2			1	40.00	40.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	2	Group 2	00000000001000000000000000000000010000000000000	2			1	25.00	25.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	1	Group 1	00001001000000000000000000000000000000000000000	2			1	25.00	40.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	10	Group 10	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H8748	004	0	1	02	01	H8748_004_0	3	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H8748	004	0	1	02	01	H8748_004_0	3	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H8748	801	0	1	02	01	H8748_801_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H8748	801	0	1	02	01	H8748_801_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H8748	801	0	1	02	01	H8748_801_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H8748	801	0	1	02	01	H8748_801_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H8748	802	0	1	02	01	H8748_802_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H8748	802	0	1	02	01	H8748_802_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H8748	802	0	1	02	01	H8748_802_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H8748	802	0	1	02	01	H8748_802_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H8748	803	0	1	02	01	H8748_803_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H8748	803	0	1	02	01	H8748_803_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H8748	803	0	1	02	01	H8748_803_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H8748	803	0	1	02	01	H8748_803_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H9011	016	0	1	02	01	H9011_016_0	4	7	Group 7	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H9011	016	0	1	02	01	H9011_016_0	4	2	Group 2	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H9011	016	0	1	02	01	H9011_016_0	4	1	Group 1	01001111011010000000100000000000010000000111010	2			1	40.00	40.00	2			2	
H9011	016	0	1	02	01	H9011_016_0	4	4	Group 4	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H9011	016	0	1	02	01	H9011_016_0	4	8	Group 8	00000000000000000000000000100001100000000000000	2			1	0.00	0.00	2			2	
H9011	016	0	1	02	01	H9011_016_0	4	3	Group 3	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H9011	016	0	1	02	01	H9011_016_0	4	6	Group 6	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H9011	016	0	1	02	01	H9011_016_0	4	5	Group 5	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H9047	024	0	1	02	01	H9047_024_0	10	1	Doctor Office Visit	00001001000000000000000000000010000000000000000	2			1	30.00	30.00	2			2	
H9047	035	0	1	02	01	H9047_035_0	8	1	Doctor Office Visit	00001001000000000000000000000010000000000000000	2			1	30.00	30.00	2			2	
H9047	805	0	1	02	01	H9047_805_0	7	1		01111111111111111111100111100001111111111011110	1	20	20	2			2			2	
H9047	806	0	1	02	01	H9047_806_0	7	1		01111111111111111111100111100001111111111011110	1	20	20	2			2			2	
H9149	002	0	1	02	01	H9149_002_0	4	3	Group 3	01000110010010000000100000000000000000000011010	2			1	40.00	40.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	2	Group 2	00000000001000000000000000000000010000000000000	2			1	20.00	20.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	1	Group 1	00001001000000000000000000000000000000000000000	2			1	20.00	40.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	10	Group 10	00000000000000000000000000100000100000000000000	2			1	0.00	0.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	9	Group 9	00000000100100000001000000000000000000000000000	2			1	35.00	45.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	8	Group 8	00000000000000000000010000000000000000000000000	2			1	150.00	150.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	7	Group 7	00100000000000000000000000000000000000000000000	2			1	75.00	75.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	6	Group 6	00000000000000001000000000000000000000000000000	2			1	21.00	21.00	2			2	
H9149	002	0	1	02	01	H9149_002_0	4	4	Group 4	00010000000000000110000111000000001111111000100	1	30	30	2			2			2	
H9149	002	0	1	02	01	H9149_002_0	4	5	Group 5	00000000000001110000000000000000000000000000000	1	30	30	1	10.00	10.00	2			2	
H9149	801	0	1	02	01	H9149_801_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H9149	801	0	1	02	01	H9149_801_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H9149	801	0	1	02	01	H9149_801_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H9149	801	0	1	02	01	H9149_801_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H9149	802	0	1	02	01	H9149_802_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H9149	802	0	1	02	01	H9149_802_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H9149	802	0	1	02	01	H9149_802_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H9149	802	0	1	02	01	H9149_802_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H9149	803	0	1	02	01	H9149_803_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H9149	803	0	1	02	01	H9149_803_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H9149	803	0	1	02	01	H9149_803_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H9149	803	0	1	02	01	H9149_803_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H9149	805	0	2	02	01	H9149_805_0	2	2	Group 2	00010000000000000000000000000000000000000000000	2			1	0.00	0.00	2			2	
H9149	805	0	2	02	01	H9149_805_0	2	4	Group 4	00100000100100000000000000000000000000000000000	1	45	45	2			2			2	
H9149	805	0	2	02	01	H9149_805_0	2	3	Group 3	00000000000001000000000000000000101000000000000	1	0	20	2			2			2	
H9149	805	0	2	02	01	H9149_805_0	2	1	Group 1	01001111011010111111110111100001010111111011110	1	20	20	2			2			2	
H9302	008	0	1	02	01	H9302_008_0	4	1	Professional Services	00001011111110000001100000000000000000000000000	2			1	50.00	50.00	2			2	
H9313	007	0	1	02	01	H9313_007_0	8	1		01111111111111111111111111100001111111111111010	1	20	20	2			2			2	
H9313	012	1	1	02	01	H9313_012_1	6	1		01111111111111111111111111100001111111111111111	1	20	20	2			2			2	
H9313	012	2	1	02	01	H9313_012_2	6	1		01111111111111111111111111100001111111111111111	1	20	20	2			2			2	
H9313	801	0	1	02	01	H9313_801_0	3	1		01101111111111111111111111110001111111111111111	1	20	20	2			2			2	
H9313	801	0	1	02	01	H9313_801_0	3	2		00010000000000000000000000000000000000000000000	2			2			2			2	
H9313	802	0	1	02	01	H9313_802_0	3	2		00010000000000000000000000000000000000000000000	2			2			2			2	
H9313	802	0	1	02	01	H9313_802_0	3	1		01101111111111111111111111110001111111111111111	1	20	20	2			2			2	
H9313	803	0	1	02	01	H9313_803_0	4	2		00010000000000000000000000000000000000000000000	2			2			2			2	
H9313	803	0	1	02	01	H9313_803_0	4	1		01101111111111111111111111110001111111111111111	1	20	20	2			2			2	
R3444	020	0	1	31	11	R3444_020_0	4	2	$10 Copayment	00000000000000000000000000000000000000000001000	2			1	10.00	10.00	2			2	
R3444	020	0	1	31	11	R3444_020_0	4	1	$0 Copayment	00010000000000000000001000000001111000000000100	2			1	0.00	0.00	2			2	
R3444	020	0	1	31	11	R3444_020_0	4	3	$15 Copay	00000000000000000000000000000000000000000100000	2			1	15.00	15.00	2			2	
R3444	020	0	1	31	11	R3444_020_0	4	4	20% Coinsurance	01001111011011111110110111100000101111111011110	1	20	20	2			2			2	
R3444	020	0	1	31	11	R3444_020_0	4	5	45% Coinsurance	00100000100100000001000000000000000000000000000	1	45	45	2			2			2	
R6801	020	0	1	31	11	R6801_020_0	4	2	$10 Copayment	00000000000000000000000000000000000000000001000	2			1	10.00	10.00	2			2	
R6801	020	0	1	31	11	R6801_020_0	4	1	$0 Copayment	00010000000000000000001000000001111000000000100	2			1	0.00	0.00	2			2	
R6801	020	0	1	31	11	R6801_020_0	4	3	$15 Copay	00000000000000000000000000000000000000000100000	2			1	15.00	15.00	2			2	
R6801	020	0	1	31	11	R6801_020_0	4	5	45% Coinsurance	00100000100100000001000000000000000000000000000	1	45	45	2			2			2	
R6801	020	0	1	31	11	R6801_020_0	4	4	20% Coinsurance	01001111011011111110110111100000101111111011110	1	20	20	2			2			2	
R9896	020	0	1	31	11	R9896_020_0	3	1	$0 Copayment	00010000000000000000001000000001111000000000100	2			1	0.00	0.00	2			2	
R9896	020	0	1	31	11	R9896_020_0	3	2	$10 Copayment	00000000000000000000000000000000000000000001000	2			1	10.00	10.00	2			2	
R9896	020	0	1	31	11	R9896_020_0	3	4	20% Coinsurance	01001111011011111110110111100000101111111011110	1	20	20	2			2			2	
R9896	020	0	1	31	11	R9896_020_0	3	3	$15 Copay	00000000000000000000000000000000000000000100000	2			1	15.00	15.00	2			2	
R9896	020	0	1	31	11	R9896_020_0	3	5	45% Coinsurance	00100000100100000001000000000000000000000000000	1	45	45	2			2			2	
