pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_c_vt_grp_id	pbp_c_vt_grp_type	pbp_c_vt_group_lbl	pbp_c_vt_outpt_bendesc_cats	pbp_c_vt_outpt_cstshr_yn	pbp_c_vt_outpt_coins_yn	pbp_c_vt_outpt_coins_min_pct	pbp_c_vt_outpt_coins_max_pct	pbp_c_vt_outpt_copay_yn	pbp_c_vt_outpt_copay_min_amt	pbp_c_vt_outpt_copay_max_amt
H0104	002	0	1	04	01	H0104_002_0	5	1	1	1	0111111111111111111111011111000011111111111011111	1						
H0104	004	0	1	04	01	H0104_004_0	5	1	1	1	0111111111111111111111011111000011111111111111111	1						
H0104	006	0	1	04	01	H0104_006_0	3	1	1	1	0111111111111111111111011111000011111111111111110	1						
H0104	008	0	1	04	01	H0104_008_0	6	1	1	1	0111111111111111111111011111000011111111111111111	1						
H0151	001	0	1	01	01	H0151_001_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H0151	015	0	1	01	01	H0151_015_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H0151	023	0	1	01	01	H0151_023_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H0303	013	0	1	01	01	H0303_013_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H0303	015	0	1	01	01	H0303_015_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H0303	039	0	1	01	01	H0303_039_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H0316	002	0	1	01	01	H0316_002_0	5	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H0316	013	0	1	01	01	H0316_013_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H0316	014	0	1	02	01	H0316_014_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H0319	004	0	1	04	01	H0319_004_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H0401	002	0	1	02	01	H0401_002_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H0710	003	0	1	04	01	H0710_003_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H0752	002	0	1	01	01	H0752_002_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H1080	004	0	1	02	01	H1080_004_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H1080	042	0	1	01	01	H1080_042_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H1108	006	0	1	04	01	H1108_006_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H1111	002	0	1	02	01	H1111_002_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1111	005	0	1	02	01	H1111_005_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H1286	002	0	1	02	01	H1286_002_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H1286	003	0	1	02	01	H1286_003_0	2	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H1286	004	0	1	02	01	H1286_004_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1286	008	0	1	02	01	H1286_008_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1303	001	0	1	04	01	H1303_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1303	006	0	1	04	01	H1303_006_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H1304	001	0	1	04	01	H1304_001_0	2	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H1304	001	0	1	04	01	H1304_001_0	2	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
H1304	001	0	1	04	01	H1304_001_0	2	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H1304	001	0	1	04	01	H1304_001_0	2	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H1304	001	0	1	04	01	H1304_001_0	2	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H1304	001	0	1	04	01	H1304_001_0	2	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H1304	002	0	1	04	01	H1304_002_0	4	6	1	$100	0000000000000000000001000000000000000000000000000	1						
H1304	002	0	1	04	01	H1304_002_0	4	1	1	$25 copay	0000111111111000000110000000000000100000000011010	1						
H1304	002	0	1	04	01	H1304_002_0	4	5	1	$0 to $25	0000000000000000000000000000000010000000000000000	1						
H1304	002	0	1	04	01	H1304_002_0	4	4	1	10% coinsurance	0001000000000011100000011010000000000000001000000	1						
H1304	002	0	1	04	01	H1304_002_0	4	2	1	$200	0000000000000000001000000000000000000000000000000	1						
H1304	002	0	1	04	01	H1304_002_0	4	7	1	0% to 10%	0000000000000100000000000000000000000000000000000	1						
H1304	002	0	1	04	01	H1304_002_0	4	8	1	$0 cost sharing	0110000000000000000000000101000001011111110000000	1						
H1304	002	0	1	04	01	H1304_002_0	4	9	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H1304	002	0	1	04	01	H1304_002_0	4	10	1	$100 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H1304	002	0	1	04	01	H1304_002_0	4	3	1	$0 to $200	0000000000000000010000000000000000000000000000000	1						
H1304	004	0	1	04	01	H1304_004_0	5	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
H1304	004	0	1	04	01	H1304_004_0	5	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H1304	004	0	1	04	01	H1304_004_0	5	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H1304	004	0	1	04	01	H1304_004_0	5	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H1304	004	0	1	04	01	H1304_004_0	5	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H1304	004	0	1	04	01	H1304_004_0	5	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H1350	009	0	1	01	01	H1350_009_0	4	1	1	Travel Benefit	0000110100000110110000000000000001000000100000000	1						
H1509	001	0	1	04	01	H1509_001_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1509	005	0	1	04	01	H1509_005_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H1509	007	0	1	04	01	H1509_007_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1509	009	0	1	04	01	H1509_009_0	2	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1517	001	0	1	04	01	H1517_001_0	10	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H1517	003	0	1	04	01	H1517_003_0	10	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H1607	001	0	1	04	01	H1607_001_0	10	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H1607	004	0	1	04	01	H1607_004_0	8	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H1717	001	0	1	04	01	H1717_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H1717	010	0	1	04	01	H1717_010_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H1944	001	0	1	02	01	H1944_001_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H1961	001	0	1	01	01	H1961_001_0	7	3	1	DME  Prosthetics / Medical Supplies	0000000000000000000000011000000000000000001000000	1						
H1961	001	0	1	01	01	H1961_001_0	7	4	1	Home Health Services	0001000000000000000000000000000000000000000000000	2	1	10	10	2		
H1961	001	0	1	01	01	H1961_001_0	7	1	1	CORF, Lab, Xray, Blood, etc	0110000000100111100010000111000000000000000000000	2	2			1	0.00	80.00
H1961	001	0	1	01	01	H1961_001_0	7	5	1	Outpatient Surgery	0000000000000000011000000000000000000000000000000	2	2			1	150.00	150.00
H1961	001	0	1	01	01	H1961_001_0	7	2	1	Physician office visits and therapy	0000111111011000000000000000000000000000000000000	2	2			1	25.00	25.00
H1961	001	0	1	01	01	H1961_001_0	7	6	1	Ambulance	0000000000000000000001000000000000000000000000000	1						
H1961	001	0	1	01	01	H1961_001_0	7	7	1	Mental Health and Substance Abuse	0000000010010000000100000000000000000000000000000	1						
H1961	003	0	1	01	01	H1961_003_0	5	1	1	All services except ambulance	0111111111111111111110011111000000000000001000000	2	2			2		
H1961	003	0	1	01	01	H1961_003_0	5	2	1	Ambulance	0000000000000000000001000000000000000000000000000	2	2			1	50.00	50.00
H2001	001	0	1	04	01	H2001_001_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2182	001	0	1	02	01	H2182_001_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H2228	009	0	1	04	01	H2228_009_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2450	001	0	1	18	06	H2450_001_0	4	1	1	Outpatient Services	0111111111111111111111111111100011111111111001111	1						
H2450	002	0	1	18	06	H2450_002_0	3	1	1	Outpatient Services	0111111111111111111111111111100011111111111001111	1						
H2450	005	0	1	18	06	H2450_005_0	5	1	1	Outpatient Services	0111111111111111111111111111100011111111111001111	1						
H2450	006	0	1	18	06	H2450_006_0	5	1	1	Outpatient Services	0111111111111111111111111111100011111111111001111	1						
H2450	007	0	1	18	06	H2450_007_0	3	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	1						
H2450	008	0	1	18	06	H2450_008_0	5	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	1						
H2450	009	0	1	18	06	H2450_009_0	4	1	1	Outpatient Services	0111111111111111111111111111100111111111111011111	1						
H2450	010	0	1	18	06	H2450_010_0	4	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	1						
H2450	011	0	1	18	06	H2450_011_0	5	1	1	Outpatient Services	0111111111111111111111111111100111111111111011111	1						
H2450	012	0	1	18	06	H2450_012_0	5	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	1						
H2450	013	0	1	18	06	H2450_013_0	4	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	1						
H2450	014	0	1	18	06	H2450_014_0	6	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	1						
H2450	015	0	1	18	06	H2450_015_0	4	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	1						
H2461	005	0	1	18	06	H2461_005_0	3	3	1	roup 3	0000000000000000000000000000111110000000000100101	1						
H2461	005	0	1	18	06	H2461_005_0	3	1	1	Group 1	0001000000000000000000000000000000000000000000000	1						
H2461	005	0	1	18	06	H2461_005_0	3	2	1	Group 2	1110111111111111111111011111000001111111111011010	1						
H2461	006	0	1	18	06	H2461_006_0	3	4	1	Group 4	0000000000000000011000000000000000000000000000000	1						
H2461	006	0	1	18	06	H2461_006_0	3	1	1	Group 1	1000000000000000000000011100000000000000111000000	1						
H2461	006	0	1	18	06	H2461_006_0	3	2	1	Group 2	0000000000000111100000000010000000111111000000000	1						
H2461	006	0	1	18	06	H2461_006_0	3	5	1	Group 5	0000000000000000000001000000000000000000000000000	1						
H2461	006	0	1	18	06	H2461_006_0	3	6	1	Group 6	0000000000000000000000000000000000000000000010000	1						
H2461	006	0	1	18	06	H2461_006_0	3	7	1	Group 7	0100111111111000000000000000000000000000000000000	1						
H2461	006	0	1	18	06	H2461_006_0	3	8	1	Group 8	0000000000000000000000100000111110000000000000000	1						
H2461	006	0	1	18	06	H2461_006_0	3	3	1	Group 3	0001000000000000000000000000000000000000000001010	1						
H2461	007	0	1	18	06	H2461_007_0	3	1	1	Group 1	0000000000000000000000100000111100000000000100000	1						
H2461	007	0	1	18	06	H2461_007_0	3	3	1	Group 3	0000000000000000000000000100000000000000001000000	1						
H2461	007	0	1	18	06	H2461_007_0	3	4	1	Group 4	0111111111111111111111010010000001111111000001111	1						
H2461	007	0	1	18	06	H2461_007_0	3	2	1	Group 2	0000000000000000000000001000000000000000000000000	1						
H2462	010	0	1	18	06	H2462_010_0	1	1	1	Medical and Diabetic Monitoring Supplies	0000000000000000000000011100000000000000001000000	1						
H2462	011	0	1	18	06	H2462_011_0	4	1	1	Medical and Diabetic Monitoring Supplies	0000000000000000000000011100000000000000001000000	1						
H2462	012	0	1	18	06	H2462_012_0	6	1	1	Medical and Diabetic Monitoring Supplies	0000000000000000000000011100000000000000001000000	1						
H2462	014	0	1	18	06	H2462_014_0	4	1	1	Medical and Diabetic Monitoring Supplies	0000000000000000000000011100000000000000001000000	1						
H2462	015	0	1	18	06	H2462_015_0	1	1	1	US Travel 20% Coinsurance	1110111111111111111111011111100001000010111001110	1						
H2462	016	0	1	18	06	H2462_016_0	1	1	1	US Travel	1111111111111111111111011111100011111111111001110	1						
H2462	017	0	1	18	06	H2462_017_0	2	1	1	US Travel	1111111111111111111111011111100011111111111001110	1						
H2654	004	0	1	01	01	H2654_004_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2654	010	0	1	02	01	H2654_010_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2654	013	0	1	02	01	H2654_013_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2654	020	0	1	01	01	H2654_020_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2654	022	0	1	02	01	H2654_022_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011110	1						
H2654	026	0	1	01	01	H2654_026_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2654	027	0	1	01	01	H2654_027_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H2802	001	0	1	02	01	H2802_001_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H2803	001	0	1	02	01	H2803_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H2803	002	0	1	02	01	H2803_002_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H2997	001	0	1	04	01	H2997_001_0	13	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H2997	002	0	1	04	01	H2997_002_0	16	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H3107	004	0	1	02	01	H3107_004_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3107	005	0	1	02	01	H3107_005_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3107	008	0	1	02	01	H3107_008_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H3305	007	0	1	01	01	H3305_007_0	4	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H3305	007	0	1	01	01	H3305_007_0	4	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H3305	011	0	1	01	01	H3305_011_0	8	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H3305	011	0	1	01	01	H3305_011_0	8	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H3305	015	0	1	01	01	H3305_015_0	10	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H3305	015	0	1	01	01	H3305_015_0	10	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H3305	801	0	1	01	01	H3305_801_0	4	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H3305	801	0	1	01	01	H3305_801_0	4	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H3305	803	0	1	01	01	H3305_803_0	3	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H3305	803	0	1	01	01	H3305_803_0	3	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H3307	002	0	1	01	01	H3307_002_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H3307	011	0	1	01	01	H3307_011_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H3307	012	0	1	01	01	H3307_012_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H3307	015	0	1	01	01	H3307_015_0	4	1	1	Visitor Travel	0111111111111111111111111111100011111111111011111	1						
H3307	018	0	1	01	01	H3307_018_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H3307	021	0	1	01	01	H3307_021_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3307	022	0	1	01	01	H3307_022_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3342	001	0	1	04	01	H3342_001_0	12	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H3342	002	0	1	04	01	H3342_002_0	11	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H3342	004	0	1	04	01	H3342_004_0	13	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H3342	012	0	1	04	01	H3342_012_0	12	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H3351	001	0	1	01	01	H3351_001_0	4	1	1	US	0101111101101111111011011111000001111111111001010	2	1	30	30	2		
H3351	002	0	1	01	01	H3351_002_0	6	1	1	Group #1	0101111101101111111011011111000001111111111001010	2	1	30	30	2		
H3351	006	0	1	01	01	H3351_006_0	7	1	1	US	0101111101101111111011011111000001111111111001010	2	1	30	30	2		
H3351	007	0	1	01	01	H3351_007_0	5	1	1	US	0101111101101111111011011111000001111111111001010	2	1	30	30	2		
H3379	001	0	1	01	01	H3379_001_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3379	005	0	1	01	01	H3379_005_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3388	001	0	1	01	01	H3388_001_0	4	1	1	30% Coinsurance	0000111101101111111010010001000000000000010001010	2	1	30	30	2		
H3388	002	0	1	01	01	H3388_002_0	7	1	1	30% Coinsurance	0000111101101111111010010001000000000000010001010	2	1	30	30	2		
H3388	003	0	1	01	01	H3388_003_0	4	1	1	30% Coinsurance	0000111101101111111010010001000000000000010001010	2	1	30	30	2		
H3388	004	0	1	01	01	H3388_004_0	6	1	1	30% Coinsurance	0000111101101111111010010001000000000000010001010	2	1	30	30	2		
H3404	001	0	1	04	01	H3404_001_0	12	1	1	Medicare covered Part B benefits	0111111111011111111111011111000011111111111011110	1						
H3404	002	0	1	04	01	H3404_002_0	13	1	1	Medicare covered Part B Benefits	0111111111011111111111011111000011111111111011110	1						
H3456	001	0	1	02	01	H3456_001_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H3456	020	0	1	02	01	H3456_020_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011110	1						
H3456	022	0	1	01	01	H3456_022_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3456	023	0	1	02	01	H3456_023_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H3456	024	0	1	01	01	H3456_024_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3659	001	0	1	02	01	H3659_001_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H3659	003	0	1	01	01	H3659_003_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H3659	031	0	1	01	01	H3659_031_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H3659	054	0	1	01	01	H3659_054_0	2	1	1	Visitor Travel	0111111111111111111111011111000011111111111011110	1						
H3659	059	0	1	01	01	H3659_059_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3812	001	0	1	04	01	H3812_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H3812	007	0	1	04	01	H3812_007_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3814	005	0	1	01	01	H3814_005_0	4	1	1	Travel Benefit	0111111111111111111111111111111111111111111111111	1						
H3814	006	0	1	01	01	H3814_006_0	6	1	1	Travel Benefit	0111111111111111111111111111111111111111111111111	1						
H3814	018	0	1	01	01	H3814_018_0	5	1	1	Travel Benefit	0111111111111111111111111111111111111111111111111	1						
H3814	019	0	1	01	01	H3814_019_0	6	1	1	Travel Benefit	0111111111111111111111111111111111111111111111111	1						
H3817	001	0	1	04	01	H3817_001_0	3	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H3817	001	0	1	04	01	H3817_001_0	3	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H3817	001	0	1	04	01	H3817_001_0	3	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H3817	001	0	1	04	01	H3817_001_0	3	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H3817	001	0	1	04	01	H3817_001_0	3	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H3817	001	0	1	04	01	H3817_001_0	3	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	9	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H3817	002	0	1	04	01	H3817_002_0	7	10	1	$100 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H3817	002	0	1	04	01	H3817_002_0	7	8	1	$0 cost sharing	0110000000000000000000000101000001011111110000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	7	1	0% to 10%	0000000000000100000000000000000000000000000000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	6	1	$100	0000000000000000000001000000000000000000000000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	5	1	$0 to $25	0000000000000000000000000000000010000000000000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	4	1	10% coinsurance	0001000000000011100000011010000000000000001000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	3	1	$0 to $200	0000000000000000010000000000000000000000000000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	2	1	$200	0000000000000000001000000000000000000000000000000	1						
H3817	002	0	1	04	01	H3817_002_0	7	1	1	$25 copay	0000111111111000000110000000000000100000000011010	1						
H3817	003	0	1	04	01	H3817_003_0	6	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H3817	003	0	1	04	01	H3817_003_0	6	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H3817	003	0	1	04	01	H3817_003_0	6	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H3817	003	0	1	04	01	H3817_003_0	6	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H3817	003	0	1	04	01	H3817_003_0	6	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H3817	003	0	1	04	01	H3817_003_0	6	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
H3887	003	0	1	02	01	H3887_003_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H3887	005	0	1	02	01	H3887_005_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111011011	1						
H3912	008	0	1	04	01	H3912_008_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3916	001	0	1	04	01	H3916_001_0	5	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3916	002	0	1	04	01	H3916_002_0	5	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3916	005	0	1	04	01	H3916_005_0	5	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3916	012	0	1	04	01	H3916_012_0	4	1	1	Group 1	0111111111111111111111111111000011111111111011111	1						
H3916	015	0	1	04	01	H3916_015_0	5	1	1	Group 1	0111111111111111111111111111000011111111111011111	1						
H3916	018	0	1	04	01	H3916_018_0	5	1	1	Group 1	0111111111111111111111111111000011111111111011111	1						
H3916	019	0	1	04	01	H3916_019_0	5	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3916	020	0	1	04	01	H3916_020_0	5	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3916	022	0	1	04	01	H3916_022_0	5	1	1	Group 1	0111111111111111111111111111000011111111111011111	1						
H3916	024	0	1	04	01	H3916_024_0	5	1	1	Group 1	0111111111111111111111111111000011111111111011111	1						
H3916	025	0	1	04	01	H3916_025_0	6	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3916	026	0	1	04	01	H3916_026_0	5	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3916	027	0	1	04	01	H3916_027_0	5	1	1	Group 1	0111111111111111111111111111000011111111111111111	1						
H3921	001	0	1	04	01	H3921_001_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3921	008	0	1	04	01	H3921_008_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H3923	013	0	1	04	01	H3923_013_0	9	1	1	VT benefit	0111111111111111111111011111111101111111111000000	1						
H3923	017	0	1	04	01	H3923_017_0	8	1	1	VT benefit	0111111111111111111111011111111101111111111000000	1						
H3923	021	0	1	04	01	H3923_021_0	8	1	1	VT benefit	0111111111111111111111011111111101111111111000000	1						
H3923	801	0	1	04	01	H3923_801_0	6	1	1	VT benefit	0111111111111111111111011111111101111111111000000	1						
H3923	802	0	1	04	01	H3923_802_0	6	1	1	VT benefit	0111111111111111111111011111111101111111111000000	1						
H3923	803	0	1	04	01	H3923_803_0	6	1	1	VT benefit	0111111111111111111111011111111101111111111000000	1						
H4003	001	0	1	01	01	H4003_001_0	5	1	1	US	0111111111111111111111111111111111111111111111111	2	1	20	20	2		
H4003	801	0	1	01	01	H4003_801_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4003	803	0	1	01	01	H4003_803_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4003	804	0	1	01	01	H4003_804_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4003	805	0	1	01	01	H4003_805_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4003	806	0	1	01	01	H4003_806_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4003	807	0	1	01	01	H4003_807_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4003	808	0	1	01	01	H4003_808_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4003	809	0	1	01	01	H4003_809_0	4	1	1	US	0111111111111111111111111111111111111111111111111	2	1	35	35	2		
H4004	015	0	1	01	01	H4004_015_0	5	1	1	US	0111111111111111111111111111111111111111111111111	2	1	20	20	2		
H4005	001	0	1	04	01	H4005_001_0	4	1	1	US	0111111111111111111111011111000001111111111000000	2	1	20	20	2		
H4005	003	0	1	04	01	H4005_003_0	4	1	1	US	0111111111111111111111011111000001111111111000000	2	1	20	20	2		
H4006	008	0	1	02	01	H4006_008_0	9	1	1	Travel Program	0111111111111111111110011101000001111111111110010	2	2			2		
H4011	004	0	1	04	01	H4011_004_0	6	1	1	Travel Benefit	0111111111111111111111111111010111111111111111111	1						
H4036	001	0	1	04	01	H4036_001_0	12	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H4036	003	0	1	04	01	H4036_003_0	11	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H4102	001	0	1	02	01	H4102_001_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H4102	025	0	1	01	01	H4102_025_0	2	1	1	Visitor Travel	0111111111111111111111111111000011111111111011110	1						
H4106	002	0	1	01	01	H4106_002_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4209	001	0	1	04	01	H4209_001_0	6	1	1	Like Section B	0111111111111111111111011111000011111111111011110	1						
H4209	003	0	1	04	01	H4209_003_0	6	1	1	Like Section B	0111111111111111111111011111000011111111111011110	1						
H4209	004	0	1	04	01	H4209_004_0	6	1	1	Like Section B	0111111111111111111111011111000011111111111111110	1						
H4209	006	0	1	04	01	H4209_006_0	6	1	1	Like Section B	0111111111111111111111011111000011111111111111110	1						
H4209	809	0	1	04	01	H4209_809_0	4	1	1	Like Section B	0111111111111111111111011111000011111111111011110	1						
H4209	810	0	1	04	01	H4209_810_0	4	1	1	Like Section B	0111111111111111111111011111000011111111111011110	1						
H4209	811	0	1	04	01	H4209_811_0	4	1	1	Like Section B	0111111111111111111111011111000011111111111011110	1						
H4209	812	0	1	04	01	H4209_812_0	4	1	1	Like Section B	0111111111111111111111011111000011111111111011110	1						
H4406	001	0	1	02	01	H4406_001_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H4456	010	0	1	01	01	H4456_010_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4456	013	0	1	01	01	H4456_013_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4456	015	0	1	01	01	H4456_015_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4456	019	0	1	01	01	H4456_019_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4456	020	0	1	01	01	H4456_020_0	2	1	1	Visitor Travel	0111111111111111111111011111000011111111111011110	1						
H4456	021	0	1	01	01	H4456_021_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4456	025	0	1	01	01	H4456_025_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4456	026	0	1	02	01	H4456_026_0	5	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4456	027	0	1	02	01	H4456_027_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4514	004	0	1	01	01	H4514_004_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H4514	007	0	1	01	01	H4514_007_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H4522	001	0	1	04	01	H4522_001_0	6	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H4522	008	0	1	04	01	H4522_008_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H4604	003	0	1	02	01	H4604_003_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H4604	005	0	1	02	01	H4604_005_0	2	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H4604	008	0	1	02	01	H4604_008_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011110	1						
H4605	001	0	1	04	01	H4605_001_0	2	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H4605	001	0	1	04	01	H4605_001_0	2	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H4605	001	0	1	04	01	H4605_001_0	2	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H4605	001	0	1	04	01	H4605_001_0	2	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H4605	001	0	1	04	01	H4605_001_0	2	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
H4605	001	0	1	04	01	H4605_001_0	2	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H4605	002	0	1	04	01	H4605_002_0	5	5	1	$0 to $25	0000000000000000000000000000000010000000000000000	1						
H4605	002	0	1	04	01	H4605_002_0	5	4	1	10% coinsurance	0001000000000011100000011010000000000000001000000	1						
H4605	002	0	1	04	01	H4605_002_0	5	3	1	$0 to $200	0000000000000000010000000000000000000000000000000	1						
H4605	002	0	1	04	01	H4605_002_0	5	2	1	$200	0000000000000000001000000000000000000000000000000	1						
H4605	002	0	1	04	01	H4605_002_0	5	1	1	$25 copay	0000111111111000000110000000000000100000000011010	1						
H4605	002	0	1	04	01	H4605_002_0	5	7	1	0% to 10%	0000000000000100000000000000000000000000000000000	1						
H4605	002	0	1	04	01	H4605_002_0	5	8	1	$0 cost sharing	0110000000000000000000000101000001011111110000000	1						
H4605	002	0	1	04	01	H4605_002_0	5	9	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H4605	002	0	1	04	01	H4605_002_0	5	6	1	$100	0000000000000000000001000000000000000000000000000	1						
H4605	002	0	1	04	01	H4605_002_0	5	10	1	$100 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H4605	004	0	1	04	01	H4605_004_0	5	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H4605	004	0	1	04	01	H4605_004_0	5	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
H4605	004	0	1	04	01	H4605_004_0	5	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H4605	004	0	1	04	01	H4605_004_0	5	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H4605	004	0	1	04	01	H4605_004_0	5	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H4605	004	0	1	04	01	H4605_004_0	5	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H4909	001	0	1	04	01	H4909_001_0	9	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H4909	004	0	1	04	01	H4909_004_0	9	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H4909	007	0	1	04	01	H4909_007_0	5	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H4971	001	0	1	02	01	H4971_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5008	004	0	1	01	01	H5008_004_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H5008	006	0	1	01	01	H5008_006_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H5009	001	0	1	04	01	H5009_001_0	2	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H5009	001	0	1	04	01	H5009_001_0	2	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H5009	001	0	1	04	01	H5009_001_0	2	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H5009	001	0	1	04	01	H5009_001_0	2	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H5009	001	0	1	04	01	H5009_001_0	2	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H5009	001	0	1	04	01	H5009_001_0	2	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
H5009	002	0	1	04	01	H5009_002_0	4	1	1	$25 copay	0000111111111000000110000000000000100000000011010	1						
H5009	002	0	1	04	01	H5009_002_0	4	10	1	$100 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H5009	002	0	1	04	01	H5009_002_0	4	9	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H5009	002	0	1	04	01	H5009_002_0	4	8	1	$0 cost sharing	0110000000000000000000000101000001011111110000000	1						
H5009	002	0	1	04	01	H5009_002_0	4	7	1	0% to 10%	0000000000000100000000000000000000000000000000000	1						
H5009	002	0	1	04	01	H5009_002_0	4	6	1	$100	0000000000000000000001000000000000000000000000000	1						
H5009	002	0	1	04	01	H5009_002_0	4	5	1	$0 to $25	0000000000000000000000000000000010000000000000000	1						
H5009	002	0	1	04	01	H5009_002_0	4	4	1	10% coinsurance	0001000000000011100000011010000000000000001000000	1						
H5009	002	0	1	04	01	H5009_002_0	4	3	1	$0 to $200	0000000000000000010000000000000000000000000000000	1						
H5009	002	0	1	04	01	H5009_002_0	4	2	1	$200	0000000000000000001000000000000000000000000000000	1						
H5009	004	0	1	04	01	H5009_004_0	5	5	1	$200 every 2 years max amount	0000000000000000000000000000000000000000000000100	1						
H5009	004	0	1	04	01	H5009_004_0	5	1	1	$10 copay	0000111111111000000110000000000000100000000011010	1						
H5009	004	0	1	04	01	H5009_004_0	5	4	1	$500 per year max amount	0000000000000000000000000000000000000000000100000	1						
H5009	004	0	1	04	01	H5009_004_0	5	3	1	$0 to $100	0000000000000000010000000000000000000000000000000	1						
H5009	004	0	1	04	01	H5009_004_0	5	2	1	$100 copay	0000000000000000001001000000000000000000000000000	1						
H5009	004	0	1	04	01	H5009_004_0	5	6	1	$0 copay	0111000000000111100000011111000001011111111000000	1						
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H5215	001	0	1	04	01	H5215_001_0	4	5	1	$50 Cost Share Group	0000000000000010000000000000000000000000000000000	1						
H5215	001	0	1	04	01	H5215_001_0	4	6	1	10% Cost Share Group	0000000000000000000000011000000000000000001000000	1						
H5215	001	0	1	04	01	H5215_001_0	4	7	1	$15 Cost Share Group	0000011111111000000100000000000000000000000011110	1						
H5215	001	0	1	04	01	H5215_001_0	4	1	1	$0 Cost Share Group	0001100000000000001000000001000111111111110000000	1						
H5215	001	0	1	04	01	H5215_001_0	4	2	1	$5 Cost Share Group	0000000000000111100000000000000000000000000000000	1						
H5215	001	0	1	04	01	H5215_001_0	4	3	1	$10 Cost Share Group	0110000000000000000010000110000000000000000000000	1						
H5215	001	0	1	04	01	H5215_001_0	4	4	1	$25 Cost Share Group	0000000000000000000001000000000000000000000000000	1						
H5215	002	0	1	04	01	H5215_002_0	4	1	1	$0 Cost Share Group	0001100000000000001000000001000111111111110000000	1						
H5215	002	0	1	04	01	H5215_002_0	4	3	1	$10 Cost Share Group	0110000000000000000010000110000000000000000000000	1						
H5215	002	0	1	04	01	H5215_002_0	4	4	1	$25 Cost Share Group	0000000000000000000001000000000000000000000000000	1						
H5215	002	0	1	04	01	H5215_002_0	4	5	1	$50 Cost Share Group	0000000000000010000000000000000000000000000000000	1						
H5215	002	0	1	04	01	H5215_002_0	4	6	1	10% Cost Share Group	0000000000000000000000011000000000000000001000000	1						
H5215	002	0	1	04	01	H5215_002_0	4	7	1	$15 Cost Share Group	0000011111111000000100000000000000000000000011110	1						
H5215	002	0	1	04	01	H5215_002_0	4	2	1	$5 Cost Share Group	0000000000000111100000000000000000000000000000000	1						
H5215	005	0	1	04	01	H5215_005_0	4	2	1	$5 Cost Share Group	0000000000000111100000000000000000000000000000000	1						
H5215	005	0	1	04	01	H5215_005_0	4	3	1	$10 Cost Share Group	0110000000000000000010000110000000000000000000000	1						
H5215	005	0	1	04	01	H5215_005_0	4	4	1	$25 Cost Share Group	0000000000000000000001000000000000000000000000000	1						
H5215	005	0	1	04	01	H5215_005_0	4	5	1	$50 Cost Share Group	0000000000000010000000000000000000000000000000000	1						
H5215	005	0	1	04	01	H5215_005_0	4	6	1	10% Cost Share Group	0000000000000000000000011000000000000000001000000	1						
H5215	005	0	1	04	01	H5215_005_0	4	1	1	$0 Cost Share Group	0001100000000000001000000001000111111111110000000	1						
H5215	005	0	1	04	01	H5215_005_0	4	7	1	$15 Cost Share Group	0000011111111000000100000000000000000000000011110	1						
H5215	006	0	1	04	01	H5215_006_0	3	1	1	$0 Cost Share Group	0001100000000000001000000001000111111111110000000	1						
H5215	006	0	1	04	01	H5215_006_0	3	2	1	$5 Cost Share Group	0000000000000111100000000000000000000000000000000	1						
H5215	006	0	1	04	01	H5215_006_0	3	3	1	$10 Cost Share Group	0110000000000000000010000110000000000000000000000	1						
H5215	006	0	1	04	01	H5215_006_0	3	4	1	$25 Cost Share Group	0000000000000000000001000000000000000000000000000	1						
H5215	006	0	1	04	01	H5215_006_0	3	5	1	$50 Cost Share Group	0000000000000010000000000000000000000000000000000	1						
H5215	006	0	1	04	01	H5215_006_0	3	7	1	$15 Cost Share Group	0000011111111000000100000000000000000000000011110	1						
H5215	006	0	1	04	01	H5215_006_0	3	6	1	10% Cost Share Group	0000000000000000000000011000000000000000001000000	1						
H5215	008	0	1	04	01	H5215_008_0	6	1	1	Same cost share as section B	0111111111111111111111011111000111111111111011110	1						
H5253	004	0	1	02	01	H5253_004_0	5	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5253	011	0	1	02	01	H5253_011_0	5	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5253	021	0	1	02	01	H5253_021_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5253	027	0	1	02	01	H5253_027_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H5253	028	0	1	02	01	H5253_028_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5253	029	0	1	02	01	H5253_029_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H5417	005	0	1	04	01	H5417_005_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H5424	001	0	1	04	01	H5424_001_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H5424	003	0	1	04	01	H5424_003_0	2	1	1	Visitor Travel	0111111111111111111111111111100011111111111111111	1						
H5434	002	0	1	04	01	H5434_002_0	6	11	1	$500 Copayment	0000000000000000000000010000000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	10	1	20% Coinsurance	0000000000000000000000000000000000000000001000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	9	1	$150 Copayment	0000000000000000010100000000000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	8	1	$100 Copayment	0000000000000010001001000000000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	7	1	$75 Copayment	0000000000000100000000000000000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	6	1	$50 copayment	0000000000000001000000000000000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	5	1	$30 copayment	0000000000000000000000000010000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	4	1	$25 Copayment	0100011111011000000010000000000000000000000011010	1						
H5434	002	0	1	04	01	H5434_002_0	6	3	1	$10 Copayment	0000100000000000000000000000000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	2	1	$5 copayment	0000000000100000000000000000000000000000000000000	1						
H5434	002	0	1	04	01	H5434_002_0	6	1	1	$0 Copayment	0011000000000000100000001101000011111111110000100	1						
H5507	001	0	1	04	01	H5507_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5516	001	0	1	04	01	H5516_001_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5526	001	0	1	04	01	H5526_001_0	5	1	1	Non Inpatient/ Non SNF Services	0111111111111111111111111111000011111111111001100	1						
H5526	002	0	1	04	01	H5526_002_0	6	1	1		0111111111111111111111111111010011111111111001110	1						
H5526	003	0	1	04	01	H5526_003_0	9	1	1	Non Inpatient/ Non SNF Services	0111111111111111111111111111000011111111111001100	1						
H5526	004	0	1	04	01	H5526_004_0	9	1	1		0111111111111111111111111111010011111111111001110	1						
H5526	007	0	1	04	01	H5526_007_0	8	1	1	Non Inpatient/ Non SNF Services	0111111111111111111111111111000011111111111001100	1						
H5526	008	0	1	04	01	H5526_008_0	12	1	1		0111111111111111111111111111010011111111111001110	1						
H5526	010	0	1	04	01	H5526_010_0	10	1	1		0111111111111111111111111111010011111111111001110	1						
H5526	011	0	1	04	01	H5526_011_0	10	1	1		0111111111111111111111111111010011111111111001110	1						
H5526	806	0	1	04	01	H5526_806_0	8	1	1	Non Inpatient/ Non SNF Services	0111111111111111111111111111000011111111111001100	1						
H5526	808	0	1	04	01	H5526_808_0	7	1	1	Non Inpatient/ Non SNF Services	0111111111111111111111111111000011111111111001100	1						
H5526	810	0	1	04	01	H5526_810_0	7	1	1	Non Inpatient/ Non SNF Services	0111111111111111111111111111000011111111111001100	1						
H5529	001	0	1	04	01	H5529_001_0	12	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H5529	004	0	1	04	01	H5529_004_0	9	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H5530	001	0	1	04	01	H5530_001_0	10	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H5530	004	0	1	04	01	H5530_004_0	9	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
H5532	001	0	1	04	01	H5532_001_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H5591	003	0	1	01	01	H5591_003_0	5	1	1	Group 1	0000100000000000000000000000000000000000000000000	1						
H5591	003	0	1	01	01	H5591_003_0	5	2	1	Group 2	0000011100001000000000000000000000000000000000000	1						
H5591	003	0	1	01	01	H5591_003_0	5	3	1	Group 3	0000000010010000000100000000000000000000000000000	1						
H5591	003	0	1	01	01	H5591_003_0	5	4	1	Group 4	0000000000000110100000000000000000000000000000000	1						
H5591	003	0	1	01	01	H5591_003_0	5	5	1	Group 5	0000000000000001000000011000000000000000001000000	1						
H5591	003	0	1	01	01	H5591_003_0	5	6	1	Group 6	0000000000000000000000000101000000000000100000000	1						
H5749	001	0	1	02	01	H5749_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H7187	003	0	1	02	01	H7187_003_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H7187	008	0	1	02	01	H7187_008_0	3	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
H7187	009	0	1	02	01	H7187_009_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H7526	001	0	1	01	01	H7526_001_0	6	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	2	1	20	20	2		
H7526	003	0	1	01	01	H7526_003_0	6	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	2	1	20	20	2		
H7526	004	0	1	01	01	H7526_004_0	6	1	1	Outpatient Services	0111111111111111111111111111100011111111111011111	2	1	20	20	2		
H8748	001	0	1	02	01	H8748_001_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H8748	002	0	1	02	01	H8748_002_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H8748	003	0	1	02	01	H8748_003_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H8748	004	0	1	02	01	H8748_004_0	3	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H9001	001	0	1	01	01	H9001_001_0	2	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	010	0	1	01	01	H9001_010_0	2	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	011	0	1	01	01	H9001_011_0	3	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	013	0	1	01	01	H9001_013_0	4	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	014	0	1	01	01	H9001_014_0	3	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	015	0	1	01	01	H9001_015_0	4	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	017	0	1	01	01	H9001_017_0	6	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	020	0	1	01	01	H9001_020_0	4	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	021	0	1	01	01	H9001_021_0	3	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	022	0	1	01	01	H9001_022_0	1	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	023	0	1	01	01	H9001_023_0	2	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	024	0	1	01	01	H9001_024_0	3	1	1		0000100101000100100000000000000000000000000000000	1						
H9001	025	0	1	01	01	H9001_025_0	3	1	1		0000100101000100100000000000000000000000000000000	1						
H9005	007	0	1	01	01	H9005_007_0	4	1	1	US Travel Benefit Coinsurance	0111111111111111111111111111100000000000001000000	2	1	20	20	2		
H9011	003	0	1	01	01	H9011_003_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111111111	1						
H9011	016	0	1	02	01	H9011_016_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
H9149	002	0	1	02	01	H9149_002_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111011111	1						
H9859	001	0	1	01	01	H9859_001_0	3	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H9859	001	0	1	01	01	H9859_001_0	3	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H9859	002	0	1	01	01	H9859_002_0	7	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H9859	002	0	1	01	01	H9859_002_0	7	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H9859	003	0	1	01	01	H9859_003_0	3	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H9859	003	0	1	01	01	H9859_003_0	3	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H9859	004	0	1	01	01	H9859_004_0	9	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H9859	004	0	1	01	01	H9859_004_0	9	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H9859	802	0	1	01	01	H9859_802_0	3	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H9859	802	0	1	01	01	H9859_802_0	3	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
H9859	804	0	1	01	01	H9859_804_0	3	1	1	30% Coinsurance	0101111101001111111010001101000000000000000000000	2	1	30	30	2		
H9859	804	0	1	01	01	H9859_804_0	3	2	1	$0 Copayment	0000000000000000000000000010000001111111110000000	2	2			2		
R3175	001	0	1	31	11	R3175_001_0	4	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
R3175	002	0	1	31	11	R3175_002_0	4	1	1	Visitor Travel	0111111111111111111111111111100011111111111111111	1						
R3175	004	0	1	31	11	R3175_004_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
R3332	001	0	1	31	11	R3332_001_0	6	7	1	$200 Copayment	0000000000000000001000000000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	6	1	$75 copayment	0000000000000100000000000000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	5	1	$50 copayment	0000000000000001000000000000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	11	1	$100 Copayment	0000000000000010000000000000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	3	1	$15 Copayment	0000100000000000000000000000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	2	1	$5 copayment	0000000000100000000000000000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	1	1	$0 Copayment	0011000000000000100000001101000011111111110000100	1						
R3332	001	0	1	31	11	R3332_001_0	6	8	1	$150 Copayment	0000000000000000000001000000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	9	1	$500 Copayment	0000000000000000010100010000000000000000000000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	10	1	20% Coinsurance	0000000000000000000000000000000000000000001000000	1						
R3332	001	0	1	31	11	R3332_001_0	6	4	1	$45 Copayment	0100011111011000000010000010000000000000000011010	1						
R5287	001	0	1	31	11	R5287_001_0	6	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
R5287	002	0	1	31	11	R5287_002_0	5	1	1	Visitor Travel	0111111111111111111111011111000011111111111111111	1						
R5342	001	0	1	31	11	R5342_001_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
R5342	002	0	1	31	11	R5342_002_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
R5342	004	0	1	31	11	R5342_004_0	5	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
R5566	005	0	1	31	11	R5566_005_0	4	1	1	Group 1	0001000000000100000000000011000001011111000000000	2	2			2		
R5566	005	0	1	31	11	R5566_005_0	4	5	1	Group 5	0000010000000011100001011100000000000000001000100	2	1	20	20	2		
R5566	005	0	1	31	11	R5566_005_0	4	6	1	Group 6	0010000000000000000000000000000000000000000000000	2	2			1	125.00	125.00
R5566	005	0	1	31	11	R5566_005_0	4	3	1	Group 3	0000100000000000000000000000000000100000000000000	1						
R5566	005	0	1	31	11	R5566_005_0	4	2	1	Group 2	0100001111101000000110000000000010000000010011000	2	2			1	35.00	35.00
R5566	005	0	1	31	11	R5566_005_0	4	4	1	Group 4	0000000000000000001000000000000000000000000000000	2	2			1	150.00	150.00
R5566	005	0	1	31	11	R5566_005_0	4	7	1	Group 7	0000000000000000010000000000000000000000000000000	2	2			1	0.00	150.00
R5941	001	0	1	31	11	R5941_001_0	10	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
R5941	003	0	1	31	11	R5941_003_0	11	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
R5941	007	0	1	31	11	R5941_007_0	10	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
R5941	008	0	1	31	11	R5941_008_0	9	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
R5941	009	0	1	31	11	R5941_009_0	8	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
R7444	001	0	1	31	11	R7444_001_0	4	1	1	Visitor Travel	0111111111111111111111111111000011111111111011111	1						
R9943	001	0	1	31	11	R9943_001_0	9	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
R9943	003	0	1	31	11	R9943_003_0	11	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
R9943	004	0	1	31	11	R9943_004_0	7	1	1	Out of Area Covered Services	0111111111111111111111011111000001111111111010000	1						
