pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	mrx_tier_id	mrx_tier_lbl	mrx_tier_gap_cost_share	mrx_tier_gap_all_drug_yn	mrx_tier_gap_drug_type_lmtd
H0104	004	0	1	04	01	H0104_004_0	5	4	Tier 4	2		
H0104	004	0	1	04	01	H0104_004_0	5	3	Tier 3	2		
H0104	004	0	1	04	01	H0104_004_0	5	2	Tier 2	2		
H0104	004	0	1	04	01	H0104_004_0	5	5	Tier 5	2		
H0104	004	0	1	04	01	H0104_004_0	5	1	Tier 1	1	1	
H0104	008	0	1	04	01	H0104_008_0	6	5	Tier 5	2		
H0104	008	0	1	04	01	H0104_008_0	6	4	Tier 4	2		
H0104	008	0	1	04	01	H0104_008_0	6	3	Tier 3	2		
H0104	008	0	1	04	01	H0104_008_0	6	2	Tier 2	2		
H0104	008	0	1	04	01	H0104_008_0	6	1	Tier 1	1	1	
H0108	004	0	1	01	01	H0108_004_0	6	3	Non-Preferred Brand	1	2	10000000
H0108	004	0	1	01	01	H0108_004_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0108	004	0	1	01	01	H0108_004_0	6	4	Specialty	1	2	10001000
H0108	004	0	1	01	01	H0108_004_0	6	1	Preferred Generic	1	2	00001000
H0108	005	0	1	01	01	H0108_005_0	5	1	Preferred Generic	1	2	00001000
H0108	005	0	1	01	01	H0108_005_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0108	005	0	1	01	01	H0108_005_0	5	3	Non-Preferred Brand	1	2	10000000
H0108	005	0	1	01	01	H0108_005_0	5	4	Specialty	1	2	10001000
H0108	006	0	1	02	01	H0108_006_0	4	4	Specialty	1	2	10001000
H0108	006	0	1	02	01	H0108_006_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0108	006	0	1	02	01	H0108_006_0	4	1	Preferred Generic	1	2	00001000
H0108	006	0	1	02	01	H0108_006_0	4	3	Non-Preferred Brand	1	2	10000000
H0150	001	0	1	01	01	H0150_001_0	7	2	Generic	1	1	
H0150	001	0	1	01	01	H0150_001_0	7	1	Preferred Generic	1	1	
H0150	001	0	1	01	01	H0150_001_0	7	4	Non-Preferred Brand	2		
H0150	001	0	1	01	01	H0150_001_0	7	3	Preferred Brand	2		
H0150	001	0	1	01	01	H0150_001_0	7	5	Specialty	2		
H0150	019	0	1	01	01	H0150_019_0	8	1	Preferred Generic	1	1	
H0150	019	0	1	01	01	H0150_019_0	8	3	Preferred Brand	2		
H0150	019	0	1	01	01	H0150_019_0	8	2	Generic	1	2	01000000
H0150	019	0	1	01	01	H0150_019_0	8	4	Non-Preferred Brand	2		
H0150	019	0	1	01	01	H0150_019_0	8	5	Specialty	2		
H0150	021	0	1	01	01	H0150_021_0	6	1	Preferred Generic	1	1	
H0150	021	0	1	01	01	H0150_021_0	6	2	Generic	1	1	
H0150	021	0	1	01	01	H0150_021_0	6	3	Preferred Brand	2		
H0150	021	0	1	01	01	H0150_021_0	6	4	Non-Preferred Brand	2		
H0150	021	0	1	01	01	H0150_021_0	6	5	Specialty	2		
H0154	011	0	1	01	01	H0154_011_0	5	4	Tier 4	2		
H0154	011	0	1	01	01	H0154_011_0	5	3	Tier 3	2		
H0154	011	0	1	01	01	H0154_011_0	5	1	Tier 1	1	1	
H0154	011	0	1	01	01	H0154_011_0	5	2	Tier 2	2		
H0154	013	0	1	01	01	H0154_013_0	4	3	Tier 3	2		
H0154	013	0	1	01	01	H0154_013_0	4	2	Tier 2	2		
H0154	013	0	1	01	01	H0154_013_0	4	1	Tier 1	1	1	
H0154	013	0	1	01	01	H0154_013_0	4	4	Tier 4	2		
H0248	001	0	1	04	01	H0248_001_0	7	3	Non-Preferred Brand	1	2	10000000
H0248	001	0	1	04	01	H0248_001_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0248	001	0	1	04	01	H0248_001_0	7	1	Preferred Generic	1	2	00001000
H0248	001	0	1	04	01	H0248_001_0	7	4	Specialty	1	2	10001000
H0248	002	0	1	04	01	H0248_002_0	6	3	Non-Preferred Brand	1	2	10000000
H0248	002	0	1	04	01	H0248_002_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0248	002	0	1	04	01	H0248_002_0	6	1	Preferred Generic	1	2	00001000
H0248	002	0	1	04	01	H0248_002_0	6	4	Specialty	1	2	10001000
H0302	001	0	1	01	01	H0302_001_0	7	1	Value Generic	1	1	
H0302	001	0	1	01	01	H0302_001_0	7	2	Generic	1	1	
H0302	001	0	1	01	01	H0302_001_0	7	3	Preferred Brand	2		
H0302	001	0	1	01	01	H0302_001_0	7	4	Non-Preferred Brand	2		
H0302	001	0	1	01	01	H0302_001_0	7	5	Specialty	2		
H0302	004	0	1	01	01	H0302_004_0	6	1	Value Generic	1	1	
H0302	004	0	1	01	01	H0302_004_0	6	2	Generic	1	1	
H0302	004	0	1	01	01	H0302_004_0	6	3	Preferred Brand	2		
H0302	004	0	1	01	01	H0302_004_0	6	4	Non-Preferred Brand	2		
H0302	004	0	1	01	01	H0302_004_0	6	5	Specialty	2		
H0302	007	0	1	01	01	H0302_007_0	6	5	Specialty	2		
H0302	007	0	1	01	01	H0302_007_0	6	1	Value Generic	1	1	
H0302	007	0	1	01	01	H0302_007_0	6	2	Generic	1	1	
H0302	007	0	1	01	01	H0302_007_0	6	3	Preferred Brand	2		
H0302	007	0	1	01	01	H0302_007_0	6	4	Non-Preferred Brand	2		
H0307	008	0	1	01	01	H0307_008_0	4	3	Non-Preferred Brand	1	2	10000000
H0307	008	0	1	01	01	H0307_008_0	4	4	Specialty	1	2	10001000
H0307	008	0	1	01	01	H0307_008_0	4	1	Preferred Generic	1	2	00001000
H0307	008	0	1	01	01	H0307_008_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0307	009	0	1	02	01	H0307_009_0	6	4	Specialty	1	2	10001000
H0307	009	0	1	02	01	H0307_009_0	6	3	Non-Preferred Brand	1	2	10000000
H0307	009	0	1	02	01	H0307_009_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0307	009	0	1	02	01	H0307_009_0	6	1	Preferred Generic	1	2	00001000
H0307	010	0	1	02	01	H0307_010_0	3	3	Non-Preferred Brand	1	2	10000000
H0307	010	0	1	02	01	H0307_010_0	3	4	Specialty	1	2	10001000
H0307	010	0	1	02	01	H0307_010_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0307	010	0	1	02	01	H0307_010_0	3	1	Preferred Generic	1	2	00001000
H0317	001	0	1	04	01	H0317_001_0	4	4	Specialty	1	2	10001000
H0317	001	0	1	04	01	H0317_001_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0317	001	0	1	04	01	H0317_001_0	4	1	Preferred Generic	1	2	00001000
H0317	001	0	1	04	01	H0317_001_0	4	3	Non-Preferred Brand	1	2	10000000
H0317	002	0	1	04	01	H0317_002_0	3	1	Preferred Generic	1	2	00001000
H0317	002	0	1	04	01	H0317_002_0	3	4	Specialty	1	2	10001000
H0317	002	0	1	04	01	H0317_002_0	3	3	Non-Preferred Brand	1	2	10000000
H0317	002	0	1	04	01	H0317_002_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0317	004	0	1	04	01	H0317_004_0	3	4	Specialty	1	2	10001000
H0317	004	0	1	04	01	H0317_004_0	3	3	Non-Preferred Brand	1	2	10000000
H0317	004	0	1	04	01	H0317_004_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0317	004	0	1	04	01	H0317_004_0	3	1	Preferred Generic	1	2	00001000
H0317	006	0	1	04	01	H0317_006_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0317	006	0	1	04	01	H0317_006_0	5	1	Preferred Generic	1	2	00001000
H0317	006	0	1	04	01	H0317_006_0	5	4	Specialty	1	2	10001000
H0317	006	0	1	04	01	H0317_006_0	5	3	Non-Preferred Brand	1	2	10000000
H0320	005	0	1	01	01	H0320_005_0	6	4	Tier 4 - Non-Preferred Brand	2		
H0320	005	0	1	01	01	H0320_005_0	6	3	Tier 3 - Preferred Brand	2		
H0320	005	0	1	01	01	H0320_005_0	6	1	Tier 1 - Preferred Generic	1	1	
H0320	005	0	1	01	01	H0320_005_0	6	2	Tier 2 - Non-Preferred Generic	2		
H0320	005	0	1	01	01	H0320_005_0	6	5	Tier 5 - Specialty	2		
H0320	007	0	1	02	01	H0320_007_0	7	5	Tier 5 - Specialty	2		
H0320	007	0	1	02	01	H0320_007_0	7	4	Tier 4 - Non-Preferred Brand	2		
H0320	007	0	1	02	01	H0320_007_0	7	3	Tier 3 - Preferred Brand	2		
H0320	007	0	1	02	01	H0320_007_0	7	1	Tier 1 - Preferred Generic	1	1	
H0320	007	0	1	02	01	H0320_007_0	7	2	Tier 2 - Non-Preferred Generic	2		
H0332	002	0	1	01	01	H0332_002_0	6	4	Specialty	2		
H0332	002	0	1	01	01	H0332_002_0	6	3	Non-Preferred Brand	2		
H0332	002	0	1	01	01	H0332_002_0	6	1	Preferred Generic	1	1	
H0332	002	0	1	01	01	H0332_002_0	6	2	Non-Preferred Generic/Preferred Brand	2		
H0332	004	0	1	02	01	H0332_004_0	5	3	Non-Preferred Brand	2		
H0332	004	0	1	02	01	H0332_004_0	5	1	Preferred Generic	1	1	
H0332	004	0	1	02	01	H0332_004_0	5	2	Non-Preferred Generic/Preferred Brand	2		
H0332	004	0	1	02	01	H0332_004_0	5	4	Specialty	2		
H0354	001	0	1	01	01	H0354_001_0	9	2	Tier 2	2		
H0354	001	0	1	01	01	H0354_001_0	9	3	Tier 3	2		
H0354	001	0	1	01	01	H0354_001_0	9	4	Tier 4	2		
H0354	001	0	1	01	01	H0354_001_0	9	1	Tier 1	1	1	
H0474	002	0	1	01	01	H0474_002_0	5	1	Tier 1 Generic	1	1	
H0474	002	0	1	01	01	H0474_002_0	5	4	Tier 4 Specialty	2		
H0474	002	0	1	01	01	H0474_002_0	5	3	Tier 3 Non-preferred Brand	2		
H0474	002	0	1	01	01	H0474_002_0	5	2	Tier 2 Preferred Brand	2		
H0504	015	0	1	01	01	H0504_015_0	4	4	Injectables	2		
H0504	015	0	1	01	01	H0504_015_0	4	3	Non-Preferred Brand	2		
H0504	015	0	1	01	01	H0504_015_0	4	2	Formulary Brand	1	1	
H0504	015	0	1	01	01	H0504_015_0	4	1	Formulary Generic	1	1	
H0504	015	0	1	01	01	H0504_015_0	4	5	Formulary Specialty (Unique High Cost Drugs)	2		
H0504	017	0	1	01	01	H0504_017_0	5	4	Injectables	2		
H0504	017	0	1	01	01	H0504_017_0	5	3	Non-Preferred Brand	2		
H0504	017	0	1	01	01	H0504_017_0	5	2	Formulary Brand	2		
H0504	017	0	1	01	01	H0504_017_0	5	1	Formulary Generic	1	1	
H0504	017	0	1	01	01	H0504_017_0	5	5	Formulary Specialty (Unique High Cost Drugs)	2		
H0504	021	0	1	01	01	H0504_021_0	7	2	Formulary Brand	1	1	
H0504	021	0	1	01	01	H0504_021_0	7	3	Non-Preferred Brand	2		
H0504	021	0	1	01	01	H0504_021_0	7	4	Injectables	2		
H0504	021	0	1	01	01	H0504_021_0	7	5	Formulary Specialty (Unique High Cost Drugs)	2		
H0504	021	0	1	01	01	H0504_021_0	7	1	Formulary Generic and Insulin	1	1	
H0523	002	0	1	01	01	H0523_002_0	5	2	Tier 2 - Non-Preferred Generic	2		
H0523	002	0	1	01	01	H0523_002_0	5	3	Tier 3 - Preferred Brand	2		
H0523	002	0	1	01	01	H0523_002_0	5	4	Tier 4 - Non-Preferred Brand	2		
H0523	002	0	1	01	01	H0523_002_0	5	5	Tier 5 - Specialty	2		
H0523	002	0	1	01	01	H0523_002_0	5	1	Tier 1 - Preferred Generic	1	1	
H0523	022	0	1	01	01	H0523_022_0	5	4	Tier 4 - Non-Preferred Brand	2		
H0523	022	0	1	01	01	H0523_022_0	5	5	Tier 5 - Specialty	2		
H0523	022	0	1	01	01	H0523_022_0	5	3	Tier 3 - Preferred Brand	2		
H0523	022	0	1	01	01	H0523_022_0	5	2	Tier 2 - Non-Preferred Generic	2		
H0523	022	0	1	01	01	H0523_022_0	5	1	Tier 1 - Preferred Generic	1	1	
H0523	032	0	1	01	01	H0523_032_0	5	5	Tier 5 - Specialty	2		
H0523	032	0	1	01	01	H0523_032_0	5	4	Tier 4 - Non-Preferred Brand	2		
H0523	032	0	1	01	01	H0523_032_0	5	3	Tier 3 - Preferred Brand	2		
H0523	032	0	1	01	01	H0523_032_0	5	2	Tier 2 - Non-Preferred Generic	2		
H0523	032	0	1	01	01	H0523_032_0	5	1	Tier 1 - Preferred Generic	1	1	
H0523	051	0	1	01	01	H0523_051_0	7	1	Tier 1 - Preferred Generic	1	1	
H0523	051	0	1	01	01	H0523_051_0	7	2	Tier 2 - Non-Preferred Generic	2		
H0523	051	0	1	01	01	H0523_051_0	7	3	Tier 3 - Preferred Brand	2		
H0523	051	0	1	01	01	H0523_051_0	7	4	Tier 4 - Non-Preferred Brand	2		
H0523	051	0	1	01	01	H0523_051_0	7	5	Tier 5 - Specialty	2		
H0523	054	0	1	01	01	H0523_054_0	4	3	Tier 3 - Preferred Brand	2		
H0523	054	0	1	01	01	H0523_054_0	4	4	Tier 4 - Non-Preferred Generic	2		
H0523	054	0	1	01	01	H0523_054_0	4	5	Tier 5 - Specialty	2		
H0523	054	0	1	01	01	H0523_054_0	4	1	Tier 1 - Preferred Generic	1	1	
H0523	054	0	1	01	01	H0523_054_0	4	2	Tier 2 - Non-Preferred Generic	2		
H0524	002	0	2	01	01	H0524_002_0	8	3	Specialty	2		
H0524	002	0	2	01	01	H0524_002_0	8	2	Brand	2		
H0524	002	0	2	01	01	H0524_002_0	8	1	Generic	1	1	
H0524	003	0	1	01	01	H0524_003_0	6	2	Brand	2		
H0524	003	0	1	01	01	H0524_003_0	6	3	Specialty	2		
H0524	003	0	1	01	01	H0524_003_0	6	1	Generic	1	1	
H0524	008	0	1	01	01	H0524_008_0	6	1	Generic	1	1	
H0524	008	0	1	01	01	H0524_008_0	6	3	Specialty	2		
H0524	008	0	1	01	01	H0524_008_0	6	2	Brand	2		
H0524	010	0	2	01	01	H0524_010_0	8	3	Specialty	2		
H0524	010	0	2	01	01	H0524_010_0	8	2	Brand	2		
H0524	010	0	2	01	01	H0524_010_0	8	1	Generic	1	1	
H0524	013	0	1	01	01	H0524_013_0	5	2	Brand	2		
H0524	013	0	1	01	01	H0524_013_0	5	1	Generic	1	1	
H0524	013	0	1	01	01	H0524_013_0	5	3	Specialty	2		
H0524	015	0	1	01	01	H0524_015_0	6	2	Brand	2		
H0524	015	0	1	01	01	H0524_015_0	6	1	Generic	1	1	
H0524	015	0	1	01	01	H0524_015_0	6	3	Specialty	2		
H0524	031	0	1	01	01	H0524_031_0	5	2	Brand	2		
H0524	031	0	1	01	01	H0524_031_0	5	3	Specialty	2		
H0524	031	0	1	01	01	H0524_031_0	5	1	Generic	1	1	
H0524	032	0	1	01	01	H0524_032_0	5	3	Specialty	2		
H0524	032	0	1	01	01	H0524_032_0	5	2	Brand	2		
H0524	032	0	1	01	01	H0524_032_0	5	1	Generic	1	1	
H0524	033	0	1	01	01	H0524_033_0	5	1	Generic	1	1	
H0524	033	0	1	01	01	H0524_033_0	5	2	Brand	2		
H0524	033	0	1	01	01	H0524_033_0	5	3	Specialty	2		
H0524	034	0	1	01	01	H0524_034_0	5	3	Specialty	2		
H0524	034	0	1	01	01	H0524_034_0	5	1	Generic	1	1	
H0524	034	0	1	01	01	H0524_034_0	5	2	Brand	2		
H0524	035	0	1	01	01	H0524_035_0	7	1	Generic	1	1	
H0524	035	0	1	01	01	H0524_035_0	7	3	Specialty	2		
H0524	035	0	1	01	01	H0524_035_0	7	2	Brand	2		
H0524	036	0	1	01	01	H0524_036_0	7	1	Generic	1	1	
H0524	036	0	1	01	01	H0524_036_0	7	2	Brand	2		
H0524	036	0	1	01	01	H0524_036_0	7	3	Specialty	2		
H0524	037	0	1	01	01	H0524_037_0	5	1	Generic	1	1	
H0524	037	0	1	01	01	H0524_037_0	5	2	Brand	2		
H0524	037	0	1	01	01	H0524_037_0	5	3	Specialty	2		
H0524	038	0	1	01	01	H0524_038_0	5	2	Brand	2		
H0524	038	0	1	01	01	H0524_038_0	5	1	Generic	1	1	
H0524	038	0	1	01	01	H0524_038_0	5	3	Specialty	2		
H0524	039	0	1	01	01	H0524_039_0	5	2	Brand	2		
H0524	039	0	1	01	01	H0524_039_0	5	1	Generic	1	1	
H0524	039	0	1	01	01	H0524_039_0	5	3	Specialty	2		
H0524	040	0	1	01	01	H0524_040_0	7	1	Generic	1	1	
H0524	040	0	1	01	01	H0524_040_0	7	2	Brand	2		
H0524	040	0	1	01	01	H0524_040_0	7	3	Specialty	2		
H0524	041	0	1	01	01	H0524_041_0	7	1	Generic	1	1	
H0524	041	0	1	01	01	H0524_041_0	7	2	Brand	2		
H0524	041	0	1	01	01	H0524_041_0	7	3	Specialty	2		
H0540	020	0	1	09	04	H0540_020_0	11	4	Tier 4 Non-Specialty Injectable Drugs	2		
H0540	020	0	1	09	04	H0540_020_0	11	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H0540	020	0	1	09	04	H0540_020_0	11	1	Tier 1 Preferred Generic Drugs	1	1	
H0540	020	0	1	09	04	H0540_020_0	11	5	Tier 5 Specialty Drugs	2		
H0540	020	0	1	09	04	H0540_020_0	11	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H0540	089	0	1	09	04	H0540_089_0	13	5	Tier 5 Specialty Drugs	2		
H0540	089	0	1	09	04	H0540_089_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H0540	089	0	1	09	04	H0540_089_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H0540	089	0	1	09	04	H0540_089_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H0540	089	0	1	09	04	H0540_089_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H0540	091	0	1	09	04	H0540_091_0	11	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H0540	091	0	1	09	04	H0540_091_0	11	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H0540	091	0	1	09	04	H0540_091_0	11	1	Tier 1 Preferred Generic Drugs	1	1	
H0540	091	0	1	09	04	H0540_091_0	11	4	Tier 4 Non-Specialty Injectable Drugs	2		
H0540	091	0	1	09	04	H0540_091_0	11	5	Tier 5 Specialty Drugs	2		
H0540	095	0	1	09	04	H0540_095_0	12	1	Tier 1 Preferred Generic Drugs	1	1	
H0540	095	0	1	09	04	H0540_095_0	12	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H0540	095	0	1	09	04	H0540_095_0	12	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H0540	095	0	1	09	04	H0540_095_0	12	5	Tier 5 Specialty Drugs	2		
H0540	095	0	1	09	04	H0540_095_0	12	4	Tier 4 Non-Specialty Injectable Drugs	2		
H0543	013	0	1	01	01	H0543_013_0	5	4	Tier 4 Specialty	2		
H0543	013	0	1	01	01	H0543_013_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	013	0	1	01	01	H0543_013_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	013	0	1	01	01	H0543_013_0	5	2	Tier 2 Generic  Preferred Brand	2		
H0543	077	0	1	01	01	H0543_077_0	5	4	Tier 4 Specialty	2		
H0543	077	0	1	01	01	H0543_077_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	077	0	1	01	01	H0543_077_0	5	2	Tier 2 Generic  Preferred Brand	2		
H0543	077	0	1	01	01	H0543_077_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	083	0	1	01	01	H0543_083_0	5	4	Tier 4 Specialty	2		
H0543	083	0	1	01	01	H0543_083_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	083	0	1	01	01	H0543_083_0	5	2	Tier 2 Generic  Preferred Brand	2		
H0543	083	0	1	01	01	H0543_083_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	095	0	1	01	01	H0543_095_0	5	4	Tier 4 Specialty	2		
H0543	095	0	1	01	01	H0543_095_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	095	0	1	01	01	H0543_095_0	5	2	Tier 2 Generic  Preferred Brand	2		
H0543	095	0	1	01	01	H0543_095_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	122	0	1	01	01	H0543_122_0	5	4	Tier 4 Specialty	2		
H0543	122	0	1	01	01	H0543_122_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	122	0	1	01	01	H0543_122_0	5	2	Tier 2 Generic  Preferred Brand	2		
H0543	122	0	1	01	01	H0543_122_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	127	0	1	01	01	H0543_127_0	5	2	Tier 2 Generic  Preferred Brand	2		
H0543	127	0	1	01	01	H0543_127_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	127	0	1	01	01	H0543_127_0	5	4	Tier 4 Specialty	2		
H0543	127	0	1	01	01	H0543_127_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	129	0	1	01	01	H0543_129_0	5	4	Tier 4 Specialty	2		
H0543	129	0	1	01	01	H0543_129_0	5	2	Tier 2 Generic  Preferred Brand	1	1	
H0543	129	0	1	01	01	H0543_129_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	129	0	1	01	01	H0543_129_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	138	0	1	01	01	H0543_138_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0543	138	0	1	01	01	H0543_138_0	5	4	Tier 4 Specialty	2		
H0543	138	0	1	01	01	H0543_138_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0543	138	0	1	01	01	H0543_138_0	5	2	Tier 2 Generic  Preferred Brand	1	1	
H0544	003	0	1	01	01	H0544_003_0	9	2	Generic Drugs	1	1	
H0544	003	0	1	01	01	H0544_003_0	9	6	Specialty Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	9	5	Brand Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	9	4	Preferred Brand Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	9	3	Enhanced Care Brand Drugs	2		
H0544	003	0	1	01	01	H0544_003_0	9	1	Preferred Generic Drugs	1	1	
H0544	008	0	1	01	01	H0544_008_0	8	5	Brand Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	8	4	Preferred Brand Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	8	6	Specialty Drugs	2		
H0544	008	0	1	01	01	H0544_008_0	8	1	Preferred Generic Drugs	1	1	
H0544	008	0	1	01	01	H0544_008_0	8	2	Generic Drugs	1	1	
H0544	008	0	1	01	01	H0544_008_0	8	3	Enhanced Care Brand Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	8	6	Specialty Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	8	5	Brand Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	8	4	Preferred Brand Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	8	3	Enhanced Care Brand Drugs	2		
H0544	009	0	1	01	01	H0544_009_0	8	1	Preferred Generic Drugs	1	1	
H0544	009	0	1	01	01	H0544_009_0	8	2	Generic Drugs	1	1	
H0544	010	0	1	01	01	H0544_010_0	9	6	Specialty Drugs	2		
H0544	010	0	1	01	01	H0544_010_0	9	4	Preferred Brand Drugs	2		
H0544	010	0	1	01	01	H0544_010_0	9	3	Enhanced Care Brand Drugs	1	1	
H0544	010	0	1	01	01	H0544_010_0	9	2	Generic Drugs	1	1	
H0544	010	0	1	01	01	H0544_010_0	9	1	Preferred Generic Drugs	1	1	
H0544	010	0	1	01	01	H0544_010_0	9	5	Brand Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	6	6	Specialty Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	6	5	Brand Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	6	4	Preferred Brand Drugs	2		
H0544	012	0	1	01	01	H0544_012_0	6	3	Enhanced Care Brand Drugs	1	1	
H0544	012	0	1	01	01	H0544_012_0	6	2	Generic Drugs	1	1	
H0544	012	0	1	01	01	H0544_012_0	6	1	Preferred Generic Drugs	1	1	
H0544	019	0	1	01	01	H0544_019_0	10	1	Preferred Generic Drugs	1	1	
H0544	019	0	1	01	01	H0544_019_0	10	6	Specialty Drugs	2		
H0544	019	0	1	01	01	H0544_019_0	10	5	Brand Drugs	2		
H0544	019	0	1	01	01	H0544_019_0	10	4	Preferred Brand Drugs	2		
H0544	019	0	1	01	01	H0544_019_0	10	3	Enhanced Care Brand Drugs	1	1	
H0544	019	0	1	01	01	H0544_019_0	10	2	Generic Drugs	1	1	
H0544	020	0	1	01	01	H0544_020_0	6	6	Specialty Drugs	2		
H0544	020	0	1	01	01	H0544_020_0	6	5	Brand Drugs	2		
H0544	020	0	1	01	01	H0544_020_0	6	4	Preferred Brand Drugs	2		
H0544	020	0	1	01	01	H0544_020_0	6	3	Enhanced Care Brand Drugs	1	1	
H0544	020	0	1	01	01	H0544_020_0	6	1	Preferred Generic Drugs	1	1	
H0544	020	0	1	01	01	H0544_020_0	6	2	Generic Drugs	1	1	
H0544	022	0	1	01	01	H0544_022_0	5	1	Preferred Generic Drugs	1	1	
H0544	022	0	1	01	01	H0544_022_0	5	2	Generic Drugs	1	1	
H0544	022	0	1	01	01	H0544_022_0	5	3	Enhanced Care Brand Drugs	1	1	
H0544	022	0	1	01	01	H0544_022_0	5	4	Preferred Brand Drugs	2		
H0544	022	0	1	01	01	H0544_022_0	5	5	Brand Drugs	2		
H0544	022	0	1	01	01	H0544_022_0	5	6	Specialty Drugs	2		
H0544	024	0	1	01	01	H0544_024_0	6	5	Brand Drugs	2		
H0544	024	0	1	01	01	H0544_024_0	6	4	Preferred Brand Drugs	2		
H0544	024	0	1	01	01	H0544_024_0	6	3	Enhanced Care Brand Drugs	1	1	
H0544	024	0	1	01	01	H0544_024_0	6	2	Generic Drugs	1	1	
H0544	024	0	1	01	01	H0544_024_0	6	1	Preferred Generic Drugs	1	1	
H0544	024	0	1	01	01	H0544_024_0	6	6	Specialty Drugs	2		
H0544	025	0	1	01	01	H0544_025_0	7	4	Preferred Brand Drugs	2		
H0544	025	0	1	01	01	H0544_025_0	7	5	Brand Drugs	2		
H0544	025	0	1	01	01	H0544_025_0	7	6	Specialty Drugs	2		
H0544	025	0	1	01	01	H0544_025_0	7	1	Preferred Generic Drugs	1	1	
H0544	025	0	1	01	01	H0544_025_0	7	2	Generic Drugs	1	1	
H0544	025	0	1	01	01	H0544_025_0	7	3	Enhanced Care Brand Drugs	1	1	
H0544	027	0	1	01	01	H0544_027_0	8	5	Brand Drugs	2		
H0544	027	0	1	01	01	H0544_027_0	8	1	Preferred Generic Drugs	1	1	
H0544	027	0	1	01	01	H0544_027_0	8	6	Specialty Drugs	2		
H0544	027	0	1	01	01	H0544_027_0	8	3	Enhanced Care Brand Drugs	1	1	
H0544	027	0	1	01	01	H0544_027_0	8	4	Preferred Brand Drugs	2		
H0544	027	0	1	01	01	H0544_027_0	8	2	Generic Drugs	1	1	
H0544	031	0	1	01	01	H0544_031_0	5	1	Preferred Generic Drugs	1	1	
H0544	031	0	1	01	01	H0544_031_0	5	2	Generic Drugs	1	1	
H0544	031	0	1	01	01	H0544_031_0	5	3	Enhanced Care Brand Drugs	1	1	
H0544	031	0	1	01	01	H0544_031_0	5	4	Preferred Brand Drugs	2		
H0544	031	0	1	01	01	H0544_031_0	5	5	Brand Drugs	2		
H0544	031	0	1	01	01	H0544_031_0	5	6	Specialty Drugs	2		
H0544	032	0	1	01	01	H0544_032_0	6	4	Preferred Brand Drugs	2		
H0544	032	0	1	01	01	H0544_032_0	6	6	Specialty Drugs	2		
H0544	032	0	1	01	01	H0544_032_0	6	3	Enhanced Care Brand Drugs	1	1	
H0544	032	0	1	01	01	H0544_032_0	6	2	Generic Drugs	1	1	
H0544	032	0	1	01	01	H0544_032_0	6	1	Preferred Generic Drugs	1	1	
H0544	032	0	1	01	01	H0544_032_0	6	5	Brand Drugs	2		
H0545	001	0	1	01	01	H0545_001_0	6	6	Specialty Drugs	2		
H0545	001	0	1	01	01	H0545_001_0	6	5	Injectables	2		
H0545	001	0	1	01	01	H0545_001_0	6	4	Non-Preferred Brand	2		
H0545	001	0	1	01	01	H0545_001_0	6	2	Non-Preferred Generic	2		
H0545	001	0	1	01	01	H0545_001_0	6	1	Preferred Generic	1	1	
H0545	001	0	1	01	01	H0545_001_0	6	3	Preferred Brand	2		
H0545	009	0	1	01	01	H0545_009_0	6	5	Non-Preferred Brand	2		
H0545	009	0	1	01	01	H0545_009_0	6	7	Specialty Drugs	2		
H0545	009	0	1	01	01	H0545_009_0	6	6	Injectables	2		
H0545	009	0	1	01	01	H0545_009_0	6	4	Preferred Brand	2		
H0545	009	0	1	01	01	H0545_009_0	6	3	Other Special Needs	1	1	
H0545	009	0	1	01	01	H0545_009_0	6	2	Non-Preferred Generic	2		
H0545	009	0	1	01	01	H0545_009_0	6	1	Preferred Generic	1	1	
H0545	012	0	1	01	01	H0545_012_0	5	1	Preferred Generic	1	1	
H0545	012	0	1	01	01	H0545_012_0	5	3	Preferred Brand	2		
H0545	012	0	1	01	01	H0545_012_0	5	2	Non-Preferred Generic	1	1	
H0545	012	0	1	01	01	H0545_012_0	5	6	Specialty Drugs	1	1	
H0545	012	0	1	01	01	H0545_012_0	5	4	Non-Preferred Brand	2		
H0545	012	0	1	01	01	H0545_012_0	5	5	Injectables	2		
H0562	002	0	1	01	01	H0562_002_0	4	1	Tier 1 Preferred Generic	1	1	
H0562	002	0	1	01	01	H0562_002_0	4	2	Tier 2 Preferred Brand	2		
H0562	002	0	1	01	01	H0562_002_0	4	3	Tier 3 Non-Preferred	2		
H0562	002	0	1	01	01	H0562_002_0	4	4	Tier 4 Injectable	2		
H0562	002	0	1	01	01	H0562_002_0	4	5	Tier 5 Specialty	2		
H0562	012	0	1	01	01	H0562_012_0	3	1	Tier 1 Preferred Generic	1	1	
H0562	012	0	1	01	01	H0562_012_0	3	2	Tier 2 Preferred Brand	2		
H0562	012	0	1	01	01	H0562_012_0	3	3	Tier 3 Non-Preferred	2		
H0562	012	0	1	01	01	H0562_012_0	3	4	Tier 4 Injectable	2		
H0562	012	0	1	01	01	H0562_012_0	3	5	Tier 5 Specialty	2		
H0562	071	0	1	01	01	H0562_071_0	3	4	Tier 4 Injectable	2		
H0562	071	0	1	01	01	H0562_071_0	3	5	Tier 5 Specialty	2		
H0562	071	0	1	01	01	H0562_071_0	3	3	Tier 3 Non-Preferred	2		
H0562	071	0	1	01	01	H0562_071_0	3	2	Tier 2 Preferred Brand	2		
H0562	071	0	1	01	01	H0562_071_0	3	1	Tier 1 Preferred Generic	1	1	
H0562	079	0	1	01	01	H0562_079_0	5	5	Tier 5 Specialty	2		
H0562	079	0	1	01	01	H0562_079_0	5	1	Tier 1 Preferred Generic	1	1	
H0562	079	0	1	01	01	H0562_079_0	5	2	Tier 2 Preferred Brand	2		
H0562	079	0	1	01	01	H0562_079_0	5	3	Tier 3 Non-Preferred	2		
H0562	079	0	1	01	01	H0562_079_0	5	4	Tier 4 Injectable	2		
H0562	081	0	1	01	01	H0562_081_0	3	5	Tier 5 Specialty	2		
H0562	081	0	1	01	01	H0562_081_0	3	4	Tier 4 Injectable	2		
H0562	081	0	1	01	01	H0562_081_0	3	3	Tier 3 Non-Preferred	2		
H0562	081	0	1	01	01	H0562_081_0	3	2	Tier 2 Preferred Brand	2		
H0562	081	0	1	01	01	H0562_081_0	3	1	Tier 1 Preferred Generic	1	1	
H0562	082	0	1	01	01	H0562_082_0	3	5	Tier 5 Specialty	2		
H0562	082	0	1	01	01	H0562_082_0	3	4	Tier 4 Injectable	2		
H0562	082	0	1	01	01	H0562_082_0	3	3	Tier 3 Non-Preferred	2		
H0562	082	0	1	01	01	H0562_082_0	3	1	Tier 1 Preferred Generic	1	1	
H0562	082	0	1	01	01	H0562_082_0	3	2	Tier 2 Preferred Brand	2		
H0562	083	0	1	01	01	H0562_083_0	3	4	Tier 4 Injectable	2		
H0562	083	0	1	01	01	H0562_083_0	3	3	Tier 3 Non-Preferred	2		
H0562	083	0	1	01	01	H0562_083_0	3	2	Tier 2 Preferred Brand	2		
H0562	083	0	1	01	01	H0562_083_0	3	1	Tier 1 Preferred Generic	1	1	
H0562	083	0	1	01	01	H0562_083_0	3	5	Tier 5 Specialty	2		
H0562	085	0	1	01	01	H0562_085_0	3	4	Tier 4 Injectable	2		
H0562	085	0	1	01	01	H0562_085_0	3	3	Tier 3 Non-Preferred	2		
H0562	085	0	1	01	01	H0562_085_0	3	2	Tier 2 Preferred Brand	2		
H0562	085	0	1	01	01	H0562_085_0	3	1	Tier 1 Preferred Generic	1	1	
H0562	085	0	1	01	01	H0562_085_0	3	5	Tier 5 Specialty	2		
H0564	006	0	1	01	01	H0564_006_0	8	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H0564	006	0	1	01	01	H0564_006_0	8	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H0564	006	0	1	01	01	H0564_006_0	8	4	Tier 4 Non-Specialty Injectable Drugs	2		
H0564	006	0	1	01	01	H0564_006_0	8	5	Tier 5 Specialty Drugs	2		
H0564	006	0	1	01	01	H0564_006_0	8	1	Tier 1 Preferred Generic Drugs	1	1	
H0564	047	0	1	01	01	H0564_047_0	8	5	Tier 5 Specialty Drugs	2		
H0564	047	0	1	01	01	H0564_047_0	8	4	Tier 4 Non-Specialty Injectable Drugs	2		
H0564	047	0	1	01	01	H0564_047_0	8	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H0564	047	0	1	01	01	H0564_047_0	8	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H0564	047	0	1	01	01	H0564_047_0	8	1	Tier 1 Preferred Generic Drugs	1	1	
H0602	018	0	1	18	06	H0602_018_0	17	1	Generic Drugs	1	1	
H0602	018	0	1	18	06	H0602_018_0	17	2	Preferred Brand	2		
H0602	018	0	1	18	06	H0602_018_0	17	4	Specialty Drugs	2		
H0602	018	0	1	18	06	H0602_018_0	17	3	Non-Preferred Brand	2		
H0602	019	0	1	18	06	H0602_019_0	14	3	Non-Preferred Brand	2		
H0602	019	0	1	18	06	H0602_019_0	14	1	Generic Drugs	1	1	
H0602	019	0	1	18	06	H0602_019_0	14	2	Preferred Brand	2		
H0602	019	0	1	18	06	H0602_019_0	14	4	Specialty Drugs	2		
H0602	021	0	1	18	06	H0602_021_0	14	2	Preferred Brand	2		
H0602	021	0	1	18	06	H0602_021_0	14	1	Generic	1	1	
H0602	021	0	1	18	06	H0602_021_0	14	3	Non-Preferred Drugs	2		
H0602	021	0	1	18	06	H0602_021_0	14	4	Specialty Drugs	2		
H0609	002	0	1	01	01	H0609_002_0	5	4	Tier 4 Specialty	2		
H0609	002	0	1	01	01	H0609_002_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H0609	002	0	1	01	01	H0609_002_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H0609	002	0	1	01	01	H0609_002_0	5	2	Tier 2 Generic  Preferred Brand	2		
H0621	004	0	1	01	01	H0621_004_0	3	4	Tier 4	1	1	
H0621	004	0	1	01	01	H0621_004_0	3	3	Tier 3	1	1	
H0621	004	0	1	01	01	H0621_004_0	3	2	Tier 2	1	1	
H0621	004	0	1	01	01	H0621_004_0	3	1	Tier 1	1	1	
H0621	005	0	1	01	01	H0621_005_0	3	1	Tier 1	1	1	
H0621	005	0	1	01	01	H0621_005_0	3	2	Tier 2	1	1	
H0621	005	0	1	01	01	H0621_005_0	3	3	Tier 3	1	1	
H0621	005	0	1	01	01	H0621_005_0	3	4	Tier 4	1	1	
H0621	007	0	1	01	01	H0621_007_0	6	2	Tier 2	2		
H0621	007	0	1	01	01	H0621_007_0	6	1	Tier 1	1	1	
H0621	007	0	1	01	01	H0621_007_0	6	3	Tier 3	2		
H0621	007	0	1	01	01	H0621_007_0	6	4	Tier 4	2		
H0623	001	0	1	04	01	H0623_001_0	6	3	Non-Preferred Brand	1	2	10000000
H0623	001	0	1	04	01	H0623_001_0	6	1	Preferred Generic	1	2	00001000
H0623	001	0	1	04	01	H0623_001_0	6	4	Specialty	1	2	10001000
H0623	001	0	1	04	01	H0623_001_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0623	005	0	1	04	01	H0623_005_0	6	3	Non-Preferred Brand	1	2	10000000
H0623	005	0	1	04	01	H0623_005_0	6	4	Specialty	1	2	10001000
H0623	005	0	1	04	01	H0623_005_0	6	1	Preferred Generic	1	2	00001000
H0623	005	0	1	04	01	H0623_005_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H0630	013	0	1	01	01	H0630_013_0	4	2	Brand Drugs	2		
H0630	013	0	1	01	01	H0630_013_0	4	3	Specialty Drugs	2		
H0630	013	0	1	01	01	H0630_013_0	4	1	Generic Drugs	1	1	
H0630	015	0	1	01	01	H0630_015_0	5	1	Generic Drugs	1	1	
H0630	015	0	1	01	01	H0630_015_0	5	3	Specialty Drugs	2		
H0630	015	0	1	01	01	H0630_015_0	5	2	Brand Drugs	2		
H0630	016	0	1	01	01	H0630_016_0	4	2	Brand Drugs	2		
H0630	016	0	1	01	01	H0630_016_0	4	1	Generic Drugs	1	1	
H0630	016	0	1	01	01	H0630_016_0	4	3	Specialty Drugs	2		
H0630	017	0	1	01	01	H0630_017_0	3	2	Brand Drugs	2		
H0630	017	0	1	01	01	H0630_017_0	3	3	Specialty Drugs	2		
H0630	017	0	1	01	01	H0630_017_0	3	1	Generic Drugs	1	1	
H0630	018	0	1	01	01	H0630_018_0	4	1	Generic Drugs	1	1	
H0630	018	0	1	01	01	H0630_018_0	4	2	Brand Drugs	2		
H0630	018	0	1	01	01	H0630_018_0	4	3	Specialty Drugs	2		
H0630	019	0	1	02	01	H0630_019_0	4	3	Specialty Drugs	2		
H0630	019	0	1	02	01	H0630_019_0	4	1	Generic Drugs	1	1	
H0630	019	0	1	02	01	H0630_019_0	4	2	Brand Drugs	2		
H0755	001	0	1	01	01	H0755_001_0	5	1	Tier 1 Preferred Generic	1	1	
H0755	001	0	1	01	01	H0755_001_0	5	2	Tier 2 Preferred Brand	2		
H0755	001	0	1	01	01	H0755_001_0	5	3	Tier 3 Non-Preferred	2		
H0755	001	0	1	01	01	H0755_001_0	5	4	Tier 4 Injectable	2		
H0755	001	0	1	01	01	H0755_001_0	5	5	Tier 5 Specialty	2		
H0755	020	0	1	02	01	H0755_020_0	7	1	Tier 1 Preferred Generic	1	1	
H0755	020	0	1	02	01	H0755_020_0	7	2	Tier 2 Preferred Brand	2		
H0755	020	0	1	02	01	H0755_020_0	7	3	Tier 3 Non-Preferred	2		
H0755	020	0	1	02	01	H0755_020_0	7	4	Tier 4 Injectable	2		
H0755	020	0	1	02	01	H0755_020_0	7	5	Tier 5 Specialty	2		
H0901	007	0	1	01	01	H0901_007_0	5	2	Tier 2 - Non-Preferred Generic	2		
H0901	007	0	1	01	01	H0901_007_0	5	3	Tier 3 - Preferred Brand	2		
H0901	007	0	1	01	01	H0901_007_0	5	1	Tier 1 - Preferred Generic	1	1	
H0901	007	0	1	01	01	H0901_007_0	5	5	Tier 5 - Specialty	2		
H0901	007	0	1	01	01	H0901_007_0	5	4	Tier 4 - Non-Preferred Brand	2		
H1013	011	0	1	01	01	H1013_011_0	8	4	Specialty Drugs	2		
H1013	011	0	1	01	01	H1013_011_0	8	3	Non-Preferred Brand	2		
H1013	011	0	1	01	01	H1013_011_0	8	2	Preferred Brand	2		
H1013	011	0	1	01	01	H1013_011_0	8	1	Preferred Generic	1	1	
H1013	021	0	1	02	01	H1013_021_0	6	3	Non-Preferred Brand	2		
H1013	021	0	1	02	01	H1013_021_0	6	2	Preferred Brand	2		
H1013	021	0	1	02	01	H1013_021_0	6	1	Preferred Generic	1	1	
H1013	021	0	1	02	01	H1013_021_0	6	4	Specialty Drugs	2		
H1013	024	0	1	01	01	H1013_024_0	7	3	Non-Preferred Brand	2		
H1013	024	0	1	01	01	H1013_024_0	7	2	Preferred Brand	2		
H1013	024	0	1	01	01	H1013_024_0	7	1	Preferred Generic	1	1	
H1013	024	0	1	01	01	H1013_024_0	7	4	Specialty Drugs	2		
H1016	001	0	1	01	01	H1016_001_0	7	1	Tier 1	1	1	
H1016	001	0	1	01	01	H1016_001_0	7	2	Tier 2	2		
H1016	001	0	1	01	01	H1016_001_0	7	3	Tier 3	2		
H1016	001	0	1	01	01	H1016_001_0	7	4	Tier 4	2		
H1016	002	0	1	01	01	H1016_002_0	7	3	Tier 3	2		
H1016	002	0	1	01	01	H1016_002_0	7	2	Tier 2	2		
H1016	002	0	1	01	01	H1016_002_0	7	1	Tier 1	1	1	
H1016	002	0	1	01	01	H1016_002_0	7	4	Tier 4	2		
H1019	001	0	1	01	01	H1019_001_0	8	1	Preferred Generic/Value Brand	1	1	
H1019	001	0	1	01	01	H1019_001_0	8	2	Non-Preferred Generic/Preferred Brand	2		
H1019	001	0	1	01	01	H1019_001_0	8	3	Non-Preferred Brand	1	2	10000000
H1019	001	0	1	01	01	H1019_001_0	8	4	Specialty	1	2	10001000
H1019	002	0	1	01	01	H1019_002_0	5	1	Preferred Generic/Value Brand	1	1	
H1019	002	0	1	01	01	H1019_002_0	5	2	Non-Preferred Generic/Preferred Brand	2		
H1019	002	0	1	01	01	H1019_002_0	5	3	Non-Preferred Brand	1	2	10000000
H1019	002	0	1	01	01	H1019_002_0	5	4	Specialty	1	2	10001000
H1019	004	0	1	01	01	H1019_004_0	8	1	Preferred Generic/Value Brand	1	2	10001000
H1019	004	0	1	01	01	H1019_004_0	8	2	Non-Preferred Generic/Preferred Brand	2		
H1019	004	0	1	01	01	H1019_004_0	8	4	Specialty	1	2	10001000
H1019	004	0	1	01	01	H1019_004_0	8	3	Non-Preferred Brand	1	2	10000000
H1019	005	0	1	01	01	H1019_005_0	10	1	Preferred Generic/Value Brand	1	2	10001000
H1019	005	0	1	01	01	H1019_005_0	10	2	Non-Preferred Generic/Preferred Brand	2		
H1019	005	0	1	01	01	H1019_005_0	10	3	Non-Preferred Brand	1	2	10000000
H1019	005	0	1	01	01	H1019_005_0	10	4	Specialty	1	2	10001000
H1019	006	0	1	01	01	H1019_006_0	4	1	Preferred Generic/Value Brand	1	1	
H1019	006	0	1	01	01	H1019_006_0	4	3	Non-Preferred Brand	1	2	10000000
H1019	006	0	1	01	01	H1019_006_0	4	2	Non-Preferred Generic/Preferred Brand	2		
H1019	006	0	1	01	01	H1019_006_0	4	4	Specialty	1	2	10001000
H1019	010	0	1	01	01	H1019_010_0	8	1	Preferred Generic/Value Brand	1	1	
H1019	010	0	1	01	01	H1019_010_0	8	2	Non-Preferred Generic/Preferred Brand	2		
H1019	010	0	1	01	01	H1019_010_0	8	3	Non-Preferred Brand	1	2	10000000
H1019	010	0	1	01	01	H1019_010_0	8	4	Specialty	1	2	10001000
H1019	011	0	1	01	01	H1019_011_0	9	1	Preferred Generic/Value Brand	1	2	10001000
H1019	011	0	1	01	01	H1019_011_0	9	2	Non-Preferred Generic/Preferred Brand	2		
H1019	011	0	1	01	01	H1019_011_0	9	3	Non-Preferred Brand	1	2	10000000
H1019	011	0	1	01	01	H1019_011_0	9	4	Specialty	1	2	10001000
H1019	014	0	1	01	01	H1019_014_0	6	1	Preferred Generic	1	2	00001000
H1019	014	0	1	01	01	H1019_014_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1019	014	0	1	01	01	H1019_014_0	6	3	Non-Preferred Brand	1	2	10000000
H1019	014	0	1	01	01	H1019_014_0	6	4	Specialty	1	2	10001000
H1019	027	0	1	01	01	H1019_027_0	7	3	Non-Preferred Brand	1	2	10000000
H1019	027	0	1	01	01	H1019_027_0	7	4	Specialty	1	2	10001000
H1019	027	0	1	01	01	H1019_027_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1019	027	0	1	01	01	H1019_027_0	7	1	Preferred Generic	1	2	00001000
H1019	032	0	1	01	01	H1019_032_0	5	4	Specialty	1	2	10001000
H1019	032	0	1	01	01	H1019_032_0	5	3	Non-Preferred Brand	1	2	10000000
H1019	032	0	1	01	01	H1019_032_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1019	032	0	1	01	01	H1019_032_0	5	1	Preferred Generic/Value Brand	1	1	
H1019	035	0	1	01	01	H1019_035_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1019	035	0	1	01	01	H1019_035_0	5	1	Preferred Generic/Value Brand	1	1	
H1019	035	0	1	01	01	H1019_035_0	5	3	Non-Preferred Brand	1	2	10000000
H1019	035	0	1	01	01	H1019_035_0	5	4	Specialty	1	2	10001000
H1019	043	0	1	01	01	H1019_043_0	9	1	Preferred Generic	1	2	00001000
H1019	043	0	1	01	01	H1019_043_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1019	043	0	1	01	01	H1019_043_0	9	3	Non-Preferred Brand	1	2	10000000
H1019	043	0	1	01	01	H1019_043_0	9	4	Specialty	1	2	10001000
H1019	044	0	1	01	01	H1019_044_0	7	1	Preferred Generic	1	2	00001000
H1019	044	0	1	01	01	H1019_044_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1019	044	0	1	01	01	H1019_044_0	7	3	Non-Preferred Brand	1	2	10000000
H1019	044	0	1	01	01	H1019_044_0	7	4	Specialty	1	2	10001000
H1026	001	0	1	01	01	H1026_001_0	8	1	Tier 1 - Covered Generic	1	1	
H1026	001	0	1	01	01	H1026_001_0	8	4	Tier S - Covered Specialty	1	2	01000000
H1026	001	0	1	01	01	H1026_001_0	8	3	Tier 3 - Covered Brand	2		
H1026	001	0	1	01	01	H1026_001_0	8	2	Tier 2 - Covered Preferred Brand	2		
H1035	002	0	1	02	01	H1035_002_0	5	1	Preferred Generic	1	1	
H1035	002	0	1	02	01	H1035_002_0	5	4	Non-Preferred Brand	2		
H1035	002	0	1	02	01	H1035_002_0	5	7	Part D Excluded Drugs	1	1	
H1035	002	0	1	02	01	H1035_002_0	5	3	Preferred Brand	2		
H1035	002	0	1	02	01	H1035_002_0	5	2	Non-Preferred Generic	1	1	
H1035	002	0	1	02	01	H1035_002_0	5	5	Injectables	2		
H1035	002	0	1	02	01	H1035_002_0	5	6	Specialty Drugs	2		
H1036	011	0	1	01	01	H1036_011_0	3	4	Specialty	1	2	10001000
H1036	011	0	1	01	01	H1036_011_0	3	3	Non-Preferred Brand	1	2	10000000
H1036	011	0	1	01	01	H1036_011_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	011	0	1	01	01	H1036_011_0	3	1	Preferred Generic	1	2	00001000
H1036	025	0	1	01	01	H1036_025_0	4	1	Preferred Generic	1	2	00001000
H1036	025	0	1	01	01	H1036_025_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	025	0	1	01	01	H1036_025_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	025	0	1	01	01	H1036_025_0	4	4	Specialty	1	2	10001000
H1036	034	0	1	01	01	H1036_034_0	3	3	Non-Preferred Brand	1	2	10000000
H1036	034	0	1	01	01	H1036_034_0	3	2	Non-Preferred Generic/Preferred Brand	2		
H1036	034	0	1	01	01	H1036_034_0	3	1	Preferred Generic/Value Brand	1	2	10001000
H1036	034	0	1	01	01	H1036_034_0	3	4	Specialty	1	2	10001000
H1036	035	0	1	01	01	H1036_035_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	035	0	1	01	01	H1036_035_0	4	1	Preferred Generic	1	2	00001000
H1036	035	0	1	01	01	H1036_035_0	4	4	Specialty	1	2	10001000
H1036	035	0	1	01	01	H1036_035_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	040	0	1	01	01	H1036_040_0	4	1	Preferred Generic	1	2	00001000
H1036	040	0	1	01	01	H1036_040_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	040	0	1	01	01	H1036_040_0	4	4	Specialty	1	2	10001000
H1036	040	0	1	01	01	H1036_040_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	044	0	1	01	01	H1036_044_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	044	0	1	01	01	H1036_044_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	044	0	1	01	01	H1036_044_0	4	1	Preferred Generic	1	2	00001000
H1036	044	0	1	01	01	H1036_044_0	4	4	Specialty	1	2	10001000
H1036	047	0	1	01	01	H1036_047_0	7	1	Preferred Generic	1	2	00001000
H1036	047	0	1	01	01	H1036_047_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	047	0	1	01	01	H1036_047_0	7	3	Non-Preferred Brand	1	2	10000000
H1036	047	0	1	01	01	H1036_047_0	7	4	Specialty	1	2	10001000
H1036	052	0	1	01	01	H1036_052_0	5	3	Non-Preferred Brand	1	2	10000000
H1036	052	0	1	01	01	H1036_052_0	5	1	Preferred Generic	1	2	00001000
H1036	052	0	1	01	01	H1036_052_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	052	0	1	01	01	H1036_052_0	5	4	Specialty	1	2	10001000
H1036	054	0	1	01	01	H1036_054_0	4	1	Preferred Generic/Value Brand	1	1	
H1036	054	0	1	01	01	H1036_054_0	4	2	Non-Preferred Generic/Preferred Brand	2		
H1036	054	0	1	01	01	H1036_054_0	4	4	Specialty	1	2	10001000
H1036	054	0	1	01	01	H1036_054_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	062	0	1	01	01	H1036_062_0	4	4	Specialty	1	2	10001000
H1036	062	0	1	01	01	H1036_062_0	4	2	Non-Preferred Generic/Preferred Brand	2		
H1036	062	0	1	01	01	H1036_062_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	062	0	1	01	01	H1036_062_0	4	1	Preferred Generic/Value Brand	1	1	
H1036	065	0	1	01	01	H1036_065_0	4	1	Preferred Generic/Value Brand	1	1	
H1036	065	0	1	01	01	H1036_065_0	4	2	Non-Preferred Generic/Preferred Brand	2		
H1036	065	0	1	01	01	H1036_065_0	4	4	Specialty	1	2	10001000
H1036	065	0	1	01	01	H1036_065_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	067	0	1	01	01	H1036_067_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	067	0	1	01	01	H1036_067_0	5	3	Non-Preferred Brand	1	2	10000000
H1036	067	0	1	01	01	H1036_067_0	5	4	Specialty	1	2	10001000
H1036	067	0	1	01	01	H1036_067_0	5	1	Preferred Generic	1	2	00001000
H1036	068	0	1	01	01	H1036_068_0	5	3	Non-Preferred Brand	1	2	10000000
H1036	068	0	1	01	01	H1036_068_0	5	4	Specialty	1	2	10001000
H1036	068	0	1	01	01	H1036_068_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	068	0	1	01	01	H1036_068_0	5	1	Preferred Generic	1	2	00001000
H1036	074	0	1	01	01	H1036_074_0	4	1	Preferred Generic	1	2	00001000
H1036	074	0	1	01	01	H1036_074_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	074	0	1	01	01	H1036_074_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	074	0	1	01	01	H1036_074_0	4	4	Specialty	1	2	10001000
H1036	081	0	1	01	01	H1036_081_0	4	3	Non-Preferred Brand	1	2	10000000
H1036	081	0	1	01	01	H1036_081_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	081	0	1	01	01	H1036_081_0	4	1	Preferred Generic	1	2	00001000
H1036	081	0	1	01	01	H1036_081_0	4	4	Specialty	1	2	10001000
H1036	121	0	1	01	01	H1036_121_0	3	4	Specialty	1	2	10001000
H1036	121	0	1	01	01	H1036_121_0	3	3	Non-Preferred Brand	1	2	10000000
H1036	121	0	1	01	01	H1036_121_0	3	1	Preferred Generic/Value Brand	1	2	10001000
H1036	121	0	1	01	01	H1036_121_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	125	0	1	01	01	H1036_125_0	2	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1036	125	0	1	01	01	H1036_125_0	2	3	Non-Preferred Brand	1	2	10000000
H1036	125	0	1	01	01	H1036_125_0	2	4	Specialty	1	2	10001000
H1036	125	0	1	01	01	H1036_125_0	2	1	Preferred Generic/Value Brand	1	1	
H1036	130	0	1	01	01	H1036_130_0	3	4	Specialty	1	2	10001000
H1036	130	0	1	01	01	H1036_130_0	3	3	Non-Preferred Brand	1	2	10000000
H1036	130	0	1	01	01	H1036_130_0	3	1	Preferred Generic/Value Brand	1	1	
H1036	130	0	1	01	01	H1036_130_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1045	001	0	1	02	01	H1045_001_0	6	1	Tier 1	1	1	
H1045	001	0	1	02	01	H1045_001_0	6	2	Tier 2	2		
H1045	001	0	1	02	01	H1045_001_0	6	3	Tier 3	2		
H1045	001	0	1	02	01	H1045_001_0	6	4	Tier 4	2		
H1045	005	0	1	01	01	H1045_005_0	6	4	Tier 4	2		
H1045	005	0	1	01	01	H1045_005_0	6	3	Tier 3	2		
H1045	005	0	1	01	01	H1045_005_0	6	2	Tier 2	2		
H1045	005	0	1	01	01	H1045_005_0	6	1	Tier 1	1	1	
H1045	008	0	1	01	01	H1045_008_0	5	3	Tier 3	2		
H1045	008	0	1	01	01	H1045_008_0	5	4	Tier 4	2		
H1045	008	0	1	01	01	H1045_008_0	5	2	Tier 2	2		
H1045	008	0	1	01	01	H1045_008_0	5	1	Tier 1	1	1	
H1045	012	0	1	01	01	H1045_012_0	6	3	Tier 3	2		
H1045	012	0	1	01	01	H1045_012_0	6	2	Tier 2	1	1	
H1045	012	0	1	01	01	H1045_012_0	6	1	Tier 1	1	1	
H1045	012	0	1	01	01	H1045_012_0	6	4	Tier 4	2		
H1045	016	0	1	01	01	H1045_016_0	5	3	Tier 3	2		
H1045	016	0	1	01	01	H1045_016_0	5	4	Tier 4	2		
H1045	016	0	1	01	01	H1045_016_0	5	1	Tier 1	1	1	
H1045	016	0	1	01	01	H1045_016_0	5	2	Tier 2	1	1	
H1045	018	0	1	01	01	H1045_018_0	4	4	Tier 4	2		
H1045	018	0	1	01	01	H1045_018_0	4	2	Tier 2	1	1	
H1045	018	0	1	01	01	H1045_018_0	4	1	Tier 1	1	1	
H1045	018	0	1	01	01	H1045_018_0	4	3	Tier 3	2		
H1076	003	0	1	01	01	H1076_003_0	6	1	Preferred Generic	1	1	
H1076	003	0	1	01	01	H1076_003_0	6	2	Preferred Brand	2		
H1076	003	0	1	01	01	H1076_003_0	6	3	Non-Preferred Brand	2		
H1076	003	0	1	01	01	H1076_003_0	6	4	Specialty Drugs	2		
H1076	016	0	1	01	01	H1076_016_0	6	1	Preferred Generic	1	1	
H1076	016	0	1	01	01	H1076_016_0	6	2	Preferred Brand	2		
H1076	016	0	1	01	01	H1076_016_0	6	3	Non-Preferred Brand	2		
H1076	016	0	1	01	01	H1076_016_0	6	4	Specialty Drugs	2		
H1099	001	0	1	02	01	H1099_001_0	6	1	Tier 1 Preferred Generic	1	1	
H1099	001	0	1	02	01	H1099_001_0	6	2	Tier 2 Generic	1	1	
H1099	001	0	1	02	01	H1099_001_0	6	3	Tier 3 Brand	2		
H1099	001	0	1	02	01	H1099_001_0	6	4	Tier 4 Specialty	2		
H1099	006	0	1	01	01	H1099_006_0	6	1	Tier 1 Preferred Generic	1	1	
H1099	006	0	1	01	01	H1099_006_0	6	2	Tier 2 Generic	2		
H1099	006	0	1	01	01	H1099_006_0	6	3	Tier 3 Brand	2		
H1099	006	0	1	01	01	H1099_006_0	6	4	Tier 4 Specialty	2		
H1109	003	0	1	01	01	H1109_003_0	6	1	Tier 1 - Preferred Generic	1	1	
H1109	003	0	1	01	01	H1109_003_0	6	5	Tier 5 - Specialty	2		
H1109	003	0	1	01	01	H1109_003_0	6	2	Tier 2 - Non-Preferred Generic	2		
H1109	003	0	1	01	01	H1109_003_0	6	4	Tier 4 - Non-Preferred Brand	2		
H1109	003	0	1	01	01	H1109_003_0	6	3	Tier 3 - Preferred Brand	2		
H1170	002	0	1	01	01	H1170_002_0	6	2	Brand	2		
H1170	002	0	1	01	01	H1170_002_0	6	1	Generic	1	1	
H1170	002	0	1	01	01	H1170_002_0	6	3	Specialty	2		
H1170	009	0	1	01	01	H1170_009_0	6	2	Brand	2		
H1170	009	0	1	01	01	H1170_009_0	6	1	Generic	1	1	
H1170	009	0	1	01	01	H1170_009_0	6	3	Specialty	2		
H1230	001	0	1	01	01	H1230_001_0	7	1	Generic	1	1	
H1230	001	0	1	01	01	H1230_001_0	7	2	Brand	2		
H1230	001	0	1	01	01	H1230_001_0	7	3	Specialty	2		
H1230	003	0	1	01	01	H1230_003_0	7	1	Generic	1	1	
H1230	003	0	1	01	01	H1230_003_0	7	2	Brand	2		
H1230	003	0	1	01	01	H1230_003_0	7	3	Specialty	2		
H1304	004	0	1	04	01	H1304_004_0	5	4	Miscellaneous Injectables	2		
H1304	004	0	1	04	01	H1304_004_0	5	3	Non-Preferred Brand	2		
H1304	004	0	1	04	01	H1304_004_0	5	2	Preferred Brand	2		
H1304	004	0	1	04	01	H1304_004_0	5	1	Generic	1	1	
H1304	004	0	1	04	01	H1304_004_0	5	5	Specialty	2		
H1350	001	0	1	01	01	H1350_001_0	4	4	Tier 4 - Injectable Drugs	2		
H1350	001	0	1	01	01	H1350_001_0	4	3	Tier 3 - Non-Preferred Brand	2		
H1350	001	0	1	01	01	H1350_001_0	4	2	Tier 2 - Preferred Brand	2		
H1350	001	0	1	01	01	H1350_001_0	4	1	Tier 1 - Preferred Generic	1	1	
H1350	001	0	1	01	01	H1350_001_0	4	5	Tier 5 - Specialty Drugs	2		
H1350	009	0	1	01	01	H1350_009_0	4	1	Tier 1 - Preferred Generics	2		
H1350	009	0	1	01	01	H1350_009_0	4	2	Tier 2 Preferred Brand	2		
H1350	009	0	1	01	01	H1350_009_0	4	3	Tier 3 - Non-Preferred Brand	2		
H1350	009	0	1	01	01	H1350_009_0	4	4	Tier 4 - Injectable	2		
H1350	009	0	1	01	01	H1350_009_0	4	5	Tier 5 - Specialty	2		
H1350	009	0	1	01	01	H1350_009_0	4	6	Tier 6 - Covered Drugs $0 Copay	1	1	
H1365	001	0	1	04	01	H1365_001_0	6	1	Tier 1	1	1	
H1365	001	0	1	04	01	H1365_001_0	6	2	Tier 2	2		
H1365	001	0	1	04	01	H1365_001_0	6	3	Tier 3	2		
H1365	001	0	1	04	01	H1365_001_0	6	4	Tier 4	2		
H1406	013	0	1	01	01	H1406_013_0	4	4	Specialty	1	2	10001000
H1406	013	0	1	01	01	H1406_013_0	4	3	Non-Preferred Brand	1	2	10000000
H1406	013	0	1	01	01	H1406_013_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1406	013	0	1	01	01	H1406_013_0	4	1	Preferred Generic	1	2	00001000
H1406	022	0	1	01	01	H1406_022_0	4	3	Non-Preferred Brand	1	2	10000000
H1406	022	0	1	01	01	H1406_022_0	4	4	Specialty	1	2	10001000
H1406	022	0	1	01	01	H1406_022_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1406	022	0	1	01	01	H1406_022_0	4	1	Preferred Generic	1	2	00001000
H1415	015	0	1	01	01	H1415_015_0	9	4	Non-Preferred Brand	2		
H1415	015	0	1	01	01	H1415_015_0	9	1	Preferred Generic	1	1	
H1415	015	0	1	01	01	H1415_015_0	9	3	Preferred Brand	2		
H1415	015	0	1	01	01	H1415_015_0	9	2	Generic	1	2	01000000
H1415	015	0	1	01	01	H1415_015_0	9	5	Specialty	2		
H1415	017	0	1	02	01	H1415_017_0	8	5	Specialty	2		
H1415	017	0	1	02	01	H1415_017_0	8	3	Preferred Brand	2		
H1415	017	0	1	02	01	H1415_017_0	8	2	Generic	1	1	
H1415	017	0	1	02	01	H1415_017_0	8	1	Preferred Generic	1	1	
H1415	017	0	1	02	01	H1415_017_0	8	4	Non-Preferred Brand	2		
H1415	021	0	1	02	01	H1415_021_0	9	1	Preferred Generic	1	1	
H1415	021	0	1	02	01	H1415_021_0	9	4	Non-Preferred Brand	2		
H1415	021	0	1	02	01	H1415_021_0	9	3	Preferred Brand	2		
H1415	021	0	1	02	01	H1415_021_0	9	2	Generic	1	1	
H1415	021	0	1	02	01	H1415_021_0	9	5	Specialty	2		
H1415	023	0	1	02	01	H1415_023_0	10	3	Preferred Brand	2		
H1415	023	0	1	02	01	H1415_023_0	10	2	Generic	1	1	
H1415	023	0	1	02	01	H1415_023_0	10	1	Preferred Generic	1	1	
H1415	023	0	1	02	01	H1415_023_0	10	4	Non-Preferred Brand	2		
H1415	023	0	1	02	01	H1415_023_0	10	5	Specialty	2		
H1417	005	0	1	04	01	H1417_005_0	11	4	Tier 4	2		
H1417	005	0	1	04	01	H1417_005_0	11	3	Tier 3	2		
H1417	005	0	1	04	01	H1417_005_0	11	1	Tier 1	1	1	
H1417	005	0	1	04	01	H1417_005_0	11	2	Tier 2	2		
H1417	006	0	1	04	01	H1417_006_0	12	4	Tier 4	2		
H1417	006	0	1	04	01	H1417_006_0	12	3	Tier 3	2		
H1417	006	0	1	04	01	H1417_006_0	12	2	Tier 2	2		
H1417	006	0	1	04	01	H1417_006_0	12	1	Tier 1	1	1	
H1418	002	0	1	04	01	H1418_002_0	5	3	Non-Preferred Brand	1	2	10000000
H1418	002	0	1	04	01	H1418_002_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	002	0	1	04	01	H1418_002_0	5	1	Preferred Generic	1	2	00001000
H1418	002	0	1	04	01	H1418_002_0	5	4	Specialty	1	2	10001000
H1418	007	0	1	04	01	H1418_007_0	4	1	Preferred Generic	1	2	00001000
H1418	007	0	1	04	01	H1418_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	007	0	1	04	01	H1418_007_0	4	3	Non-Preferred Brand	1	2	10000000
H1418	007	0	1	04	01	H1418_007_0	4	4	Specialty	1	2	10001000
H1418	008	0	1	04	01	H1418_008_0	7	3	Non-Preferred Brand	1	2	10000000
H1418	008	0	1	04	01	H1418_008_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	008	0	1	04	01	H1418_008_0	7	1	Preferred Generic	1	2	00001000
H1418	008	0	1	04	01	H1418_008_0	7	4	Specialty	1	2	10001000
H1418	010	0	1	04	01	H1418_010_0	5	4	Specialty	1	2	10001000
H1418	010	0	1	04	01	H1418_010_0	5	3	Non-Preferred Brand	1	2	10000000
H1418	010	0	1	04	01	H1418_010_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	010	0	1	04	01	H1418_010_0	5	1	Preferred Generic	1	2	00001000
H1418	011	0	1	04	01	H1418_011_0	4	1	Preferred Generic	1	2	00001000
H1418	011	0	1	04	01	H1418_011_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	011	0	1	04	01	H1418_011_0	4	4	Specialty	1	2	10001000
H1418	011	0	1	04	01	H1418_011_0	4	3	Non-Preferred Brand	1	2	10000000
H1418	012	0	1	04	01	H1418_012_0	4	1	Preferred Generic	1	2	00001000
H1418	012	0	1	04	01	H1418_012_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	012	0	1	04	01	H1418_012_0	4	3	Non-Preferred Brand	1	2	10000000
H1418	012	0	1	04	01	H1418_012_0	4	4	Specialty	1	2	10001000
H1418	013	0	1	04	01	H1418_013_0	4	1	Preferred Generic	1	2	00001000
H1418	013	0	1	04	01	H1418_013_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	013	0	1	04	01	H1418_013_0	4	3	Non-Preferred Brand	1	2	10000000
H1418	013	0	1	04	01	H1418_013_0	4	4	Specialty	1	2	10001000
H1418	014	0	1	04	01	H1418_014_0	4	3	Non-Preferred Brand	1	2	10000000
H1418	014	0	1	04	01	H1418_014_0	4	4	Specialty	1	2	10001000
H1418	014	0	1	04	01	H1418_014_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1418	014	0	1	04	01	H1418_014_0	4	1	Preferred Generic	1	2	00001000
H1463	005	0	1	01	01	H1463_005_0	2	1	Tier 1	1	1	
H1463	005	0	1	01	01	H1463_005_0	2	2	Tier 2	2		
H1463	005	0	1	01	01	H1463_005_0	2	3	Tier 3	2		
H1463	005	0	1	01	01	H1463_005_0	2	4	Tier 4	2		
H1468	007	0	1	01	01	H1468_007_0	6	4	Specialty	1	2	10001000
H1468	007	0	1	01	01	H1468_007_0	6	3	Non-Preferred Brand	1	2	10000000
H1468	007	0	1	01	01	H1468_007_0	6	2	Non-Preferred Generic and Preferred Brand	1	2	10001000
H1468	007	0	1	01	01	H1468_007_0	6	1	Preferred Generic	1	2	00001000
H1510	001	0	1	04	01	H1510_001_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1510	001	0	1	04	01	H1510_001_0	8	1	Preferred Generic	1	2	00001000
H1510	001	0	1	04	01	H1510_001_0	8	3	Non-Preferred Brand	1	2	10000000
H1510	001	0	1	04	01	H1510_001_0	8	4	Specialty	1	2	10001000
H1510	004	0	1	04	01	H1510_004_0	8	1	Preferred Generic	1	2	00001000
H1510	004	0	1	04	01	H1510_004_0	8	4	Specialty	1	2	10001000
H1510	004	0	1	04	01	H1510_004_0	8	3	Non-Preferred Brand	1	2	10000000
H1510	004	0	1	04	01	H1510_004_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1510	005	0	1	04	01	H1510_005_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1510	005	0	1	04	01	H1510_005_0	8	1	Preferred Generic	1	2	00001000
H1510	005	0	1	04	01	H1510_005_0	8	3	Non-Preferred Brand	1	2	10000000
H1510	005	0	1	04	01	H1510_005_0	8	4	Specialty	1	2	10001000
H1517	001	0	1	04	01	H1517_001_0	10	5	Tier 5 Specialty Drugs	2		
H1517	001	0	1	04	01	H1517_001_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H1517	001	0	1	04	01	H1517_001_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H1517	001	0	1	04	01	H1517_001_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H1517	001	0	1	04	01	H1517_001_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H1517	003	0	1	04	01	H1517_003_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H1517	003	0	1	04	01	H1517_003_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H1517	003	0	1	04	01	H1517_003_0	10	5	Tier 5 Specialty Drugs	2		
H1517	003	0	1	04	01	H1517_003_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H1517	003	0	1	04	01	H1517_003_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H1595	002	0	1	04	01	H1595_002_0	5	3	Non-Preferred Brand	2		
H1595	002	0	1	04	01	H1595_002_0	5	2	Preferred Brand	2		
H1595	002	0	1	04	01	H1595_002_0	5	1	Generic	1	1	
H1595	002	0	1	04	01	H1595_002_0	5	4	Specialty	2		
H1607	001	0	1	04	01	H1607_001_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H1607	001	0	1	04	01	H1607_001_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H1607	001	0	1	04	01	H1607_001_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H1607	001	0	1	04	01	H1607_001_0	10	5	Tier 5 Specialty Drugs	2		
H1607	001	0	1	04	01	H1607_001_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H1607	004	0	1	04	01	H1607_004_0	8	5	Tier 5 Specialty Drugs	2		
H1607	004	0	1	04	01	H1607_004_0	8	1	Tier 1 Preferred Generic Drugs	1	1	
H1607	004	0	1	04	01	H1607_004_0	8	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H1607	004	0	1	04	01	H1607_004_0	8	4	Tier 4 Non-Specialty Injectable Drugs	2		
H1607	004	0	1	04	01	H1607_004_0	8	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H1681	001	0	1	04	01	H1681_001_0	7	1	Preferred Generic	1	2	00001000
H1681	001	0	1	04	01	H1681_001_0	7	4	Specialty	1	2	10001000
H1681	001	0	1	04	01	H1681_001_0	7	3	Non-Preferred Brand	1	2	10000000
H1681	001	0	1	04	01	H1681_001_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1681	002	0	1	04	01	H1681_002_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1681	002	0	1	04	01	H1681_002_0	5	3	Non-Preferred Brand	1	2	10000000
H1681	002	0	1	04	01	H1681_002_0	5	4	Specialty	1	2	10001000
H1681	002	0	1	04	01	H1681_002_0	5	1	Preferred Generic	1	2	00001000
H1681	003	0	1	04	01	H1681_003_0	4	4	Specialty	1	2	10001000
H1681	003	0	1	04	01	H1681_003_0	4	3	Non-Preferred Brand	1	2	10000000
H1681	003	0	1	04	01	H1681_003_0	4	1	Preferred Generic	1	2	00001000
H1681	003	0	1	04	01	H1681_003_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1681	004	0	1	04	01	H1681_004_0	5	1	Preferred Generic	1	2	00001000
H1681	004	0	1	04	01	H1681_004_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1681	004	0	1	04	01	H1681_004_0	5	3	Non-Preferred Brand	1	2	10000000
H1681	004	0	1	04	01	H1681_004_0	5	4	Specialty	1	2	10001000
H1681	005	0	1	04	01	H1681_005_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1681	005	0	1	04	01	H1681_005_0	4	3	Non-Preferred Brand	1	2	10000000
H1681	005	0	1	04	01	H1681_005_0	4	4	Specialty	1	2	10001000
H1681	005	0	1	04	01	H1681_005_0	4	1	Preferred Generic	1	2	00001000
H1681	006	0	1	04	01	H1681_006_0	4	3	Non-Preferred Brand	1	2	10000000
H1681	006	0	1	04	01	H1681_006_0	4	4	Specialty	1	2	10001000
H1681	006	0	1	04	01	H1681_006_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1681	006	0	1	04	01	H1681_006_0	4	1	Preferred Generic	1	2	00001000
H1681	007	0	1	04	01	H1681_007_0	4	1	Preferred Generic	1	2	00001000
H1681	007	0	1	04	01	H1681_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1681	007	0	1	04	01	H1681_007_0	4	3	Non-Preferred Brand	1	2	10000000
H1681	007	0	1	04	01	H1681_007_0	4	4	Specialty	1	2	10001000
H1689	013	0	1	09	04	H1689_013_0	13	5	Tier 5 Specialty Drugs	2		
H1689	013	0	1	09	04	H1689_013_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H1689	013	0	1	09	04	H1689_013_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H1689	013	0	1	09	04	H1689_013_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H1689	013	0	1	09	04	H1689_013_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H1716	001	0	1	04	01	H1716_001_0	9	1	Preferred Generic	1	2	00001000
H1716	001	0	1	04	01	H1716_001_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1716	001	0	1	04	01	H1716_001_0	9	3	Non-Preferred Brand	1	2	10000000
H1716	001	0	1	04	01	H1716_001_0	9	4	Specialty	1	2	10001000
H1716	002	0	1	04	01	H1716_002_0	9	4	Specialty	1	2	10001000
H1716	002	0	1	04	01	H1716_002_0	9	3	Non-Preferred Brand	1	2	10000000
H1716	002	0	1	04	01	H1716_002_0	9	1	Preferred Generic	1	2	00001000
H1716	002	0	1	04	01	H1716_002_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1716	004	0	1	04	01	H1716_004_0	9	3	Non-Preferred Brand	1	2	10000000
H1716	004	0	1	04	01	H1716_004_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1716	004	0	1	04	01	H1716_004_0	9	1	Preferred Generic	1	2	00001000
H1716	004	0	1	04	01	H1716_004_0	9	4	Specialty	1	2	10001000
H1716	006	0	1	04	01	H1716_006_0	11	1	Preferred Generic	1	2	00001000
H1716	006	0	1	04	01	H1716_006_0	11	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1716	006	0	1	04	01	H1716_006_0	11	3	Non-Preferred Brand	1	2	10000000
H1716	006	0	1	04	01	H1716_006_0	11	4	Specialty	1	2	10001000
H1804	128	0	1	09	04	H1804_128_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1804	128	0	1	09	04	H1804_128_0	7	1	Preferred Generic	1	2	00001000
H1804	128	0	1	09	04	H1804_128_0	7	4	Specialty	1	2	10001000
H1804	128	0	1	09	04	H1804_128_0	7	3	Non-Preferred Brand	1	2	10000000
H1806	001	0	1	04	01	H1806_001_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1806	001	0	1	04	01	H1806_001_0	6	1	Preferred Generic	1	2	00001000
H1806	001	0	1	04	01	H1806_001_0	6	4	Specialty	1	2	10001000
H1806	001	0	1	04	01	H1806_001_0	6	3	Non-Preferred Brand	1	2	10000000
H1806	002	0	1	04	01	H1806_002_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1806	002	0	1	04	01	H1806_002_0	7	4	Specialty	1	2	10001000
H1806	002	0	1	04	01	H1806_002_0	7	3	Non-Preferred Brand	1	2	10000000
H1806	002	0	1	04	01	H1806_002_0	7	1	Preferred Generic	1	2	00001000
H1806	005	0	1	04	01	H1806_005_0	9	4	Specialty	1	2	10001000
H1806	005	0	1	04	01	H1806_005_0	9	1	Preferred Generic	1	2	00001000
H1806	005	0	1	04	01	H1806_005_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1806	005	0	1	04	01	H1806_005_0	9	3	Non-Preferred Brand	1	2	10000000
H1806	006	0	1	04	01	H1806_006_0	7	3	Non-Preferred Brand	1	2	10000000
H1806	006	0	1	04	01	H1806_006_0	7	1	Preferred Generic	1	2	00001000
H1806	006	0	1	04	01	H1806_006_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1806	006	0	1	04	01	H1806_006_0	7	4	Specialty	1	2	10001000
H1837	003	0	1	01	01	H1837_003_0	7	4	Tier 4 specialty	2		
H1837	003	0	1	01	01	H1837_003_0	7	3	Tier 3 non-preferred brand	2		
H1837	003	0	1	01	01	H1837_003_0	7	1	Tier 1 Generic	1	1	
H1837	003	0	1	01	01	H1837_003_0	7	2	Tier 2 Preferred Brand	2		
H1837	006	0	1	01	01	H1837_006_0	5	1	Tier 1 Generic	1	1	
H1837	006	0	1	01	01	H1837_006_0	5	3	Tier 3 non-preferred brand	2		
H1837	006	0	1	01	01	H1837_006_0	5	2	Tier 2 Preferred Brand	2		
H1837	006	0	1	01	01	H1837_006_0	5	4	Tier 4 specialty	2		
H1846	001	0	1	04	01	H1846_001_0	6	5	Specialty Drugs	2		
H1846	001	0	1	04	01	H1846_001_0	6	4	Non-Preferred Brand	2		
H1846	001	0	1	04	01	H1846_001_0	6	3	Preferred Brand	2		
H1846	001	0	1	04	01	H1846_001_0	6	1	Value Generic	1	1	
H1846	001	0	1	04	01	H1846_001_0	6	2	Generic	1	1	
H1849	005	0	1	01	01	H1849_005_0	7	5	Tier 5 Specialty Drugs	2		
H1849	005	0	1	01	01	H1849_005_0	7	1	Tier 1 Preferred Generic Drugs	1	1	
H1849	005	0	1	01	01	H1849_005_0	7	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H1849	005	0	1	01	01	H1849_005_0	7	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H1849	005	0	1	01	01	H1849_005_0	7	4	Tier 4 Non-Specialty Injectable Drugs	2		
H1849	015	0	1	01	01	H1849_015_0	6	4	Tier 4 Non-Specialty Injectable Drugs	2		
H1849	015	0	1	01	01	H1849_015_0	6	1	Tier 1 Preferred Generic Drugs	1	1	
H1849	015	0	1	01	01	H1849_015_0	6	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H1849	015	0	1	01	01	H1849_015_0	6	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H1849	015	0	1	01	01	H1849_015_0	6	5	Tier 5 Specialty Drugs	2		
H1906	001	0	1	09	04	H1906_001_0	10	1	Preferred Generic	1	2	00001000
H1906	001	0	1	09	04	H1906_001_0	10	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1906	001	0	1	09	04	H1906_001_0	10	4	Specialty	1	2	10001000
H1906	001	0	1	09	04	H1906_001_0	10	3	Non-Preferred Brand	1	2	10000000
H1906	009	0	1	09	04	H1906_009_0	5	1	Preferred Generic	1	2	00001000
H1906	009	0	1	09	04	H1906_009_0	5	3	Non-Preferred Brand	1	2	10000000
H1906	009	0	1	09	04	H1906_009_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1906	009	0	1	09	04	H1906_009_0	5	4	Specialty	1	2	10001000
H1951	001	0	1	01	01	H1951_001_0	5	3	Non-Preferred Brand	1	2	10000000
H1951	001	0	1	01	01	H1951_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1951	001	0	1	01	01	H1951_001_0	5	1	Preferred Generic	1	1	
H1951	001	0	1	01	01	H1951_001_0	5	4	Specialty	1	2	10001000
H1951	005	0	1	01	01	H1951_005_0	4	3	Non-Preferred Brand	1	2	10000000
H1951	005	0	1	01	01	H1951_005_0	4	4	Specialty	1	2	10001000
H1951	005	0	1	01	01	H1951_005_0	4	1	Preferred Generic	1	1	
H1951	005	0	1	01	01	H1951_005_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1951	013	0	1	01	01	H1951_013_0	4	4	Specialty	1	2	10001000
H1951	013	0	1	01	01	H1951_013_0	4	3	Non-Preferred Brand	1	2	10000000
H1951	013	0	1	01	01	H1951_013_0	4	1	Preferred Generic	1	2	00001000
H1951	013	0	1	01	01	H1951_013_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1951	024	0	1	01	01	H1951_024_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1951	024	0	1	01	01	H1951_024_0	3	3	Non-Preferred Brand	1	2	10000000
H1951	024	0	1	01	01	H1951_024_0	3	4	Specialty	1	2	10001000
H1951	024	0	1	01	01	H1951_024_0	3	1	Preferred Generic	1	2	00001000
H1951	025	0	1	01	01	H1951_025_0	3	3	Non-Preferred Brand	1	2	10000000
H1951	025	0	1	01	01	H1951_025_0	3	4	Specialty	1	2	10001000
H1951	025	0	1	01	01	H1951_025_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H1951	025	0	1	01	01	H1951_025_0	3	1	Preferred Generic	1	2	00001000
H1961	001	0	1	01	01	H1961_001_0	7	1	Generic	1	1	
H1961	001	0	1	01	01	H1961_001_0	7	2	Preferred Brand	1	1	
H1961	001	0	1	01	01	H1961_001_0	7	3	Non-Preferred Brand	2		
H1961	001	0	1	01	01	H1961_001_0	7	4	Specialty	2		
H1961	002	0	1	02	01	H1961_002_0	5	3	Non-Preferred Brand	2		
H1961	002	0	1	02	01	H1961_002_0	5	2	Preferred Brand	1	1	
H1961	002	0	1	02	01	H1961_002_0	5	1	Generic	1	1	
H1961	002	0	1	02	01	H1961_002_0	5	4	Specialty	2		
H1961	007	0	1	02	01	H1961_007_0	6	1	Generic	1	1	
H1961	007	0	1	02	01	H1961_007_0	6	2	Preferred Brand	2		
H1961	007	0	1	02	01	H1961_007_0	6	3	Non-Preferred Brand	2		
H1961	007	0	1	02	01	H1961_007_0	6	4	Specialty	2		
H2012	001	0	1	01	01	H2012_001_0	7	1	Preferred Generic	1	1	
H2012	001	0	1	01	01	H2012_001_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2012	001	0	1	01	01	H2012_001_0	7	3	Non-Preferred Brand	1	2	10000000
H2012	001	0	1	01	01	H2012_001_0	7	4	Specialty	1	2	10001000
H2012	002	0	1	01	01	H2012_002_0	3	4	Specialty	1	2	10001000
H2012	002	0	1	01	01	H2012_002_0	3	1	Preferred Generic	1	2	00001000
H2012	002	0	1	01	01	H2012_002_0	3	3	Non-Preferred Brand	1	2	10000000
H2012	002	0	1	01	01	H2012_002_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2012	003	0	1	01	01	H2012_003_0	3	3	Non-Preferred Brand	1	2	10000000
H2012	003	0	1	01	01	H2012_003_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2012	003	0	1	01	01	H2012_003_0	3	1	Preferred Generic	1	2	00001000
H2012	003	0	1	01	01	H2012_003_0	3	4	Specialty	1	2	10001000
H2012	006	0	1	01	01	H2012_006_0	5	4	Specialty	1	2	10001000
H2012	006	0	1	01	01	H2012_006_0	5	3	Non-Preferred Brand	1	2	10000000
H2012	006	0	1	01	01	H2012_006_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2012	006	0	1	01	01	H2012_006_0	5	1	Preferred Generic	1	2	00001000
H2012	007	0	1	01	01	H2012_007_0	4	1	Preferred Generic	1	2	00001000
H2012	007	0	1	01	01	H2012_007_0	4	4	Specialty	1	2	10001000
H2012	007	0	1	01	01	H2012_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2012	007	0	1	01	01	H2012_007_0	4	3	Non-Preferred Brand	1	2	10000000
H2012	008	0	1	01	01	H2012_008_0	5	1	Preferred Generic	1	1	
H2012	008	0	1	01	01	H2012_008_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2012	008	0	1	01	01	H2012_008_0	5	3	Non-Preferred Brand	1	2	10000000
H2012	008	0	1	01	01	H2012_008_0	5	4	Specialty	1	2	10001000
H2012	009	0	1	01	01	H2012_009_0	6	3	Non-Preferred Brand	1	2	10000000
H2012	009	0	1	01	01	H2012_009_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2012	009	0	1	01	01	H2012_009_0	6	1	Preferred Generic	1	2	00001000
H2012	009	0	1	01	01	H2012_009_0	6	4	Specialty	1	2	10001000
H2029	001	0	1	04	01	H2029_001_0	3	3	Non-Preferred Brand	1	2	10000000
H2029	001	0	1	04	01	H2029_001_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2029	001	0	1	04	01	H2029_001_0	3	1	Preferred Generic	1	1	
H2029	001	0	1	04	01	H2029_001_0	3	4	Specialty	1	2	10001000
H2108	029	0	1	01	01	H2108_029_0	2	5	Preferred Diabetic Drugs	1	1	
H2108	029	0	1	01	01	H2108_029_0	2	1	Generic	2		
H2108	029	0	1	01	01	H2108_029_0	2	2	Preferred Brand	2		
H2108	029	0	1	01	01	H2108_029_0	2	3	Non-Preferred Brand	2		
H2108	029	0	1	01	01	H2108_029_0	2	4	Specialty	2		
H2108	030	0	1	01	01	H2108_030_0	2	5	Preferred Diabetic Drugs	1	1	
H2108	030	0	1	01	01	H2108_030_0	2	1	Generic	2		
H2108	030	0	1	01	01	H2108_030_0	2	2	Preferred Brand	2		
H2108	030	0	1	01	01	H2108_030_0	2	3	Non-Preferred Brand	2		
H2108	030	0	1	01	01	H2108_030_0	2	4	Specialty	2		
H2112	014	0	1	01	01	H2112_014_0	6	3	Tier 3 - Preferred Brand	2		
H2112	014	0	1	01	01	H2112_014_0	6	5	Tier 5 - Specialty	2		
H2112	014	0	1	01	01	H2112_014_0	6	4	Tier 4 - Non-Preferred Brand	2		
H2112	014	0	1	01	01	H2112_014_0	6	2	Tier 2 - Non-Preferred Generic	2		
H2112	014	0	1	01	01	H2112_014_0	6	1	Tier 1 - Preferred Generic	1	1	
H2150	002	0	1	18	06	H2150_002_0	4	1	Generic	1	1	
H2150	002	0	1	18	06	H2150_002_0	4	2	Brand	2		
H2150	002	0	1	18	06	H2150_002_0	4	3	Specialty	2		
H2150	028	0	2	18	06	H2150_028_0	4	1	Generic	1	1	
H2150	028	0	2	18	06	H2150_028_0	4	2	Brand	2		
H2150	028	0	2	18	06	H2150_028_0	4	3	Specialty	2		
H2165	005	0	1	01	01	H2165_005_0	6	3	Preferred Brand	2		
H2165	005	0	1	01	01	H2165_005_0	6	5	Specialty	2		
H2165	005	0	1	01	01	H2165_005_0	6	1	Preferred Generic	1	1	
H2165	005	0	1	01	01	H2165_005_0	6	4	Non-Preferred Brand	2		
H2165	005	0	1	01	01	H2165_005_0	6	2	Generic	1	1	
H2165	006	0	1	01	01	H2165_006_0	6	3	Preferred Brand	2		
H2165	006	0	1	01	01	H2165_006_0	6	4	Non-Preferred Brand	2		
H2165	006	0	1	01	01	H2165_006_0	6	1	Preferred Generic	1	1	
H2165	006	0	1	01	01	H2165_006_0	6	2	Generic	1	2	01000000
H2165	006	0	1	01	01	H2165_006_0	6	5	Specialty	2		
H2165	010	0	1	01	01	H2165_010_0	6	4	Non-Preferred Brand	2		
H2165	010	0	1	01	01	H2165_010_0	6	5	Specialty	2		
H2165	010	0	1	01	01	H2165_010_0	6	1	Preferred Generic	1	1	
H2165	010	0	1	01	01	H2165_010_0	6	2	Generic	1	1	
H2165	010	0	1	01	01	H2165_010_0	6	3	Preferred Brand	2		
H2174	002	0	1	01	01	H2174_002_0	8	1	Preferred Generic	1	1	
H2174	002	0	1	01	01	H2174_002_0	8	3	Non-Preferred	2		
H2174	002	0	1	01	01	H2174_002_0	8	2	Preferred Brand	2		
H2174	006	0	1	01	01	H2174_006_0	4	1	Preferred Generic	1	1	
H2174	006	0	1	01	01	H2174_006_0	4	2	Preferred Brand	2		
H2174	006	0	1	01	01	H2174_006_0	4	3	Non-Preferred	2		
H2174	007	0	1	01	01	H2174_007_0	4	2	Preferred Brand	2		
H2174	007	0	1	01	01	H2174_007_0	4	1	Preferred Generic	1	1	
H2174	007	0	1	01	01	H2174_007_0	4	3	Non-Preferred	2		
H2241	001	0	1	01	01	H2241_001_0	7	3	Tier 3	2		
H2241	001	0	1	01	01	H2241_001_0	7	2	Tier 2	2		
H2241	001	0	1	01	01	H2241_001_0	7	4	Specialty	2		
H2241	001	0	1	01	01	H2241_001_0	7	1	Tier 1	1	1	
H2256	001	1	1	01	01	H2256_001_1	6	2	Tier 2	2		
H2256	001	1	1	01	01	H2256_001_1	6	1	Tier 1	1	1	
H2256	001	1	1	01	01	H2256_001_1	6	3	Tier 3	2		
H2256	001	2	1	01	01	H2256_001_2	6	2	Tier 2	2		
H2256	001	2	1	01	01	H2256_001_2	6	3	Tier 3	2		
H2256	001	2	1	01	01	H2256_001_2	6	1	Tier 1	1	1	
H2256	017	1	1	01	01	H2256_017_1	7	3	Tier 3	2		
H2256	017	1	1	01	01	H2256_017_1	7	1	Tier 1	1	1	
H2256	017	1	1	01	01	H2256_017_1	7	2	Tier 2	2		
H2256	017	7	1	01	01	H2256_017_7	7	2	Tier 2	2		
H2256	017	7	1	01	01	H2256_017_7	7	1	Tier 1	1	1	
H2256	017	7	1	01	01	H2256_017_7	7	3	Tier 3	2		
H2256	023	0	1	01	01	H2256_023_0	6	3	Tier 3	2		
H2256	023	0	1	01	01	H2256_023_0	6	1	Tier 1	1	1	
H2256	023	0	1	01	01	H2256_023_0	6	2	Tier 2	2		
H2312	009	0	1	01	01	H2312_009_0	5	4	Tier 4	2		
H2312	009	0	1	01	01	H2312_009_0	5	3	Tier 3	2		
H2312	009	0	1	01	01	H2312_009_0	5	2	Tier 2	2		
H2312	009	0	1	01	01	H2312_009_0	5	1	Tier 1	1	1	
H2312	010	0	1	01	01	H2312_010_0	7	4	Tier 4	2		
H2312	010	0	1	01	01	H2312_010_0	7	3	Tier 3	2		
H2312	010	0	1	01	01	H2312_010_0	7	2	Tier 2	2		
H2312	010	0	1	01	01	H2312_010_0	7	1	Tier 1	1	1	
H2320	009	0	1	02	01	H2320_009_0	6	1	Generic	1	1	
H2320	009	0	1	02	01	H2320_009_0	6	2	Preferred Brand	2		
H2320	009	0	1	02	01	H2320_009_0	6	3	Non-Preferred Brand	2		
H2320	009	0	1	02	01	H2320_009_0	6	4	Specialty Tier	2		
H2320	010	0	1	02	01	H2320_010_0	6	1	Generic	1	1	
H2320	010	0	1	02	01	H2320_010_0	6	2	Preferred Brand	2		
H2320	010	0	1	02	01	H2320_010_0	6	3	Non-Preferred Brand	2		
H2320	010	0	1	02	01	H2320_010_0	6	4	Specialty Tier	2		
H2320	014	0	1	02	01	H2320_014_0	6	3	Non-Preferred Brand	2		
H2320	014	0	1	02	01	H2320_014_0	6	2	Preferred Brand	2		
H2320	014	0	1	02	01	H2320_014_0	6	1	Generic	1	1	
H2320	014	0	1	02	01	H2320_014_0	6	4	Specialty Tier	2		
H2320	017	0	1	02	01	H2320_017_0	6	1	Generic	1	1	
H2320	017	0	1	02	01	H2320_017_0	6	2	Preferred Brand	2		
H2320	017	0	1	02	01	H2320_017_0	6	3	Non-Preferred Brand	2		
H2320	017	0	1	02	01	H2320_017_0	6	4	Specialty Tier	2		
H2320	020	0	1	02	01	H2320_020_0	6	1	Generic	1	1	
H2320	020	0	1	02	01	H2320_020_0	6	2	Preferred Brand	2		
H2320	020	0	1	02	01	H2320_020_0	6	3	Non-Preferred Brand	2		
H2320	020	0	1	02	01	H2320_020_0	6	4	Specialty Tier	2		
H2322	004	0	1	04	01	H2322_004_0	7	1	Tier 1	1	1	
H2322	004	0	1	04	01	H2322_004_0	7	2	Tier 2	2		
H2322	004	0	1	04	01	H2322_004_0	7	3	Tier 3	2		
H2322	004	0	1	04	01	H2322_004_0	7	4	Tier 4	2		
H2323	006	0	1	01	01	H2323_006_0	6	3	Non-Preferred Brand	2		
H2323	006	0	1	01	01	H2323_006_0	6	2	Preferred Brand	2		
H2323	006	0	1	01	01	H2323_006_0	6	1	generic	1	1	
H2323	006	0	1	01	01	H2323_006_0	6	4	Specialty	2		
H2323	007	0	1	01	01	H2323_007_0	6	1	Generic	1	1	
H2323	007	0	1	01	01	H2323_007_0	6	2	Preferred Brand	2		
H2323	007	0	1	01	01	H2323_007_0	6	3	Non-Preferred	2		
H2323	007	0	1	01	01	H2323_007_0	6	4	Specialty	2		
H2323	008	0	1	01	01	H2323_008_0	7	3	Non-Preferred Brand	2		
H2323	008	0	1	01	01	H2323_008_0	7	2	Preferred Brand	2		
H2323	008	0	1	01	01	H2323_008_0	7	1	Generic	1	1	
H2323	008	0	1	01	01	H2323_008_0	7	4	Specialty	2		
H2354	013	0	1	01	01	H2354_013_0	3	1	Generic	1	1	
H2354	013	0	1	01	01	H2354_013_0	3	2	Preferred Brand	2		
H2354	013	0	1	01	01	H2354_013_0	3	3	Non-Preferred Brand	2		
H2354	013	0	1	01	01	H2354_013_0	3	4	Specialty	2		
H2450	005	0	1	18	06	H2450_005_0	5	1	Generic	1	1	
H2450	005	0	1	18	06	H2450_005_0	5	2	Preferred Brand	2		
H2450	005	0	1	18	06	H2450_005_0	5	3	Non-Preferred Brand	2		
H2450	005	0	1	18	06	H2450_005_0	5	4	Specialty	2		
H2450	006	0	1	18	06	H2450_006_0	5	4	Specialty	2		
H2450	006	0	1	18	06	H2450_006_0	5	3	Non-Preferred Brand	2		
H2450	006	0	1	18	06	H2450_006_0	5	2	Preferred Brand	2		
H2450	006	0	1	18	06	H2450_006_0	5	1	Generic	1	1	
H2450	009	0	1	18	06	H2450_009_0	4	4	Specialty	2		
H2450	009	0	1	18	06	H2450_009_0	4	3	Non-Preferred Brand	2		
H2450	009	0	1	18	06	H2450_009_0	4	2	Preferred Brand	2		
H2450	009	0	1	18	06	H2450_009_0	4	1	Generic	1	1	
H2450	010	0	1	18	06	H2450_010_0	4	1	Generic	1	1	
H2450	010	0	1	18	06	H2450_010_0	4	2	Preferred Brand	2		
H2450	010	0	1	18	06	H2450_010_0	4	3	Non-Preferred Brand	2		
H2450	010	0	1	18	06	H2450_010_0	4	4	Specialty	2		
H2450	013	0	1	18	06	H2450_013_0	4	4	Specialty	2		
H2450	013	0	1	18	06	H2450_013_0	4	3	Non-Preferred Brand	2		
H2450	013	0	1	18	06	H2450_013_0	4	1	Generic	1	1	
H2450	013	0	1	18	06	H2450_013_0	4	2	Preferred Brand	2		
H2450	015	0	1	18	06	H2450_015_0	4	1	Generic	1	1	
H2450	015	0	1	18	06	H2450_015_0	4	2	Preferred Brand	2		
H2450	015	0	1	18	06	H2450_015_0	4	4	Specialty	2		
H2450	015	0	1	18	06	H2450_015_0	4	3	Non-Preferred Brand	2		
H2459	002	0	1	02	01	H2459_002_0	8	4	Tier 4	2		
H2459	002	0	1	02	01	H2459_002_0	8	3	Tier 3	2		
H2459	002	0	1	02	01	H2459_002_0	8	2	Tier 2	2		
H2459	002	0	1	02	01	H2459_002_0	8	1	Tier 1	1	1	
H2459	006	0	1	02	01	H2459_006_0	7	4	Tier 4	2		
H2459	006	0	1	02	01	H2459_006_0	7	3	Tier 3	2		
H2459	006	0	1	02	01	H2459_006_0	7	2	Tier 2	2		
H2459	006	0	1	02	01	H2459_006_0	7	1	Tier 1	1	1	
H2462	014	0	1	18	06	H2462_014_0	4	3	Formulary Specialty	2		
H2462	014	0	1	18	06	H2462_014_0	4	1	Formulary Generic	1	1	
H2462	014	0	1	18	06	H2462_014_0	4	2	Formulary Brand	2		
H2486	002	0	1	01	01	H2486_002_0	9	3	Non-Preferred Brand	1	2	10000000
H2486	002	0	1	01	01	H2486_002_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10000000
H2486	002	0	1	01	01	H2486_002_0	9	1	Preferred Generic	1	2	00001000
H2486	002	0	1	01	01	H2486_002_0	9	4	Specialty	1	2	10001000
H2542	001	0	1	04	01	H2542_001_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2542	001	0	1	04	01	H2542_001_0	8	3	Non-Preferred Brand	1	2	10000000
H2542	001	0	1	04	01	H2542_001_0	8	4	Specialty	1	2	10001000
H2542	001	0	1	04	01	H2542_001_0	8	1	Preferred Generic	1	2	00001000
H2542	002	0	1	04	01	H2542_002_0	8	1	Preferred Generic	1	2	00001000
H2542	002	0	1	04	01	H2542_002_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2542	002	0	1	04	01	H2542_002_0	8	3	Non-Preferred Brand	1	2	10000000
H2542	002	0	1	04	01	H2542_002_0	8	4	Specialty	1	2	10001000
H2593	001	0	1	01	01	H2593_001_0	6	2	Generic Drugs	1	1	
H2593	001	0	1	01	01	H2593_001_0	6	6	Specialty Drugs	2		
H2593	001	0	1	01	01	H2593_001_0	6	5	Brand Drugs	2		
H2593	001	0	1	01	01	H2593_001_0	6	4	Preferred Brand Drugs	2		
H2593	001	0	1	01	01	H2593_001_0	6	3	Enhanced Care Brand Drugs	2		
H2593	001	0	1	01	01	H2593_001_0	6	1	Preferred Generic Drugs	1	1	
H2593	003	0	1	01	01	H2593_003_0	6	6	Specialty Drugs	2		
H2593	003	0	1	01	01	H2593_003_0	6	5	Brand Drugs	2		
H2593	003	0	1	01	01	H2593_003_0	6	4	Preferred Brand Drugs	2		
H2593	003	0	1	01	01	H2593_003_0	6	3	Enhanced Care Brand Drugs	1	1	
H2593	003	0	1	01	01	H2593_003_0	6	2	Generic Drugs	1	1	
H2593	003	0	1	01	01	H2593_003_0	6	1	Preferred Generic Drugs	1	1	
H2593	005	0	1	01	01	H2593_005_0	6	2	Generic Drugs	1	1	
H2593	005	0	1	01	01	H2593_005_0	6	1	Preferred Generic Drugs	1	1	
H2593	005	0	1	01	01	H2593_005_0	6	3	Enhanced Care Brand Drugs	1	1	
H2593	005	0	1	01	01	H2593_005_0	6	4	Preferred Brand Drugs	2		
H2593	005	0	1	01	01	H2593_005_0	6	5	Brand Drugs	2		
H2593	005	0	1	01	01	H2593_005_0	6	6	Specialty Drugs	2		
H2593	006	0	1	01	01	H2593_006_0	6	1	Preferred Generic Drugs	1	1	
H2593	006	0	1	01	01	H2593_006_0	6	6	Specialty Drugs	2		
H2593	006	0	1	01	01	H2593_006_0	6	2	Generic Drugs	1	1	
H2593	006	0	1	01	01	H2593_006_0	6	3	Enhanced Care Brand Drugs	1	1	
H2593	006	0	1	01	01	H2593_006_0	6	4	Preferred Brand Drugs	2		
H2593	006	0	1	01	01	H2593_006_0	6	5	Brand Drugs	2		
H2610	006	0	1	01	01	H2610_006_0	4	2	Tier 2 Preferred Brand	2		
H2610	006	0	1	01	01	H2610_006_0	4	4	Tier 4 Specialty	2		
H2610	006	0	1	01	01	H2610_006_0	4	1	Tier 1 Generic	1	1	
H2610	006	0	1	01	01	H2610_006_0	4	3	Tier 3 Non-preferred Brand	2		
H2611	002	0	1	04	01	H2611_002_0	8	1	Tier 1	1	1	
H2611	002	0	1	04	01	H2611_002_0	8	2	Tier 2	2		
H2611	002	0	1	04	01	H2611_002_0	8	3	3	2		
H2611	002	0	1	04	01	H2611_002_0	8	4	4	2		
H2611	012	0	1	04	01	H2611_012_0	8	4	Tier 4	2		
H2611	012	0	1	04	01	H2611_012_0	8	3	Tier 3	2		
H2611	012	0	1	04	01	H2611_012_0	8	1	Tier 1	1	1	
H2611	012	0	1	04	01	H2611_012_0	8	2	Tier 2	2		
H2611	016	0	1	04	01	H2611_016_0	9	3	Tier 3	2		
H2611	016	0	1	04	01	H2611_016_0	9	2	Tier 2	2		
H2611	016	0	1	04	01	H2611_016_0	9	1	Tier 1	1	1	
H2611	016	0	1	04	01	H2611_016_0	9	4	Tier 4	2		
H2613	004	0	1	09	04	H2613_004_0	15	5	Tier 5 Specialty Drugs	2		
H2613	004	0	1	09	04	H2613_004_0	15	4	Tier 4 Non-Specialty Injectable Drugs	2		
H2613	004	0	1	09	04	H2613_004_0	15	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H2613	004	0	1	09	04	H2613_004_0	15	1	Tier 1 Preferred Generic Drugs	1	1	
H2613	004	0	1	09	04	H2613_004_0	15	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H2649	004	0	1	01	01	H2649_004_0	8	3	Non-Preferred Brand	1	2	10000000
H2649	004	0	1	01	01	H2649_004_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2649	004	0	1	01	01	H2649_004_0	8	1	Preferred Generic	1	2	00001000
H2649	004	0	1	01	01	H2649_004_0	8	4	Specialty	1	2	10001000
H2649	011	0	1	01	01	H2649_011_0	8	4	Specialty	1	2	10001000
H2649	011	0	1	01	01	H2649_011_0	8	1	Preferred Generic	1	2	00001000
H2649	011	0	1	01	01	H2649_011_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2649	011	0	1	01	01	H2649_011_0	8	3	Non-Preferred Brand	1	2	10000000
H2649	016	0	1	01	01	H2649_016_0	8	4	Specialty	1	2	10001000
H2649	016	0	1	01	01	H2649_016_0	8	3	Non-Preferred Brand	1	2	10000000
H2649	016	0	1	01	01	H2649_016_0	8	1	Preferred Generic	1	2	00001000
H2649	016	0	1	01	01	H2649_016_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2701	001	0	1	04	01	H2701_001_0	6	1	Formulary Generic	1	1	
H2701	001	0	1	04	01	H2701_001_0	6	2	Formulary Preferred Brand	2		
H2701	001	0	1	04	01	H2701_001_0	6	3	Formulary Non-Preferred Brand	2		
H2701	001	0	1	04	01	H2701_001_0	6	4	Specialty	2		
H2773	001	0	1	01	01	H2773_001_0	6	5	Specialty	2		
H2773	001	0	1	01	01	H2773_001_0	6	4	Non-Preferred Brand	2		
H2773	001	0	1	01	01	H2773_001_0	6	3	Brand	2		
H2773	001	0	1	01	01	H2773_001_0	6	1	Generic	1	1	
H2773	001	0	1	01	01	H2773_001_0	6	2	Preferred Brand	2		
H2775	082	0	1	04	01	H2775_082_0	6	1	Generic	1	1	
H2775	082	0	1	04	01	H2775_082_0	6	2	Preferred Brand	2		
H2775	082	0	1	04	01	H2775_082_0	6	3	Non-Preferred Brand	2		
H2775	082	0	1	04	01	H2775_082_0	6	4	Specialty	2		
H2775	083	0	1	04	01	H2775_083_0	6	4	Specialty	2		
H2775	083	0	1	04	01	H2775_083_0	6	3	Non-Preferred Brand	2		
H2775	083	0	1	04	01	H2775_083_0	6	2	Preferred Brand	2		
H2775	083	0	1	04	01	H2775_083_0	6	1	Generic	1	1	
H2775	084	0	1	04	01	H2775_084_0	6	3	Non-Preferred Brand	2		
H2775	084	0	1	04	01	H2775_084_0	6	2	Preferred Brand	2		
H2775	084	0	1	04	01	H2775_084_0	6	1	Generic	1	1	
H2775	084	0	1	04	01	H2775_084_0	6	4	Specialty	2		
H2775	085	0	1	04	01	H2775_085_0	6	2	Preferred Brand	2		
H2775	085	0	1	04	01	H2775_085_0	6	1	Generic	1	1	
H2775	085	0	1	04	01	H2775_085_0	6	3	Non-Preferred Brand	2		
H2775	085	0	1	04	01	H2775_085_0	6	4	Specialty	2		
H2775	086	0	1	04	01	H2775_086_0	6	4	Specialty	2		
H2775	086	0	1	04	01	H2775_086_0	6	3	Non-Preferred Brand	2		
H2775	086	0	1	04	01	H2775_086_0	6	2	Preferred Brand	2		
H2775	086	0	1	04	01	H2775_086_0	6	1	Generic	1	1	
H2775	087	0	1	04	01	H2775_087_0	6	1	Generic	1	1	
H2775	087	0	1	04	01	H2775_087_0	6	2	Preferred Brand	2		
H2775	087	0	1	04	01	H2775_087_0	6	3	Non-Preferred Brand	2		
H2775	087	0	1	04	01	H2775_087_0	6	4	Specialty	2		
H2899	001	0	1	01	01	H2899_001_0	10	2	Tier 2 - Non-Preferred Generic	2		
H2899	001	0	1	01	01	H2899_001_0	10	1	Tier 1 - Preferred  Generic	1	1	
H2899	001	0	1	01	01	H2899_001_0	10	3	Tier 3 - Preferred Brand	2		
H2899	001	0	1	01	01	H2899_001_0	10	4	Tier - Non-Preferred Brand	2		
H2899	001	0	1	01	01	H2899_001_0	10	5	Tier 5 - Specialty	2		
H2899	003	0	1	01	01	H2899_003_0	6	5	Tier 5 - Specialty	2		
H2899	003	0	1	01	01	H2899_003_0	6	4	Tier 4 - Non-Preferred Brand	2		
H2899	003	0	1	01	01	H2899_003_0	6	3	Tier 3 - Preferred Brand	2		
H2899	003	0	1	01	01	H2899_003_0	6	2	Tier 2 - Non-Preferred Generic	2		
H2899	003	0	1	01	01	H2899_003_0	6	1	Tier 1 - Preferred Generic	1	1	
H2899	004	0	1	01	01	H2899_004_0	6	2	Tier 2 - Non-Preferred Generic	2		
H2899	004	0	1	01	01	H2899_004_0	6	1	Tier 1 - Preferred Generic	1	1	
H2899	004	0	1	01	01	H2899_004_0	6	3	Tier 3 - Preferred Brand	2		
H2899	004	0	1	01	01	H2899_004_0	6	5	Tier 5 - Specialty	2		
H2899	004	0	1	01	01	H2899_004_0	6	4	Tier 4 - Non-Preferred Brand	2		
H2899	006	0	1	01	01	H2899_006_0	7	5	Tier 5 - Specialty	2		
H2899	006	0	1	01	01	H2899_006_0	7	4	Tier 4 - Non-Preferred Brand	2		
H2899	006	0	1	01	01	H2899_006_0	7	3	Tier 3 - Preferred Brand	2		
H2899	006	0	1	01	01	H2899_006_0	7	2	Tier 2 - Non-Preferred Generic	2		
H2899	006	0	1	01	01	H2899_006_0	7	1	Tier 1 - Preferred Generic	1	1	
H2899	009	0	1	01	01	H2899_009_0	7	1	Tier 1 - Preferred Generic	1	1	
H2899	009	0	1	01	01	H2899_009_0	7	2	Tier 2 - Non-Preferred Generic	2		
H2899	009	0	1	01	01	H2899_009_0	7	4	Tier 4 - Non-Preferred Brand	2		
H2899	009	0	1	01	01	H2899_009_0	7	3	Tier 3 - Preferred Brand	2		
H2899	009	0	1	01	01	H2899_009_0	7	5	Tier 5 - Specialty	2		
H2905	001	0	1	04	01	H2905_001_0	9	4	Specialty	2		
H2905	001	0	1	04	01	H2905_001_0	9	3	Non-Preferred	2		
H2905	001	0	1	04	01	H2905_001_0	9	2	Preferred Brand	2		
H2905	001	0	1	04	01	H2905_001_0	9	1	Preferred Generic/Some Brand Maintenance	1	1	
H2906	003	0	1	04	01	H2906_003_0	6	5	Special Pharmaceutical	2		
H2906	003	0	1	04	01	H2906_003_0	6	4	Non- Preferred Brand Name	2		
H2906	003	0	1	04	01	H2906_003_0	6	3	Preferred Brand	1	1	
H2906	003	0	1	04	01	H2906_003_0	6	1	Preferred Generic	1	1	
H2906	003	0	1	04	01	H2906_003_0	6	2	Non-Preferred Generic	1	1	
H2931	002	0	1	02	01	H2931_002_0	9	2	Preferred Brand	1	1	
H2931	002	0	1	02	01	H2931_002_0	9	1	Preferred Generic/Some Brand Maintenance	1	1	
H2931	002	0	1	02	01	H2931_002_0	9	4	Specialty	2		
H2931	002	0	1	02	01	H2931_002_0	9	5	Special Coverage - Generic	1	1	
H2931	002	0	1	02	01	H2931_002_0	9	6	Special Coverage - Brand	2		
H2931	002	0	1	02	01	H2931_002_0	9	3	Non-preferred	2		
H2931	004	0	1	01	01	H2931_004_0	7	3	Non-preferred	2		
H2931	004	0	1	01	01	H2931_004_0	7	4	Specialty	2		
H2931	004	0	1	01	01	H2931_004_0	7	2	Preferred Brand	2		
H2931	004	0	1	01	01	H2931_004_0	7	1	Preferred Generic/Some Brand Maintenance	1	1	
H2931	004	0	1	01	01	H2931_004_0	7	6	Special Coverage - Brand	2		
H2931	004	0	1	01	01	H2931_004_0	7	5	Special Coverage - Generic	1	1	
H2931	015	0	1	01	01	H2931_015_0	5	7	Special Coverage - Brand	2		
H2931	015	0	1	01	01	H2931_015_0	5	1	Preferred Generic/Some Brand Maintenance	1	1	
H2931	015	0	1	01	01	H2931_015_0	5	2	Preferred Brand	1	2	10000000
H2931	015	0	1	01	01	H2931_015_0	5	6	Special Coverage - Generic	1	1	
H2931	015	0	1	01	01	H2931_015_0	5	5	Special Coverage - Vitamins	1	1	
H2931	015	0	1	01	01	H2931_015_0	5	4	Specialty	2		
H2931	015	0	1	01	01	H2931_015_0	5	3	Non-preferred	2		
H2931	016	0	1	01	01	H2931_016_0	7	3	Non-preferred	2		
H2931	016	0	1	01	01	H2931_016_0	7	2	Preferred Brand	1	1	
H2931	016	0	1	01	01	H2931_016_0	7	1	Preferred Generic/Some Brand Maintenance	1	1	
H2931	016	0	1	01	01	H2931_016_0	7	4	Specialty	2		
H2931	016	0	1	01	01	H2931_016_0	7	6	Special Coverage - Brand	2		
H2931	016	0	1	01	01	H2931_016_0	7	5	Special Coverage - Generic	1	1	
H2944	002	0	1	09	04	H2944_002_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	002	0	1	09	04	H2944_002_0	3	4	Specialty	1	2	10001000
H2944	002	0	1	09	04	H2944_002_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	002	0	1	09	04	H2944_002_0	3	1	Preferred Generic	1	2	00001000
H2944	003	0	1	09	04	H2944_003_0	3	1	Preferred Generic	1	2	00001000
H2944	003	0	1	09	04	H2944_003_0	3	4	Specialty	1	2	10001000
H2944	003	0	1	09	04	H2944_003_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	003	0	1	09	04	H2944_003_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	004	0	1	09	04	H2944_004_0	3	4	Specialty	1	2	10001000
H2944	004	0	1	09	04	H2944_004_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	004	0	1	09	04	H2944_004_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	004	0	1	09	04	H2944_004_0	3	1	Preferred Generic	1	2	00001000
H2944	005	0	1	09	04	H2944_005_0	5	4	Specialty	1	2	10001000
H2944	005	0	1	09	04	H2944_005_0	5	1	Preferred Generic	1	2	00001000
H2944	005	0	1	09	04	H2944_005_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	005	0	1	09	04	H2944_005_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	006	0	1	09	04	H2944_006_0	7	1	Preferred Generic	1	2	00001000
H2944	006	0	1	09	04	H2944_006_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	006	0	1	09	04	H2944_006_0	7	4	Specialty	1	2	10001000
H2944	006	0	1	09	04	H2944_006_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	007	0	1	09	04	H2944_007_0	5	1	Preferred Generic	1	2	00001000
H2944	007	0	1	09	04	H2944_007_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	007	0	1	09	04	H2944_007_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	007	0	1	09	04	H2944_007_0	5	4	Specialty	1	2	10001000
H2944	008	0	1	09	04	H2944_008_0	6	1	Preferred Generic	1	2	00001000
H2944	008	0	1	09	04	H2944_008_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	008	0	1	09	04	H2944_008_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	008	0	1	09	04	H2944_008_0	6	4	Specialty	1	2	10001000
H2944	009	0	1	09	04	H2944_009_0	4	1	Preferred Generic	1	2	00001000
H2944	009	0	1	09	04	H2944_009_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	009	0	1	09	04	H2944_009_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	009	0	1	09	04	H2944_009_0	4	4	Specialty	1	2	10001000
H2944	010	0	1	09	04	H2944_010_0	5	1	Preferred Generic	1	2	00001000
H2944	010	0	1	09	04	H2944_010_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	010	0	1	09	04	H2944_010_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	010	0	1	09	04	H2944_010_0	5	4	Specialty	1	2	10001000
H2944	011	0	1	09	04	H2944_011_0	4	4	Specialty	1	2	10001000
H2944	011	0	1	09	04	H2944_011_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	011	0	1	09	04	H2944_011_0	4	1	Preferred Generic	1	2	00001000
H2944	011	0	1	09	04	H2944_011_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	012	0	1	09	04	H2944_012_0	4	1	Preferred Generic	1	2	00001000
H2944	012	0	1	09	04	H2944_012_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	012	0	1	09	04	H2944_012_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	012	0	1	09	04	H2944_012_0	4	4	Specialty	1	2	10001000
H2944	013	0	1	09	04	H2944_013_0	4	1	Preferred Generic	1	2	00001000
H2944	013	0	1	09	04	H2944_013_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	013	0	1	09	04	H2944_013_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	013	0	1	09	04	H2944_013_0	4	4	Specialty	1	2	10001000
H2944	014	0	1	09	04	H2944_014_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	014	0	1	09	04	H2944_014_0	3	4	Specialty	1	2	10001000
H2944	014	0	1	09	04	H2944_014_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	014	0	1	09	04	H2944_014_0	3	1	Preferred Generic	1	2	00001000
H2944	015	0	1	09	04	H2944_015_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	015	0	1	09	04	H2944_015_0	3	4	Specialty	1	2	10001000
H2944	015	0	1	09	04	H2944_015_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	015	0	1	09	04	H2944_015_0	3	1	Preferred Generic	1	2	00001000
H2944	016	0	1	09	04	H2944_016_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	016	0	1	09	04	H2944_016_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	016	0	1	09	04	H2944_016_0	4	1	Preferred Generic	1	2	00001000
H2944	016	0	1	09	04	H2944_016_0	4	4	Specialty	1	2	10001000
H2944	017	0	1	09	04	H2944_017_0	4	4	Specialty	1	2	10001000
H2944	017	0	1	09	04	H2944_017_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	017	0	1	09	04	H2944_017_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	017	0	1	09	04	H2944_017_0	4	1	Preferred Generic	1	2	00001000
H2944	019	0	1	09	04	H2944_019_0	3	1	Preferred Generic	1	2	00001000
H2944	019	0	1	09	04	H2944_019_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	019	0	1	09	04	H2944_019_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	019	0	1	09	04	H2944_019_0	3	4	Specialty	1	2	10001000
H2944	020	0	1	09	04	H2944_020_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	020	0	1	09	04	H2944_020_0	3	4	Specialty	1	2	10001000
H2944	020	0	1	09	04	H2944_020_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	020	0	1	09	04	H2944_020_0	3	1	Preferred Generic	1	2	00001000
H2944	021	0	1	09	04	H2944_021_0	3	1	Preferred Generic	1	2	00001000
H2944	021	0	1	09	04	H2944_021_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	021	0	1	09	04	H2944_021_0	3	4	Specialty	1	2	10001000
H2944	021	0	1	09	04	H2944_021_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	022	0	1	09	04	H2944_022_0	3	1	Preferred Generic	1	2	00001000
H2944	022	0	1	09	04	H2944_022_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	022	0	1	09	04	H2944_022_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	022	0	1	09	04	H2944_022_0	3	4	Specialty	1	2	10001000
H2944	023	0	1	09	04	H2944_023_0	3	4	Specialty	1	2	10001000
H2944	023	0	1	09	04	H2944_023_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	023	0	1	09	04	H2944_023_0	3	1	Preferred Generic	1	2	00001000
H2944	023	0	1	09	04	H2944_023_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	024	0	1	09	04	H2944_024_0	3	4	Specialty	1	2	10001000
H2944	024	0	1	09	04	H2944_024_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	024	0	1	09	04	H2944_024_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	024	0	1	09	04	H2944_024_0	3	1	Preferred Generic	1	2	00001000
H2944	026	0	1	09	04	H2944_026_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	026	0	1	09	04	H2944_026_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	026	0	1	09	04	H2944_026_0	3	1	Preferred Generic	1	2	00001000
H2944	026	0	1	09	04	H2944_026_0	3	4	Specialty	1	2	10001000
H2944	027	0	1	09	04	H2944_027_0	3	1	Preferred Generic	1	2	00001000
H2944	027	0	1	09	04	H2944_027_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	027	0	1	09	04	H2944_027_0	3	4	Specialty	1	2	10001000
H2944	027	0	1	09	04	H2944_027_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	028	0	1	09	04	H2944_028_0	3	1	Preferred Generic	1	2	00001000
H2944	028	0	1	09	04	H2944_028_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	028	0	1	09	04	H2944_028_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	028	0	1	09	04	H2944_028_0	3	4	Specialty	1	2	10001000
H2944	029	0	1	09	04	H2944_029_0	3	1	Preferred Generic	1	2	00001000
H2944	029	0	1	09	04	H2944_029_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	029	0	1	09	04	H2944_029_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	029	0	1	09	04	H2944_029_0	3	4	Specialty	1	2	10001000
H2944	030	0	1	09	04	H2944_030_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	030	0	1	09	04	H2944_030_0	3	4	Specialty	1	2	10001000
H2944	030	0	1	09	04	H2944_030_0	3	1	Preferred Generic	1	2	00001000
H2944	030	0	1	09	04	H2944_030_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	031	0	1	09	04	H2944_031_0	3	4	Specialty	1	2	10001000
H2944	031	0	1	09	04	H2944_031_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	031	0	1	09	04	H2944_031_0	3	1	Preferred Generic	1	2	00001000
H2944	031	0	1	09	04	H2944_031_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	032	0	1	09	04	H2944_032_0	6	4	Specialty	1	2	10001000
H2944	032	0	1	09	04	H2944_032_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	032	0	1	09	04	H2944_032_0	6	1	Preferred Generic	1	2	00001000
H2944	032	0	1	09	04	H2944_032_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	033	0	1	09	04	H2944_033_0	10	3	Non-Preferred Brand	1	2	10000000
H2944	033	0	1	09	04	H2944_033_0	10	1	Preferred Generic	1	2	00001000
H2944	033	0	1	09	04	H2944_033_0	10	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	033	0	1	09	04	H2944_033_0	10	4	Specialty	1	2	10001000
H2944	034	0	1	09	04	H2944_034_0	3	4	Specialty	1	2	10001000
H2944	034	0	1	09	04	H2944_034_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	034	0	1	09	04	H2944_034_0	3	1	Preferred Generic	1	2	00001000
H2944	034	0	1	09	04	H2944_034_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	035	0	1	09	04	H2944_035_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	035	0	1	09	04	H2944_035_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	035	0	1	09	04	H2944_035_0	3	1	Preferred Generic	1	2	00001000
H2944	035	0	1	09	04	H2944_035_0	3	4	Specialty	1	2	10001000
H2944	036	0	1	09	04	H2944_036_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	036	0	1	09	04	H2944_036_0	3	4	Specialty	1	2	10001000
H2944	036	0	1	09	04	H2944_036_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	036	0	1	09	04	H2944_036_0	3	1	Preferred Generic	1	2	00001000
H2944	037	0	1	09	04	H2944_037_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	037	0	1	09	04	H2944_037_0	3	1	Preferred Generic	1	2	00001000
H2944	037	0	1	09	04	H2944_037_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	037	0	1	09	04	H2944_037_0	3	4	Specialty	1	2	10001000
H2944	038	0	1	09	04	H2944_038_0	3	1	Preferred Generic	1	2	00001000
H2944	038	0	1	09	04	H2944_038_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	038	0	1	09	04	H2944_038_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	038	0	1	09	04	H2944_038_0	3	4	Specialty	1	2	10001000
H2944	039	0	1	09	04	H2944_039_0	3	1	Preferred Generic	1	2	00001000
H2944	039	0	1	09	04	H2944_039_0	3	4	Specialty	1	2	10001000
H2944	039	0	1	09	04	H2944_039_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	039	0	1	09	04	H2944_039_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	040	0	1	09	04	H2944_040_0	3	1	Preferred Generic	1	2	00001000
H2944	040	0	1	09	04	H2944_040_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	040	0	1	09	04	H2944_040_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	040	0	1	09	04	H2944_040_0	3	4	Specialty	1	2	10001000
H2944	041	0	1	09	04	H2944_041_0	7	4	Specialty	1	2	10001000
H2944	041	0	1	09	04	H2944_041_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	041	0	1	09	04	H2944_041_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	041	0	1	09	04	H2944_041_0	7	1	Preferred Generic	1	2	00001000
H2944	042	0	1	09	04	H2944_042_0	3	4	Specialty	1	2	10001000
H2944	042	0	1	09	04	H2944_042_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	042	0	1	09	04	H2944_042_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	042	0	1	09	04	H2944_042_0	3	1	Preferred Generic	1	2	00001000
H2944	043	0	1	09	04	H2944_043_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	043	0	1	09	04	H2944_043_0	3	1	Preferred Generic	1	2	00001000
H2944	043	0	1	09	04	H2944_043_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	043	0	1	09	04	H2944_043_0	3	4	Specialty	1	2	10001000
H2944	044	0	1	09	04	H2944_044_0	3	1	Preferred Generic	1	2	00001000
H2944	044	0	1	09	04	H2944_044_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	044	0	1	09	04	H2944_044_0	3	4	Specialty	1	2	10001000
H2944	044	0	1	09	04	H2944_044_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	046	0	1	09	04	H2944_046_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	046	0	1	09	04	H2944_046_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	046	0	1	09	04	H2944_046_0	3	1	Preferred Generic	1	2	00001000
H2944	046	0	1	09	04	H2944_046_0	3	4	Specialty	1	2	10001000
H2944	047	0	1	09	04	H2944_047_0	3	4	Specialty	1	2	10001000
H2944	047	0	1	09	04	H2944_047_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	047	0	1	09	04	H2944_047_0	3	1	Preferred Generic	1	2	00001000
H2944	047	0	1	09	04	H2944_047_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	049	0	1	09	04	H2944_049_0	3	4	Specialty	1	2	10001000
H2944	049	0	1	09	04	H2944_049_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	049	0	1	09	04	H2944_049_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	049	0	1	09	04	H2944_049_0	3	1	Preferred Generic	1	2	00001000
H2944	051	0	1	09	04	H2944_051_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	051	0	1	09	04	H2944_051_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	051	0	1	09	04	H2944_051_0	3	4	Specialty	1	2	10001000
H2944	051	0	1	09	04	H2944_051_0	3	1	Preferred Generic	1	2	00001000
H2944	052	0	1	09	04	H2944_052_0	5	4	Specialty	1	2	10001000
H2944	052	0	1	09	04	H2944_052_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	052	0	1	09	04	H2944_052_0	5	1	Preferred Generic	1	2	00001000
H2944	052	0	1	09	04	H2944_052_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	053	0	1	09	04	H2944_053_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	053	0	1	09	04	H2944_053_0	3	1	Preferred Generic	1	2	00001000
H2944	053	0	1	09	04	H2944_053_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	053	0	1	09	04	H2944_053_0	3	4	Specialty	1	2	10001000
H2944	054	0	1	09	04	H2944_054_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	054	0	1	09	04	H2944_054_0	5	4	Specialty	1	2	10001000
H2944	054	0	1	09	04	H2944_054_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	054	0	1	09	04	H2944_054_0	5	1	Preferred Generic	1	2	00001000
H2944	055	0	1	09	04	H2944_055_0	5	1	Preferred Generic	1	2	00001000
H2944	055	0	1	09	04	H2944_055_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	055	0	1	09	04	H2944_055_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	055	0	1	09	04	H2944_055_0	5	4	Specialty	1	2	10001000
H2944	056	0	1	09	04	H2944_056_0	3	1	Preferred Generic	1	2	00001000
H2944	056	0	1	09	04	H2944_056_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	056	0	1	09	04	H2944_056_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	056	0	1	09	04	H2944_056_0	3	4	Specialty	1	2	10001000
H2944	057	0	1	09	04	H2944_057_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	057	0	1	09	04	H2944_057_0	3	1	Preferred Generic	1	2	00001000
H2944	057	0	1	09	04	H2944_057_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	057	0	1	09	04	H2944_057_0	3	4	Specialty	1	2	10001000
H2944	058	0	1	09	04	H2944_058_0	3	4	Specialty	1	2	10001000
H2944	058	0	1	09	04	H2944_058_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	058	0	1	09	04	H2944_058_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	058	0	1	09	04	H2944_058_0	3	1	Preferred Generic	1	2	00001000
H2944	059	0	1	09	04	H2944_059_0	4	1	Preferred Generic	1	2	00001000
H2944	059	0	1	09	04	H2944_059_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	059	0	1	09	04	H2944_059_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	059	0	1	09	04	H2944_059_0	4	4	Specialty	1	2	10001000
H2944	060	0	1	09	04	H2944_060_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	060	0	1	09	04	H2944_060_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	060	0	1	09	04	H2944_060_0	3	1	Preferred Generic	1	2	00001000
H2944	060	0	1	09	04	H2944_060_0	3	4	Specialty	1	2	10001000
H2944	061	0	1	09	04	H2944_061_0	3	4	Specialty	1	2	10001000
H2944	061	0	1	09	04	H2944_061_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	061	0	1	09	04	H2944_061_0	3	1	Preferred Generic	1	2	00001000
H2944	061	0	1	09	04	H2944_061_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	062	0	1	09	04	H2944_062_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	062	0	1	09	04	H2944_062_0	3	4	Specialty	1	2	10001000
H2944	062	0	1	09	04	H2944_062_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	062	0	1	09	04	H2944_062_0	3	1	Preferred Generic	1	2	00001000
H2944	063	0	1	09	04	H2944_063_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	063	0	1	09	04	H2944_063_0	3	4	Specialty	1	2	10001000
H2944	063	0	1	09	04	H2944_063_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	063	0	1	09	04	H2944_063_0	3	1	Preferred Generic	1	2	00001000
H2944	064	0	1	09	04	H2944_064_0	3	4	Specialty	1	2	10001000
H2944	064	0	1	09	04	H2944_064_0	3	1	Preferred Generic	1	2	00001000
H2944	064	0	1	09	04	H2944_064_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	064	0	1	09	04	H2944_064_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	065	0	1	09	04	H2944_065_0	6	1	Preferred Generic	1	2	00001000
H2944	065	0	1	09	04	H2944_065_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	065	0	1	09	04	H2944_065_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	065	0	1	09	04	H2944_065_0	6	4	Specialty	1	2	10001000
H2944	066	0	1	09	04	H2944_066_0	6	4	Specialty	1	2	10001000
H2944	066	0	1	09	04	H2944_066_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	066	0	1	09	04	H2944_066_0	6	1	Preferred Generic	1	2	00001000
H2944	066	0	1	09	04	H2944_066_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	067	0	1	09	04	H2944_067_0	3	1	Preferred Generic	1	2	00001000
H2944	067	0	1	09	04	H2944_067_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	067	0	1	09	04	H2944_067_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	067	0	1	09	04	H2944_067_0	3	4	Specialty	1	2	10001000
H2944	069	0	1	09	04	H2944_069_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	069	0	1	09	04	H2944_069_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	069	0	1	09	04	H2944_069_0	3	4	Specialty	1	2	10001000
H2944	069	0	1	09	04	H2944_069_0	3	1	Preferred Generic	1	2	00001000
H2944	070	0	1	09	04	H2944_070_0	6	1	Preferred Generic	1	2	00001000
H2944	070	0	1	09	04	H2944_070_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	070	0	1	09	04	H2944_070_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	070	0	1	09	04	H2944_070_0	6	4	Specialty	1	2	10001000
H2944	071	0	1	09	04	H2944_071_0	5	1	Preferred Generic	1	2	00001000
H2944	071	0	1	09	04	H2944_071_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	071	0	1	09	04	H2944_071_0	5	4	Specialty	1	2	10001000
H2944	071	0	1	09	04	H2944_071_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	073	0	1	09	04	H2944_073_0	5	4	Specialty	1	2	10001000
H2944	073	0	1	09	04	H2944_073_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	073	0	1	09	04	H2944_073_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	073	0	1	09	04	H2944_073_0	5	1	Preferred Generic	1	2	00001000
H2944	074	0	1	09	04	H2944_074_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	074	0	1	09	04	H2944_074_0	7	4	Specialty	1	2	10001000
H2944	074	0	1	09	04	H2944_074_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	074	0	1	09	04	H2944_074_0	7	1	Preferred Generic	1	2	00001000
H2944	075	0	1	09	04	H2944_075_0	7	1	Preferred Generic	1	2	00001000
H2944	075	0	1	09	04	H2944_075_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	075	0	1	09	04	H2944_075_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	075	0	1	09	04	H2944_075_0	7	4	Specialty	1	2	10001000
H2944	076	0	1	09	04	H2944_076_0	7	1	Preferred Generic	1	2	00001000
H2944	076	0	1	09	04	H2944_076_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	076	0	1	09	04	H2944_076_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	076	0	1	09	04	H2944_076_0	7	4	Specialty	1	2	10001000
H2944	077	0	1	09	04	H2944_077_0	7	4	Specialty	1	2	10001000
H2944	077	0	1	09	04	H2944_077_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	077	0	1	09	04	H2944_077_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	077	0	1	09	04	H2944_077_0	7	1	Preferred Generic	1	2	00001000
H2944	078	0	1	09	04	H2944_078_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	078	0	1	09	04	H2944_078_0	7	4	Specialty	1	2	10001000
H2944	078	0	1	09	04	H2944_078_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	078	0	1	09	04	H2944_078_0	7	1	Preferred Generic	1	2	00001000
H2944	079	0	1	09	04	H2944_079_0	7	1	Preferred Generic	1	2	00001000
H2944	079	0	1	09	04	H2944_079_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	079	0	1	09	04	H2944_079_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	079	0	1	09	04	H2944_079_0	7	4	Specialty	1	2	10001000
H2944	080	0	1	09	04	H2944_080_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	080	0	1	09	04	H2944_080_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	080	0	1	09	04	H2944_080_0	7	4	Specialty	1	2	10001000
H2944	080	0	1	09	04	H2944_080_0	7	1	Preferred Generic	1	2	00001000
H2944	081	0	1	09	04	H2944_081_0	10	4	Specialty	1	2	10001000
H2944	081	0	1	09	04	H2944_081_0	10	3	Non-Preferred Brand	1	2	10000000
H2944	081	0	1	09	04	H2944_081_0	10	1	Preferred Generic	1	2	00001000
H2944	081	0	1	09	04	H2944_081_0	10	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	082	0	1	09	04	H2944_082_0	7	1	Preferred Generic	1	2	00001000
H2944	082	0	1	09	04	H2944_082_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	082	0	1	09	04	H2944_082_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	082	0	1	09	04	H2944_082_0	7	4	Specialty	1	2	10001000
H2944	084	0	1	09	04	H2944_084_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	084	0	1	09	04	H2944_084_0	4	4	Specialty	1	2	10001000
H2944	084	0	1	09	04	H2944_084_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	084	0	1	09	04	H2944_084_0	4	1	Preferred Generic	1	2	00001000
H2944	085	0	1	09	04	H2944_085_0	7	1	Preferred Generic	1	2	00001000
H2944	085	0	1	09	04	H2944_085_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	085	0	1	09	04	H2944_085_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	085	0	1	09	04	H2944_085_0	7	4	Specialty	1	2	10001000
H2944	086	0	1	09	04	H2944_086_0	7	1	Preferred Generic	1	2	00001000
H2944	086	0	1	09	04	H2944_086_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	086	0	1	09	04	H2944_086_0	7	3	Non-Preferred Brand	1	2	10000000
H2944	086	0	1	09	04	H2944_086_0	7	4	Specialty	1	2	10001000
H2944	087	0	1	09	04	H2944_087_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	087	0	1	09	04	H2944_087_0	3	4	Specialty	1	2	10001000
H2944	087	0	1	09	04	H2944_087_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	087	0	1	09	04	H2944_087_0	3	1	Preferred Generic	1	2	00001000
H2944	088	0	1	09	04	H2944_088_0	3	4	Specialty	1	2	10001000
H2944	088	0	1	09	04	H2944_088_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	088	0	1	09	04	H2944_088_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	088	0	1	09	04	H2944_088_0	3	1	Preferred Generic	1	2	00001000
H2944	089	0	1	09	04	H2944_089_0	6	1	Preferred Generic	1	2	00001000
H2944	089	0	1	09	04	H2944_089_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	089	0	1	09	04	H2944_089_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	089	0	1	09	04	H2944_089_0	6	4	Specialty	1	2	10001000
H2944	090	0	1	09	04	H2944_090_0	6	1	Preferred Generic	1	2	00001000
H2944	090	0	1	09	04	H2944_090_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	090	0	1	09	04	H2944_090_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	090	0	1	09	04	H2944_090_0	6	4	Specialty	1	2	10001000
H2944	091	0	1	09	04	H2944_091_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	091	0	1	09	04	H2944_091_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	091	0	1	09	04	H2944_091_0	3	1	Preferred Generic	1	2	00001000
H2944	091	0	1	09	04	H2944_091_0	3	4	Specialty	1	2	10001000
H2944	092	0	1	09	04	H2944_092_0	6	4	Specialty	1	2	10001000
H2944	092	0	1	09	04	H2944_092_0	6	1	Preferred Generic	1	2	00001000
H2944	092	0	1	09	04	H2944_092_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	092	0	1	09	04	H2944_092_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	093	0	1	09	04	H2944_093_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	093	0	1	09	04	H2944_093_0	3	4	Specialty	1	2	10001000
H2944	093	0	1	09	04	H2944_093_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	093	0	1	09	04	H2944_093_0	3	1	Preferred Generic	1	2	00001000
H2944	095	0	1	09	04	H2944_095_0	4	1	Preferred Generic	1	2	00001000
H2944	095	0	1	09	04	H2944_095_0	4	4	Specialty	1	2	10001000
H2944	095	0	1	09	04	H2944_095_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	095	0	1	09	04	H2944_095_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	096	0	1	09	04	H2944_096_0	4	4	Specialty	1	2	10001000
H2944	096	0	1	09	04	H2944_096_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	096	0	1	09	04	H2944_096_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	096	0	1	09	04	H2944_096_0	4	1	Preferred Generic	1	2	00001000
H2944	097	0	1	09	04	H2944_097_0	4	4	Specialty	1	2	10001000
H2944	097	0	1	09	04	H2944_097_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	097	0	1	09	04	H2944_097_0	4	1	Preferred Generic	1	2	00001000
H2944	097	0	1	09	04	H2944_097_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	098	0	1	09	04	H2944_098_0	5	1	Preferred Generic	1	2	00001000
H2944	098	0	1	09	04	H2944_098_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	098	0	1	09	04	H2944_098_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	098	0	1	09	04	H2944_098_0	5	4	Specialty	1	2	10001000
H2944	099	0	1	09	04	H2944_099_0	4	1	Preferred Generic	1	2	00001000
H2944	099	0	1	09	04	H2944_099_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	099	0	1	09	04	H2944_099_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	099	0	1	09	04	H2944_099_0	4	4	Specialty	1	2	10001000
H2944	100	0	1	09	04	H2944_100_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	100	0	1	09	04	H2944_100_0	4	1	Preferred Generic	1	2	00001000
H2944	100	0	1	09	04	H2944_100_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	100	0	1	09	04	H2944_100_0	4	4	Specialty	1	2	10001000
H2944	101	0	1	09	04	H2944_101_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	101	0	1	09	04	H2944_101_0	4	1	Preferred Generic	1	2	00001000
H2944	101	0	1	09	04	H2944_101_0	4	4	Specialty	1	2	10001000
H2944	101	0	1	09	04	H2944_101_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	107	0	1	09	04	H2944_107_0	5	4	Specialty	1	2	10001000
H2944	107	0	1	09	04	H2944_107_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	107	0	1	09	04	H2944_107_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	107	0	1	09	04	H2944_107_0	5	1	Preferred Generic	1	2	00001000
H2944	108	0	1	09	04	H2944_108_0	2	4	Specialty	1	2	10001000
H2944	108	0	1	09	04	H2944_108_0	2	3	Non-Preferred Brand	1	2	10000000
H2944	108	0	1	09	04	H2944_108_0	2	1	Preferred Generic	1	2	00001000
H2944	108	0	1	09	04	H2944_108_0	2	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	109	0	1	09	04	H2944_109_0	4	4	Specialty	1	2	10001000
H2944	109	0	1	09	04	H2944_109_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	109	0	1	09	04	H2944_109_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	109	0	1	09	04	H2944_109_0	4	1	Preferred Generic	1	2	00001000
H2944	110	0	1	09	04	H2944_110_0	2	3	Non-Preferred Brand	1	2	10000000
H2944	110	0	1	09	04	H2944_110_0	2	4	Specialty	1	2	10001000
H2944	110	0	1	09	04	H2944_110_0	2	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	110	0	1	09	04	H2944_110_0	2	1	Preferred Generic	1	2	00001000
H2944	111	0	1	09	04	H2944_111_0	6	1	Preferred Generic	1	2	00001000
H2944	111	0	1	09	04	H2944_111_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	111	0	1	09	04	H2944_111_0	6	4	Specialty	1	2	10001000
H2944	111	0	1	09	04	H2944_111_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	112	0	1	09	04	H2944_112_0	2	4	Specialty	1	2	10001000
H2944	112	0	1	09	04	H2944_112_0	2	3	Non-Preferred Brand	1	2	10000000
H2944	112	0	1	09	04	H2944_112_0	2	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	112	0	1	09	04	H2944_112_0	2	1	Preferred Generic	1	2	00001000
H2944	113	0	1	09	04	H2944_113_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	113	0	1	09	04	H2944_113_0	4	4	Specialty	1	2	10001000
H2944	113	0	1	09	04	H2944_113_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	113	0	1	09	04	H2944_113_0	4	1	Preferred Generic	1	2	00001000
H2944	114	0	1	09	04	H2944_114_0	5	4	Specialty	1	2	10001000
H2944	114	0	1	09	04	H2944_114_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	114	0	1	09	04	H2944_114_0	5	1	Preferred Generic	1	2	00001000
H2944	114	0	1	09	04	H2944_114_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	115	0	1	09	04	H2944_115_0	5	4	Specialty	1	2	10001000
H2944	115	0	1	09	04	H2944_115_0	5	1	Preferred Generic	1	2	00001000
H2944	115	0	1	09	04	H2944_115_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	115	0	1	09	04	H2944_115_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	116	0	1	09	04	H2944_116_0	3	1	Preferred Generic	1	2	00001000
H2944	116	0	1	09	04	H2944_116_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	116	0	1	09	04	H2944_116_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	116	0	1	09	04	H2944_116_0	3	4	Specialty	1	2	10001000
H2944	117	0	1	09	04	H2944_117_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	117	0	1	09	04	H2944_117_0	4	4	Specialty	1	2	10001000
H2944	117	0	1	09	04	H2944_117_0	4	1	Preferred Generic	1	2	00001000
H2944	117	0	1	09	04	H2944_117_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	118	0	1	09	04	H2944_118_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	118	0	1	09	04	H2944_118_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	118	0	1	09	04	H2944_118_0	4	1	Preferred Generic	1	2	00001000
H2944	118	0	1	09	04	H2944_118_0	4	4	Specialty	1	2	10001000
H2944	119	0	1	09	04	H2944_119_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	119	0	1	09	04	H2944_119_0	5	4	Specialty	1	2	10001000
H2944	119	0	1	09	04	H2944_119_0	5	1	Preferred Generic	1	2	00001000
H2944	119	0	1	09	04	H2944_119_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	120	0	1	09	04	H2944_120_0	5	1	Preferred Generic	1	2	00001000
H2944	120	0	1	09	04	H2944_120_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	120	0	1	09	04	H2944_120_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	120	0	1	09	04	H2944_120_0	5	4	Specialty	1	2	10001000
H2944	121	0	1	09	04	H2944_121_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	121	0	1	09	04	H2944_121_0	5	4	Specialty	1	2	10001000
H2944	121	0	1	09	04	H2944_121_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	121	0	1	09	04	H2944_121_0	5	1	Preferred Generic	1	2	00001000
H2944	122	0	1	09	04	H2944_122_0	5	4	Specialty	1	2	10001000
H2944	122	0	1	09	04	H2944_122_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	122	0	1	09	04	H2944_122_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	122	0	1	09	04	H2944_122_0	5	1	Preferred Generic	1	2	00001000
H2944	123	0	1	09	04	H2944_123_0	6	1	Preferred Generic	1	2	00001000
H2944	123	0	1	09	04	H2944_123_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	123	0	1	09	04	H2944_123_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	123	0	1	09	04	H2944_123_0	6	4	Specialty	1	2	10001000
H2944	124	0	1	09	04	H2944_124_0	4	1	Preferred Generic	1	2	00001000
H2944	124	0	1	09	04	H2944_124_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	124	0	1	09	04	H2944_124_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	124	0	1	09	04	H2944_124_0	4	4	Specialty	1	2	10001000
H2944	125	0	1	09	04	H2944_125_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	125	0	1	09	04	H2944_125_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	125	0	1	09	04	H2944_125_0	5	1	Preferred Generic	1	2	00001000
H2944	125	0	1	09	04	H2944_125_0	5	4	Specialty	1	2	10001000
H2944	127	0	1	09	04	H2944_127_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	127	0	1	09	04	H2944_127_0	4	1	Preferred Generic	1	2	00001000
H2944	127	0	1	09	04	H2944_127_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	127	0	1	09	04	H2944_127_0	4	4	Specialty	1	2	10001000
H2944	128	0	1	09	04	H2944_128_0	4	4	Specialty	1	2	10001000
H2944	128	0	1	09	04	H2944_128_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	128	0	1	09	04	H2944_128_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	128	0	1	09	04	H2944_128_0	4	1	Preferred Generic	1	2	00001000
H2944	129	0	1	09	04	H2944_129_0	4	1	Preferred Generic	1	2	00001000
H2944	129	0	1	09	04	H2944_129_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	129	0	1	09	04	H2944_129_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	129	0	1	09	04	H2944_129_0	4	4	Specialty	1	2	10001000
H2944	131	0	1	09	04	H2944_131_0	4	4	Specialty	1	2	10001000
H2944	131	0	1	09	04	H2944_131_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	131	0	1	09	04	H2944_131_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	131	0	1	09	04	H2944_131_0	4	1	Preferred Generic	1	2	00001000
H2944	132	0	1	09	04	H2944_132_0	4	4	Specialty	1	2	10001000
H2944	132	0	1	09	04	H2944_132_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	132	0	1	09	04	H2944_132_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	132	0	1	09	04	H2944_132_0	4	1	Preferred Generic	1	2	00001000
H2944	133	0	1	09	04	H2944_133_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	133	0	1	09	04	H2944_133_0	4	1	Preferred Generic	1	2	00001000
H2944	133	0	1	09	04	H2944_133_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	133	0	1	09	04	H2944_133_0	4	4	Specialty	1	2	10001000
H2944	134	0	1	09	04	H2944_134_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	134	0	1	09	04	H2944_134_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	134	0	1	09	04	H2944_134_0	6	1	Preferred Generic	1	2	00001000
H2944	134	0	1	09	04	H2944_134_0	6	4	Specialty	1	2	10001000
H2944	135	0	1	09	04	H2944_135_0	4	4	Specialty	1	2	10001000
H2944	135	0	1	09	04	H2944_135_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	135	0	1	09	04	H2944_135_0	4	1	Preferred Generic	1	2	00001000
H2944	135	0	1	09	04	H2944_135_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	136	0	1	09	04	H2944_136_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	136	0	1	09	04	H2944_136_0	6	4	Specialty	1	2	10001000
H2944	136	0	1	09	04	H2944_136_0	6	3	Non-Preferred Brand	1	2	10000000
H2944	136	0	1	09	04	H2944_136_0	6	1	Preferred Generic	1	2	00001000
H2944	137	0	1	09	04	H2944_137_0	5	3	Non-Preferred Brand	1	2	10000000
H2944	137	0	1	09	04	H2944_137_0	5	4	Specialty	1	2	10001000
H2944	137	0	1	09	04	H2944_137_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	137	0	1	09	04	H2944_137_0	5	1	Preferred Generic	1	2	00001000
H2944	138	0	1	09	04	H2944_138_0	3	4	Specialty	1	2	10001000
H2944	138	0	1	09	04	H2944_138_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	138	0	1	09	04	H2944_138_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	138	0	1	09	04	H2944_138_0	3	1	Preferred Generic	1	2	00001000
H2944	139	0	1	09	04	H2944_139_0	3	1	Preferred Generic	1	2	00001000
H2944	139	0	1	09	04	H2944_139_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	139	0	1	09	04	H2944_139_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	139	0	1	09	04	H2944_139_0	3	4	Specialty	1	2	10001000
H2944	140	0	1	09	04	H2944_140_0	4	1	Preferred Generic	1	2	00001000
H2944	140	0	1	09	04	H2944_140_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	140	0	1	09	04	H2944_140_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	140	0	1	09	04	H2944_140_0	4	4	Specialty	1	2	10001000
H2944	141	0	1	09	04	H2944_141_0	3	1	Preferred Generic	1	2	00001000
H2944	141	0	1	09	04	H2944_141_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	141	0	1	09	04	H2944_141_0	3	4	Specialty	1	2	10001000
H2944	141	0	1	09	04	H2944_141_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	142	0	1	09	04	H2944_142_0	3	1	Preferred Generic	1	2	00001000
H2944	142	0	1	09	04	H2944_142_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	142	0	1	09	04	H2944_142_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	142	0	1	09	04	H2944_142_0	3	4	Specialty	1	2	10001000
H2944	143	0	1	09	04	H2944_143_0	3	4	Specialty	1	2	10001000
H2944	143	0	1	09	04	H2944_143_0	3	1	Preferred Generic	1	2	00001000
H2944	143	0	1	09	04	H2944_143_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	143	0	1	09	04	H2944_143_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	144	0	1	09	04	H2944_144_0	3	4	Specialty	1	2	10001000
H2944	144	0	1	09	04	H2944_144_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	144	0	1	09	04	H2944_144_0	3	1	Preferred Generic	1	2	00001000
H2944	144	0	1	09	04	H2944_144_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	146	0	1	09	04	H2944_146_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	146	0	1	09	04	H2944_146_0	3	4	Specialty	1	2	10001000
H2944	146	0	1	09	04	H2944_146_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	146	0	1	09	04	H2944_146_0	3	1	Preferred Generic	1	2	00001000
H2944	147	0	1	09	04	H2944_147_0	3	4	Specialty	1	2	10001000
H2944	147	0	1	09	04	H2944_147_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	147	0	1	09	04	H2944_147_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	147	0	1	09	04	H2944_147_0	3	1	Preferred Generic	1	2	00001000
H2944	148	0	1	09	04	H2944_148_0	2	4	Specialty	1	2	10001000
H2944	148	0	1	09	04	H2944_148_0	2	1	Preferred Generic	1	2	00001000
H2944	148	0	1	09	04	H2944_148_0	2	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	148	0	1	09	04	H2944_148_0	2	3	Non-Preferred Brand	1	2	10000000
H2944	149	0	1	09	04	H2944_149_0	3	4	Specialty	1	2	10001000
H2944	149	0	1	09	04	H2944_149_0	3	3	Non-Preferred Brand	1	2	10000000
H2944	149	0	1	09	04	H2944_149_0	3	1	Preferred Generic	1	2	00001000
H2944	149	0	1	09	04	H2944_149_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	150	0	1	09	04	H2944_150_0	2	3	Non-Preferred Brand	1	2	10000000
H2944	150	0	1	09	04	H2944_150_0	2	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	150	0	1	09	04	H2944_150_0	2	1	Preferred Generic	1	2	00001000
H2944	150	0	1	09	04	H2944_150_0	2	4	Specialty	1	2	10001000
H2944	151	0	1	09	04	H2944_151_0	4	4	Specialty	1	2	10001000
H2944	151	0	1	09	04	H2944_151_0	4	1	Preferred Generic	1	2	00001000
H2944	151	0	1	09	04	H2944_151_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2944	151	0	1	09	04	H2944_151_0	4	3	Non-Preferred Brand	1	2	10000000
H2944	152	0	1	09	04	H2944_152_0	2	4	Specialty	1	2	10001000
H2944	152	0	1	09	04	H2944_152_0	2	3	Non-Preferred Brand	1	2	10000000
H2944	152	0	1	09	04	H2944_152_0	2	1	Preferred Generic	1	2	00001000
H2944	152	0	1	09	04	H2944_152_0	2	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2949	002	0	1	01	01	H2949_002_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2949	002	0	1	01	01	H2949_002_0	6	4	Specialty	1	2	10001000
H2949	002	0	1	01	01	H2949_002_0	6	3	Non-Preferred Brand	1	2	10000000
H2949	002	0	1	01	01	H2949_002_0	6	1	Preferred Generic	1	1	
H2949	007	0	1	01	01	H2949_007_0	5	4	Specialty	1	2	10001000
H2949	007	0	1	01	01	H2949_007_0	5	3	Non-Preferred Brand	1	2	10000000
H2949	007	0	1	01	01	H2949_007_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2949	007	0	1	01	01	H2949_007_0	5	1	Preferred Generic	1	1	
H2949	012	0	1	01	01	H2949_012_0	5	1	Preferred Generic	1	1	
H2949	012	0	1	01	01	H2949_012_0	5	4	Specialty	1	2	10001000
H2949	012	0	1	01	01	H2949_012_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H2949	012	0	1	01	01	H2949_012_0	5	3	Non-Preferred Brand	1	2	10000000
H2960	004	0	1	01	01	H2960_004_0	6	2	Non-Preferred Generic	1	1	
H2960	004	0	1	01	01	H2960_004_0	6	3	Preferred Brand	2		
H2960	004	0	1	01	01	H2960_004_0	6	4	Non-Preferred Brand	2		
H2960	004	0	1	01	01	H2960_004_0	6	5	Special Pharmaceutical	2		
H2960	004	0	1	01	01	H2960_004_0	6	1	Preferred Generic	1	1	
H2960	010	0	1	01	01	H2960_010_0	6	4	Non-Preferred Brand	2		
H2960	010	0	1	01	01	H2960_010_0	6	3	Preferred Brand	1	1	
H2960	010	0	1	01	01	H2960_010_0	6	2	Non-Preferred Generic	1	1	
H2960	010	0	1	01	01	H2960_010_0	6	1	Preferred Generic	1	1	
H2960	010	0	1	01	01	H2960_010_0	6	5	Special Pharmaceutical	2		
H2960	012	0	1	01	01	H2960_012_0	7	3	Preferred Brand	2		
H2960	012	0	1	01	01	H2960_012_0	7	5	Special Pharmaceutical	2		
H2960	012	0	1	01	01	H2960_012_0	7	4	Non-Preferred Brand	2		
H2960	012	0	1	01	01	H2960_012_0	7	2	Non-Preferred Generic	2		
H2960	012	0	1	01	01	H2960_012_0	7	1	Preferred Generic	1	1	
H2961	002	0	1	02	01	H2961_002_0	13	2	Preferred Brand	1	1	
H2961	002	0	1	02	01	H2961_002_0	13	3	Non-preferred	2		
H2961	002	0	1	02	01	H2961_002_0	13	6	Special Coverage - Brand	2		
H2961	002	0	1	02	01	H2961_002_0	13	4	Specialty	2		
H2961	002	0	1	02	01	H2961_002_0	13	1	Preferred Generic/Some Brand Maintenance	1	1	
H2961	002	0	1	02	01	H2961_002_0	13	5	Special Coverage - Generic	1	1	
H2961	011	0	1	02	01	H2961_011_0	10	6	Special Coverage - Brand	2		
H2961	011	0	1	02	01	H2961_011_0	10	2	Preferred Brand	1	1	
H2961	011	0	1	02	01	H2961_011_0	10	3	Non-preferred	2		
H2961	011	0	1	02	01	H2961_011_0	10	4	Specialty	2		
H2961	011	0	1	02	01	H2961_011_0	10	5	Special Coverage - Generic	1	1	
H2961	011	0	1	02	01	H2961_011_0	10	1	Preferred Generic/Some Brand Maintenance	1	1	
H2997	001	0	1	04	01	H2997_001_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H2997	001	0	1	04	01	H2997_001_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H2997	001	0	1	04	01	H2997_001_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H2997	001	0	1	04	01	H2997_001_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H2997	001	0	1	04	01	H2997_001_0	13	5	Tier 5 Specialty Drugs	2		
H2997	002	0	1	04	01	H2997_002_0	16	1	Preferred Generic Drugs	1	1	
H2997	002	0	1	04	01	H2997_002_0	16	2	Preferred Brand  Certain Generic Drugs	2		
H2997	002	0	1	04	01	H2997_002_0	16	3	Non-Preferred Brand  Certain Generic Drugs	2		
H2997	002	0	1	04	01	H2997_002_0	16	4	Non-Specialty Injectable Drugs	2		
H2997	002	0	1	04	01	H2997_002_0	16	5	Specialty Drugs	2		
H3028	001	0	1	01	01	H3028_001_0	7	1	Preferred Generic	1	2	00001000
H3028	001	0	1	01	01	H3028_001_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3028	001	0	1	01	01	H3028_001_0	7	3	Non-Preferred Brand	1	2	10000000
H3028	001	0	1	01	01	H3028_001_0	7	4	Specialty	1	2	10001000
H3044	003	0	1	01	01	H3044_003_0	5	1	Tier One	1	1	
H3044	003	0	1	01	01	H3044_003_0	5	2	Tier Two	2		
H3044	003	0	1	01	01	H3044_003_0	5	4	Tier Four - Specialty	2		
H3044	003	0	1	01	01	H3044_003_0	5	3	Tier Three	2		
H3044	004	0	1	02	01	H3044_004_0	4	1	Tier One	1	1	
H3044	004	0	1	02	01	H3044_004_0	4	3	Tier Three	2		
H3044	004	0	1	02	01	H3044_004_0	4	2	Tier Two	2		
H3044	004	0	1	02	01	H3044_004_0	4	4	Tier Four - Specialty	2		
H3152	048	0	1	01	01	H3152_048_0	7	3	Tier 3 - Preferred Brand	2		
H3152	048	0	1	01	01	H3152_048_0	7	5	Tier 5 - Specialty	2		
H3152	048	0	1	01	01	H3152_048_0	7	4	Tier 4 - Non-Preferred Brand	2		
H3152	048	0	1	01	01	H3152_048_0	7	2	Tier 2 - Non-Preferred Generic	2		
H3152	048	0	1	01	01	H3152_048_0	7	1	Tier 1 - Preferred Generic	1	1	
H3154	006	0	1	02	01	H3154_006_0	5	4	Specialty	2		
H3154	006	0	1	02	01	H3154_006_0	5	3	Non-Preferred Brand	2		
H3154	006	0	1	02	01	H3154_006_0	5	2	Preferred Brand	2		
H3154	006	0	1	02	01	H3154_006_0	5	1	Generic	1	1	
H3154	016	0	1	01	01	H3154_016_0	5	1	Generic	1	1	
H3154	016	0	1	01	01	H3154_016_0	5	4	Specialty	2		
H3154	016	0	1	01	01	H3154_016_0	5	2	Preferred Brand	2		
H3154	016	0	1	01	01	H3154_016_0	5	3	Non-Preferred Brand	2		
H3204	007	0	1	01	01	H3204_007_0	8	3	Non-Preferred	2		
H3204	007	0	1	01	01	H3204_007_0	8	2	Preferred Brand	2		
H3204	007	0	1	01	01	H3204_007_0	8	1	Preferred Generic	1	1	
H3204	007	0	1	01	01	H3204_007_0	8	4	Specialty	2		
H3206	002	0	1	04	01	H3206_002_0	8	1	Preferred Generic	1	1	
H3206	002	0	1	04	01	H3206_002_0	8	4	Specialty	2		
H3206	002	0	1	04	01	H3206_002_0	8	3	Non-Preferred	2		
H3206	002	0	1	04	01	H3206_002_0	8	2	Preferred Brand	2		
H3240	008	0	1	01	01	H3240_008_0	7	4	Non-Preferred Brand Drugs	2		
H3240	008	0	1	01	01	H3240_008_0	7	5	Specialty Drugs	2		
H3240	008	0	1	01	01	H3240_008_0	7	1	Preferred Generic Drugs	1	1	
H3240	008	0	1	01	01	H3240_008_0	7	2	Non-Preferred Generic Drugs	2		
H3240	008	0	1	01	01	H3240_008_0	7	3	Preferred Brand Drugs	2		
H3240	010	0	1	01	01	H3240_010_0	6	4	Non-Preferred Brand Drugs	2		
H3240	010	0	1	01	01	H3240_010_0	6	5	Specialty Drugs	2		
H3240	010	0	1	01	01	H3240_010_0	6	1	Preferred Generic Drugs	1	1	
H3240	010	0	1	01	01	H3240_010_0	6	2	Non-Preferred Generic Drugs	2		
H3240	010	0	1	01	01	H3240_010_0	6	3	Preferred Brand Drugs	2		
H3240	013	0	1	01	01	H3240_013_0	7	1	Preferred Generic Drugs	1	1	
H3240	013	0	1	01	01	H3240_013_0	7	4	Non-Preferred Brand Drugs	2		
H3240	013	0	1	01	01	H3240_013_0	7	3	Preferred Brand Drugs	2		
H3240	013	0	1	01	01	H3240_013_0	7	2	Non-Preferred Generic Drugs	2		
H3240	013	0	1	01	01	H3240_013_0	7	5	Specialty Drugs	2		
H3251	002	0	1	01	01	H3251_002_0	8	1	Preferred Generic	1	1	
H3251	002	0	1	01	01	H3251_002_0	8	2	Preferred Brand	2		
H3251	002	0	1	01	01	H3251_002_0	8	4	Specialty Drug	2		
H3251	002	0	1	01	01	H3251_002_0	8	3	Non-Preferred	2		
H3251	021	0	1	01	01	H3251_021_0	8	3	Non-Preferred	2		
H3251	021	0	1	01	01	H3251_021_0	8	1	Preferred Generic	1	1	
H3251	021	0	1	01	01	H3251_021_0	8	2	Preferred Brand	2		
H3251	021	0	1	01	01	H3251_021_0	8	4	Specialty Drug	2		
H3312	028	0	1	01	01	H3312_028_0	7	1	Tier 1 - Preferred Generic	1	1	
H3312	028	0	1	01	01	H3312_028_0	7	2	Tier 2 - Non-Preferred Generic	2		
H3312	028	0	1	01	01	H3312_028_0	7	3	Tier 3 - Preferred Brand	2		
H3312	028	0	1	01	01	H3312_028_0	7	4	Tier 4 - Non-Preferred Brand	2		
H3312	028	0	1	01	01	H3312_028_0	7	5	Tier 5 - Specialty	2		
H3312	044	0	1	01	01	H3312_044_0	7	4	Tier 4 - Non-Preferred Brand	2		
H3312	044	0	1	01	01	H3312_044_0	7	5	Tier 5 - Specialty	2		
H3312	044	0	1	01	01	H3312_044_0	7	3	Tier 3 - Preferred Brand	2		
H3312	044	0	1	01	01	H3312_044_0	7	2	Tier 2 - Non-Preferred Generic	2		
H3312	044	0	1	01	01	H3312_044_0	7	1	Tier 1 - Preferred Generic	1	1	
H3312	052	0	1	01	01	H3312_052_0	7	5	Tier 5 - Specialty	2		
H3312	052	0	1	01	01	H3312_052_0	7	4	Tier 4 - Non-Preferred Brand	2		
H3312	052	0	1	01	01	H3312_052_0	7	3	Tier 3 - Preferred Brand	2		
H3312	052	0	1	01	01	H3312_052_0	7	2	Tier 2 - Non-Preferred Generic	2		
H3312	052	0	1	01	01	H3312_052_0	7	1	Tier 1 - Preferred Generic	1	1	
H3312	055	0	1	01	01	H3312_055_0	6	5	Tier 5 - Specialty	2		
H3312	055	0	1	01	01	H3312_055_0	6	1	Tier 1 - Preferred Generic	1	1	
H3312	055	0	1	01	01	H3312_055_0	6	2	Tier 2 - Non-Preferred Generic	2		
H3312	055	0	1	01	01	H3312_055_0	6	3	Tier 3 - Preferred Brand	2		
H3312	055	0	1	01	01	H3312_055_0	6	4	Tier 4 - Non-Preferred Brand	2		
H3312	058	0	1	01	01	H3312_058_0	6	1	Tier 1 - Preferred Generic	1	1	
H3312	058	0	1	01	01	H3312_058_0	6	2	Tier 2 - Non-Preferred Generic	2		
H3312	058	0	1	01	01	H3312_058_0	6	3	Tier 3 - Preferred Brand	2		
H3312	058	0	1	01	01	H3312_058_0	6	4	Tier 4 - Non-Preferred Brand	2		
H3312	058	0	1	01	01	H3312_058_0	6	5	Tier 5 - Specialty	2		
H3312	059	0	1	01	01	H3312_059_0	6	4	Tier 4 - Non-Preferred Brand	2		
H3312	059	0	1	01	01	H3312_059_0	6	5	Tier 5 - Specialty	2		
H3312	059	0	1	01	01	H3312_059_0	6	3	Tier 3 - Preferred Brand	2		
H3312	059	0	1	01	01	H3312_059_0	6	2	Tier 2 - Non-Preferred Generic	2		
H3312	059	0	1	01	01	H3312_059_0	6	1	Tier 1 - Preferred Generic	1	1	
H3327	001	0	1	01	01	H3327_001_0	9	4	Biological and Specialty Injectables	2		
H3327	001	0	1	01	01	H3327_001_0	9	3	Non-Preferred Brand	2		
H3327	001	0	1	01	01	H3327_001_0	9	1	Generic	1	1	
H3327	001	0	1	01	01	H3327_001_0	9	2	Preferred Brand	2		
H3327	002	0	1	01	01	H3327_002_0	6	3	Non-Preferred Brand	2		
H3327	002	0	1	01	01	H3327_002_0	6	4	Biological and Specialty Injectables	2		
H3327	002	0	1	01	01	H3327_002_0	6	2	Preferred Brand	2		
H3327	002	0	1	01	01	H3327_002_0	6	1	Generic	1	1	
H3327	023	0	1	02	01	H3327_023_0	6	2	Preferred Brand	2		
H3327	023	0	1	02	01	H3327_023_0	6	1	Generic	1	1	
H3327	023	0	1	02	01	H3327_023_0	6	3	Non-Preferred Brand	2		
H3327	023	0	1	02	01	H3327_023_0	6	4	Biological and Specialty Injectables	2		
H3328	012	0	1	02	01	H3328_012_0	4	2	Preferred Brand	2		
H3328	012	0	1	02	01	H3328_012_0	4	3	Non-Preferred Brand	2		
H3328	012	0	1	02	01	H3328_012_0	4	4	Specialty	2		
H3328	012	0	1	02	01	H3328_012_0	4	1	Generic	1	1	
H3333	049	0	1	09	04	H3333_049_0	6	2	Preferred Brand	2		
H3333	049	0	1	09	04	H3333_049_0	6	3	Non-Preferred Brand	2		
H3333	049	0	1	09	04	H3333_049_0	6	4	Specialty	2		
H3333	049	0	1	09	04	H3333_049_0	6	1	Generic	1	1	
H3333	050	0	1	09	04	H3333_050_0	6	4	Specialty	2		
H3333	050	0	1	09	04	H3333_050_0	6	2	Preferred Brand	2		
H3333	050	0	1	09	04	H3333_050_0	6	1	Generic	1	1	
H3333	050	0	1	09	04	H3333_050_0	6	3	Non-Preferred Brand	2		
H3333	051	0	1	09	04	H3333_051_0	6	3	Non-Preferred Brand	2		
H3333	051	0	1	09	04	H3333_051_0	6	4	Specialty	2		
H3333	051	0	1	09	04	H3333_051_0	6	2	Preferred Brand	2		
H3333	051	0	1	09	04	H3333_051_0	6	1	Generic	1	1	
H3333	052	0	1	09	04	H3333_052_0	6	3	Non-Preferred Brand	2		
H3333	052	0	1	09	04	H3333_052_0	6	1	Generic	1	1	
H3333	052	0	1	09	04	H3333_052_0	6	2	Preferred Brand	2		
H3333	052	0	1	09	04	H3333_052_0	6	4	Specialty	2		
H3333	053	0	1	09	04	H3333_053_0	6	2	Preferred Brand	2		
H3333	053	0	1	09	04	H3333_053_0	6	4	Specialty	2		
H3333	053	0	1	09	04	H3333_053_0	6	3	Non-Preferred Brand	2		
H3333	053	0	1	09	04	H3333_053_0	6	1	Generic	1	1	
H3333	054	0	1	09	04	H3333_054_0	6	1	Generic	1	1	
H3333	054	0	1	09	04	H3333_054_0	6	4	Specialty	2		
H3333	054	0	1	09	04	H3333_054_0	6	3	Non-Preferred Brand	2		
H3333	054	0	1	09	04	H3333_054_0	6	2	Preferred Brand	2		
H3333	105	0	1	09	04	H3333_105_0	6	1	Generic	1	1	
H3333	105	0	1	09	04	H3333_105_0	6	2	Preferred Brand	2		
H3333	105	0	1	09	04	H3333_105_0	6	3	Non-Preferred Brand	2		
H3333	105	0	1	09	04	H3333_105_0	6	4	Specialty	2		
H3333	113	0	1	09	04	H3333_113_0	6	3	Non-Preferred Brand	2		
H3333	113	0	1	09	04	H3333_113_0	6	4	Specialty	2		
H3333	113	0	1	09	04	H3333_113_0	6	2	Preferred Brand	2		
H3333	113	0	1	09	04	H3333_113_0	6	1	Generic	1	1	
H3333	121	0	1	09	04	H3333_121_0	6	3	Non-Preferred Brand	2		
H3333	121	0	1	09	04	H3333_121_0	6	4	Specialty	2		
H3333	121	0	1	09	04	H3333_121_0	6	1	Generic	1	1	
H3333	121	0	1	09	04	H3333_121_0	6	2	Preferred Brand	2		
H3333	129	0	1	09	04	H3333_129_0	6	1	Generic	1	1	
H3333	129	0	1	09	04	H3333_129_0	6	2	Preferred Brand	2		
H3333	129	0	1	09	04	H3333_129_0	6	3	Non-Preferred Brand	2		
H3333	129	0	1	09	04	H3333_129_0	6	4	Specialty	2		
H3333	137	0	1	09	04	H3333_137_0	6	4	Specialty	2		
H3333	137	0	1	09	04	H3333_137_0	6	3	Non-Preferred Brand	2		
H3333	137	0	1	09	04	H3333_137_0	6	2	Preferred Brand	2		
H3333	137	0	1	09	04	H3333_137_0	6	1	Generic	1	1	
H3333	145	0	1	09	04	H3333_145_0	6	3	Non-Preferred Brand	2		
H3333	145	0	1	09	04	H3333_145_0	6	1	Generic	1	1	
H3333	145	0	1	09	04	H3333_145_0	6	2	Preferred Brand	2		
H3333	145	0	1	09	04	H3333_145_0	6	4	Specialty	2		
H3335	005	0	1	04	01	H3335_005_0	6	3	Tier 3	2		
H3335	005	0	1	04	01	H3335_005_0	6	1	Tier 1	1	1	
H3335	005	0	1	04	01	H3335_005_0	6	2	Tier 2	2		
H3335	005	0	1	04	01	H3335_005_0	6	4	Tier 4	2		
H3335	008	0	1	04	01	H3335_008_0	6	4	Tier 4	2		
H3335	008	0	1	04	01	H3335_008_0	6	2	Tier 2	2		
H3335	008	0	1	04	01	H3335_008_0	6	3	Tier 3	2		
H3335	008	0	1	04	01	H3335_008_0	6	1	Tier 1	1	1	
H3335	014	0	1	04	01	H3335_014_0	6	2	Tier 2	2		
H3335	014	0	1	04	01	H3335_014_0	6	1	Tier 1	1	1	
H3335	014	0	1	04	01	H3335_014_0	6	4	Tier 4	2		
H3335	014	0	1	04	01	H3335_014_0	6	3	Tier 3	2		
H3335	017	0	1	04	01	H3335_017_0	6	4	Tier 4	2		
H3335	017	0	1	04	01	H3335_017_0	6	2	Tier 2	2		
H3335	017	0	1	04	01	H3335_017_0	6	3	Tier 3	2		
H3335	017	0	1	04	01	H3335_017_0	6	1	Tier 1	1	1	
H3335	020	0	1	04	01	H3335_020_0	6	3	Tier 3	2		
H3335	020	0	1	04	01	H3335_020_0	6	1	Tier 1	1	1	
H3335	020	0	1	04	01	H3335_020_0	6	2	Tier 2	2		
H3335	020	0	1	04	01	H3335_020_0	6	4	Tier 4	2		
H3337	001	0	1	01	01	H3337_001_0	6	6	Specialty Drugs	2		
H3337	001	0	1	01	01	H3337_001_0	6	4	Preferred Brands	2		
H3337	001	0	1	01	01	H3337_001_0	6	3	Liberty Choice Drugs	1	1	
H3337	001	0	1	01	01	H3337_001_0	6	2	Generics	1	1	
H3337	001	0	1	01	01	H3337_001_0	6	1	Preferred Generics	1	1	
H3337	001	0	1	01	01	H3337_001_0	6	5	Brands	2		
H3342	001	0	1	04	01	H3342_001_0	12	5	Tier 5 Specialty Drugs	2		
H3342	001	0	1	04	01	H3342_001_0	12	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3342	001	0	1	04	01	H3342_001_0	12	1	Tier 1 Preferred Generic Drugs	1	1	
H3342	001	0	1	04	01	H3342_001_0	12	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3342	001	0	1	04	01	H3342_001_0	12	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3342	002	0	1	04	01	H3342_002_0	11	1	Tier 1 Preferred Generic Drugs	1	1	
H3342	002	0	1	04	01	H3342_002_0	11	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3342	002	0	1	04	01	H3342_002_0	11	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3342	002	0	1	04	01	H3342_002_0	11	5	Tier 5 Specialty Drugs	2		
H3342	002	0	1	04	01	H3342_002_0	11	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3342	004	0	1	04	01	H3342_004_0	13	5	Tier 5 Specialty Drugs	2		
H3342	004	0	1	04	01	H3342_004_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3342	004	0	1	04	01	H3342_004_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H3342	004	0	1	04	01	H3342_004_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3342	004	0	1	04	01	H3342_004_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3342	012	0	1	04	01	H3342_012_0	12	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3342	012	0	1	04	01	H3342_012_0	12	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3342	012	0	1	04	01	H3342_012_0	12	5	Tier 5 Specialty Drugs	2		
H3342	012	0	1	04	01	H3342_012_0	12	1	Tier 1 Preferred Generic Drugs	1	1	
H3342	012	0	1	04	01	H3342_012_0	12	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3344	001	0	1	04	01	H3344_001_0	8	4	Specialty Tier 4	2		
H3344	001	0	1	04	01	H3344_001_0	8	2	Tier 2	2		
H3344	001	0	1	04	01	H3344_001_0	8	1	Tier 1	1	2	10001000
H3344	001	0	1	04	01	H3344_001_0	8	3	Tier 3	2		
H3344	003	0	1	04	01	H3344_003_0	8	2	Tier 2	2		
H3344	003	0	1	04	01	H3344_003_0	8	3	Tier 3	2		
H3344	003	0	1	04	01	H3344_003_0	8	4	Specialty Tier 4	2		
H3344	003	0	1	04	01	H3344_003_0	8	1	Tier 1	1	2	10001000
H3344	005	0	1	04	01	H3344_005_0	12	4	Specialty Tier 4	2		
H3344	005	0	1	04	01	H3344_005_0	12	3	Tier 3	2		
H3344	005	0	1	04	01	H3344_005_0	12	1	Tier 1	1	2	10001000
H3344	005	0	1	04	01	H3344_005_0	12	2	Tier 2	2		
H3346	002	0	1	04	01	H3346_002_0	12	4	Tier 4	2		
H3346	002	0	1	04	01	H3346_002_0	12	3	Tier 3	2		
H3346	002	0	1	04	01	H3346_002_0	12	2	Tier 2	2		
H3346	002	0	1	04	01	H3346_002_0	12	5	Tier 5	2		
H3346	002	0	1	04	01	H3346_002_0	12	1	Tier 1	1	1	
H3347	001	0	1	01	01	H3347_001_0	4	1	Generic	1	1	
H3347	001	0	1	01	01	H3347_001_0	4	4	Specialty	2		
H3347	001	0	1	01	01	H3347_001_0	4	3	Brand	2		
H3347	001	0	1	01	01	H3347_001_0	4	2	Preferred	2		
H3347	005	0	1	01	01	H3347_005_0	4	4	Specialty	2		
H3347	005	0	1	01	01	H3347_005_0	4	1	Generic	1	1	
H3347	005	0	1	01	01	H3347_005_0	4	2	Preferred	2		
H3347	005	0	1	01	01	H3347_005_0	4	3	Brand	2		
H3347	010	0	1	02	01	H3347_010_0	4	3	Brand	2		
H3347	010	0	1	02	01	H3347_010_0	4	2	Preferred	2		
H3347	010	0	1	02	01	H3347_010_0	4	1	Generic	1	1	
H3347	010	0	1	02	01	H3347_010_0	4	4	Specialty	2		
H3362	003	0	1	01	01	H3362_003_0	6	1	Tier 1	1	2	10001000
H3362	003	0	1	01	01	H3362_003_0	6	2	Tier 2	2		
H3362	003	0	1	01	01	H3362_003_0	6	3	Tier 3	2		
H3362	003	0	1	01	01	H3362_003_0	6	4	Specialty Tier 4	2		
H3362	004	0	1	01	01	H3362_004_0	6	3	Tier 3	2		
H3362	004	0	1	01	01	H3362_004_0	6	2	Tier 2	2		
H3362	004	0	1	01	01	H3362_004_0	6	1	Tier 1	1	2	10001000
H3362	004	0	1	01	01	H3362_004_0	6	4	Specialty Tier 4	2		
H3362	017	0	1	01	01	H3362_017_0	7	3	Tier 3	2		
H3362	017	0	1	01	01	H3362_017_0	7	2	Tier 2	2		
H3362	017	0	1	01	01	H3362_017_0	7	1	Tier 1	1	2	10001000
H3362	017	0	1	01	01	H3362_017_0	7	4	Specialty Tier 4	2		
H3362	020	0	1	01	01	H3362_020_0	5	1	Tier 1	1	2	10001000
H3362	020	0	1	01	01	H3362_020_0	5	2	Tier 2	2		
H3362	020	0	1	01	01	H3362_020_0	5	3	Tier 3	2		
H3362	020	0	1	01	01	H3362_020_0	5	4	Specialty Tier 4	2		
H3370	001	0	1	01	01	H3370_001_0	14	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3370	001	0	1	01	01	H3370_001_0	14	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3370	001	0	1	01	01	H3370_001_0	14	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3370	001	0	1	01	01	H3370_001_0	14	1	Tier 1 Preferred Generic Drugs	1	1	
H3370	001	0	1	01	01	H3370_001_0	14	5	Tier 5 Specialty Drugs	2		
H3370	002	0	1	01	01	H3370_002_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3370	002	0	1	01	01	H3370_002_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3370	002	0	1	01	01	H3370_002_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3370	002	0	1	01	01	H3370_002_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H3370	002	0	1	01	01	H3370_002_0	13	5	Tier 5 Specialty Drugs	2		
H3370	003	0	1	01	01	H3370_003_0	11	1	Tier 1 Preferred Generic Drugs	1	1	
H3370	003	0	1	01	01	H3370_003_0	11	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3370	003	0	1	01	01	H3370_003_0	11	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3370	003	0	1	01	01	H3370_003_0	11	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3370	003	0	1	01	01	H3370_003_0	11	5	Tier 5 Specialty Drugs	2		
H3370	004	0	1	01	01	H3370_004_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H3370	004	0	1	01	01	H3370_004_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3370	004	0	1	01	01	H3370_004_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3370	004	0	1	01	01	H3370_004_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3370	004	0	1	01	01	H3370_004_0	13	5	Tier 5 Specialty Drugs	2		
H3370	014	0	1	01	01	H3370_014_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3370	014	0	1	01	01	H3370_014_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3370	014	0	1	01	01	H3370_014_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3370	014	0	1	01	01	H3370_014_0	10	5	Tier 5 Specialty Drugs	2		
H3370	014	0	1	01	01	H3370_014_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H3370	021	0	1	01	01	H3370_021_0	12	1	Tier 1 Preferred Generic Drugs	1	1	
H3370	021	0	1	01	01	H3370_021_0	12	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3370	021	0	1	01	01	H3370_021_0	12	5	Tier 5 Specialty Drugs	2		
H3370	021	0	1	01	01	H3370_021_0	12	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3370	021	0	1	01	01	H3370_021_0	12	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3370	022	0	1	01	01	H3370_022_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H3370	022	0	1	01	01	H3370_022_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3370	022	0	1	01	01	H3370_022_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3370	022	0	1	01	01	H3370_022_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3370	022	0	1	01	01	H3370_022_0	13	5	Tier 5 Specialty Drugs	2		
H3384	013	0	1	01	01	H3384_013_0	12	2	Preferred Brand	2		
H3384	013	0	1	01	01	H3384_013_0	12	1	Formulary Generic	1	2	00001000
H3384	013	0	1	01	01	H3384_013_0	12	4	Specialty Injectables	2		
H3384	013	0	1	01	01	H3384_013_0	12	3	Non-Preferred Brand/Generic	2		
H3384	019	0	1	01	01	H3384_019_0	10	3	Non-Preferred	2		
H3384	019	0	1	01	01	H3384_019_0	10	2	Preferred Brand	2		
H3384	019	0	1	01	01	H3384_019_0	10	1	Formulary Generic	1	2	00001000
H3384	019	0	1	01	01	H3384_019_0	10	4	Specialty Injectables	2		
H3384	041	0	1	01	01	H3384_041_0	12	1	Formulary Generic	1	2	00001000
H3384	041	0	1	01	01	H3384_041_0	12	2	Preferred Brand	2		
H3384	041	0	1	01	01	H3384_041_0	12	3	Non-Preferred	2		
H3384	041	0	1	01	01	H3384_041_0	12	4	Specialty Injectables	2		
H3384	052	0	1	01	01	H3384_052_0	10	4	Specialty Injectables	2		
H3384	052	0	1	01	01	H3384_052_0	10	3	Non-Preferred	2		
H3384	052	0	1	01	01	H3384_052_0	10	1	Formulary Generic	1	2	00001000
H3384	052	0	1	01	01	H3384_052_0	10	2	Preferred Brand	2		
H3388	002	0	1	01	01	H3388_002_0	7	4	Tier 4 Formulary Non-Preferred Brand	2		
H3388	002	0	1	01	01	H3388_002_0	7	3	Tier 3 Formulary Preferred Brand	2		
H3388	002	0	1	01	01	H3388_002_0	7	2	Tier 2 Formulary Non-Preferred Generics	1	1	
H3388	002	0	1	01	01	H3388_002_0	7	1	Tier 1 Formulary Preferred Generics	1	1	
H3388	002	0	1	01	01	H3388_002_0	7	5	Tier 5 Formulary Specialty	2		
H3404	001	0	1	04	01	H3404_001_0	12	4	Tier 4 - Specialty	2		
H3404	001	0	1	04	01	H3404_001_0	12	3	Tier 3 - Non-preferred	2		
H3404	001	0	1	04	01	H3404_001_0	12	2	Tier 2 - Preferred Brand	2		
H3404	001	0	1	04	01	H3404_001_0	12	1	Tier 1 - Generic	1	1	
H3404	002	0	1	04	01	H3404_002_0	13	3	Tier 3 - Non-preferred	2		
H3404	002	0	1	04	01	H3404_002_0	13	4	Tier 4 - Specialty	2		
H3404	002	0	1	04	01	H3404_002_0	13	2	Tier 2 - Preferred Brand	2		
H3404	002	0	1	04	01	H3404_002_0	13	1	Tier 1 - Generic	1	1	
H3405	001	0	1	04	01	H3405_001_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3405	001	0	1	04	01	H3405_001_0	4	3	Non-Preferred Brand	1	2	10000000
H3405	001	0	1	04	01	H3405_001_0	4	4	Specialty	1	2	10001000
H3405	001	0	1	04	01	H3405_001_0	4	1	Preferred Generic	1	2	00001000
H3405	002	0	1	04	01	H3405_002_0	4	3	Non-Preferred Brand	1	2	10000000
H3405	002	0	1	04	01	H3405_002_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3405	002	0	1	04	01	H3405_002_0	4	1	Preferred Generic	1	2	00001000
H3405	002	0	1	04	01	H3405_002_0	4	4	Specialty	1	2	10001000
H3405	005	0	1	04	01	H3405_005_0	4	1	Preferred Generic	1	2	00001000
H3405	005	0	1	04	01	H3405_005_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3405	005	0	1	04	01	H3405_005_0	4	3	Non-Preferred Brand	1	2	10000000
H3405	005	0	1	04	01	H3405_005_0	4	4	Specialty	1	2	10001000
H3449	005	0	1	01	01	H3449_005_0	8	4	Tier 4 - Specialty	2		
H3449	005	0	1	01	01	H3449_005_0	8	3	Tier 3 - Non-preferred	2		
H3449	005	0	1	01	01	H3449_005_0	8	2	Tier 2 - Preferred Brand	2		
H3449	005	0	1	01	01	H3449_005_0	8	1	Tier 1 - Generic	1	1	
H3528	002	0	1	01	01	H3528_002_0	6	1	Tier 1	1	1	
H3528	002	0	1	01	01	H3528_002_0	6	2	Tier 2	2		
H3528	002	0	1	01	01	H3528_002_0	6	3	Tier 3	2		
H3528	002	0	1	01	01	H3528_002_0	6	4	Tier 4	2		
H3528	006	0	1	02	01	H3528_006_0	6	3	Tier 3	2		
H3528	006	0	1	02	01	H3528_006_0	6	4	Tier 4	2		
H3528	006	0	1	02	01	H3528_006_0	6	2	Tier 2	2		
H3528	006	0	1	02	01	H3528_006_0	6	1	Tier 1	1	1	
H3533	001	0	1	01	01	H3533_001_0	9	2	Tier 2 - Non-Preferred Generic	2		
H3533	001	0	1	01	01	H3533_001_0	9	3	Tier 3 - Preferred Brand	2		
H3533	001	0	1	01	01	H3533_001_0	9	4	Tier 4 - Non-Preferred Brand	2		
H3533	001	0	1	01	01	H3533_001_0	9	5	Tier 5 - Specialty	2		
H3533	001	0	1	01	01	H3533_001_0	9	1	Tier 1 - Preferred Generic	1	1	
H3597	002	0	1	01	01	H3597_002_0	9	5	Tier 5 - Specialty	2		
H3597	002	0	1	01	01	H3597_002_0	9	3	Tier 3 - Preferred Brand	2		
H3597	002	0	1	01	01	H3597_002_0	9	2	Tier 2 - Non-Preferred Generic	2		
H3597	002	0	1	01	01	H3597_002_0	9	1	Tier 1 - Preferred Generic	1	1	
H3597	002	0	1	01	01	H3597_002_0	9	4	Tier 4 - Non-Preferred Brand	2		
H3619	001	0	1	04	01	H3619_001_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3619	001	0	1	04	01	H3619_001_0	9	1	Preferred Generic	1	2	00001000
H3619	001	0	1	04	01	H3619_001_0	9	3	Non-Preferred Brand	1	2	10000000
H3619	001	0	1	04	01	H3619_001_0	9	4	Specialty	1	2	10001000
H3619	004	0	1	04	01	H3619_004_0	8	1	Preferred Generic	1	2	00001000
H3619	004	0	1	04	01	H3619_004_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3619	004	0	1	04	01	H3619_004_0	8	4	Specialty	1	2	10001000
H3619	004	0	1	04	01	H3619_004_0	8	3	Non-Preferred Brand	1	2	10000000
H3619	012	0	1	04	01	H3619_012_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3619	012	0	1	04	01	H3619_012_0	6	3	Non-Preferred Brand	1	2	10000000
H3619	012	0	1	04	01	H3619_012_0	6	4	Specialty	1	2	10001000
H3619	012	0	1	04	01	H3619_012_0	6	1	Preferred Generic	1	2	00001000
H3619	013	0	1	04	01	H3619_013_0	6	4	Specialty	1	2	10001000
H3619	013	0	1	04	01	H3619_013_0	6	3	Non-Preferred Brand	1	2	10000000
H3619	013	0	1	04	01	H3619_013_0	6	1	Preferred Generic	1	2	00001000
H3619	013	0	1	04	01	H3619_013_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3619	014	0	1	04	01	H3619_014_0	7	1	Preferred Generic	1	2	00001000
H3619	014	0	1	04	01	H3619_014_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3619	014	0	1	04	01	H3619_014_0	7	3	Non-Preferred Brand	1	2	10000000
H3619	014	0	1	04	01	H3619_014_0	7	4	Specialty	1	2	10001000
H3619	015	0	1	04	01	H3619_015_0	8	3	Non-Preferred Brand	1	2	10000000
H3619	015	0	1	04	01	H3619_015_0	8	4	Specialty	1	2	10001000
H3619	015	0	1	04	01	H3619_015_0	8	1	Preferred Generic	1	2	00001000
H3619	015	0	1	04	01	H3619_015_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3619	016	0	1	04	01	H3619_016_0	7	3	Non-Preferred Brand	1	2	10000000
H3619	016	0	1	04	01	H3619_016_0	7	4	Specialty	1	2	10001000
H3619	016	0	1	04	01	H3619_016_0	7	1	Preferred Generic	1	2	00001000
H3619	016	0	1	04	01	H3619_016_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3619	017	0	1	04	01	H3619_017_0	7	3	Non-Preferred Brand	1	2	10000000
H3619	017	0	1	04	01	H3619_017_0	7	4	Specialty	1	2	10001000
H3619	017	0	1	04	01	H3619_017_0	7	1	Preferred Generic	1	2	00001000
H3619	017	0	1	04	01	H3619_017_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H3655	013	0	1	01	01	H3655_013_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H3655	013	0	1	01	01	H3655_013_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H3655	013	0	1	01	01	H3655_013_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3655	013	0	1	01	01	H3655_013_0	10	5	Tier 5 Specialty Drugs	2		
H3655	013	0	1	01	01	H3655_013_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3655	030	0	1	01	01	H3655_030_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3655	030	0	1	01	01	H3655_030_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3655	030	0	1	01	01	H3655_030_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
H3655	030	0	1	01	01	H3655_030_0	9	4	Tier 4 Non-Specialty Injectible Drugs	2		
H3655	030	0	1	01	01	H3655_030_0	9	5	Tier 5 Specialty Drugs	2		
H3655	031	0	1	01	01	H3655_031_0	9	4	Tier 4 Non-Specialty Injectible Drugs	2		
H3655	031	0	1	01	01	H3655_031_0	9	5	Tier 5 Specialty Drugs	2		
H3655	031	0	1	01	01	H3655_031_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H3655	031	0	1	01	01	H3655_031_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H3655	031	0	1	01	01	H3655_031_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
H3659	003	0	1	01	01	H3659_003_0	6	4	Tier 4 Specialty	2		
H3659	003	0	1	01	01	H3659_003_0	6	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H3659	003	0	1	01	01	H3659_003_0	6	2	Tier 2 Generic  Preferred Brand	2		
H3659	003	0	1	01	01	H3659_003_0	6	1	Tier 1 Preferred Generic  Brand	1	1	
H3660	028	0	1	02	01	H3660_028_0	7	1	Tier 1	1	1	
H3660	028	0	1	02	01	H3660_028_0	7	2	Tier 2	2		
H3660	028	0	1	02	01	H3660_028_0	7	4	Tier 4	2		
H3660	028	0	1	02	01	H3660_028_0	7	3	Tier 3	2		
H3660	029	0	1	02	01	H3660_029_0	7	3	Tier 3	2		
H3660	029	0	1	02	01	H3660_029_0	7	4	Tier 4	2		
H3660	029	0	1	02	01	H3660_029_0	7	1	Tier 1	1	1	
H3660	029	0	1	02	01	H3660_029_0	7	2	Tier 2	2		
H3660	032	0	1	02	01	H3660_032_0	7	4	Tier 4	2		
H3660	032	0	1	02	01	H3660_032_0	7	3	Tier 3	2		
H3660	032	0	1	02	01	H3660_032_0	7	2	Tier 2	2		
H3660	032	0	1	02	01	H3660_032_0	7	1	Tier 1	1	1	
H3664	012	0	1	02	01	H3664_012_0	2	3	Non-Preferred Brand	2		
H3664	012	0	1	02	01	H3664_012_0	2	2	Preferred Brand	2		
H3664	012	0	1	02	01	H3664_012_0	2	1	Generic	1	1	
H3664	012	0	1	02	01	H3664_012_0	2	4	Specialty	2		
H3668	005	0	1	01	01	H3668_005_0	4	1	Value Generic	1	1	
H3668	005	0	1	01	01	H3668_005_0	4	3	Preferred Brand	2		
H3668	005	0	1	01	01	H3668_005_0	4	4	Non-Preferred Brand	2		
H3668	005	0	1	01	01	H3668_005_0	4	5	Specialty Drugs	2		
H3668	005	0	1	01	01	H3668_005_0	4	2	Generic	1	1	
H3672	013	0	1	01	01	H3672_013_0	3	4	Specialty	1	2	01000000
H3672	013	0	1	01	01	H3672_013_0	3	3	Non-Preferred Brand	2		
H3672	013	0	1	01	01	H3672_013_0	3	2	Preferred Brand	2		
H3672	013	0	1	01	01	H3672_013_0	3	1	Generic	1	1	
H3706	017	0	1	01	01	H3706_017_0	5	1	Generic	1	1	
H3706	017	0	1	01	01	H3706_017_0	5	4	Specialty	2		
H3706	017	0	1	01	01	H3706_017_0	5	3	Non-Preferred Brand	2		
H3706	017	0	1	01	01	H3706_017_0	5	2	Preferred Brand	1	2	10000000
H3749	001	0	1	01	01	H3749_001_0	4	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H3749	001	0	1	01	01	H3749_001_0	4	2	Tier 2 Generic  Preferred Brand	2		
H3749	001	0	1	01	01	H3749_001_0	4	1	Tier 1 Preferred Generic  Brand	1	1	
H3749	001	0	1	01	01	H3749_001_0	4	4	Tier 4 Specialty	2		
H3811	009	0	1	01	01	H3811_009_0	4	5	Non-Preferred Brands Tier	2		
H3811	009	0	1	01	01	H3811_009_0	4	4	Specialty Tier	2		
H3811	009	0	1	01	01	H3811_009_0	4	3	Preferred Brands Tier	2		
H3811	009	0	1	01	01	H3811_009_0	4	2	Generic Tier	1	1	
H3811	009	0	1	01	01	H3811_009_0	4	1	Therapeutic Tier	1	1	
H3813	003	0	1	04	01	H3813_003_0	9	2	Brand	2		
H3813	003	0	1	04	01	H3813_003_0	9	3	Specialty Tier	2		
H3813	003	0	1	04	01	H3813_003_0	9	1	Generic	1	1	
H3815	001	0	1	01	01	H3815_001_0	6	4	Injectable Drugs Tier 4	2		
H3815	001	0	1	01	01	H3815_001_0	6	5	Specialty Drugs Tier 5	2		
H3815	001	0	1	01	01	H3815_001_0	6	3	Formulary Non-Preferred Brand Tier 3	2		
H3815	001	0	1	01	01	H3815_001_0	6	1	Formulary Generic Tier 1	1	1	
H3815	001	0	1	01	01	H3815_001_0	6	2	Formulary Preferred Brand Tier 2	2		
H3815	005	0	1	01	01	H3815_005_0	6	1	Formulary Generic Tier 1	1	1	
H3815	005	0	1	01	01	H3815_005_0	6	2	Formulary Preferred Brand Tier 2	2		
H3815	005	0	1	01	01	H3815_005_0	6	3	Formulary Non-Preferred Brand Tier 3	2		
H3815	005	0	1	01	01	H3815_005_0	6	4	Injectable Drugs Tier 4	2		
H3815	005	0	1	01	01	H3815_005_0	6	5	Specialty Drugs Tier 5	2		
H3817	003	0	1	04	01	H3817_003_0	6	2	Preferred Brand	2		
H3817	003	0	1	04	01	H3817_003_0	6	3	Non-Preferred Brand	2		
H3817	003	0	1	04	01	H3817_003_0	6	1	Generic	1	1	
H3817	003	0	1	04	01	H3817_003_0	6	4	Miscellaneous Injectables	2		
H3817	003	0	1	04	01	H3817_003_0	6	5	Specialty	2		
H3916	005	0	1	04	01	H3916_005_0	5	2	Preferred Brand	2		
H3916	005	0	1	04	01	H3916_005_0	5	4	Specialty	2		
H3916	005	0	1	04	01	H3916_005_0	5	3	Non-Preferred Brand	2		
H3916	005	0	1	04	01	H3916_005_0	5	1	Generic	1	1	
H3916	026	0	1	04	01	H3916_026_0	5	3	Non-Preferred Brand	2		
H3916	026	0	1	04	01	H3916_026_0	5	1	Generic	1	1	
H3916	026	0	1	04	01	H3916_026_0	5	4	Specialty	2		
H3916	026	0	1	04	01	H3916_026_0	5	2	Preferred Brand	2		
H3916	027	0	1	04	01	H3916_027_0	5	4	Specialty	2		
H3916	027	0	1	04	01	H3916_027_0	5	1	Generic	1	1	
H3916	027	0	1	04	01	H3916_027_0	5	2	Preferred Brand	2		
H3916	027	0	1	04	01	H3916_027_0	5	3	Non-Preferred Brand	2		
H3923	013	0	1	04	01	H3923_013_0	9	4	Specialty Drugs	2		
H3923	013	0	1	04	01	H3923_013_0	9	3	Non-Preferred Brand Drugs	2		
H3923	013	0	1	04	01	H3923_013_0	9	1	Generic Drugs	1	1	
H3923	013	0	1	04	01	H3923_013_0	9	2	Preferred Brand Drugs	2		
H3923	017	0	1	04	01	H3923_017_0	8	3	Non-Preferred Brand Drugs	2		
H3923	017	0	1	04	01	H3923_017_0	8	2	Preferred Brand Drugs	2		
H3923	017	0	1	04	01	H3923_017_0	8	1	Generic Drugs	1	1	
H3923	017	0	1	04	01	H3923_017_0	8	4	Specialty Drugs	2		
H3931	077	0	1	01	01	H3931_077_0	6	5	Tier 5 - Specialty	2		
H3931	077	0	1	01	01	H3931_077_0	6	1	Tier 1 - Preferred Generic	1	1	
H3931	077	0	1	01	01	H3931_077_0	6	2	Tier 2 - Non-Preferred Generic	2		
H3931	077	0	1	01	01	H3931_077_0	6	3	Tier 3 - Preferred Brand	2		
H3931	077	0	1	01	01	H3931_077_0	6	4	Tier 4 - Non-Preferred Brand	2		
H3949	024	0	1	01	01	H3949_024_0	2	3	Non-Preferred Brand	2		
H3949	024	0	1	01	01	H3949_024_0	2	2	Preferred Brand	2		
H3949	024	0	1	01	01	H3949_024_0	2	1	Generic	2		
H3949	024	0	1	01	01	H3949_024_0	2	4	Specialty	2		
H3949	024	0	1	01	01	H3949_024_0	2	5	Preferred Diabetic Drugs	1	1	
H3949	025	0	1	01	01	H3949_025_0	3	3	Non-Preferred Brand	2		
H3949	025	0	1	01	01	H3949_025_0	3	2	Preferred Brand	2		
H3949	025	0	1	01	01	H3949_025_0	3	1	Generic	2		
H3949	025	0	1	01	01	H3949_025_0	3	4	Specialty	2		
H3949	025	0	1	01	01	H3949_025_0	3	5	Preferred Diabetic Drugs	1	1	
H3952	020	0	1	01	01	H3952_020_0	7	1	Generic	1	1	
H3952	020	0	1	01	01	H3952_020_0	7	2	Preferred Brand	2		
H3952	020	0	1	01	01	H3952_020_0	7	3	Non-Preferred Brand	2		
H3952	020	0	1	01	01	H3952_020_0	7	4	Specialty	2		
H3952	045	0	1	01	01	H3952_045_0	5	4	Specialty	2		
H3952	045	0	1	01	01	H3952_045_0	5	3	Non-Preferred Brand	2		
H3952	045	0	1	01	01	H3952_045_0	5	2	Preferred Brand	2		
H3952	045	0	1	01	01	H3952_045_0	5	1	Generic	1	1	
H3954	134	0	1	01	01	H3954_134_0	6	3	Tier 3	2		
H3954	134	0	1	01	01	H3954_134_0	6	4	Tier 4	2		
H3954	134	0	1	01	01	H3954_134_0	6	2	Tier 2	2		
H3954	134	0	1	01	01	H3954_134_0	6	1	Tier 1	1	2	00001000
H3954	135	0	1	01	01	H3954_135_0	5	1	Tier 1	1	2	00001000
H3954	135	0	1	01	01	H3954_135_0	5	2	Tier 2	2		
H3954	135	0	1	01	01	H3954_135_0	5	3	Tier 3	2		
H3954	135	0	1	01	01	H3954_135_0	5	4	Tier 4	2		
H3957	020	0	1	01	01	H3957_020_0	9	1	Generic	1	1	
H3957	020	0	1	01	01	H3957_020_0	9	2	Preferred Brand	2		
H3957	020	0	1	01	01	H3957_020_0	9	3	Non-Preferred Brand	2		
H3957	020	0	1	01	01	H3957_020_0	9	4	Specialty	2		
H3957	021	0	1	01	01	H3957_021_0	9	4	Specialty	2		
H3957	021	0	1	01	01	H3957_021_0	9	3	Non-Preferred Brand	2		
H3957	021	0	1	01	01	H3957_021_0	9	1	Generic	1	1	
H3957	021	0	1	01	01	H3957_021_0	9	2	Preferred Brand	2		
H3959	001	0	1	01	01	H3959_001_0	7	4	Tier 4 - Specialty Drugs	2		
H3959	001	0	1	01	01	H3959_001_0	7	1	Tier 1 - Preferred Generics	1	1	
H3959	001	0	1	01	01	H3959_001_0	7	2	Tier 2 - Preferred Brand	2		
H3959	001	0	1	01	01	H3959_001_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	002	0	1	01	01	H3959_002_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H3959	002	0	1	01	01	H3959_002_0	8	2	Tier 2 - Preferred Brand	2		
H3959	002	0	1	01	01	H3959_002_0	8	1	Tier 1 - Preferred Generics	1	1	
H3959	002	0	1	01	01	H3959_002_0	8	4	Tier 4 - Specialty Drugs	2		
H3962	001	0	1	01	01	H3962_001_0	6	4	Specialty Drugs	2		
H3962	001	0	1	01	01	H3962_001_0	6	3	Non-Preferred Brand Drugs	2		
H3962	001	0	1	01	01	H3962_001_0	6	1	Generic Drugs	1	1	
H3962	001	0	1	01	01	H3962_001_0	6	2	Preferred Brand Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	6	4	Specialty Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	6	2	Preferred Brand Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	6	3	Non-Preferred Brand Drugs	2		
H3962	004	0	1	01	01	H3962_004_0	6	1	Generic Drugs	1	1	
H4003	001	0	1	01	01	H4003_001_0	5	1	Generic	1	2	00001000
H4003	001	0	1	01	01	H4003_001_0	5	2	Brand	2		
H4003	001	0	1	01	01	H4003_001_0	5	3	Non-Preferred Brand	2		
H4003	001	0	1	01	01	H4003_001_0	5	4	Specialty	2		
H4003	009	0	1	01	01	H4003_009_0	6	1	Generics DM, CHF, CV	1	2	00001000
H4003	009	0	1	01	01	H4003_009_0	6	2	Other Generics	1	2	00001000
H4003	009	0	1	01	01	H4003_009_0	6	5	Specialty Drugs	2		
H4003	009	0	1	01	01	H4003_009_0	6	4	Other Brands	2		
H4003	009	0	1	01	01	H4003_009_0	6	3	Insulins	2		
H4003	015	0	1	01	01	H4003_015_0	5	1	Generic	1	2	00001000
H4003	015	0	1	01	01	H4003_015_0	5	2	Brand	2		
H4003	015	0	1	01	01	H4003_015_0	5	3	Specialty	2		
H4003	019	0	1	01	01	H4003_019_0	5	4	Specialty	2		
H4003	019	0	1	01	01	H4003_019_0	5	1	Generic	1	2	00001000
H4003	019	0	1	01	01	H4003_019_0	5	2	Brand	2		
H4003	019	0	1	01	01	H4003_019_0	5	3	Non-Preferred Brand	2		
H4004	015	0	1	01	01	H4004_015_0	5	4	Specialty	2		
H4004	015	0	1	01	01	H4004_015_0	5	1	Generic	1	2	00001000
H4004	015	0	1	01	01	H4004_015_0	5	2	Brand	2		
H4004	015	0	1	01	01	H4004_015_0	5	3	Non-Preferred Brand	2		
H4004	035	0	1	01	01	H4004_035_0	5	2	Brand	2		
H4004	035	0	1	01	01	H4004_035_0	5	3	Specialty	2		
H4004	035	0	1	01	01	H4004_035_0	5	1	Generic	1	2	00001000
H4004	049	0	1	01	01	H4004_049_0	5	2	Brand	2		
H4004	049	0	1	01	01	H4004_049_0	5	1	Generic	1	2	00001000
H4004	049	0	1	01	01	H4004_049_0	5	3	Specialty	2		
H4004	050	0	1	01	01	H4004_050_0	5	1	Generic	1	2	00001000
H4004	050	0	1	01	01	H4004_050_0	5	2	Brand	2		
H4004	050	0	1	01	01	H4004_050_0	5	3	Specialty	2		
H4005	003	0	1	04	01	H4005_003_0	4	2	Tier 2/Nivel 2	2		
H4005	003	0	1	04	01	H4005_003_0	4	5	Tier 5/Nivel 5	2		
H4005	003	0	1	04	01	H4005_003_0	4	4	Tier 4/Nivel 4	2		
H4005	003	0	1	04	01	H4005_003_0	4	3	Tier 3/Nivel 3	2		
H4005	003	0	1	04	01	H4005_003_0	4	1	Tier 1/Nivel 1	1	1	
H4005	004	0	1	04	01	H4005_004_0	4	4	Tier 4/Nivel 4	2		
H4005	004	0	1	04	01	H4005_004_0	4	5	Tier 5/Nivel 5	2		
H4005	004	0	1	04	01	H4005_004_0	4	3	Tier 3/Nivel 3	2		
H4005	004	0	1	04	01	H4005_004_0	4	2	Tier 2/Nivel 2	2		
H4005	004	0	1	04	01	H4005_004_0	4	1	Tier 1/Nivel 1	1	1	
H4006	007	0	1	01	01	H4006_007_0	10	3	Non-Preferred Brand	2		
H4006	007	0	1	01	01	H4006_007_0	10	4	Specialty	2		
H4006	007	0	1	01	01	H4006_007_0	10	2	Preferred Brand	2		
H4006	007	0	1	01	01	H4006_007_0	10	1	Generic	1	1	
H4006	008	0	1	02	01	H4006_008_0	9	3	Non-Preferred Brand	2		
H4006	008	0	1	02	01	H4006_008_0	9	1	Generic	1	1	
H4006	008	0	1	02	01	H4006_008_0	9	4	Specialty	2		
H4006	008	0	1	02	01	H4006_008_0	9	2	Preferred Brand	2		
H4006	020	0	1	01	01	H4006_020_0	10	4	Specialty	2		
H4006	020	0	1	01	01	H4006_020_0	10	3	Non-Preferred Brand	2		
H4006	020	0	1	01	01	H4006_020_0	10	1	Generic	1	1	
H4006	020	0	1	01	01	H4006_020_0	10	2	Preferred Brand	2		
H4007	010	0	1	01	01	H4007_010_0	4	4	Specialty	1	2	10001000
H4007	010	0	1	01	01	H4007_010_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4007	010	0	1	01	01	H4007_010_0	4	1	Preferred Generic	1	2	00001000
H4007	010	0	1	01	01	H4007_010_0	4	3	Non-Preferred Brand	1	2	10000000
H4007	012	0	1	01	01	H4007_012_0	3	3	Non-Preferred Brand	1	2	10000000
H4007	012	0	1	01	01	H4007_012_0	3	2	Brand	1	2	10000000
H4007	012	0	1	01	01	H4007_012_0	3	1	Generic	1	2	00001000
H4008	001	0	1	09	04	H4008_001_0	5	3	Non-Preferred Brand	1	2	10000000
H4008	001	0	1	09	04	H4008_001_0	5	4	Specialty	1	2	10001000
H4008	001	0	1	09	04	H4008_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4008	001	0	1	09	04	H4008_001_0	5	1	Preferred Generic	1	2	00001000
H4011	003	0	1	04	01	H4011_003_0	6	3	3	2		
H4011	003	0	1	04	01	H4011_003_0	6	2	2	2		
H4011	003	0	1	04	01	H4011_003_0	6	1	1	1	1	
H4011	003	0	1	04	01	H4011_003_0	6	4	4	1	2	01000000
H4011	004	0	1	04	01	H4011_004_0	6	1	1	1	1	
H4011	004	0	1	04	01	H4011_004_0	6	2	2	2		
H4011	004	0	1	04	01	H4011_004_0	6	3	3	2		
H4011	004	0	1	04	01	H4011_004_0	6	4	4	1	2	01000000
H4012	004	0	1	01	01	H4012_004_0	4	3	Tier 3/Nivel 3	2		
H4012	004	0	1	01	01	H4012_004_0	4	2	Tier 2/Nivel 2	2		
H4012	004	0	1	01	01	H4012_004_0	4	1	Tier 1/Nivel 1	1	1	
H4012	004	0	1	01	01	H4012_004_0	4	4	Tier 4/Nivel 4	2		
H4012	005	0	1	01	01	H4012_005_0	4	1	Tier 1/Nivel 1	1	1	
H4012	005	0	1	01	01	H4012_005_0	4	2	Tier 2/Nivel 2	2		
H4012	005	0	1	01	01	H4012_005_0	4	3	Tier 3/Nivel 3	2		
H4012	005	0	1	01	01	H4012_005_0	4	4	Tier 4/Nivel 4	2		
H4012	007	0	1	01	01	H4012_007_0	3	1	Tier 1/Nivel 1	1	1	
H4012	007	0	1	01	01	H4012_007_0	3	2	Tier 2/Nivel 2	2		
H4012	007	0	1	01	01	H4012_007_0	3	4	Tier 4/Nivel 4	2		
H4012	007	0	1	01	01	H4012_007_0	3	3	Tier 3/Nivel 3	2		
H4012	008	0	1	01	01	H4012_008_0	3	1	Tier 1/Nivel 1	1	1	
H4012	008	0	1	01	01	H4012_008_0	3	3	Tier 3/Nivel 3	2		
H4012	008	0	1	01	01	H4012_008_0	3	2	Tier 2/Nivel 2	2		
H4012	008	0	1	01	01	H4012_008_0	3	4	Tier 4/Nivel 4	2		
H4036	001	0	1	04	01	H4036_001_0	12	4	Tier 4 Non-Specialty Injectable Drugs	2		
H4036	001	0	1	04	01	H4036_001_0	12	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H4036	001	0	1	04	01	H4036_001_0	12	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H4036	001	0	1	04	01	H4036_001_0	12	1	Tier 1 Preferred Generic Drugs	1	1	
H4036	001	0	1	04	01	H4036_001_0	12	5	Tier 5 Specialty Drugs	2		
H4036	003	0	1	04	01	H4036_003_0	11	4	Tier 4 Non-Specialty Injectable Drugs	2		
H4036	003	0	1	04	01	H4036_003_0	11	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H4036	003	0	1	04	01	H4036_003_0	11	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H4036	003	0	1	04	01	H4036_003_0	11	1	Tier 1 Preferred Generic Drugs	1	1	
H4036	003	0	1	04	01	H4036_003_0	11	5	Tier 5 Specialty Drugs	2		
H4125	001	0	1	01	01	H4125_001_0	7	4	Tier 4 - Non-Preferred Brand	2		
H4125	001	0	1	01	01	H4125_001_0	7	3	Tier 3 - Preferred Brand	2		
H4125	001	0	1	01	01	H4125_001_0	7	2	Tier 2 - Non-Preferred Generic	2		
H4125	001	0	1	01	01	H4125_001_0	7	1	Tier 1 - Preferred Generic	1	1	
H4125	001	0	1	01	01	H4125_001_0	7	5	Tier 5 - Specialty	2		
H4125	002	0	1	01	01	H4125_002_0	7	4	Tier 4 - Non-Preferred Brand	2		
H4125	002	0	1	01	01	H4125_002_0	7	3	Tier 3 - Preferred Brand	2		
H4125	002	0	1	01	01	H4125_002_0	7	2	Tier 2 - Non-Preferred Generic	2		
H4125	002	0	1	01	01	H4125_002_0	7	1	Tier 1 - Preferred Generic	1	1	
H4125	002	0	1	01	01	H4125_002_0	7	5	Tier 5 - Specialty	2		
H4125	003	0	1	01	01	H4125_003_0	7	1	Tier 1 - Preferred Generic	1	1	
H4125	003	0	1	01	01	H4125_003_0	7	2	Tier 2 - Non-Preferred Generic	2		
H4125	003	0	1	01	01	H4125_003_0	7	3	Tier 3 - Preferred Brand	2		
H4125	003	0	1	01	01	H4125_003_0	7	4	Tier 4 - Non-Preferred Brand	2		
H4125	003	0	1	01	01	H4125_003_0	7	5	Tier 5 - Specialty	2		
H4125	006	0	1	01	01	H4125_006_0	7	1	Tier 1 - Preferred Generic	1	1	
H4125	006	0	1	01	01	H4125_006_0	7	5	Tier 5 - Specialty	2		
H4125	006	0	1	01	01	H4125_006_0	7	4	Tier 4 - Non-Preferred Brand	2		
H4125	006	0	1	01	01	H4125_006_0	7	3	Tier 3 - Preferred Brand	2		
H4125	006	0	1	01	01	H4125_006_0	7	2	Tier 2 - Non-Preferred Generic	2		
H4141	001	0	1	01	01	H4141_001_0	5	4	Specialty	1	2	10001000
H4141	001	0	1	01	01	H4141_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4141	001	0	1	01	01	H4141_001_0	5	3	Non-Preferred Brand	1	2	10000000
H4141	001	0	1	01	01	H4141_001_0	5	1	Preferred Generic	1	1	
H4152	007	0	1	02	01	H4152_007_0	8	1	Tier 1	1	1	
H4152	007	0	1	02	01	H4152_007_0	8	2	Tier 2	2		
H4152	007	0	1	02	01	H4152_007_0	8	3	Tier 3	2		
H4152	007	0	1	02	01	H4152_007_0	8	4	Tier 4	2		
H4155	001	0	1	01	01	H4155_001_0	5	4	Specialty	2		
H4155	001	0	1	01	01	H4155_001_0	5	1	Generic	1	1	
H4155	001	0	1	01	01	H4155_001_0	5	2	Preferred Brand	2		
H4155	001	0	1	01	01	H4155_001_0	5	3	Non-Preferred Brand	2		
H4155	004	0	1	01	01	H4155_004_0	5	4	Specialty	2		
H4155	004	0	1	01	01	H4155_004_0	5	3	Non-Preferred Brand	2		
H4155	004	0	1	01	01	H4155_004_0	5	2	Preferred Brand	2		
H4155	004	0	1	01	01	H4155_004_0	5	1	Generic	1	1	
H4205	005	0	1	09	04	H4205_005_0	6	4	Non-Preferred Brand	2		
H4205	005	0	1	09	04	H4205_005_0	6	1	Value Generics	1	1	
H4205	005	0	1	09	04	H4205_005_0	6	2	Generics	1	1	
H4205	005	0	1	09	04	H4205_005_0	6	3	Preferred Brand	2		
H4205	005	0	1	09	04	H4205_005_0	6	5	Specialty	2		
H4205	006	0	1	09	04	H4205_006_0	6	4	Non-Preferred Brand	2		
H4205	006	0	1	09	04	H4205_006_0	6	3	Preferred Brand	2		
H4205	006	0	1	09	04	H4205_006_0	6	2	Generics	1	1	
H4205	006	0	1	09	04	H4205_006_0	6	1	Value Generics	1	1	
H4205	006	0	1	09	04	H4205_006_0	6	5	Specialty	2		
H4205	007	0	1	09	04	H4205_007_0	6	1	Value Generics	1	1	
H4205	007	0	1	09	04	H4205_007_0	6	2	Generics	1	1	
H4205	007	0	1	09	04	H4205_007_0	6	3	Preferred Brand	2		
H4205	007	0	1	09	04	H4205_007_0	6	4	Non-Preferred Brand	2		
H4205	007	0	1	09	04	H4205_007_0	6	5	Specialty	2		
H4205	008	0	1	09	04	H4205_008_0	6	3	Preferred Brand	2		
H4205	008	0	1	09	04	H4205_008_0	6	2	Generics	1	1	
H4205	008	0	1	09	04	H4205_008_0	6	5	Specialty	2		
H4205	008	0	1	09	04	H4205_008_0	6	1	Value Generics	1	1	
H4205	008	0	1	09	04	H4205_008_0	6	4	Non-Preferred Brand	2		
H4209	004	0	1	04	01	H4209_004_0	6	6	Specialty	2		
H4209	004	0	1	04	01	H4209_004_0	6	5	Non-Preferred Brand	2		
H4209	004	0	1	04	01	H4209_004_0	6	4	Preferred Brand	2		
H4209	004	0	1	04	01	H4209_004_0	6	2	Generics	1	1	
H4209	004	0	1	04	01	H4209_004_0	6	1	Value Generics	1	1	
H4209	004	0	1	04	01	H4209_004_0	6	3	Value Preferred Brand	2		
H4209	006	0	1	04	01	H4209_006_0	6	6	Specialty	2		
H4209	006	0	1	04	01	H4209_006_0	6	4	Preferred Brand	2		
H4209	006	0	1	04	01	H4209_006_0	6	3	Value Preferred Brand	2		
H4209	006	0	1	04	01	H4209_006_0	6	2	Generics	1	1	
H4209	006	0	1	04	01	H4209_006_0	6	5	Non-Preferred Brand	2		
H4209	006	0	1	04	01	H4209_006_0	6	1	Value Generics	1	1	
H4270	002	0	1	02	01	H4270_002_0	8	1	Tier 1	1	1	
H4270	002	0	1	02	01	H4270_002_0	8	2	Tier 2	2		
H4270	002	0	1	02	01	H4270_002_0	8	3	Tier 3	2		
H4270	002	0	1	02	01	H4270_002_0	8	4	Tier 4	2		
H4346	001	0	1	01	01	H4346_001_0	8	5	Brand Drugs	2		
H4346	001	0	1	01	01	H4346_001_0	8	4	Preferred Brand Drugs	2		
H4346	001	0	1	01	01	H4346_001_0	8	3	Enhanced Care Brand Drugs	1	1	
H4346	001	0	1	01	01	H4346_001_0	8	2	Generic Drugs	1	1	
H4346	001	0	1	01	01	H4346_001_0	8	1	Preferred Generic Drugs	1	1	
H4346	001	0	1	01	01	H4346_001_0	8	6	Specialty Drugs	2		
H4346	003	0	1	01	01	H4346_003_0	9	5	Brand Drugs	2		
H4346	003	0	1	01	01	H4346_003_0	9	4	Preferred Brand Drugs	2		
H4346	003	0	1	01	01	H4346_003_0	9	3	Enhanced Care Brand Drugs	1	1	
H4346	003	0	1	01	01	H4346_003_0	9	2	Generic Drugs	1	1	
H4346	003	0	1	01	01	H4346_003_0	9	1	Preferred Generic Drugs	1	1	
H4346	003	0	1	01	01	H4346_003_0	9	6	Specialty Drugs	2		
H4346	005	0	1	01	01	H4346_005_0	7	1	Preferred Generic Drugs	1	1	
H4346	005	0	1	01	01	H4346_005_0	7	2	Generic Drugs	1	1	
H4346	005	0	1	01	01	H4346_005_0	7	3	Enhanced Care Brand Drugs	1	1	
H4346	005	0	1	01	01	H4346_005_0	7	4	Preferred Brand Drugs	2		
H4346	005	0	1	01	01	H4346_005_0	7	5	Brand Drugs	2		
H4346	005	0	1	01	01	H4346_005_0	7	6	Specialty Drugs	2		
H4346	006	0	1	01	01	H4346_006_0	8	1	Preferred Generic Drugs	1	1	
H4346	006	0	1	01	01	H4346_006_0	8	2	Generic Drugs	1	1	
H4346	006	0	1	01	01	H4346_006_0	8	3	Enhanced Care Brand Drugs	1	1	
H4346	006	0	1	01	01	H4346_006_0	8	4	Preferred Brand Drugs	2		
H4346	006	0	1	01	01	H4346_006_0	8	5	Brand Drugs	2		
H4346	006	0	1	01	01	H4346_006_0	8	6	Specialty Drugs	2		
H4407	001	0	1	01	01	H4407_001_0	5	1	Preferred Generic	1	1	
H4407	001	0	1	01	01	H4407_001_0	5	2	Generic	1	1	
H4407	001	0	1	01	01	H4407_001_0	5	3	Preferred Brand	2		
H4407	001	0	1	01	01	H4407_001_0	5	4	Non-Preferred Brand	2		
H4407	001	0	1	01	01	H4407_001_0	5	5	Specialty	2		
H4407	002	0	1	01	01	H4407_002_0	8	1	Preferred Generic	1	1	
H4407	002	0	1	01	01	H4407_002_0	8	2	Generic	1	1	
H4407	002	0	1	01	01	H4407_002_0	8	3	Preferred Brand	2		
H4407	002	0	1	01	01	H4407_002_0	8	4	Non-Preferred Brand	2		
H4407	002	0	1	01	01	H4407_002_0	8	5	Specialty	2		
H4407	009	0	1	01	01	H4407_009_0	6	1	Preferred Generic	1	1	
H4407	009	0	1	01	01	H4407_009_0	6	2	Generic	1	2	01000000
H4407	009	0	1	01	01	H4407_009_0	6	3	Preferred Brand	2		
H4407	009	0	1	01	01	H4407_009_0	6	4	Non-Preferred Brand	2		
H4407	009	0	1	01	01	H4407_009_0	6	5	Specialty	2		
H4407	013	0	1	01	01	H4407_013_0	5	4	Non-Preferred Brand	2		
H4407	013	0	1	01	01	H4407_013_0	5	3	Preferred Brand	2		
H4407	013	0	1	01	01	H4407_013_0	5	2	Generic	1	2	01000000
H4407	013	0	1	01	01	H4407_013_0	5	1	Preferred Generic	1	1	
H4407	013	0	1	01	01	H4407_013_0	5	5	Specialty	2		
H4407	020	0	1	01	01	H4407_020_0	6	5	Specialty	2		
H4407	020	0	1	01	01	H4407_020_0	6	4	Non-Preferred Brand	2		
H4407	020	0	1	01	01	H4407_020_0	6	3	Preferred Brand	2		
H4407	020	0	1	01	01	H4407_020_0	6	1	Preferred Generic	1	1	
H4407	020	0	1	01	01	H4407_020_0	6	2	Generic	1	1	
H4407	021	0	1	01	01	H4407_021_0	7	1	Preferred Generic	1	1	
H4407	021	0	1	01	01	H4407_021_0	7	2	Generic	1	1	
H4407	021	0	1	01	01	H4407_021_0	7	3	Preferred Brand	2		
H4407	021	0	1	01	01	H4407_021_0	7	4	Non-Preferred Brand	2		
H4407	021	0	1	01	01	H4407_021_0	7	5	Specialty	2		
H4408	001	0	1	04	01	H4408_001_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4408	001	0	1	04	01	H4408_001_0	4	3	Non-Preferred Brand	1	2	10000000
H4408	001	0	1	04	01	H4408_001_0	4	4	Specialty	1	2	10001000
H4408	001	0	1	04	01	H4408_001_0	4	1	Preferred Generic	1	2	00001000
H4408	002	0	1	04	01	H4408_002_0	4	3	Non-Preferred Brand	1	2	10000000
H4408	002	0	1	04	01	H4408_002_0	4	1	Preferred Generic	1	2	00001000
H4408	002	0	1	04	01	H4408_002_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4408	002	0	1	04	01	H4408_002_0	4	4	Specialty	1	2	10001000
H4408	006	0	1	04	01	H4408_006_0	4	1	Preferred Generic	1	2	00001000
H4408	006	0	1	04	01	H4408_006_0	4	4	Specialty	1	2	10001000
H4408	006	0	1	04	01	H4408_006_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4408	006	0	1	04	01	H4408_006_0	4	3	Non-Preferred Brand	1	2	10000000
H4408	007	0	1	04	01	H4408_007_0	4	4	Specialty	1	2	10001000
H4408	007	0	1	04	01	H4408_007_0	4	1	Preferred Generic	1	2	00001000
H4408	007	0	1	04	01	H4408_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4408	007	0	1	04	01	H4408_007_0	4	3	Non-Preferred Brand	1	2	10000000
H4454	002	0	1	01	01	H4454_002_0	6	2	Generic	1	1	
H4454	002	0	1	01	01	H4454_002_0	6	1	Preferred Generic	1	1	
H4454	002	0	1	01	01	H4454_002_0	6	4	Non-Preferred Brand	2		
H4454	002	0	1	01	01	H4454_002_0	6	3	Preferred Brand	2		
H4454	002	0	1	01	01	H4454_002_0	6	5	Specialty	2		
H4454	007	0	1	01	01	H4454_007_0	5	4	Non-Preferred Brand	2		
H4454	007	0	1	01	01	H4454_007_0	5	2	Generic	1	2	01000000
H4454	007	0	1	01	01	H4454_007_0	5	5	Specialty	2		
H4454	007	0	1	01	01	H4454_007_0	5	3	Preferred Brand	2		
H4454	007	0	1	01	01	H4454_007_0	5	1	Preferred Generic	1	1	
H4454	019	0	1	01	01	H4454_019_0	5	1	Preferred Generic	1	1	
H4454	019	0	1	01	01	H4454_019_0	5	5	Specialty	2		
H4454	019	0	1	01	01	H4454_019_0	5	4	Non-Preferred Brand	2		
H4454	019	0	1	01	01	H4454_019_0	5	2	Generic	1	1	
H4454	019	0	1	01	01	H4454_019_0	5	3	Preferred Brand	2		
H4454	021	0	1	01	01	H4454_021_0	7	2	Generic	1	1	
H4454	021	0	1	01	01	H4454_021_0	7	3	Preferred Brand	2		
H4454	021	0	1	01	01	H4454_021_0	7	4	Non-Preferred Brand	2		
H4454	021	0	1	01	01	H4454_021_0	7	5	Specialty	2		
H4454	021	0	1	01	01	H4454_021_0	7	1	Preferred Generic	1	1	
H4461	001	0	1	01	01	H4461_001_0	4	4	Specialty	1	2	10001000
H4461	001	0	1	01	01	H4461_001_0	4	3	Non-Preferred Brand	1	2	10000000
H4461	001	0	1	01	01	H4461_001_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4461	001	0	1	01	01	H4461_001_0	4	1	Preferred Generic	1	2	00001000
H4461	012	0	1	01	01	H4461_012_0	4	4	Specialty	1	2	10001000
H4461	012	0	1	01	01	H4461_012_0	4	3	Non-Preferred Brand	1	2	10000000
H4461	012	0	1	01	01	H4461_012_0	4	1	Preferred Generic	1	2	00001000
H4461	012	0	1	01	01	H4461_012_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4461	015	0	1	01	01	H4461_015_0	3	4	Specialty	1	2	10001000
H4461	015	0	1	01	01	H4461_015_0	3	3	Non-Preferred Brand	1	2	10000000
H4461	015	0	1	01	01	H4461_015_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4461	015	0	1	01	01	H4461_015_0	3	1	Preferred Generic	1	2	00001000
H4461	016	0	1	01	01	H4461_016_0	4	3	Non-Preferred Brand	1	2	10000000
H4461	016	0	1	01	01	H4461_016_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4461	016	0	1	01	01	H4461_016_0	4	1	Preferred Generic	1	2	00001000
H4461	016	0	1	01	01	H4461_016_0	4	4	Specialty	1	2	10001000
H4506	003	0	1	01	01	H4506_003_0	7	4	Specialty	2		
H4506	003	0	1	01	01	H4506_003_0	7	3	Non-Preferred Brand	2		
H4506	003	0	1	01	01	H4506_003_0	7	2	Preferred Brand	1	2	10000000
H4506	003	0	1	01	01	H4506_003_0	7	1	Generic	1	1	
H4506	025	0	1	01	01	H4506_025_0	6	4	Specialty	2		
H4506	025	0	1	01	01	H4506_025_0	6	1	Generic	1	1	
H4506	025	0	1	01	01	H4506_025_0	6	2	Preferred Brand	1	2	10000000
H4506	025	0	1	01	01	H4506_025_0	6	3	Non-Preferred Brand	2		
H4510	012	0	1	01	01	H4510_012_0	6	3	Non-Preferred Brand	1	2	10000000
H4510	012	0	1	01	01	H4510_012_0	6	4	Specialty	1	2	10001000
H4510	012	0	1	01	01	H4510_012_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4510	012	0	1	01	01	H4510_012_0	6	1	Preferred Generic	1	2	00001000
H4510	015	0	1	01	01	H4510_015_0	6	1	Preferred Generic	1	2	00001000
H4510	015	0	1	01	01	H4510_015_0	6	4	Specialty	1	2	10001000
H4510	015	0	1	01	01	H4510_015_0	6	3	Non-Preferred Brand	1	2	10000000
H4510	015	0	1	01	01	H4510_015_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4510	018	0	1	01	01	H4510_018_0	6	3	Non-Preferred Brand	1	2	10000000
H4510	018	0	1	01	01	H4510_018_0	6	4	Specialty	1	2	10001000
H4510	018	0	1	01	01	H4510_018_0	6	1	Preferred Generic	1	2	00001000
H4510	018	0	1	01	01	H4510_018_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4510	020	0	1	01	01	H4510_020_0	6	4	Specialty	1	2	10001000
H4510	020	0	1	01	01	H4510_020_0	6	3	Non-Preferred Brand	1	2	10000000
H4510	020	0	1	01	01	H4510_020_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4510	020	0	1	01	01	H4510_020_0	6	1	Preferred Generic	1	2	00001000
H4510	022	0	1	01	01	H4510_022_0	6	1	Preferred Generic	1	2	00001000
H4510	022	0	1	01	01	H4510_022_0	6	4	Specialty	1	2	10001000
H4510	022	0	1	01	01	H4510_022_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4510	022	0	1	01	01	H4510_022_0	6	3	Non-Preferred Brand	1	2	10000000
H4513	001	0	1	01	01	H4513_001_0	5	5	Specialty	2		
H4513	001	0	1	01	01	H4513_001_0	5	4	Non-Preferred Brand	2		
H4513	001	0	1	01	01	H4513_001_0	5	3	Preferred Brand	2		
H4513	001	0	1	01	01	H4513_001_0	5	2	Generic	1	1	
H4513	001	0	1	01	01	H4513_001_0	5	1	Preferred Generic	1	1	
H4513	014	0	1	01	01	H4513_014_0	5	5	Specialty	2		
H4513	014	0	1	01	01	H4513_014_0	5	1	Preferred Generic	1	1	
H4513	014	0	1	01	01	H4513_014_0	5	2	Generic	1	1	
H4513	014	0	1	01	01	H4513_014_0	5	3	Preferred Brand	2		
H4513	014	0	1	01	01	H4513_014_0	5	4	Non-Preferred Brand	2		
H4513	019	0	1	01	01	H4513_019_0	6	3	Preferred Brand	2		
H4513	019	0	1	01	01	H4513_019_0	6	1	Preferred Generic	1	1	
H4513	019	0	1	01	01	H4513_019_0	6	2	Generic	1	2	01000000
H4513	019	0	1	01	01	H4513_019_0	6	5	Specialty	2		
H4513	019	0	1	01	01	H4513_019_0	6	4	Non-Preferred Brand	2		
H4513	020	0	1	01	01	H4513_020_0	3	1	Preferred Generic	1	1	
H4513	020	0	1	01	01	H4513_020_0	3	2	Generic	1	1	
H4513	020	0	1	01	01	H4513_020_0	3	3	Preferred Brand	2		
H4513	020	0	1	01	01	H4513_020_0	3	4	Non-Preferred Brand	2		
H4513	020	0	1	01	01	H4513_020_0	3	5	Specialty	2		
H4513	022	0	1	01	01	H4513_022_0	6	1	Preferred Generic	1	1	
H4513	022	0	1	01	01	H4513_022_0	6	5	Specialty	2		
H4513	022	0	1	01	01	H4513_022_0	6	4	Non-Preferred Brand	2		
H4513	022	0	1	01	01	H4513_022_0	6	3	Preferred Brand	2		
H4513	022	0	1	01	01	H4513_022_0	6	2	Generic	1	1	
H4520	001	0	1	04	01	H4520_001_0	5	1	Preferred Generic	1	2	00001000
H4520	001	0	1	04	01	H4520_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	001	0	1	04	01	H4520_001_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	001	0	1	04	01	H4520_001_0	5	4	Specialty	1	2	10001000
H4520	002	0	1	04	01	H4520_002_0	5	1	Preferred Generic	1	2	00001000
H4520	002	0	1	04	01	H4520_002_0	5	4	Specialty	1	2	10001000
H4520	002	0	1	04	01	H4520_002_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	002	0	1	04	01	H4520_002_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	003	0	1	04	01	H4520_003_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	003	0	1	04	01	H4520_003_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	003	0	1	04	01	H4520_003_0	5	4	Specialty	1	2	10001000
H4520	003	0	1	04	01	H4520_003_0	5	1	Preferred Generic	1	2	00001000
H4520	005	0	1	04	01	H4520_005_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	005	0	1	04	01	H4520_005_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	005	0	1	04	01	H4520_005_0	5	1	Preferred Generic	1	2	00001000
H4520	005	0	1	04	01	H4520_005_0	5	4	Specialty	1	2	10001000
H4520	006	0	1	04	01	H4520_006_0	4	4	Specialty	1	2	10001000
H4520	006	0	1	04	01	H4520_006_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	006	0	1	04	01	H4520_006_0	4	1	Preferred Generic	1	2	00001000
H4520	006	0	1	04	01	H4520_006_0	4	3	Non-Preferred Brand	1	2	10000000
H4520	016	0	1	04	01	H4520_016_0	5	4	Specialty	1	2	10001000
H4520	016	0	1	04	01	H4520_016_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	016	0	1	04	01	H4520_016_0	5	1	Preferred Generic	1	2	00001000
H4520	016	0	1	04	01	H4520_016_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	018	0	1	04	01	H4520_018_0	5	1	Preferred Generic	1	2	00001000
H4520	018	0	1	04	01	H4520_018_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	018	0	1	04	01	H4520_018_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	018	0	1	04	01	H4520_018_0	5	4	Specialty	1	2	10001000
H4520	020	0	1	04	01	H4520_020_0	5	1	Preferred Generic	1	2	00001000
H4520	020	0	1	04	01	H4520_020_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	020	0	1	04	01	H4520_020_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	020	0	1	04	01	H4520_020_0	5	4	Specialty	1	2	10001000
H4520	021	0	1	04	01	H4520_021_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4520	021	0	1	04	01	H4520_021_0	5	1	Preferred Generic	1	2	00001000
H4520	021	0	1	04	01	H4520_021_0	5	3	Non-Preferred Brand	1	2	10000000
H4520	021	0	1	04	01	H4520_021_0	5	4	Specialty	1	2	10001000
H4522	001	0	1	04	01	H4522_001_0	6	1	Tier 1 Preferred Generic  Brand	1	1	
H4522	001	0	1	04	01	H4522_001_0	6	2	Tier 2 Generic  Preferred Brand	2		
H4522	001	0	1	04	01	H4522_001_0	6	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H4522	001	0	1	04	01	H4522_001_0	6	4	Tier 4 Specialty	2		
H4523	001	0	1	01	01	H4523_001_0	6	2	Tier 2 - Non-Preferred Generic	2		
H4523	001	0	1	01	01	H4523_001_0	6	1	Tier 1 - Preferred Generic	1	1	
H4523	001	0	1	01	01	H4523_001_0	6	3	Tier 3 - Preferred Brand	2		
H4523	001	0	1	01	01	H4523_001_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4523	001	0	1	01	01	H4523_001_0	6	5	Tier 5 - Specialty	2		
H4523	015	0	1	01	01	H4523_015_0	5	4	Tier 4 - Non-Preferred Brand	2		
H4523	015	0	1	01	01	H4523_015_0	5	5	Tier 5 - Specialty	2		
H4523	015	0	1	01	01	H4523_015_0	5	3	Tier 3 - Preferred Brand	2		
H4523	015	0	1	01	01	H4523_015_0	5	1	Tier 1 - Preferred Generic	1	1	
H4523	015	0	1	01	01	H4523_015_0	5	2	Tier 2 - Non-Preferred Generic	2		
H4524	002	0	1	04	01	H4524_002_0	7	5	Tier 5 - Specialty	2		
H4524	002	0	1	04	01	H4524_002_0	7	1	Tier 1 - Preferred Generic	1	1	
H4524	002	0	1	04	01	H4524_002_0	7	3	Tier 3 - Preferred Brand	2		
H4524	002	0	1	04	01	H4524_002_0	7	2	Tier 2 - Non-Preferred Generic	2		
H4524	002	0	1	04	01	H4524_002_0	7	4	Tier 4 - Non-Preferred Brand	2		
H4524	008	0	1	04	01	H4524_008_0	7	4	Tier 4 - Non-Preferred Brand	2		
H4524	008	0	1	04	01	H4524_008_0	7	5	Tier 5 - Specialty	2		
H4524	008	0	1	04	01	H4524_008_0	7	3	Tier 3 - Preferred Brand	2		
H4524	008	0	1	04	01	H4524_008_0	7	2	Tier 2 - Non-Preferred Generic	2		
H4524	008	0	1	04	01	H4524_008_0	7	1	Tier 1 - Preferred Generic	1	1	
H4524	014	0	1	04	01	H4524_014_0	6	2	Tier 2 - Non-Preferred Generic	2		
H4524	014	0	1	04	01	H4524_014_0	6	1	Tier 1 - Preferred Generic	1	1	
H4524	014	0	1	04	01	H4524_014_0	6	5	Tier 5 - Specialty	2		
H4524	014	0	1	04	01	H4524_014_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4524	014	0	1	04	01	H4524_014_0	6	3	Tier 3 - Preferred Brand	2		
H4525	007	0	1	01	01	H4525_007_0	3	3	Specialty	2		
H4525	007	0	1	01	01	H4525_007_0	3	2	Brands	2		
H4525	007	0	1	01	01	H4525_007_0	3	1	Generics	1	1	
H4525	008	0	1	01	01	H4525_008_0	3	2	Brands	2		
H4525	008	0	1	01	01	H4525_008_0	3	1	Generics	1	1	
H4525	008	0	1	01	01	H4525_008_0	3	3	Specialty	2		
H4525	009	0	1	01	01	H4525_009_0	3	3	Specialty	2		
H4525	009	0	1	01	01	H4525_009_0	3	1	Generics	1	1	
H4525	009	0	1	01	01	H4525_009_0	3	2	Brands	2		
H4527	001	0	1	01	01	H4527_001_0	5	3	Tier 3	2		
H4527	001	0	1	01	01	H4527_001_0	5	2	Tier 2	1	1	
H4527	001	0	1	01	01	H4527_001_0	5	1	Tier 1	1	1	
H4527	001	0	1	01	01	H4527_001_0	5	4	Tier 4	2		
H4527	002	0	1	01	01	H4527_002_0	7	3	Tier 3	2		
H4527	002	0	1	01	01	H4527_002_0	7	4	Tier 4	2		
H4527	002	0	1	01	01	H4527_002_0	7	1	Tier 1	1	1	
H4527	002	0	1	01	01	H4527_002_0	7	2	Tier 2	2		
H4527	005	0	1	01	01	H4527_005_0	4	1	Tier 1	1	1	
H4527	005	0	1	01	01	H4527_005_0	4	4	Tier 4	2		
H4527	005	0	1	01	01	H4527_005_0	4	3	Tier 3	2		
H4527	005	0	1	01	01	H4527_005_0	4	2	Tier 2	2		
H4527	008	0	1	01	01	H4527_008_0	4	4	Tier 4	2		
H4527	008	0	1	01	01	H4527_008_0	4	3	Tier 3	2		
H4527	008	0	1	01	01	H4527_008_0	4	1	Tier 1	1	1	
H4527	008	0	1	01	01	H4527_008_0	4	2	Tier 2	2		
H4527	013	0	1	01	01	H4527_013_0	5	1	Tier 1	1	1	
H4527	013	0	1	01	01	H4527_013_0	5	3	Tier 3	2		
H4527	013	0	1	01	01	H4527_013_0	5	4	Tier 4	2		
H4527	013	0	1	01	01	H4527_013_0	5	2	Tier 2	2		
H4527	014	0	1	01	01	H4527_014_0	5	4	Tier 4	2		
H4527	014	0	1	01	01	H4527_014_0	5	2	Tier 2	2		
H4527	014	0	1	01	01	H4527_014_0	5	3	Tier 3	2		
H4527	014	0	1	01	01	H4527_014_0	5	1	Tier 1	1	1	
H4527	026	0	1	01	01	H4527_026_0	4	4	Tier 4	2		
H4527	026	0	1	01	01	H4527_026_0	4	2	Tier 2	2		
H4527	026	0	1	01	01	H4527_026_0	4	3	Tier 3	2		
H4527	026	0	1	01	01	H4527_026_0	4	1	Tier 1	1	1	
H4527	030	0	1	01	01	H4527_030_0	5	3	Tier 3	2		
H4527	030	0	1	01	01	H4527_030_0	5	2	Tier 2	2		
H4527	030	0	1	01	01	H4527_030_0	5	4	Tier 4	2		
H4527	030	0	1	01	01	H4527_030_0	5	1	Tier 1	1	1	
H4528	014	0	1	01	01	H4528_014_0	2	3	Non-Preferred Brand	2		
H4528	014	0	1	01	01	H4528_014_0	2	1	Generic	2		
H4528	014	0	1	01	01	H4528_014_0	2	2	Preferred Brand	2		
H4528	014	0	1	01	01	H4528_014_0	2	4	Specialty	2		
H4528	014	0	1	01	01	H4528_014_0	2	5	Preferred Diabetic Drugs	1	1	
H4528	015	0	1	01	01	H4528_015_0	2	2	Preferred Brand	2		
H4528	015	0	1	01	01	H4528_015_0	2	3	Non-Preferred Brand	2		
H4528	015	0	1	01	01	H4528_015_0	2	5	Preferred Diabetic Drugs	1	1	
H4528	015	0	1	01	01	H4528_015_0	2	4	Specialty	2		
H4528	015	0	1	01	01	H4528_015_0	2	1	Generic	2		
H4529	002	0	1	02	01	H4529_002_0	10	4	Tier 4 - Non-Preferred Brand	2		
H4529	002	0	1	02	01	H4529_002_0	10	3	Tier 3 - Preferred Brand	2		
H4529	002	0	1	02	01	H4529_002_0	10	1	Tier 1 - Preferred Generic	1	1	
H4529	002	0	1	02	01	H4529_002_0	10	5	Tier 5 - Specialty	2		
H4529	002	0	1	02	01	H4529_002_0	10	2	Tier 2 - Non-Preferred Generic	2		
H4529	004	0	1	01	01	H4529_004_0	10	5	Tier 5 - Specialty	2		
H4529	004	0	1	01	01	H4529_004_0	10	4	Tier 4 - Non-Preferred Brand	2		
H4529	004	0	1	01	01	H4529_004_0	10	3	Tier 3 - Preferred Brand	2		
H4529	004	0	1	01	01	H4529_004_0	10	2	Tier 2 - Non-Preferred Generic	2		
H4529	004	0	1	01	01	H4529_004_0	10	1	Tier 1 - Preferred Generic	1	1	
H4529	014	0	1	01	01	H4529_014_0	7	2	Tier 2 - Non-Preferred Generic	2		
H4529	014	0	1	01	01	H4529_014_0	7	3	Tier 3 - Preferred Brand	2		
H4529	014	0	1	01	01	H4529_014_0	7	4	Tier 4 - Non-Preferred Brand	2		
H4529	014	0	1	01	01	H4529_014_0	7	5	Tier 5 - Specialty	2		
H4529	014	0	1	01	01	H4529_014_0	7	1	Tier 1 - Preferred Generic	1	1	
H4529	027	0	1	01	01	H4529_027_0	6	2	Tier 2 - Non-Preferred Generic	2		
H4529	027	0	1	01	01	H4529_027_0	6	3	Tier 3 - Preferred Brand	2		
H4529	027	0	1	01	01	H4529_027_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4529	027	0	1	01	01	H4529_027_0	6	5	Tier 5 - Specialty	2		
H4529	027	0	1	01	01	H4529_027_0	6	1	Tier 1 - Preferred Generic	1	1	
H4529	028	0	1	01	01	H4529_028_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4529	028	0	1	01	01	H4529_028_0	6	5	Tier 5 - Specialty	2		
H4529	028	0	1	01	01	H4529_028_0	6	3	Tier 3 - Preferred Brand	2		
H4529	028	0	1	01	01	H4529_028_0	6	2	Tier 2 - Non-Preferred Generic	1	1	
H4529	028	0	1	01	01	H4529_028_0	6	1	Tier 1 - Preferred Generic	1	1	
H4529	030	0	1	01	01	H4529_030_0	6	1	Tier 1 - Preferred Generic	1	1	
H4529	030	0	1	01	01	H4529_030_0	6	2	Tier 2 - Non-Preferred Generic	2		
H4529	030	0	1	01	01	H4529_030_0	6	3	Tier 3 - Preferred Brand	2		
H4529	030	0	1	01	01	H4529_030_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4529	030	0	1	01	01	H4529_030_0	6	5	Tier 5 - Specialty	2		
H4564	004	0	1	18	06	H4564_004_0	9	2	Preferred Brand	2		
H4564	004	0	1	18	06	H4564_004_0	9	4	Specialty	2		
H4564	004	0	1	18	06	H4564_004_0	9	3	Non-Preferred Brand or Generic	2		
H4564	004	0	1	18	06	H4564_004_0	9	1	Preferred Generic	1	1	
H4564	005	0	1	18	06	H4564_005_0	7	1	Preferred Generic	1	1	
H4564	005	0	1	18	06	H4564_005_0	7	4	Specialty	2		
H4564	005	0	1	18	06	H4564_005_0	7	2	Preferred Brand	2		
H4564	005	0	1	18	06	H4564_005_0	7	3	Non-Preferred Brand or Generic	2		
H4564	006	0	1	18	06	H4564_006_0	7	4	Specialty	2		
H4564	006	0	1	18	06	H4564_006_0	7	3	Non-Preferred Brand or Generic	2		
H4564	006	0	1	18	06	H4564_006_0	7	2	Preferred Brand	2		
H4564	006	0	1	18	06	H4564_006_0	7	1	Preferred Generic	1	1	
H4590	010	0	1	01	01	H4590_010_0	4	1	Tier 1 Preferred Generic  Brand	1	1	
H4590	010	0	1	01	01	H4590_010_0	4	2	Tier 2 Generic  Preferred Brand	2		
H4590	010	0	1	01	01	H4590_010_0	4	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H4590	010	0	1	01	01	H4590_010_0	4	4	Tier 4 Specialty	2		
H4590	012	0	1	01	01	H4590_012_0	7	1	Tier 1 Preferred Generic  Brand	1	1	
H4590	012	0	1	01	01	H4590_012_0	7	2	Tier 2 Generic  Preferred Brand	2		
H4590	012	0	1	01	01	H4590_012_0	7	4	Tier 4 Specialty	2		
H4590	012	0	1	01	01	H4590_012_0	7	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H4590	037	0	1	01	01	H4590_037_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H4590	037	0	1	01	01	H4590_037_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H4590	037	0	1	01	01	H4590_037_0	5	2	Tier 2 Generic  Preferred Brand	2		
H4590	037	0	1	01	01	H4590_037_0	5	4	Tier 4 Specialty	2		
H4605	004	0	1	04	01	H4605_004_0	5	1	Generic	1	1	
H4605	004	0	1	04	01	H4605_004_0	5	4	Miscellaneous Injectables	2		
H4605	004	0	1	04	01	H4605_004_0	5	3	Non-Preferred Brand	2		
H4605	004	0	1	04	01	H4605_004_0	5	2	Preferred Brand	2		
H4605	004	0	1	04	01	H4605_004_0	5	5	Specialty	2		
H4606	001	0	1	04	01	H4606_001_0	8	4	Specialty	1	2	10001000
H4606	001	0	1	04	01	H4606_001_0	8	3	Non-Preferred Brand	1	2	10000000
H4606	001	0	1	04	01	H4606_001_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10000000
H4606	001	0	1	04	01	H4606_001_0	8	1	Preferred Generic	1	2	00001000
H4774	001	0	1	09	04	H4774_001_0	5	4	Specialty	1	2	10001000
H4774	001	0	1	09	04	H4774_001_0	5	3	Non-Preferred Brand	1	2	10000000
H4774	001	0	1	09	04	H4774_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4774	001	0	1	09	04	H4774_001_0	5	1	Preferred Generic	1	2	00001000
H4774	002	0	1	09	04	H4774_002_0	3	1	Preferred Generic	1	2	00001000
H4774	002	0	1	09	04	H4774_002_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4774	002	0	1	09	04	H4774_002_0	3	3	Non-Preferred Brand	1	2	10000000
H4774	002	0	1	09	04	H4774_002_0	3	4	Specialty	1	2	10001000
H4774	003	0	1	09	04	H4774_003_0	5	3	Non-Preferred Brand	1	2	10000000
H4774	003	0	1	09	04	H4774_003_0	5	4	Specialty	1	2	10001000
H4774	003	0	1	09	04	H4774_003_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4774	003	0	1	09	04	H4774_003_0	5	1	Preferred Generic	1	2	00001000
H4774	004	0	1	09	04	H4774_004_0	3	1	Preferred Generic	1	2	00001000
H4774	004	0	1	09	04	H4774_004_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4774	004	0	1	09	04	H4774_004_0	3	3	Non-Preferred Brand	1	2	10000000
H4774	004	0	1	09	04	H4774_004_0	3	4	Specialty	1	2	10001000
H4909	001	0	1	04	01	H4909_001_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
H4909	001	0	1	04	01	H4909_001_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H4909	001	0	1	04	01	H4909_001_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H4909	001	0	1	04	01	H4909_001_0	9	4	Tier 4 Non-Specialty Injectable Drugs	2		
H4909	001	0	1	04	01	H4909_001_0	9	5	Tier 5 Specialty Drugs	2		
H4909	004	0	1	04	01	H4909_004_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
H4909	004	0	1	04	01	H4909_004_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H4909	004	0	1	04	01	H4909_004_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H4909	004	0	1	04	01	H4909_004_0	9	4	Tier 4 Non-Specialty Injectable Drugs	2		
H4909	004	0	1	04	01	H4909_004_0	9	5	Tier 5 Specialty Drugs	2		
H4910	005	0	1	01	01	H4910_005_0	6	5	Tier 5 - Specialty	2		
H4910	005	0	1	01	01	H4910_005_0	6	4	Tier 4 - Non-Preferred Brand	2		
H4910	005	0	1	01	01	H4910_005_0	6	3	Tier 3 - Preferred Brand	2		
H4910	005	0	1	01	01	H4910_005_0	6	1	Tier 1 - Preferred Generic	1	1	
H4910	005	0	1	01	01	H4910_005_0	6	2	Tier 2 - Non-Preferred Generic	2		
H4917	001	0	1	09	04	H4917_001_0	8	2	Preferred Generic	1	1	
H4917	001	0	1	09	04	H4917_001_0	8	1	Generic	1	1	
H4917	001	0	1	09	04	H4917_001_0	8	3	Non-Preferred Generic	2		
H4917	001	0	1	09	04	H4917_001_0	8	4	Preferred Brand	2		
H4917	001	0	1	09	04	H4917_001_0	8	5	Non-Preferred Brand	2		
H4917	001	0	1	09	04	H4917_001_0	8	6	Specialty	2		
H4917	002	0	1	09	04	H4917_002_0	7	4	Preferred Brand	2		
H4917	002	0	1	09	04	H4917_002_0	7	2	Preferred Generic	1	1	
H4917	002	0	1	09	04	H4917_002_0	7	1	Generic	1	1	
H4917	002	0	1	09	04	H4917_002_0	7	6	Specialty	2		
H4917	002	0	1	09	04	H4917_002_0	7	3	Non-Preferred Generic	2		
H4917	002	0	1	09	04	H4917_002_0	7	5	Non-Preferred Brand	2		
H4956	001	0	1	04	01	H4956_001_0	3	1	Preferred Generic	1	2	00001000
H4956	001	0	1	04	01	H4956_001_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4956	001	0	1	04	01	H4956_001_0	3	4	Specialty	1	2	10001000
H4956	001	0	1	04	01	H4956_001_0	3	3	Non-Preferred Brand	1	2	10000000
H4956	002	0	1	04	01	H4956_002_0	3	1	Preferred Generic	1	2	00001000
H4956	002	0	1	04	01	H4956_002_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4956	002	0	1	04	01	H4956_002_0	3	3	Non-Preferred Brand	1	2	10000000
H4956	002	0	1	04	01	H4956_002_0	3	4	Specialty	1	2	10001000
H4956	003	0	1	04	01	H4956_003_0	3	1	Preferred Generic	1	2	00001000
H4956	003	0	1	04	01	H4956_003_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4956	003	0	1	04	01	H4956_003_0	3	4	Specialty	1	2	10001000
H4956	003	0	1	04	01	H4956_003_0	3	3	Non-Preferred Brand	1	2	10000000
H4956	004	0	1	04	01	H4956_004_0	3	4	Specialty	1	2	10001000
H4956	004	0	1	04	01	H4956_004_0	3	3	Non-Preferred Brand	1	2	10000000
H4956	004	0	1	04	01	H4956_004_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H4956	004	0	1	04	01	H4956_004_0	3	1	Preferred Generic	1	2	00001000
H5005	024	0	1	01	01	H5005_024_0	5	1	Tier 1 Preferred Generic  Brand	1	1	
H5005	024	0	1	01	01	H5005_024_0	5	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H5005	024	0	1	01	01	H5005_024_0	5	2	Tier 2 Generic  Preferred Brand	2		
H5005	024	0	1	01	01	H5005_024_0	5	4	Tier 4 Specialty	2		
H5009	004	0	1	04	01	H5009_004_0	5	1	Generic	1	1	
H5009	004	0	1	04	01	H5009_004_0	5	2	Preferred Brand	2		
H5009	004	0	1	04	01	H5009_004_0	5	3	Non-Preferred Brand	2		
H5009	004	0	1	04	01	H5009_004_0	5	5	Specialty	2		
H5009	004	0	1	04	01	H5009_004_0	5	4	Miscellaneous Injectables	2		
H5010	004	0	1	04	01	H5010_004_0	5	5	Specialty	2		
H5010	004	0	1	04	01	H5010_004_0	5	4	Miscellaneous Injectables	2		
H5010	004	0	1	04	01	H5010_004_0	5	2	Preferred Brand	2		
H5010	004	0	1	04	01	H5010_004_0	5	3	Non-Preferred Brand	2		
H5010	004	0	1	04	01	H5010_004_0	5	1	Generic	1	1	
H5041	001	0	1	04	01	H5041_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5041	001	0	1	04	01	H5041_001_0	5	4	Specialty	1	2	10001000
H5041	001	0	1	04	01	H5041_001_0	5	3	Non-Preferred Brand	1	2	10000000
H5041	001	0	1	04	01	H5041_001_0	5	1	Preferred Generic	1	2	00001000
H5041	002	0	1	04	01	H5041_002_0	5	3	Non-Preferred Brand	1	2	10000000
H5041	002	0	1	04	01	H5041_002_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5041	002	0	1	04	01	H5041_002_0	5	1	Preferred Generic	1	2	00001000
H5041	002	0	1	04	01	H5041_002_0	5	4	Specialty	1	2	10001000
H5042	001	0	1	04	01	H5042_001_0	7	2	Tier 2 Formulary Non-Preferred Generics	1	1	
H5042	001	0	1	04	01	H5042_001_0	7	3	Tier 3 Formulary Preferred Brand	2		
H5042	001	0	1	04	01	H5042_001_0	7	4	Tier 4 Formulary Non-Preferred Brand	2		
H5042	001	0	1	04	01	H5042_001_0	7	5	Tier 5 Formulary Specialty	2		
H5042	001	0	1	04	01	H5042_001_0	7	1	Tier 1 Formulary Preferred Generics	1	1	
H5042	007	0	1	04	01	H5042_007_0	9	4	Tier 4 Formulary Non-Preferred Brand	2		
H5042	007	0	1	04	01	H5042_007_0	9	5	Tier 5 Formulary Specialty	2		
H5042	007	0	1	04	01	H5042_007_0	9	1	Tier 1 Formulary Preferred Generics	1	1	
H5042	007	0	1	04	01	H5042_007_0	9	3	Tier 3 Formulary Preferred Brand	2		
H5042	007	0	1	04	01	H5042_007_0	9	2	Tier 2 Formulary Non-Preferred Generics	1	1	
H5050	012	0	1	01	01	H5050_012_0	6	1	Prefered Generics	1	1	
H5050	012	0	1	01	01	H5050_012_0	6	2	Preferred Brand	2		
H5050	012	0	1	01	01	H5050_012_0	6	3	Non-Preferred	2		
H5087	001	0	1	01	01	H5087_001_0	11	4	Specialty	2		
H5087	001	0	1	01	01	H5087_001_0	11	3	Non-Preferred Brand	2		
H5087	001	0	1	01	01	H5087_001_0	11	1	Preferred Generic	1	1	
H5087	001	0	1	01	01	H5087_001_0	11	2	Preferred Brand	1	1	
H5087	002	0	1	01	01	H5087_002_0	16	3	Non-Preferred Brand	2		
H5087	002	0	1	01	01	H5087_002_0	16	2	Preferred Brand	1	1	
H5087	002	0	1	01	01	H5087_002_0	16	1	Preferred Generics	1	1	
H5087	002	0	1	01	01	H5087_002_0	16	4	Specialty	2		
H5087	005	0	1	01	01	H5087_005_0	15	4	Specialty	2		
H5087	005	0	1	01	01	H5087_005_0	15	1	Preferred Generic	1	1	
H5087	005	0	1	01	01	H5087_005_0	15	2	Preferred Brand	2		
H5087	005	0	1	01	01	H5087_005_0	15	3	Non-Preferred Brand	2		
H5106	014	0	1	04	01	H5106_014_0	5	2	Preferred Brand	2		
H5106	014	0	1	04	01	H5106_014_0	5	4	Specialty	2		
H5106	014	0	1	04	01	H5106_014_0	5	3	Non-Preferred Brand	2		
H5106	014	0	1	04	01	H5106_014_0	5	1	Generic	1	1	
H5106	016	0	1	04	01	H5106_016_0	5	1	Generic	1	1	
H5106	016	0	1	04	01	H5106_016_0	5	4	Specialty	2		
H5106	016	0	1	04	01	H5106_016_0	5	2	Preferred Brand	2		
H5106	016	0	1	04	01	H5106_016_0	5	3	Non-Preferred Brand	2		
H5151	002	0	1	01	01	H5151_002_0	3	4	Specialty	1	2	01000000
H5151	002	0	1	01	01	H5151_002_0	3	3	Non-Preferred Brand	2		
H5151	002	0	1	01	01	H5151_002_0	3	2	Preferred Brand	2		
H5151	002	0	1	01	01	H5151_002_0	3	1	Generic	1	1	
H5214	003	0	1	04	01	H5214_003_0	5	1	Preferred Generic	1	2	00001000
H5214	003	0	1	04	01	H5214_003_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5214	003	0	1	04	01	H5214_003_0	5	3	Non-Preferred Brand	1	2	10000000
H5214	003	0	1	04	01	H5214_003_0	5	4	Specialty	1	2	10001000
H5214	004	0	1	04	01	H5214_004_0	5	1	Preferred Generic	1	2	00001000
H5214	004	0	1	04	01	H5214_004_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5214	004	0	1	04	01	H5214_004_0	5	3	Non-Preferred Brand	1	2	10000000
H5214	004	0	1	04	01	H5214_004_0	5	4	Specialty	1	2	10001000
H5214	008	0	1	04	01	H5214_008_0	5	3	Non-Preferred Brand	1	2	10000000
H5214	008	0	1	04	01	H5214_008_0	5	4	Specialty	1	2	10001000
H5214	008	0	1	04	01	H5214_008_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5214	008	0	1	04	01	H5214_008_0	5	1	Preferred Generic	1	2	00001000
H5214	009	0	1	04	01	H5214_009_0	5	1	Preferred Generic	1	2	00001000
H5214	009	0	1	04	01	H5214_009_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5214	009	0	1	04	01	H5214_009_0	5	3	Non-Preferred Brand	1	2	10000000
H5214	009	0	1	04	01	H5214_009_0	5	4	Specialty	1	2	10001000
H5214	010	0	1	04	01	H5214_010_0	5	4	Specialty	1	2	10001000
H5214	010	0	1	04	01	H5214_010_0	5	3	Non-Preferred Brand	1	2	10000000
H5214	010	0	1	04	01	H5214_010_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5214	010	0	1	04	01	H5214_010_0	5	1	Preferred Generic	1	2	00001000
H5215	002	0	1	04	01	H5215_002_0	4	5	Specialty	2		
H5215	002	0	1	04	01	H5215_002_0	4	4	Non-Preferred Brand	2		
H5215	002	0	1	04	01	H5215_002_0	4	3	Preferred Brand	2		
H5215	002	0	1	04	01	H5215_002_0	4	2	Non-Preferred Generic	1	1	
H5215	002	0	1	04	01	H5215_002_0	4	1	Preferred Generic	1	1	
H5215	005	0	1	04	01	H5215_005_0	4	5	Specialty	2		
H5215	005	0	1	04	01	H5215_005_0	4	2	Non-Preferred Generic	1	1	
H5215	005	0	1	04	01	H5215_005_0	4	3	Preferred Brand	2		
H5215	005	0	1	04	01	H5215_005_0	4	4	Non-Preferred Brand	2		
H5215	005	0	1	04	01	H5215_005_0	4	1	Preferred Generic	1	1	
H5216	001	0	1	04	01	H5216_001_0	4	1	Preferred Generic	1	2	00001000
H5216	001	0	1	04	01	H5216_001_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5216	001	0	1	04	01	H5216_001_0	4	3	Non-Preferred Brand	1	2	10000000
H5216	001	0	1	04	01	H5216_001_0	4	4	Specialty	1	2	10001000
H5216	003	0	1	04	01	H5216_003_0	4	3	Non-Preferred Brand	1	2	10000000
H5216	003	0	1	04	01	H5216_003_0	4	4	Specialty	1	2	10001000
H5216	003	0	1	04	01	H5216_003_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5216	003	0	1	04	01	H5216_003_0	4	1	Preferred Generic	1	2	00001000
H5216	006	0	1	04	01	H5216_006_0	4	1	Preferred Generic	1	2	00001000
H5216	006	0	1	04	01	H5216_006_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5216	006	0	1	04	01	H5216_006_0	4	3	Non-Preferred Brand	1	2	10000000
H5216	006	0	1	04	01	H5216_006_0	4	4	Specialty	1	2	10001000
H5216	007	0	1	04	01	H5216_007_0	4	3	Non-Preferred Brand	1	2	10000000
H5216	007	0	1	04	01	H5216_007_0	4	4	Specialty	1	2	10001000
H5216	007	0	1	04	01	H5216_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5216	007	0	1	04	01	H5216_007_0	4	1	Preferred Generic	1	2	00001000
H5216	008	0	1	04	01	H5216_008_0	4	4	Specialty	1	2	10001000
H5216	008	0	1	04	01	H5216_008_0	4	3	Non-Preferred Brand	1	2	10000000
H5216	008	0	1	04	01	H5216_008_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5216	008	0	1	04	01	H5216_008_0	4	1	Preferred Generic	1	2	00001000
H5291	001	0	1	01	01	H5291_001_0	7	1	Preferred Generic	1	2	00001000
H5291	001	0	1	01	01	H5291_001_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5291	001	0	1	01	01	H5291_001_0	7	3	Non-Preferred Brand	1	2	10000000
H5291	001	0	1	01	01	H5291_001_0	7	4	Specialty	1	2	10001000
H5302	003	0	1	02	01	H5302_003_0	10	3	non-preferred generic/Non-preferred brand	2		
H5302	003	0	1	02	01	H5302_003_0	10	2	preferred brand	2		
H5302	003	0	1	02	01	H5302_003_0	10	1	preferred generic	1	1	
H5302	003	0	1	02	01	H5302_003_0	10	4	Specialty - Generic and Brand	2		
H5302	004	0	1	02	01	H5302_004_0	10	4	Specialty - Generic and Brand	2		
H5302	004	0	1	02	01	H5302_004_0	10	3	non-preferred generic/Non-preferred brand	2		
H5302	004	0	1	02	01	H5302_004_0	10	2	preferred brand	2		
H5302	004	0	1	02	01	H5302_004_0	10	1	preferred generic	1	1	
H5302	005	0	1	02	01	H5302_005_0	8	4	Specialty - Generic and Brand	2		
H5302	005	0	1	02	01	H5302_005_0	8	3	non-preferred generic/Non-preferred brand	2		
H5302	005	0	1	02	01	H5302_005_0	8	2	preferred brand	2		
H5302	005	0	1	02	01	H5302_005_0	8	1	preferred generic	1	1	
H5302	006	0	1	02	01	H5302_006_0	10	4	Specialty - Generic and Brand	2		
H5302	006	0	1	02	01	H5302_006_0	10	3	non-preferred generic/Non-preferred brand	2		
H5302	006	0	1	02	01	H5302_006_0	10	2	preferred brand	2		
H5302	006	0	1	02	01	H5302_006_0	10	1	preferred generic	1	1	
H5378	010	0	1	04	01	H5378_010_0	5	1	Generic	1	1	
H5378	010	0	1	04	01	H5378_010_0	5	2	Preferred Brand	2		
H5378	010	0	1	04	01	H5378_010_0	5	3	Non-Preferred Brand	2		
H5378	010	0	1	04	01	H5378_010_0	5	4	Specialty	2		
H5378	011	0	1	04	01	H5378_011_0	5	2	Preferred Brand	2		
H5378	011	0	1	04	01	H5378_011_0	5	1	Generic	1	1	
H5378	011	0	1	04	01	H5378_011_0	5	3	Non-Preferred Brand	2		
H5378	011	0	1	04	01	H5378_011_0	5	4	Specialty	2		
H5378	092	0	1	04	01	H5378_092_0	5	3	Non-Preferred Brand	2		
H5378	092	0	1	04	01	H5378_092_0	5	2	Preferred Brand	2		
H5378	092	0	1	04	01	H5378_092_0	5	1	Generic	1	1	
H5378	092	0	1	04	01	H5378_092_0	5	4	Specialty	2		
H5378	181	0	1	04	01	H5378_181_0	5	4	Specialty	2		
H5378	181	0	1	04	01	H5378_181_0	5	3	Non-Preferred Brand	2		
H5378	181	0	1	04	01	H5378_181_0	5	2	Preferred Brand	2		
H5378	181	0	1	04	01	H5378_181_0	5	1	Generic	1	1	
H5378	182	0	1	04	01	H5378_182_0	5	1	Generic	1	1	
H5378	182	0	1	04	01	H5378_182_0	5	4	Specialty	2		
H5378	182	0	1	04	01	H5378_182_0	5	3	Non-Preferred Brand	2		
H5378	182	0	1	04	01	H5378_182_0	5	2	Preferred Brand	2		
H5378	183	0	1	04	01	H5378_183_0	5	4	Specialty	2		
H5378	183	0	1	04	01	H5378_183_0	5	3	Non-Preferred Brand	2		
H5378	183	0	1	04	01	H5378_183_0	5	2	Preferred Brand	2		
H5378	183	0	1	04	01	H5378_183_0	5	1	Generic	1	1	
H5378	184	0	1	04	01	H5378_184_0	5	4	Specialty	2		
H5378	184	0	1	04	01	H5378_184_0	5	1	Generic	1	1	
H5378	184	0	1	04	01	H5378_184_0	5	2	Preferred Brand	2		
H5378	184	0	1	04	01	H5378_184_0	5	3	Non-Preferred Brand	2		
H5378	185	0	1	04	01	H5378_185_0	5	1	Generic	1	1	
H5378	185	0	1	04	01	H5378_185_0	5	2	Preferred Brand	2		
H5378	185	0	1	04	01	H5378_185_0	5	3	Non-Preferred Brand	2		
H5378	185	0	1	04	01	H5378_185_0	5	4	Specialty	2		
H5378	186	0	1	04	01	H5378_186_0	5	1	Generic	1	1	
H5378	186	0	1	04	01	H5378_186_0	5	4	Specialty	2		
H5378	186	0	1	04	01	H5378_186_0	5	3	Non-Preferred Brand	2		
H5378	186	0	1	04	01	H5378_186_0	5	2	Preferred Brand	2		
H5378	188	0	1	04	01	H5378_188_0	5	2	Preferred Brand	2		
H5378	188	0	1	04	01	H5378_188_0	5	3	Non-Preferred Brand	2		
H5378	188	0	1	04	01	H5378_188_0	5	4	Specialty	2		
H5378	188	0	1	04	01	H5378_188_0	5	1	Generic	1	1	
H5402	007	0	1	01	01	H5402_007_0	5	3	Brand	2		
H5402	007	0	1	01	01	H5402_007_0	5	2	Preferred Brand	2		
H5402	007	0	1	01	01	H5402_007_0	5	4	Non-Preferred Brand	2		
H5402	007	0	1	01	01	H5402_007_0	5	5	Specialty	2		
H5402	007	0	1	01	01	H5402_007_0	5	1	Generic	1	1	
H5402	032	0	1	01	01	H5402_032_0	4	4	Non-Preferred Brand	2		
H5402	032	0	1	01	01	H5402_032_0	4	5	Specialty	2		
H5402	032	0	1	01	01	H5402_032_0	4	3	Brand	2		
H5402	032	0	1	01	01	H5402_032_0	4	1	Generic	1	1	
H5402	032	0	1	01	01	H5402_032_0	4	2	Preferred Brand	2		
H5402	035	0	1	01	01	H5402_035_0	5	2	Preferred Brand	2		
H5402	035	0	1	01	01	H5402_035_0	5	3	Brand	2		
H5402	035	0	1	01	01	H5402_035_0	5	5	Specialty	2		
H5402	035	0	1	01	01	H5402_035_0	5	4	Non-Preferred Brand	2		
H5402	035	0	1	01	01	H5402_035_0	5	1	Generic	1	1	
H5402	036	0	1	01	01	H5402_036_0	6	4	Non-Preferred Brand	2		
H5402	036	0	1	01	01	H5402_036_0	6	5	Specialty	2		
H5402	036	0	1	01	01	H5402_036_0	6	3	Brand	2		
H5402	036	0	1	01	01	H5402_036_0	6	2	Preferred Brand	2		
H5402	036	0	1	01	01	H5402_036_0	6	1	Generic	1	1	
H5402	038	0	1	01	01	H5402_038_0	5	5	Specialty	2		
H5402	038	0	1	01	01	H5402_038_0	5	1	Generic	1	1	
H5402	038	0	1	01	01	H5402_038_0	5	3	Brand	2		
H5402	038	0	1	01	01	H5402_038_0	5	4	Non-Preferred Brand	2		
H5402	038	0	1	01	01	H5402_038_0	5	2	Preferred Brand	2		
H5407	001	0	1	02	01	H5407_001_0	6	4	Specialty	2		
H5407	001	0	1	02	01	H5407_001_0	6	1	Preferred Generics	1	1	
H5407	001	0	1	02	01	H5407_001_0	6	2	Preferred Brands and Non-Preferred Generics	2		
H5407	001	0	1	02	01	H5407_001_0	6	3	Non-Preferred Brands	2		
H5407	004	0	1	02	01	H5407_004_0	6	1	Preferred Generics	1	1	
H5407	004	0	1	02	01	H5407_004_0	6	2	Preferred Brands and Non-Preferred Generics	2		
H5407	004	0	1	02	01	H5407_004_0	6	4	Specialty	2		
H5407	004	0	1	02	01	H5407_004_0	6	3	Non-Preferred Brands	2		
H5407	005	0	1	02	01	H5407_005_0	6	1	Preferred Generics	1	1	
H5407	005	0	1	02	01	H5407_005_0	6	2	Preferred Brands and Non-Preferred Generics	2		
H5407	005	0	1	02	01	H5407_005_0	6	4	Specialty	2		
H5407	005	0	1	02	01	H5407_005_0	6	3	Non-Preferred Brands	2		
H5407	009	0	1	02	01	H5407_009_0	7	4	Specialty	2		
H5407	009	0	1	02	01	H5407_009_0	7	3	Non-Preferred Brands	2		
H5407	009	0	1	02	01	H5407_009_0	7	1	Preferred Generics	1	1	
H5407	009	0	1	02	01	H5407_009_0	7	2	Preferred Brands and Non-Preferred Generics	2		
H5407	014	0	1	02	01	H5407_014_0	6	1	Preferred Generics	1	1	
H5407	014	0	1	02	01	H5407_014_0	6	3	Non-Preferred Brands	2		
H5407	014	0	1	02	01	H5407_014_0	6	4	Specialty	2		
H5407	014	0	1	02	01	H5407_014_0	6	2	Preferred Brands and Non-Preferred Generics	2		
H5407	016	0	1	02	01	H5407_016_0	8	4	Specialty	2		
H5407	016	0	1	02	01	H5407_016_0	8	3	Non-Preferred Brands	2		
H5407	016	0	1	02	01	H5407_016_0	8	2	Preferred Brands and Non-Preferred Generics	2		
H5407	016	0	1	02	01	H5407_016_0	8	1	Preferred Generics	1	1	
H5410	001	0	1	01	01	H5410_001_0	7	1	Generic Drugs	1	1	
H5410	001	0	1	01	01	H5410_001_0	7	2	Brand Name Drugs	2		
H5410	001	0	1	01	01	H5410_001_0	7	3	Specialty Drugs	1	2	01000000
H5410	003	0	1	01	01	H5410_003_0	4	5	Specialty	2		
H5410	003	0	1	01	01	H5410_003_0	4	4	Non-Preferred Brand	2		
H5410	003	0	1	01	01	H5410_003_0	4	3	Preferred Brand	2		
H5410	003	0	1	01	01	H5410_003_0	4	1	Preferred Generic	1	1	
H5410	003	0	1	01	01	H5410_003_0	4	2	Generic	1	1	
H5410	005	0	1	01	01	H5410_005_0	5	1	Preferred Generic	1	1	
H5410	005	0	1	01	01	H5410_005_0	5	2	Generic	1	1	
H5410	005	0	1	01	01	H5410_005_0	5	3	Preferred Brand	2		
H5410	005	0	1	01	01	H5410_005_0	5	4	Non-Preferred Brand	2		
H5410	005	0	1	01	01	H5410_005_0	5	5	Specialty	2		
H5414	002	0	1	01	01	H5414_002_0	7	1	Tier 1 - Preferred Generic	1	1	
H5414	002	0	1	01	01	H5414_002_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5414	002	0	1	01	01	H5414_002_0	7	3	Tier 3 - Preferred Brand	2		
H5414	002	0	1	01	01	H5414_002_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5414	002	0	1	01	01	H5414_002_0	7	5	Tier 5 - Specialty	2		
H5414	012	0	1	01	01	H5414_012_0	7	1	Tier 1 - Preferred Generic	1	1	
H5414	012	0	1	01	01	H5414_012_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5414	012	0	1	01	01	H5414_012_0	7	3	Tier 3 - Preferred Brand	2		
H5414	012	0	1	01	01	H5414_012_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5414	012	0	1	01	01	H5414_012_0	7	5	Tier 5 - Specialty	2		
H5414	020	0	1	01	01	H5414_020_0	7	1	Tier 1 - Preferred Generic	1	1	
H5414	020	0	1	01	01	H5414_020_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5414	020	0	1	01	01	H5414_020_0	7	3	Tier 3 - Preferred Brand	2		
H5414	020	0	1	01	01	H5414_020_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5414	020	0	1	01	01	H5414_020_0	7	5	Tier 5 - Specialty	2		
H5415	039	0	1	04	01	H5415_039_0	6	1	Preferred Generic	1	2	00001000
H5415	039	0	1	04	01	H5415_039_0	6	4	Specialty	1	2	10001000
H5415	039	0	1	04	01	H5415_039_0	6	3	Non-Preferred Brand	1	2	10000000
H5415	039	0	1	04	01	H5415_039_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5416	001	0	1	01	01	H5416_001_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5416	001	0	1	01	01	H5416_001_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	001	0	1	01	01	H5416_001_0	6	5	Tier 5 - Specialty	2		
H5416	001	0	1	01	01	H5416_001_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	001	0	1	01	01	H5416_001_0	6	3	Tier 3 - Preferred Brand	2		
H5416	002	0	1	01	01	H5416_002_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	002	0	1	01	01	H5416_002_0	6	5	Tier 5 - Specialty	2		
H5416	002	0	1	01	01	H5416_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	002	0	1	01	01	H5416_002_0	6	3	Tier 3 - Preferred Brand	2		
H5416	002	0	1	01	01	H5416_002_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5416	004	0	1	01	01	H5416_004_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5416	004	0	1	01	01	H5416_004_0	7	5	Tier 5 - Specialty	2		
H5416	004	0	1	01	01	H5416_004_0	7	3	Tier 3 - Preferred Brand	2		
H5416	004	0	1	01	01	H5416_004_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5416	004	0	1	01	01	H5416_004_0	7	1	Tier 1 - Preferred Generic	1	1	
H5416	009	0	1	01	01	H5416_009_0	6	3	Tier 3 - Preferred Brand	2		
H5416	009	0	1	01	01	H5416_009_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5416	009	0	1	01	01	H5416_009_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	009	0	1	01	01	H5416_009_0	6	5	Tier 5 - Specialty	2		
H5416	009	0	1	01	01	H5416_009_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	011	0	1	01	01	H5416_011_0	7	5	Tier 5 - Specialty	2		
H5416	011	0	1	01	01	H5416_011_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5416	011	0	1	01	01	H5416_011_0	7	3	Tier 3 - Preferred Brand	2		
H5416	011	0	1	01	01	H5416_011_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5416	011	0	1	01	01	H5416_011_0	7	1	Tier 1 - Preferred Generic	1	1	
H5416	013	0	1	01	01	H5416_013_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	013	0	1	01	01	H5416_013_0	6	3	Tier 3 - Preferred Brand	2		
H5416	013	0	1	01	01	H5416_013_0	6	2	Tier 2 - Non-Preferred Generic	1	1	
H5416	013	0	1	01	01	H5416_013_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	013	0	1	01	01	H5416_013_0	6	5	Tier 5 - Specialty	2		
H5416	016	0	1	01	01	H5416_016_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	016	0	1	01	01	H5416_016_0	6	3	Tier 3 - Preferred Brand	2		
H5416	016	0	1	01	01	H5416_016_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5416	016	0	1	01	01	H5416_016_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	016	0	1	01	01	H5416_016_0	6	5	Tier 5 - Specialty	2		
H5416	017	0	1	01	01	H5416_017_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	017	0	1	01	01	H5416_017_0	6	3	Tier 3 - Preferred Brand	2		
H5416	017	0	1	01	01	H5416_017_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5416	017	0	1	01	01	H5416_017_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	017	0	1	01	01	H5416_017_0	6	5	Tier 5 - Specialty	2		
H5416	018	0	1	01	01	H5416_018_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	018	0	1	01	01	H5416_018_0	6	3	Tier 3 - Preferred Brand	2		
H5416	018	0	1	01	01	H5416_018_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5416	018	0	1	01	01	H5416_018_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	018	0	1	01	01	H5416_018_0	6	5	Tier 5 - Specialty	2		
H5416	020	0	1	01	01	H5416_020_0	6	1	Tier 1 - Preferred Generic	1	1	
H5416	020	0	1	01	01	H5416_020_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5416	020	0	1	01	01	H5416_020_0	6	3	Tier 3 - Preferred Brand	2		
H5416	020	0	1	01	01	H5416_020_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5416	020	0	1	01	01	H5416_020_0	6	5	Tier 5 - Specialty	2		
H5416	021	0	1	01	01	H5416_021_0	8	2	Tier 2 - Non-Preferred Generic	2		
H5416	021	0	1	01	01	H5416_021_0	8	3	Tier 3 - Preferred Brand	2		
H5416	021	0	1	01	01	H5416_021_0	8	4	Tier 4 - Non-Preferred Brand	2		
H5416	021	0	1	01	01	H5416_021_0	8	5	Tier 5 - Specialty	2		
H5416	021	0	1	01	01	H5416_021_0	8	1	Tier 1 - Preferred Generic	1	1	
H5416	023	0	1	01	01	H5416_023_0	8	1	Tier 1 - Preferred Generic	1	1	
H5416	023	0	1	01	01	H5416_023_0	8	2	Tier 2 - Non-Preferred Generic	1	1	
H5416	023	0	1	01	01	H5416_023_0	8	3	Tier 3 - Preferred Brand	2		
H5416	023	0	1	01	01	H5416_023_0	8	4	Tier 4 - Non-Preferred Brand	2		
H5416	023	0	1	01	01	H5416_023_0	8	5	Tier 5 - Specialty	2		
H5416	029	0	1	02	01	H5416_029_0	7	5	Tier 5 - Specialty	2		
H5416	029	0	1	02	01	H5416_029_0	7	1	Tier 1 - Preferred Generic	1	1	
H5416	029	0	1	02	01	H5416_029_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5416	029	0	1	02	01	H5416_029_0	7	3	Tier 3 - Preferred Brand	2		
H5416	029	0	1	02	01	H5416_029_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5416	030	0	1	02	01	H5416_030_0	7	1	Tier 1 - Preferred Generic	1	1	
H5416	030	0	1	02	01	H5416_030_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5416	030	0	1	02	01	H5416_030_0	7	5	Tier 5 - Specialty	2		
H5416	030	0	1	02	01	H5416_030_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5416	030	0	1	02	01	H5416_030_0	7	3	Tier 3 - Preferred Brand	2		
H5419	004	0	1	09	04	H5419_004_0	14	5	Tier 5 Specialty Drugs	2		
H5419	004	0	1	09	04	H5419_004_0	14	1	Tier 1 Preferred Generic Drugs	1	1	
H5419	004	0	1	09	04	H5419_004_0	14	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5419	004	0	1	09	04	H5419_004_0	14	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5419	004	0	1	09	04	H5419_004_0	14	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5420	003	0	1	05	01	H5420_003_0	4	1	Generic	1	1	
H5420	003	0	1	05	01	H5420_003_0	4	2	Preferred Brand	2		
H5420	003	0	1	05	01	H5420_003_0	4	3	Formulary Brand	2		
H5420	003	0	1	05	01	H5420_003_0	4	4	Non-Preferred Brand	2		
H5420	003	0	1	05	01	H5420_003_0	4	5	Specialty	2		
H5420	004	0	1	05	01	H5420_004_0	4	4	Non-Preferred Brand	2		
H5420	004	0	1	05	01	H5420_004_0	4	5	Specialty	2		
H5420	004	0	1	05	01	H5420_004_0	4	3	Formulary Brand	2		
H5420	004	0	1	05	01	H5420_004_0	4	2	Preferred Brand	1	1	
H5420	004	0	1	05	01	H5420_004_0	4	1	Generic	1	1	
H5420	005	0	1	05	01	H5420_005_0	6	5	Specialty	2		
H5420	005	0	1	05	01	H5420_005_0	6	1	Generic	1	1	
H5420	005	0	1	05	01	H5420_005_0	6	4	Non-Preferred Brand	2		
H5420	005	0	1	05	01	H5420_005_0	6	3	Formulary Brand	2		
H5420	005	0	1	05	01	H5420_005_0	6	2	Preferred Brand	2		
H5420	006	0	1	05	01	H5420_006_0	6	1	Generic	1	1	
H5420	006	0	1	05	01	H5420_006_0	6	2	Preferred Brand	1	1	
H5420	006	0	1	05	01	H5420_006_0	6	3	Formulary Brand	2		
H5420	006	0	1	05	01	H5420_006_0	6	4	Non-Preferred Brand	2		
H5420	006	0	1	05	01	H5420_006_0	6	5	Specialty	2		
H5421	064	0	1	09	04	H5421_064_0	7	4	Specialty	2		
H5421	064	0	1	09	04	H5421_064_0	7	3	Non-Preferred Brand	2		
H5421	064	0	1	09	04	H5421_064_0	7	2	Preferred Brand	2		
H5421	064	0	1	09	04	H5421_064_0	7	1	Generic	1	1	
H5421	065	0	1	09	04	H5421_065_0	7	3	Non-Preferred Brand	2		
H5421	065	0	1	09	04	H5421_065_0	7	4	Specialty	2		
H5421	065	0	1	09	04	H5421_065_0	7	2	Preferred Brand	2		
H5421	065	0	1	09	04	H5421_065_0	7	1	Generic	1	1	
H5421	066	0	1	09	04	H5421_066_0	7	2	Preferred Brand	2		
H5421	066	0	1	09	04	H5421_066_0	7	1	Generic	1	1	
H5421	066	0	1	09	04	H5421_066_0	7	4	Specialty	2		
H5421	066	0	1	09	04	H5421_066_0	7	3	Non-Preferred Brand	2		
H5421	067	0	1	09	04	H5421_067_0	7	2	Preferred Brand	2		
H5421	067	0	1	09	04	H5421_067_0	7	4	Specialty	2		
H5421	067	0	1	09	04	H5421_067_0	7	3	Non-Preferred Brand	2		
H5421	067	0	1	09	04	H5421_067_0	7	1	Generic	1	1	
H5421	068	0	1	09	04	H5421_068_0	7	4	Specialty	2		
H5421	068	0	1	09	04	H5421_068_0	7	3	Non-Preferred Brand	2		
H5421	068	0	1	09	04	H5421_068_0	7	2	Preferred Brand	2		
H5421	068	0	1	09	04	H5421_068_0	7	1	Generic	1	1	
H5421	069	0	1	09	04	H5421_069_0	7	1	Generic	1	1	
H5421	069	0	1	09	04	H5421_069_0	7	2	Preferred Brand	2		
H5421	069	0	1	09	04	H5421_069_0	7	3	Non-Preferred Brand	2		
H5421	069	0	1	09	04	H5421_069_0	7	4	Specialty	2		
H5421	103	0	1	09	04	H5421_103_0	6	3	Non-Preferred Brand	2		
H5421	103	0	1	09	04	H5421_103_0	6	4	Specialty	2		
H5421	103	0	1	09	04	H5421_103_0	6	1	Generic	1	1	
H5421	103	0	1	09	04	H5421_103_0	6	2	Preferred Brand	2		
H5421	109	0	1	09	04	H5421_109_0	6	3	Non-Preferred Brand	2		
H5421	109	0	1	09	04	H5421_109_0	6	2	Preferred Brand	2		
H5421	109	0	1	09	04	H5421_109_0	6	4	Specialty	2		
H5421	109	0	1	09	04	H5421_109_0	6	1	Generic	1	1	
H5421	115	0	1	09	04	H5421_115_0	6	3	Non-Preferred Brand	2		
H5421	115	0	1	09	04	H5421_115_0	6	4	Specialty	2		
H5421	115	0	1	09	04	H5421_115_0	6	2	Preferred Brand	2		
H5421	115	0	1	09	04	H5421_115_0	6	1	Generic	1	1	
H5421	127	0	1	09	04	H5421_127_0	6	2	Preferred Brand	2		
H5421	127	0	1	09	04	H5421_127_0	6	1	Generic	1	1	
H5421	127	0	1	09	04	H5421_127_0	6	4	Specialty	2		
H5421	127	0	1	09	04	H5421_127_0	6	3	Non-Preferred Brand	2		
H5421	133	0	1	09	04	H5421_133_0	9	4	Specialty	2		
H5421	133	0	1	09	04	H5421_133_0	9	3	Non-Preferred Brand	2		
H5421	133	0	1	09	04	H5421_133_0	9	2	Preferred Brand	2		
H5421	133	0	1	09	04	H5421_133_0	9	1	Generic	1	1	
H5421	140	0	1	09	04	H5421_140_0	6	4	Specialty	2		
H5421	140	0	1	09	04	H5421_140_0	6	3	Non-Preferred Brand	2		
H5421	140	0	1	09	04	H5421_140_0	6	1	Generic	1	1	
H5421	140	0	1	09	04	H5421_140_0	6	2	Preferred Brand	2		
H5421	148	0	1	09	04	H5421_148_0	6	1	Generic	1	1	
H5421	148	0	1	09	04	H5421_148_0	6	2	Preferred Brand	2		
H5421	148	0	1	09	04	H5421_148_0	6	3	Non-Preferred Brand	2		
H5421	148	0	1	09	04	H5421_148_0	6	4	Specialty	2		
H5421	156	0	1	09	04	H5421_156_0	6	1	Generic	1	1	
H5421	156	0	1	09	04	H5421_156_0	6	2	Preferred Brand	2		
H5421	156	0	1	09	04	H5421_156_0	6	3	Non-Preferred Brand	2		
H5421	156	0	1	09	04	H5421_156_0	6	4	Specialty	2		
H5421	164	0	1	09	04	H5421_164_0	6	4	Specialty	2		
H5421	164	0	1	09	04	H5421_164_0	6	3	Non-Preferred Brand	2		
H5421	164	0	1	09	04	H5421_164_0	6	1	Generic	1	1	
H5421	164	0	1	09	04	H5421_164_0	6	2	Preferred Brand	2		
H5421	172	0	1	09	04	H5421_172_0	6	2	Preferred Brand	2		
H5421	172	0	1	09	04	H5421_172_0	6	3	Non-Preferred Brand	2		
H5421	172	0	1	09	04	H5421_172_0	6	4	Specialty	2		
H5421	172	0	1	09	04	H5421_172_0	6	1	Generic	1	1	
H5421	180	0	1	09	04	H5421_180_0	6	3	Non-Preferred Brand	2		
H5421	180	0	1	09	04	H5421_180_0	6	4	Specialty	2		
H5421	180	0	1	09	04	H5421_180_0	6	2	Preferred Brand	2		
H5421	180	0	1	09	04	H5421_180_0	6	1	Generic	1	1	
H5422	002	0	1	01	01	H5422_002_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5422	002	0	1	01	01	H5422_002_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5422	002	0	1	01	01	H5422_002_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5422	002	0	1	01	01	H5422_002_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H5422	002	0	1	01	01	H5422_002_0	10	5	Tier 5 Specialty Drugs	2		
H5422	006	0	1	01	01	H5422_006_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5422	006	0	1	01	01	H5422_006_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5422	006	0	1	01	01	H5422_006_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5422	006	0	1	01	01	H5422_006_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H5422	006	0	1	01	01	H5422_006_0	10	5	Tier 5 Specialty Drugs	2		
H5425	001	0	1	01	01	H5425_001_0	6	1	Select Generic	1	1	
H5425	001	0	1	01	01	H5425_001_0	6	2	Generic	1	1	
H5425	001	0	1	01	01	H5425_001_0	6	3	Brand	2		
H5425	001	0	1	01	01	H5425_001_0	6	4	Additional Brand	2		
H5425	001	0	1	01	01	H5425_001_0	6	5	Specialty	2		
H5425	003	0	1	01	01	H5425_003_0	6	3	Brand	2		
H5425	003	0	1	01	01	H5425_003_0	6	5	Specialty	2		
H5425	003	0	1	01	01	H5425_003_0	6	4	Additional Brand	2		
H5425	003	0	1	01	01	H5425_003_0	6	2	Generic	1	1	
H5425	003	0	1	01	01	H5425_003_0	6	1	Select Generic	1	1	
H5425	004	0	1	01	01	H5425_004_0	5	2	Generic	1	1	
H5425	004	0	1	01	01	H5425_004_0	5	4	Additional Brand	2		
H5425	004	0	1	01	01	H5425_004_0	5	1	Select Generic	1	1	
H5425	004	0	1	01	01	H5425_004_0	5	3	Brand	2		
H5425	004	0	1	01	01	H5425_004_0	5	5	Specialty	2		
H5425	005	0	1	01	01	H5425_005_0	5	2	Generic	1	1	
H5425	005	0	1	01	01	H5425_005_0	5	5	Specialty	2		
H5425	005	0	1	01	01	H5425_005_0	5	3	Brand	2		
H5425	005	0	1	01	01	H5425_005_0	5	4	Additional Brand	2		
H5425	005	0	1	01	01	H5425_005_0	5	1	Select Generic	1	1	
H5425	006	0	1	01	01	H5425_006_0	6	5	Specialty	2		
H5425	006	0	1	01	01	H5425_006_0	6	4	Additional Brand	2		
H5425	006	0	1	01	01	H5425_006_0	6	3	Brand	2		
H5425	006	0	1	01	01	H5425_006_0	6	1	Select Generic	1	1	
H5425	006	0	1	01	01	H5425_006_0	6	2	Generic	1	1	
H5425	007	0	1	01	01	H5425_007_0	6	2	Generic	1	1	
H5425	007	0	1	01	01	H5425_007_0	6	1	Select Generic	1	1	
H5425	007	0	1	01	01	H5425_007_0	6	4	Additional Brand	2		
H5425	007	0	1	01	01	H5425_007_0	6	3	Brand	2		
H5425	007	0	1	01	01	H5425_007_0	6	5	Specialty	2		
H5425	008	0	1	01	01	H5425_008_0	5	2	Generic	1	1	
H5425	008	0	1	01	01	H5425_008_0	5	3	Brand	2		
H5425	008	0	1	01	01	H5425_008_0	5	4	Additional Brand	2		
H5425	008	0	1	01	01	H5425_008_0	5	5	Specialty	2		
H5425	008	0	1	01	01	H5425_008_0	5	1	Select Generic	1	1	
H5425	009	0	1	01	01	H5425_009_0	5	4	Additional Brand	2		
H5425	009	0	1	01	01	H5425_009_0	5	3	Brand	2		
H5425	009	0	1	01	01	H5425_009_0	5	2	Generic	1	1	
H5425	009	0	1	01	01	H5425_009_0	5	1	Select Generic	1	1	
H5425	009	0	1	01	01	H5425_009_0	5	5	Specialty	2		
H5425	013	0	1	01	01	H5425_013_0	8	4	Additional Brand	2		
H5425	013	0	1	01	01	H5425_013_0	8	5	Specialty	2		
H5425	013	0	1	01	01	H5425_013_0	8	3	Brand	2		
H5425	013	0	1	01	01	H5425_013_0	8	2	Generic	1	1	
H5425	013	0	1	01	01	H5425_013_0	8	1	Select Generic	1	1	
H5425	014	0	1	01	01	H5425_014_0	8	4	Additional Brand	2		
H5425	014	0	1	01	01	H5425_014_0	8	5	Specialty	2		
H5425	014	0	1	01	01	H5425_014_0	8	3	Brand	2		
H5425	014	0	1	01	01	H5425_014_0	8	2	Generic	1	1	
H5425	014	0	1	01	01	H5425_014_0	8	1	Select Generic	1	1	
H5425	015	0	1	01	01	H5425_015_0	8	5	Specialty	2		
H5425	015	0	1	01	01	H5425_015_0	8	1	Select Generic	1	1	
H5425	015	0	1	01	01	H5425_015_0	8	2	Generic	1	1	
H5425	015	0	1	01	01	H5425_015_0	8	4	Additional Brand	2		
H5425	015	0	1	01	01	H5425_015_0	8	3	Brand	2		
H5425	016	0	1	01	01	H5425_016_0	8	5	Specialty	2		
H5425	016	0	1	01	01	H5425_016_0	8	4	Additional Brand	2		
H5425	016	0	1	01	01	H5425_016_0	8	3	Brand	2		
H5425	016	0	1	01	01	H5425_016_0	8	1	Select Generic	1	1	
H5425	016	0	1	01	01	H5425_016_0	8	2	Generic	1	1	
H5425	018	0	1	01	01	H5425_018_0	8	1	Select Generic	1	1	
H5425	018	0	1	01	01	H5425_018_0	8	2	Generic	1	1	
H5425	018	0	1	01	01	H5425_018_0	8	3	Brand	2		
H5425	018	0	1	01	01	H5425_018_0	8	4	Additional Brand	2		
H5425	018	0	1	01	01	H5425_018_0	8	5	Specialty	2		
H5425	019	0	1	01	01	H5425_019_0	9	1	Select Generic	1	1	
H5425	019	0	1	01	01	H5425_019_0	9	2	Generic	1	1	
H5425	019	0	1	01	01	H5425_019_0	9	3	Brand	2		
H5425	019	0	1	01	01	H5425_019_0	9	4	Additional Brand	2		
H5425	019	0	1	01	01	H5425_019_0	9	5	Specialty	2		
H5425	020	0	1	01	01	H5425_020_0	9	1	Select Generic	1	1	
H5425	020	0	1	01	01	H5425_020_0	9	2	Generic	1	1	
H5425	020	0	1	01	01	H5425_020_0	9	3	Brand	2		
H5425	020	0	1	01	01	H5425_020_0	9	5	Specialty	2		
H5425	020	0	1	01	01	H5425_020_0	9	4	Additional Brand	2		
H5425	025	0	1	02	01	H5425_025_0	10	3	Brand	2		
H5425	025	0	1	02	01	H5425_025_0	10	2	Generic	1	1	
H5425	025	0	1	02	01	H5425_025_0	10	5	Specialty	2		
H5425	025	0	1	02	01	H5425_025_0	10	4	Additional Brand	2		
H5425	025	0	1	02	01	H5425_025_0	10	1	Select Generic	1	1	
H5425	026	0	1	02	01	H5425_026_0	10	5	Specialty	2		
H5425	026	0	1	02	01	H5425_026_0	10	1	Select Generic	1	1	
H5425	026	0	1	02	01	H5425_026_0	10	2	Generic	1	1	
H5425	026	0	1	02	01	H5425_026_0	10	3	Brand	2		
H5425	026	0	1	02	01	H5425_026_0	10	4	Additional Brand	2		
H5425	027	0	1	02	01	H5425_027_0	10	4	Additional Brand	2		
H5425	027	0	1	02	01	H5425_027_0	10	5	Specialty	2		
H5425	027	0	1	02	01	H5425_027_0	10	3	Brand	2		
H5425	027	0	1	02	01	H5425_027_0	10	2	Generic	1	1	
H5425	027	0	1	02	01	H5425_027_0	10	1	Select Generic	1	1	
H5426	001	0	1	02	01	H5426_001_0	5	4	Specialty	1	2	10001000
H5426	001	0	1	02	01	H5426_001_0	5	3	Non-Preferred Brand	1	2	10000000
H5426	001	0	1	02	01	H5426_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5426	001	0	1	02	01	H5426_001_0	5	1	Preferred Generic	1	2	00001000
H5426	002	0	1	02	01	H5426_002_0	7	4	Specialty	1	2	10001000
H5426	002	0	1	02	01	H5426_002_0	7	3	Non-Preferred Brand	1	2	10000000
H5426	002	0	1	02	01	H5426_002_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5426	002	0	1	02	01	H5426_002_0	7	1	Preferred Generic	1	2	00001000
H5426	008	0	1	02	01	H5426_008_0	8	1	Preferred Generic	1	2	00001000
H5426	008	0	1	02	01	H5426_008_0	8	3	Non-Preferred Brand	1	2	10000000
H5426	008	0	1	02	01	H5426_008_0	8	4	Specialty	1	2	10001000
H5426	008	0	1	02	01	H5426_008_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5426	019	0	1	01	01	H5426_019_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5426	019	0	1	01	01	H5426_019_0	5	1	Preferred Generic	1	2	00001000
H5426	019	0	1	01	01	H5426_019_0	5	3	Non-Preferred Brand	1	2	10000000
H5426	019	0	1	01	01	H5426_019_0	5	4	Specialty	1	2	10001000
H5427	060	0	1	01	01	H5427_060_0	5	4	Tier 4	2		
H5427	060	0	1	01	01	H5427_060_0	5	3	Tier 3	2		
H5427	060	0	1	01	01	H5427_060_0	5	1	Tier 1	1	1	
H5427	060	0	1	01	01	H5427_060_0	5	2	Tier2	2		
H5427	062	0	1	01	01	H5427_062_0	6	3	Tier 3	2		
H5427	062	0	1	01	01	H5427_062_0	6	2	Tier2	2		
H5427	062	0	1	01	01	H5427_062_0	6	1	Tier 1	1	1	
H5427	062	0	1	01	01	H5427_062_0	6	4	Tier 4	2		
H5427	070	0	1	01	01	H5427_070_0	6	2	Tier2	2		
H5427	070	0	1	01	01	H5427_070_0	6	4	Tier 4	2		
H5427	070	0	1	01	01	H5427_070_0	6	3	Tier 3	2		
H5427	070	0	1	01	01	H5427_070_0	6	1	Tier 1	1	1	
H5427	076	0	1	01	01	H5427_076_0	6	1	Tier 1	1	1	
H5427	076	0	1	01	01	H5427_076_0	6	4	Tier 4	2		
H5427	076	0	1	01	01	H5427_076_0	6	2	Tier2	2		
H5427	076	0	1	01	01	H5427_076_0	6	3	Tier 3	2		
H5427	080	0	1	01	01	H5427_080_0	7	1	Tier 1	1	1	
H5427	080	0	1	01	01	H5427_080_0	7	2	Tier2	2		
H5427	080	0	1	01	01	H5427_080_0	7	4	Tier 4	2		
H5427	080	0	1	01	01	H5427_080_0	7	3	Tier 3	2		
H5427	081	0	1	01	01	H5427_081_0	9	4	Tier 4	2		
H5427	081	0	1	01	01	H5427_081_0	9	2	Tier2	2		
H5427	081	0	1	01	01	H5427_081_0	9	3	Tier 3	2		
H5427	081	0	1	01	01	H5427_081_0	9	1	Tier 1	1	1	
H5431	001	0	1	01	01	H5431_001_0	4	1	Preferred Generic	1	1	
H5431	001	0	1	01	01	H5431_001_0	4	2	Non-Preferred Generic	1	1	
H5431	001	0	1	01	01	H5431_001_0	4	3	Preferred Brand	2		
H5431	001	0	1	01	01	H5431_001_0	4	4	Non-Preferred Brand	2		
H5431	001	0	1	01	01	H5431_001_0	4	5	Specialty	2		
H5431	002	0	1	01	01	H5431_002_0	4	1	Preferred Generic	1	1	
H5431	002	0	1	01	01	H5431_002_0	4	2	Non-Preferred Generic	1	1	
H5431	002	0	1	01	01	H5431_002_0	4	3	Preferred Brand	2		
H5431	002	0	1	01	01	H5431_002_0	4	4	Non-Preferred Brand	2		
H5431	002	0	1	01	01	H5431_002_0	4	5	Specialty	2		
H5431	005	0	1	01	01	H5431_005_0	4	2	Non-Preferred Generic	1	1	
H5431	005	0	1	01	01	H5431_005_0	4	3	Preferred Brand	2		
H5431	005	0	1	01	01	H5431_005_0	4	4	Non-Preferred Brand	2		
H5431	005	0	1	01	01	H5431_005_0	4	5	Specialty	2		
H5431	005	0	1	01	01	H5431_005_0	4	1	Preferred Generic	1	1	
H5433	001	0	1	01	01	H5433_001_0	7	1	Tier #1	1	1	
H5433	001	0	1	01	01	H5433_001_0	7	2	Pre-ICL Tier 2, Tier #2	2		
H5470	002	0	1	04	01	H5470_002_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5470	002	0	1	04	01	H5470_002_0	5	1	Preferred Generic	1	2	00001000
H5470	002	0	1	04	01	H5470_002_0	5	3	Non-Preferred Brand	1	2	10000000
H5470	002	0	1	04	01	H5470_002_0	5	4	Specialty	1	2	10001000
H5470	004	0	1	04	01	H5470_004_0	4	4	Specialty	1	2	10001000
H5470	004	0	1	04	01	H5470_004_0	4	1	Preferred Generic	1	2	00001000
H5470	004	0	1	04	01	H5470_004_0	4	3	Non-Preferred Brand	1	2	10000000
H5470	004	0	1	04	01	H5470_004_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5470	005	0	1	04	01	H5470_005_0	4	4	Specialty	1	2	10001000
H5470	005	0	1	04	01	H5470_005_0	4	3	Non-Preferred Brand	1	2	10000000
H5470	005	0	1	04	01	H5470_005_0	4	1	Preferred Generic	1	2	00001000
H5470	005	0	1	04	01	H5470_005_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5470	007	0	1	04	01	H5470_007_0	4	3	Non-Preferred Brand	1	2	10000000
H5470	007	0	1	04	01	H5470_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5470	007	0	1	04	01	H5470_007_0	4	1	Preferred Generic	1	2	00001000
H5470	007	0	1	04	01	H5470_007_0	4	4	Specialty	1	2	10001000
H5508	001	0	1	04	01	H5508_001_0	7	4	Specialty	2		
H5508	001	0	1	04	01	H5508_001_0	7	3	Preferred Brand	2		
H5508	001	0	1	04	01	H5508_001_0	7	2	Generic	1	1	
H5508	001	0	1	04	01	H5508_001_0	7	1	Preferred Generic	1	1	
H5508	001	0	1	04	01	H5508_001_0	7	5	Non-Preferred Agents	2		
H5508	004	0	1	04	01	H5508_004_0	6	5	Non-Preferred Agents	2		
H5508	004	0	1	04	01	H5508_004_0	6	3	Preferred Brand	2		
H5508	004	0	1	04	01	H5508_004_0	6	2	Generic	1	1	
H5508	004	0	1	04	01	H5508_004_0	6	1	Preferred Generic	1	1	
H5508	004	0	1	04	01	H5508_004_0	6	4	Specialty	2		
H5521	014	0	1	04	01	H5521_014_0	6	5	Tier 5 - Specialty	2		
H5521	014	0	1	04	01	H5521_014_0	6	3	Tier 3 - Preferred Brand	2		
H5521	014	0	1	04	01	H5521_014_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5521	014	0	1	04	01	H5521_014_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5521	014	0	1	04	01	H5521_014_0	6	1	Tier 1 - Preferred Generic	1	1	
H5521	035	0	1	04	01	H5521_035_0	7	1	Tier 1 - Preferred Generic	1	1	
H5521	035	0	1	04	01	H5521_035_0	7	5	Tier 5 - Specialty	2		
H5521	035	0	1	04	01	H5521_035_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5521	035	0	1	04	01	H5521_035_0	7	3	Tier 3 - Preferred Brand	2		
H5521	035	0	1	04	01	H5521_035_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5521	038	0	1	04	01	H5521_038_0	6	3	Tier 3 - Preferred Brand	2		
H5521	038	0	1	04	01	H5521_038_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5521	038	0	1	04	01	H5521_038_0	6	5	Tier 5 - Specialty	2		
H5521	038	0	1	04	01	H5521_038_0	6	1	Tier 1 - Preferred Generic	1	1	
H5521	038	0	1	04	01	H5521_038_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5521	041	0	1	04	01	H5521_041_0	6	5	Tier 5 - Specialty	2		
H5521	041	0	1	04	01	H5521_041_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5521	041	0	1	04	01	H5521_041_0	6	3	Tier 3 - Preferred Brand	2		
H5521	041	0	1	04	01	H5521_041_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5521	041	0	1	04	01	H5521_041_0	6	1	Tier 1 - Preferred Generic	1	1	
H5521	044	0	1	04	01	H5521_044_0	6	5	Tier 5 - Specialty	2		
H5521	044	0	1	04	01	H5521_044_0	6	3	Tier 3 - Preferred Brand	2		
H5521	044	0	1	04	01	H5521_044_0	6	1	Tier 1 - Preferred Generic	1	1	
H5521	044	0	1	04	01	H5521_044_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5521	044	0	1	04	01	H5521_044_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5522	001	0	1	04	01	H5522_001_0	7	1	Tier 1 - Preferred Generic	1	1	
H5522	001	0	1	04	01	H5522_001_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H5522	001	0	1	04	01	H5522_001_0	7	4	Tier 4 - Specialty Drugs	2		
H5522	001	0	1	04	01	H5522_001_0	7	2	Tier 2 - Preferred Brand	2		
H5522	002	0	1	04	01	H5522_002_0	7	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H5522	002	0	1	04	01	H5522_002_0	7	1	Tier 1 - Preferred Generic	1	1	
H5522	002	0	1	04	01	H5522_002_0	7	2	Tier 2 - Preferred Brand	2		
H5522	002	0	1	04	01	H5522_002_0	7	4	Tier 4 - Specialty Drugs	2		
H5522	003	0	1	04	01	H5522_003_0	8	2	Tier 2 - Preferred Brand	2		
H5522	003	0	1	04	01	H5522_003_0	8	1	Tier 1 - Preferred Generic	1	1	
H5522	003	0	1	04	01	H5522_003_0	8	3	Tier 3 - Non-Preferred Generic/Non-Preferred Brand	2		
H5522	003	0	1	04	01	H5522_003_0	8	4	Tier 4 - Specialty Drugs	2		
H5525	004	0	1	04	01	H5525_004_0	7	3	Non-Preferred Brand	1	2	10000000
H5525	004	0	1	04	01	H5525_004_0	7	4	Specialty	1	2	10001000
H5525	004	0	1	04	01	H5525_004_0	7	2	Non-Preferred Generic and Preferred Brand	1	2	10001000
H5525	004	0	1	04	01	H5525_004_0	7	1	Preferred Generic	1	2	00001000
H5526	007	0	1	04	01	H5526_007_0	8	4	Speciality Injectables	2		
H5526	007	0	1	04	01	H5526_007_0	8	1	Formulary Generic	1	2	00001000
H5526	007	0	1	04	01	H5526_007_0	8	2	Preferred Brand	2		
H5526	007	0	1	04	01	H5526_007_0	8	3	Non-Preferred	2		
H5526	008	0	1	04	01	H5526_008_0	12	1	Formulary Generic	1	2	00001000
H5526	008	0	1	04	01	H5526_008_0	12	4	Specialty Injectables	2		
H5526	008	0	1	04	01	H5526_008_0	12	2	Preferred Brand	2		
H5526	008	0	1	04	01	H5526_008_0	12	3	Non-Preferred Brand/Generic	2		
H5526	010	0	1	04	01	H5526_010_0	10	4	Specialty Injectables	2		
H5526	010	0	1	04	01	H5526_010_0	10	3	Non-Preferred Brand/Generic	2		
H5526	010	0	1	04	01	H5526_010_0	10	1	Formulary Generic	1	1	
H5526	010	0	1	04	01	H5526_010_0	10	2	Preferred Brand	1	1	
H5526	011	0	1	04	01	H5526_011_0	10	1	Formulary Generic	1	1	
H5526	011	0	1	04	01	H5526_011_0	10	2	Preferred Brand	1	1	
H5526	011	0	1	04	01	H5526_011_0	10	3	Non-Preferred Brand/Generic	2		
H5526	011	0	1	04	01	H5526_011_0	10	4	Specialty Injectables	2		
H5528	003	0	1	04	01	H5528_003_0	4	1	Tier 1	1	1	
H5528	003	0	1	04	01	H5528_003_0	4	2	Tier 2	2		
H5528	003	0	1	04	01	H5528_003_0	4	3	Tier 3	2		
H5528	003	0	1	04	01	H5528_003_0	4	4	Tier 4	2		
H5528	008	0	1	04	01	H5528_008_0	5	3	Tier 3	2		
H5528	008	0	1	04	01	H5528_008_0	5	4	Tier 4	2		
H5528	008	0	1	04	01	H5528_008_0	5	1	Tier 1	1	1	
H5528	008	0	1	04	01	H5528_008_0	5	2	Tier 2	2		
H5528	011	0	1	04	01	H5528_011_0	4	1	Tier 1	1	1	
H5528	011	0	1	04	01	H5528_011_0	4	3	Tier 3	2		
H5528	011	0	1	04	01	H5528_011_0	4	2	Tier 2	2		
H5528	011	0	1	04	01	H5528_011_0	4	4	Tier 4	2		
H5529	001	0	1	04	01	H5529_001_0	12	5	Tier 5 Specialty Drugs	2		
H5529	001	0	1	04	01	H5529_001_0	12	1	Tier 1 Preferred Generic Drugs	1	1	
H5529	001	0	1	04	01	H5529_001_0	12	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5529	001	0	1	04	01	H5529_001_0	12	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5529	001	0	1	04	01	H5529_001_0	12	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5529	004	0	1	04	01	H5529_004_0	9	5	Tier 5 Specialty Drugs	2		
H5529	004	0	1	04	01	H5529_004_0	9	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5529	004	0	1	04	01	H5529_004_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5529	004	0	1	04	01	H5529_004_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
H5529	004	0	1	04	01	H5529_004_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5530	001	0	1	04	01	H5530_001_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
H5530	001	0	1	04	01	H5530_001_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5530	001	0	1	04	01	H5530_001_0	10	5	Tier 5 Specialty Drugs	2		
H5530	001	0	1	04	01	H5530_001_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5530	001	0	1	04	01	H5530_001_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5530	004	0	1	04	01	H5530_004_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5530	004	0	1	04	01	H5530_004_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
H5530	004	0	1	04	01	H5530_004_0	9	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5530	004	0	1	04	01	H5530_004_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5530	004	0	1	04	01	H5530_004_0	9	5	Tier 5 Specialty Drugs	2		
H5533	002	0	1	04	01	H5533_002_0	10	3	Tier 3 - Non-Preferred Brand	2		
H5533	002	0	1	04	01	H5533_002_0	10	2	Tier 2 - Preferred Brand	2		
H5533	002	0	1	04	01	H5533_002_0	10	1	Tier 1 - Generic	1	1	
H5533	002	0	1	04	01	H5533_002_0	10	4	Tier 4 - Specialty	2		
H5575	006	0	1	01	01	H5575_006_0	6	2	Preferred Brand	2		
H5575	006	0	1	01	01	H5575_006_0	6	1	generic	1	1	
H5575	006	0	1	01	01	H5575_006_0	6	4	Specialty	2		
H5575	006	0	1	01	01	H5575_006_0	6	3	Non-Preferred Brand	2		
H5575	007	0	1	01	01	H5575_007_0	6	4	Specialty	2		
H5575	007	0	1	01	01	H5575_007_0	6	3	Non-Preferred	2		
H5575	007	0	1	01	01	H5575_007_0	6	2	Preferred Brand	2		
H5575	007	0	1	01	01	H5575_007_0	6	1	Generic	1	1	
H5576	006	0	1	02	01	H5576_006_0	7	1	Tier 1	1	1	
H5576	006	0	1	02	01	H5576_006_0	7	2	Tier 2	2		
H5576	006	0	1	02	01	H5576_006_0	7	4	Tier 4	2		
H5576	006	0	1	02	01	H5576_006_0	7	3	Tier 3	2		
H5578	002	0	1	01	01	H5578_002_0	10	5	Tier 5 - Specialty	2		
H5578	002	0	1	01	01	H5578_002_0	10	4	Tier - Non-Preferred Brand	2		
H5578	002	0	1	01	01	H5578_002_0	10	3	Tier 3 - Preferred Brand	2		
H5578	002	0	1	01	01	H5578_002_0	10	1	Tier 1 - Preferred  Generic	1	1	
H5578	002	0	1	01	01	H5578_002_0	10	2	Tier 2 - Non-Preferred Generic	2		
H5578	006	0	1	01	01	H5578_006_0	11	1	Tier 1 - Preferred  Generic	1	1	
H5578	006	0	1	01	01	H5578_006_0	11	2	Tier 2 - Non-Preferred Generic	2		
H5578	006	0	1	01	01	H5578_006_0	11	3	Tier 3 - Preferred Brand	2		
H5578	006	0	1	01	01	H5578_006_0	11	4	Tier - Non-Preferred Brand	2		
H5578	006	0	1	01	01	H5578_006_0	11	5	Tier 5 - Specialty	2		
H5578	009	0	1	01	01	H5578_009_0	6	5	Tier 5 - Specialty	2		
H5578	009	0	1	01	01	H5578_009_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5578	009	0	1	01	01	H5578_009_0	6	3	Tier 3 - Preferred Brand	2		
H5578	009	0	1	01	01	H5578_009_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5578	009	0	1	01	01	H5578_009_0	6	1	Tier 1 - Preferred Generic	1	1	
H5578	012	0	1	01	01	H5578_012_0	6	5	Tier 5 - Specialty	2		
H5578	012	0	1	01	01	H5578_012_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5578	012	0	1	01	01	H5578_012_0	6	3	Tier 3 - Preferred Brand	2		
H5578	012	0	1	01	01	H5578_012_0	6	1	Tier 1 - Preferred Generic	1	1	
H5578	012	0	1	01	01	H5578_012_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5578	013	0	1	01	01	H5578_013_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5578	013	0	1	01	01	H5578_013_0	6	3	Tier 3 - Preferred Brand	2		
H5578	013	0	1	01	01	H5578_013_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5578	013	0	1	01	01	H5578_013_0	6	1	Tier 1 - Preferred Generic	1	1	
H5578	013	0	1	01	01	H5578_013_0	6	5	Tier 5 - Specialty	2		
H5591	001	0	1	02	01	H5591_001_0	3	1	Tier 1	1	1	
H5591	001	0	1	02	01	H5591_001_0	3	2	Tier 2	2		
H5591	001	0	1	02	01	H5591_001_0	3	3	Tier 3	2		
H5591	001	0	1	02	01	H5591_001_0	3	4	Tier 4	2		
H5594	001	0	1	01	01	H5594_001_0	6	4	Tier 4	2		
H5594	001	0	1	01	01	H5594_001_0	6	3	Tier 3	2		
H5594	001	0	1	01	01	H5594_001_0	6	2	Tier2	2		
H5594	001	0	1	01	01	H5594_001_0	6	1	Tier 1	1	1	
H5594	002	0	1	01	01	H5594_002_0	5	3	Tier 3	2		
H5594	002	0	1	01	01	H5594_002_0	5	4	Tier 4	2		
H5594	002	0	1	01	01	H5594_002_0	5	2	Tier2	2		
H5594	002	0	1	01	01	H5594_002_0	5	1	Tier 1	1	1	
H5594	006	0	1	01	01	H5594_006_0	4	1	Tier 1	1	1	
H5594	006	0	1	01	01	H5594_006_0	4	2	Tier2	2		
H5594	006	0	1	01	01	H5594_006_0	4	3	Tier 3	2		
H5594	006	0	1	01	01	H5594_006_0	4	4	Tier 4	2		
H5609	001	0	1	01	01	H5609_001_0	7	1	Preferred Generics	1	1	
H5609	001	0	1	01	01	H5609_001_0	7	2	Non-Preferred Generics	2		
H5609	001	0	1	01	01	H5609_001_0	7	6	Specialty	2		
H5609	001	0	1	01	01	H5609_001_0	7	4	Non-preferred Brand	2		
H5609	001	0	1	01	01	H5609_001_0	7	5	Injectables	2		
H5609	001	0	1	01	01	H5609_001_0	7	3	Preferred Brand	2		
H5619	001	0	1	01	01	H5619_001_0	6	1	Tier 1 - Preferred Generic	1	1	
H5619	001	0	1	01	01	H5619_001_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5619	001	0	1	01	01	H5619_001_0	6	5	Tier 5 - Specialty	2		
H5619	001	0	1	01	01	H5619_001_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5619	001	0	1	01	01	H5619_001_0	6	3	Tier 3 - Preferred Brand	2		
H5619	004	0	1	01	01	H5619_004_0	6	5	Tier 5 - Specialty	2		
H5619	004	0	1	01	01	H5619_004_0	6	3	Tier 3 - Preferred Brand	2		
H5619	004	0	1	01	01	H5619_004_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5619	004	0	1	01	01	H5619_004_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5619	004	0	1	01	01	H5619_004_0	6	1	Tier 1 - Preferred Generic	1	1	
H5619	007	0	1	01	01	H5619_007_0	7	1	Tier 1 - Preferred Generic	1	1	
H5619	007	0	1	01	01	H5619_007_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5619	007	0	1	01	01	H5619_007_0	7	3	Tier 3 - Preferred Brand	2		
H5619	007	0	1	01	01	H5619_007_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5619	007	0	1	01	01	H5619_007_0	7	5	Tier 5 - Specialty	2		
H5619	008	0	1	01	01	H5619_008_0	6	3	Tier 3 - Preferred Brand	2		
H5619	008	0	1	01	01	H5619_008_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5619	008	0	1	01	01	H5619_008_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5619	008	0	1	01	01	H5619_008_0	6	1	Tier 1 - Preferred Generic	1	1	
H5619	008	0	1	01	01	H5619_008_0	6	5	Tier 5 - Specialty	2		
H5640	001	0	1	01	01	H5640_001_0	2	2	Brand	2		
H5640	001	0	1	01	01	H5640_001_0	2	1	Generic	1	1	
H5656	001	0	1	01	01	H5656_001_0	9	3	Non-Preferred Brand	2		
H5656	001	0	1	01	01	H5656_001_0	9	2	Preferred Brand	1	2	10000000
H5656	001	0	1	01	01	H5656_001_0	9	1	Generic	1	1	
H5656	001	0	1	01	01	H5656_001_0	9	4	Specialty	2		
H5656	009	0	1	01	01	H5656_009_0	6	3	Non-Preferred Brand	2		
H5656	009	0	1	01	01	H5656_009_0	6	2	Preferred Brand	1	2	10000000
H5656	009	0	1	01	01	H5656_009_0	6	1	Generic	1	1	
H5656	009	0	1	01	01	H5656_009_0	6	4	Specialty	2		
H5679	001	0	1	01	01	H5679_001_0	7	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5679	001	0	1	01	01	H5679_001_0	7	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5679	001	0	1	01	01	H5679_001_0	7	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5679	001	0	1	01	01	H5679_001_0	7	1	Tier 1 Preferred Generic Drugs	1	1	
H5679	001	0	1	01	01	H5679_001_0	7	5	Tier 5 Specialty Drugs	2		
H5679	002	0	1	01	01	H5679_002_0	7	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5679	002	0	1	01	01	H5679_002_0	7	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5679	002	0	1	01	01	H5679_002_0	7	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5679	002	0	1	01	01	H5679_002_0	7	1	Tier 1 Preferred Generic Drugs	1	1	
H5679	002	0	1	01	01	H5679_002_0	7	5	Tier 5 Specialty Drugs	2		
H5696	001	0	1	01	01	H5696_001_0	7	4	Tier 4 - Non-Preferred	2		
H5696	001	0	1	01	01	H5696_001_0	7	3	Tier 3 - Preferred Brand	2		
H5696	001	0	1	01	01	H5696_001_0	7	2	Tier 2 - Generic	2		
H5696	001	0	1	01	01	H5696_001_0	7	1	Tier 1 - Preferred Generic	1	1	
H5696	001	0	1	01	01	H5696_001_0	7	5	Tier 5 - Injectables  Specialty	2		
H5696	003	0	1	01	01	H5696_003_0	6	1	Tier 1 - Preferred Generic	1	1	
H5696	003	0	1	01	01	H5696_003_0	6	2	Tier 2 - Generic	2		
H5696	003	0	1	01	01	H5696_003_0	6	3	Tier 3 - Preferred Brand	2		
H5696	003	0	1	01	01	H5696_003_0	6	4	Tier 4 - Non-Preferred	2		
H5696	003	0	1	01	01	H5696_003_0	6	5	Tier 5 - Injectables  Specialty	2		
H5696	023	0	1	01	01	H5696_023_0	5	5	Tier 5 - Injectables  Specialty	2		
H5696	023	0	1	01	01	H5696_023_0	5	4	Tier 4 - Non-Preferred	2		
H5696	023	0	1	01	01	H5696_023_0	5	3	Tier 3 - Preferred Brand	2		
H5696	023	0	1	01	01	H5696_023_0	5	1	Tier 1 - Preferred Generic	1	1	
H5696	023	0	1	01	01	H5696_023_0	5	2	Tier 2 - Generic	2		
H5696	025	0	1	01	01	H5696_025_0	5	2	Tier 2 - Generic	1	1	
H5696	025	0	1	01	01	H5696_025_0	5	1	Tier 1 - Preferred Generic	1	1	
H5696	025	0	1	01	01	H5696_025_0	5	3	Tier 3 - Preferred Brand	2		
H5696	025	0	1	01	01	H5696_025_0	5	4	Tier 4 - Non-Preferred	2		
H5696	025	0	1	01	01	H5696_025_0	5	5	Tier 5 - Injectables  Specialty	2		
H5696	026	0	1	01	01	H5696_026_0	6	2	Tier 2 - Generic	1	1	
H5696	026	0	1	01	01	H5696_026_0	6	1	Tier 1 - Preferred Generic	1	1	
H5696	026	0	1	01	01	H5696_026_0	6	3	Tier 3 - Preferred Brand	2		
H5696	026	0	1	01	01	H5696_026_0	6	5	Tier 5 - Injectables  Specialty	2		
H5696	026	0	1	01	01	H5696_026_0	6	4	Tier 4 - Non-Preferred	2		
H5696	027	0	1	01	01	H5696_027_0	7	1	Tier 1 - Preferred Generic	1	1	
H5696	027	0	1	01	01	H5696_027_0	7	2	Tier 2 - Generic	1	1	
H5696	027	0	1	01	01	H5696_027_0	7	4	Tier 4 - Non-Preferred	2		
H5696	027	0	1	01	01	H5696_027_0	7	3	Tier 3 - Preferred Brand	2		
H5696	027	0	1	01	01	H5696_027_0	7	5	Tier 5 - Injectables  Specialty	2		
H5698	020	0	1	01	01	H5698_020_0	6	1	Tier 1- Preferred Generic	1	1	
H5698	020	0	1	01	01	H5698_020_0	6	2	Tier 2 - Generic or Brand	2		
H5698	020	0	1	01	01	H5698_020_0	6	3	Tier 3 - Preferred Brand	2		
H5698	020	0	1	01	01	H5698_020_0	6	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	020	0	1	01	01	H5698_020_0	6	5	Tier 5 - Specialty	2		
H5698	028	0	1	01	01	H5698_028_0	6	5	Tier 5 - Specialty	2		
H5698	028	0	1	01	01	H5698_028_0	6	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	028	0	1	01	01	H5698_028_0	6	3	Tier 3 - Preferred Brand	2		
H5698	028	0	1	01	01	H5698_028_0	6	2	Tier 2 - Generic or Brand	2		
H5698	028	0	1	01	01	H5698_028_0	6	1	Tier 1- Preferred Generic	1	1	
H5698	036	0	1	01	01	H5698_036_0	5	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	036	0	1	01	01	H5698_036_0	5	5	Tier 5 - Specialty	2		
H5698	036	0	1	01	01	H5698_036_0	5	3	Tier 3 - Preferred Brand	2		
H5698	036	0	1	01	01	H5698_036_0	5	2	Tier 2 - Generic or Brand	2		
H5698	036	0	1	01	01	H5698_036_0	5	1	Tier 1- Preferred Generic	1	1	
H5698	061	0	1	01	01	H5698_061_0	4	5	Tier 5 - Specialty	2		
H5698	061	0	1	01	01	H5698_061_0	4	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	061	0	1	01	01	H5698_061_0	4	3	Tier 3 - Preferred Brand	2		
H5698	061	0	1	01	01	H5698_061_0	4	2	Tier 2 - Generic or Brand	2		
H5698	061	0	1	01	01	H5698_061_0	4	1	Tier 1- Preferred Generic	1	1	
H5698	062	0	1	01	01	H5698_062_0	4	5	Tier 5 - Specialty	2		
H5698	062	0	1	01	01	H5698_062_0	4	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	062	0	1	01	01	H5698_062_0	4	3	Tier 3 - Preferred Brand	2		
H5698	062	0	1	01	01	H5698_062_0	4	1	Tier 1- Preferred Generic	1	1	
H5698	062	0	1	01	01	H5698_062_0	4	2	Tier 2 - Generic or Brand	2		
H5698	063	0	1	01	01	H5698_063_0	5	3	Tier 3 - Preferred Brand	2		
H5698	063	0	1	01	01	H5698_063_0	5	2	Tier 2 - Generic or Brand	2		
H5698	063	0	1	01	01	H5698_063_0	5	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	063	0	1	01	01	H5698_063_0	5	5	Tier 5 - Specialty	2		
H5698	063	0	1	01	01	H5698_063_0	5	1	Tier 1- Preferred Generic	1	1	
H5698	067	0	1	01	01	H5698_067_0	5	2	Tier 2 - Generic or Brand	2		
H5698	067	0	1	01	01	H5698_067_0	5	1	Tier 1- Preferred Generic	1	1	
H5698	067	0	1	01	01	H5698_067_0	5	3	Tier 3 - Preferred Brand	2		
H5698	067	0	1	01	01	H5698_067_0	5	5	Tier 5 - Specialty	2		
H5698	067	0	1	01	01	H5698_067_0	5	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	068	0	1	01	01	H5698_068_0	4	1	Tier 1- Preferred Generic	1	1	
H5698	068	0	1	01	01	H5698_068_0	4	2	Tier 2 - Generic or Brand	2		
H5698	068	0	1	01	01	H5698_068_0	4	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	068	0	1	01	01	H5698_068_0	4	3	Tier 3 - Preferred Brand	2		
H5698	068	0	1	01	01	H5698_068_0	4	5	Tier 5 - Specialty	2		
H5698	069	0	1	01	01	H5698_069_0	5	5	Tier 5 - Specialty	2		
H5698	069	0	1	01	01	H5698_069_0	5	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	069	0	1	01	01	H5698_069_0	5	3	Tier 3 - Preferred Brand	2		
H5698	069	0	1	01	01	H5698_069_0	5	1	Tier 1- Preferred Generic	1	1	
H5698	069	0	1	01	01	H5698_069_0	5	2	Tier 2 - Generic or Brand	2		
H5698	123	0	1	01	01	H5698_123_0	7	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	123	0	1	01	01	H5698_123_0	7	3	Tier 3 - Preferred Brand	2		
H5698	123	0	1	01	01	H5698_123_0	7	2	Tier 2 - Generic or Brand	2		
H5698	123	0	1	01	01	H5698_123_0	7	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	123	0	1	01	01	H5698_123_0	7	5	Tier 5 - Specialty	2		
H5698	129	0	1	01	01	H5698_129_0	5	5	Tier 5 - Specialty	2		
H5698	129	0	1	01	01	H5698_129_0	5	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	129	0	1	01	01	H5698_129_0	5	2	Tier 2 - Generic or Brand	2		
H5698	129	0	1	01	01	H5698_129_0	5	3	Tier 3 - Preferred Brand	2		
H5698	129	0	1	01	01	H5698_129_0	5	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	135	0	1	01	01	H5698_135_0	4	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	135	0	1	01	01	H5698_135_0	4	2	Tier 2 - Generic or Brand	2		
H5698	135	0	1	01	01	H5698_135_0	4	3	Tier 3 - Preferred Brand	2		
H5698	135	0	1	01	01	H5698_135_0	4	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	135	0	1	01	01	H5698_135_0	4	5	Tier 5 - Specialty	2		
H5698	141	0	1	01	01	H5698_141_0	4	3	Tier 3 - Preferred Brand	2		
H5698	141	0	1	01	01	H5698_141_0	4	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	141	0	1	01	01	H5698_141_0	4	2	Tier 2 - Generic or Brand	2		
H5698	141	0	1	01	01	H5698_141_0	4	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	141	0	1	01	01	H5698_141_0	4	5	Tier 5 - Specialty	2		
H5698	150	0	1	01	01	H5698_150_0	6	3	Tier 3 - Preferred Brand	2		
H5698	150	0	1	01	01	H5698_150_0	6	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	150	0	1	01	01	H5698_150_0	6	5	Tier 5 - Specialty	2		
H5698	150	0	1	01	01	H5698_150_0	6	2	Tier 2 - Generic or Brand	2		
H5698	150	0	1	01	01	H5698_150_0	6	1	Tier 1- Preferred Generic	1	1	
H5698	151	0	1	01	01	H5698_151_0	7	3	Tier 3 - Preferred Brand	2		
H5698	151	0	1	01	01	H5698_151_0	7	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	151	0	1	01	01	H5698_151_0	7	5	Tier 5 - Specialty	2		
H5698	151	0	1	01	01	H5698_151_0	7	2	Tier 2 - Generic or Brand	2		
H5698	151	0	1	01	01	H5698_151_0	7	1	Tier 1- Preferred Generic	1	1	
H5698	152	0	1	01	01	H5698_152_0	6	1	Tier 1- Preferred Generic	1	1	
H5698	152	0	1	01	01	H5698_152_0	6	2	Tier 2 - Generic or Brand	2		
H5698	152	0	1	01	01	H5698_152_0	6	3	Tier 3 - Preferred Brand	2		
H5698	152	0	1	01	01	H5698_152_0	6	4	Tier 4 - NonPreferred Brand/NonPreferred Generic	2		
H5698	152	0	1	01	01	H5698_152_0	6	5	Tier 5 - Specialty	2		
H5698	153	0	1	01	01	H5698_153_0	8	3	Tier 3 - Preferred Brand	2		
H5698	153	0	1	01	01	H5698_153_0	8	2	Tier 2 - Generic or Brand	2		
H5698	153	0	1	01	01	H5698_153_0	8	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	153	0	1	01	01	H5698_153_0	8	5	Tier 5 - Specialty	2		
H5698	153	0	1	01	01	H5698_153_0	8	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	154	0	1	01	01	H5698_154_0	6	2	Tier 2 - Generic or Brand	2		
H5698	154	0	1	01	01	H5698_154_0	6	3	Tier 3 - Preferred Brand	2		
H5698	154	0	1	01	01	H5698_154_0	6	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	154	0	1	01	01	H5698_154_0	6	5	Tier 5 - Specialty	2		
H5698	154	0	1	01	01	H5698_154_0	6	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	155	0	1	01	01	H5698_155_0	6	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	155	0	1	01	01	H5698_155_0	6	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	155	0	1	01	01	H5698_155_0	6	5	Tier 5 - Specialty	2		
H5698	155	0	1	01	01	H5698_155_0	6	2	Tier 2 - Generic or Brand	2		
H5698	155	0	1	01	01	H5698_155_0	6	3	Tier 3 - Preferred Brand	2		
H5698	156	0	1	01	01	H5698_156_0	6	2	Tier 2 - Generic or Brand	2		
H5698	156	0	1	01	01	H5698_156_0	6	1	Tier 1- Preferred Generic or Brand	1	1	
H5698	156	0	1	01	01	H5698_156_0	6	3	Tier 3 - Preferred Brand	2		
H5698	156	0	1	01	01	H5698_156_0	6	4	Tier 4 - Non-Preferred Brand/Non-Preferred Generic	2		
H5698	156	0	1	01	01	H5698_156_0	6	5	Tier 5 - Specialty	2		
H5700	002	0	1	01	01	H5700_002_0	9	1	Tier 1 - Preferred  Generic	1	1	
H5700	002	0	1	01	01	H5700_002_0	9	2	Tier 2 - Non-Preferred Generic	2		
H5700	002	0	1	01	01	H5700_002_0	9	3	Tier 3 - Preferred Brand	2		
H5700	002	0	1	01	01	H5700_002_0	9	4	Tier - Non-Preferred Brand	2		
H5700	002	0	1	01	01	H5700_002_0	9	5	Tier 5 - Specialty	2		
H5700	005	0	1	01	01	H5700_005_0	7	1	Tier 1 - Preferred Generic	1	1	
H5700	005	0	1	01	01	H5700_005_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5700	005	0	1	01	01	H5700_005_0	7	3	Tier 3 - Preferred Brand	2		
H5700	005	0	1	01	01	H5700_005_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5700	005	0	1	01	01	H5700_005_0	7	5	Tier 5 - Specialty	2		
H5700	009	0	1	01	01	H5700_009_0	9	1	Tier 1 - Preferred  Generic	1	1	
H5700	009	0	1	01	01	H5700_009_0	9	2	Tier 2 - Non-Preferred Generic	2		
H5700	009	0	1	01	01	H5700_009_0	9	3	Tier 3 - Preferred Brand	2		
H5700	009	0	1	01	01	H5700_009_0	9	4	Tier - Non-Preferred Brand	2		
H5700	009	0	1	01	01	H5700_009_0	9	5	Tier 5 - Specialty	2		
H5700	020	0	1	01	01	H5700_020_0	9	4	Tier - Non-Preferred Brand	2		
H5700	020	0	1	01	01	H5700_020_0	9	5	Tier 5 - Specialty	2		
H5700	020	0	1	01	01	H5700_020_0	9	1	Tier 1 - Preferred  Generic	1	1	
H5700	020	0	1	01	01	H5700_020_0	9	2	Tier 2 - Non-Preferred Generic	2		
H5700	020	0	1	01	01	H5700_020_0	9	3	Tier 3 - Preferred Brand	2		
H5700	025	0	1	02	01	H5700_025_0	9	3	Tier 3 - Preferred Brand	2		
H5700	025	0	1	02	01	H5700_025_0	9	4	Tier - Non-Preferred Brand	2		
H5700	025	0	1	02	01	H5700_025_0	9	1	Tier 1 - Preferred  Generic	1	1	
H5700	025	0	1	02	01	H5700_025_0	9	2	Tier 2 - Non-Preferred Generic	2		
H5700	025	0	1	02	01	H5700_025_0	9	5	Tier 5 - Specialty	2		
H5700	027	0	1	01	01	H5700_027_0	6	5	Tier 5 - Specialty	2		
H5700	027	0	1	01	01	H5700_027_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5700	027	0	1	01	01	H5700_027_0	6	3	Tier 3 - Preferred Brand	2		
H5700	027	0	1	01	01	H5700_027_0	6	1	Tier 1 - Preferred Generic	1	1	
H5700	027	0	1	01	01	H5700_027_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5732	001	0	1	01	01	H5732_001_0	3	4	Tier 4/ Nivel 4	2		
H5732	001	0	1	01	01	H5732_001_0	3	3	Tier 3/ Nivel 3	2		
H5732	001	0	1	01	01	H5732_001_0	3	2	Tier 2/ Nivel 2	2		
H5732	001	0	1	01	01	H5732_001_0	3	1	Tier 1/ Nivel 1	1	1	
H5732	001	0	1	01	01	H5732_001_0	3	5	Tier 5/ Nivel 5	2		
H5746	006	0	1	01	01	H5746_006_0	5	3	Preferred Brand Drugs	2		
H5746	006	0	1	01	01	H5746_006_0	5	4	Non-Preferred Brand Drugs	2		
H5746	006	0	1	01	01	H5746_006_0	5	5	Specialty Drugs	2		
H5746	006	0	1	01	01	H5746_006_0	5	1	Preferred Generic Drugs	1	1	
H5746	006	0	1	01	01	H5746_006_0	5	2	Non-Preferred Generic Drugs	2		
H5746	012	0	1	02	01	H5746_012_0	8	1	Preferred Generic Drugs	1	1	
H5746	012	0	1	02	01	H5746_012_0	8	2	Non-Preferred Generic Drugs	2		
H5746	012	0	1	02	01	H5746_012_0	8	3	Preferred Brand Drugs	2		
H5746	012	0	1	02	01	H5746_012_0	8	4	Non-Preferred Brand Drugs	2		
H5746	012	0	1	02	01	H5746_012_0	8	5	Specialty Drugs	2		
H5750	003	0	1	02	01	H5750_003_0	4	1	Generic	1	1	
H5750	003	0	1	02	01	H5750_003_0	4	2	Brand	2		
H5750	003	0	1	02	01	H5750_003_0	4	3	Specialty	2		
H5774	005	0	1	01	01	H5774_005_0	4	5	Specialty	2		
H5774	005	0	1	01	01	H5774_005_0	4	1	Preferred Generic	1	1	
H5774	005	0	1	01	01	H5774_005_0	4	2	Non Preferred Generic	1	1	
H5774	005	0	1	01	01	H5774_005_0	4	3	Preferred Brand	2		
H5774	005	0	1	01	01	H5774_005_0	4	4	Non Preferred Brand	2		
H5774	005	0	1	01	01	H5774_005_0	4	6	Part D Excluded Drugs	1	1	
H5774	008	0	1	01	01	H5774_008_0	4	2	Non Preferred Generic	1	1	
H5774	008	0	1	01	01	H5774_008_0	4	3	Preferred Brand	2		
H5774	008	0	1	01	01	H5774_008_0	4	1	Preferred Generic	1	1	
H5774	008	0	1	01	01	H5774_008_0	4	4	Non Preferred Brand	2		
H5774	008	0	1	01	01	H5774_008_0	4	5	Specialty	2		
H5774	009	0	1	01	01	H5774_009_0	6	5	Specialty	2		
H5774	009	0	1	01	01	H5774_009_0	6	1	Preferred Generic	1	1	
H5774	009	0	1	01	01	H5774_009_0	6	2	Non Preferred Generic	1	1	
H5774	009	0	1	01	01	H5774_009_0	6	4	Non Preferred Brand	2		
H5774	009	0	1	01	01	H5774_009_0	6	3	Preferred Brand	2		
H5774	014	0	1	01	01	H5774_014_0	6	5	Specialty	2		
H5774	014	0	1	01	01	H5774_014_0	6	6	Part D Excluded Drugs	1	1	
H5774	014	0	1	01	01	H5774_014_0	6	4	Non Preferred Brand	2		
H5774	014	0	1	01	01	H5774_014_0	6	3	Preferred Brand	2		
H5774	014	0	1	01	01	H5774_014_0	6	2	Non Preferred Generic	1	1	
H5774	014	0	1	01	01	H5774_014_0	6	1	Preferred Generic	1	1	
H5782	001	0	1	01	01	H5782_001_0	3	1	Generic Tier	1	1	
H5782	001	0	1	01	01	H5782_001_0	3	2	Brand	2		
H5783	002	0	1	01	01	H5783_002_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5783	002	0	1	01	01	H5783_002_0	7	3	Tier 3 - Preferred Brand	2		
H5783	002	0	1	01	01	H5783_002_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5783	002	0	1	01	01	H5783_002_0	7	5	Tier 5 - Specialty	2		
H5783	002	0	1	01	01	H5783_002_0	7	1	Tier 1 - Preferred Generic	1	1	
H5783	006	0	1	01	01	H5783_006_0	13	1	Tier 1 - Preferred  Generic	1	1	
H5783	006	0	1	01	01	H5783_006_0	13	2	Tier 2 - Non-Preferred Generic	2		
H5783	006	0	1	01	01	H5783_006_0	13	3	Tier 3 - Preferred Brand	2		
H5783	006	0	1	01	01	H5783_006_0	13	4	Tier - Non-Preferred Brand	2		
H5783	006	0	1	01	01	H5783_006_0	13	5	Tier 5 - Specialty	2		
H5783	009	0	1	01	01	H5783_009_0	8	5	Tier 5 - Specialty	2		
H5783	009	0	1	01	01	H5783_009_0	8	2	Tier 2 - Non-Preferred Generic	2		
H5783	009	0	1	01	01	H5783_009_0	8	3	Tier 3 - Preferred Brand	2		
H5783	009	0	1	01	01	H5783_009_0	8	1	Tier 1 - Preferred  Generic	1	1	
H5783	009	0	1	01	01	H5783_009_0	8	4	Tier - Non-Preferred Brand	2		
H5783	010	0	1	01	01	H5783_010_0	6	1	Tier 1 - Preferred Generic	1	1	
H5783	010	0	1	01	01	H5783_010_0	6	4	Tier 4 - Non-Preferred Brand	2		
H5783	010	0	1	01	01	H5783_010_0	6	3	Tier 3 - Preferred Brand	2		
H5783	010	0	1	01	01	H5783_010_0	6	5	Tier 5 - Specialty	2		
H5783	010	0	1	01	01	H5783_010_0	6	2	Tier 2 - Non-Preferred Generic	2		
H5783	012	0	1	01	01	H5783_012_0	7	4	Tier 4 - Non-Preferred Brand	2		
H5783	012	0	1	01	01	H5783_012_0	7	5	Tier 5 - Specialty	2		
H5783	012	0	1	01	01	H5783_012_0	7	2	Tier 2 - Non-Preferred Generic	2		
H5783	012	0	1	01	01	H5783_012_0	7	1	Tier 1 - Preferred Generic	1	1	
H5783	012	0	1	01	01	H5783_012_0	7	3	Tier 3 - Preferred Brand	2		
H5793	003	0	1	01	01	H5793_003_0	5	1	Tier 1 - Preferred Generic	1	1	
H5793	003	0	1	01	01	H5793_003_0	5	5	Tier 5 - Specialty	2		
H5793	003	0	1	01	01	H5793_003_0	5	4	Tier 4 - Non-Preferred Brand	2		
H5793	003	0	1	01	01	H5793_003_0	5	3	Tier 3 - Preferred Brand	2		
H5793	003	0	1	01	01	H5793_003_0	5	2	Tier 2 - Non-Preferred Generic	2		
H5811	001	0	1	01	01	H5811_001_0	4	1	Generic	1	1	
H5811	001	0	1	01	01	H5811_001_0	4	2	Brand	2		
H5811	001	0	1	01	01	H5811_001_0	4	3	Specialty	2		
H5813	006	0	1	01	01	H5813_006_0	5	5	Tier 5 - Specialty	2		
H5813	006	0	1	01	01	H5813_006_0	5	4	Tier 4 - Non-Preferred Brand	2		
H5813	006	0	1	01	01	H5813_006_0	5	3	Tier 3 - Preferred Brand	2		
H5813	006	0	1	01	01	H5813_006_0	5	2	Tier 2 - Non-Preferred Generic	2		
H5813	006	0	1	01	01	H5813_006_0	5	1	Tier 1 - Preferred Generic	1	1	
H5817	009	0	1	01	01	H5817_009_0	3	4	Non-Preferred Brand Drugs	2		
H5817	009	0	1	01	01	H5817_009_0	3	3	Preferred Brand Drugs	2		
H5817	009	0	1	01	01	H5817_009_0	3	5	Specialty Drugs	2		
H5817	009	0	1	01	01	H5817_009_0	3	1	Preferred Generic Drugs	1	1	
H5817	009	0	1	01	01	H5817_009_0	3	2	Non-Preferred Generic Drugs	1	1	
H5817	010	0	1	01	01	H5817_010_0	3	4	Non-Preferred Brand Drugs	2		
H5817	010	0	1	01	01	H5817_010_0	3	5	Specialty Drugs	2		
H5817	010	0	1	01	01	H5817_010_0	3	2	Non-Preferred Generic Drugs	2		
H5817	010	0	1	01	01	H5817_010_0	3	1	Preferred Generic Drugs	1	1	
H5817	010	0	1	01	01	H5817_010_0	3	3	Preferred Brand Drugs	2		
H5817	011	0	1	01	01	H5817_011_0	4	5	Specialty Drugs	2		
H5817	011	0	1	01	01	H5817_011_0	4	4	Non-Preferred Brand Drugs	2		
H5817	011	0	1	01	01	H5817_011_0	4	3	Preferred Brand Drugs	2		
H5817	011	0	1	01	01	H5817_011_0	4	1	Preferred Generic Drugs	1	1	
H5817	011	0	1	01	01	H5817_011_0	4	2	Non-Preferred Generic Drugs	2		
H5821	001	0	1	02	01	H5821_001_0	5	1	Generic Drugs	1	1	
H5821	001	0	1	02	01	H5821_001_0	5	2	Preferred Brand Drugs	2		
H5821	001	0	1	02	01	H5821_001_0	5	3	Non-Preferred Brand Drugs	2		
H5821	001	0	1	02	01	H5821_001_0	5	4	Specialty Drugs	2		
H5821	004	0	1	02	01	H5821_004_0	5	4	Specialty Drugs	2		
H5821	004	0	1	02	01	H5821_004_0	5	3	Non-Preferred Brand Drugs	2		
H5821	004	0	1	02	01	H5821_004_0	5	2	Preferred Brand Drugs	2		
H5821	004	0	1	02	01	H5821_004_0	5	1	Generic Drugs	1	1	
H5821	013	0	1	02	01	H5821_013_0	8	4	Specialty Drugs	2		
H5821	013	0	1	02	01	H5821_013_0	8	3	Non-Preferred Brand Drugs	2		
H5821	013	0	1	02	01	H5821_013_0	8	1	Generic Drugs	1	1	
H5821	013	0	1	02	01	H5821_013_0	8	2	Preferred Brand Drugs	2		
H5826	010	0	1	01	01	H5826_010_0	8	3	Tier 3 - Specialty	2		
H5826	010	0	1	01	01	H5826_010_0	8	1	Tier 1 - Generic	1	1	
H5826	010	0	1	01	01	H5826_010_0	8	2	Tier 2 - Brand	2		
H5826	011	0	1	02	01	H5826_011_0	6	2	Tier 2 - Brand	2		
H5826	011	0	1	02	01	H5826_011_0	6	1	Tier 1 - Generic	1	1	
H5826	011	0	1	02	01	H5826_011_0	6	3	Tier 3 - Specialty	2		
H5850	001	0	1	01	01	H5850_001_0	7	3	Non-Preferred Brand	2		
H5850	001	0	1	01	01	H5850_001_0	7	2	Preferred Brand	2		
H5850	001	0	1	01	01	H5850_001_0	7	1	Preferred Generic	1	1	
H5850	001	0	1	01	01	H5850_001_0	7	4	Specialty Drugs	2		
H5850	002	0	1	01	01	H5850_002_0	6	1	Preferred Generic	1	1	
H5850	002	0	1	01	01	H5850_002_0	6	2	Preferred Brand	2		
H5850	002	0	1	01	01	H5850_002_0	6	3	Non-Preferred Brand	2		
H5850	002	0	1	01	01	H5850_002_0	6	4	Specialty Drugs	2		
H5850	003	0	1	01	01	H5850_003_0	6	1	Preferred Generic	1	1	
H5850	003	0	1	01	01	H5850_003_0	6	2	Preferred Brand	2		
H5850	003	0	1	01	01	H5850_003_0	6	3	Non-Preferred Brand	2		
H5850	003	0	1	01	01	H5850_003_0	6	4	Specialty Drugs	2		
H5850	004	0	1	01	01	H5850_004_0	6	1	Preferred Generic	1	1	
H5850	004	0	1	01	01	H5850_004_0	6	2	Preferred Brand	2		
H5850	004	0	1	01	01	H5850_004_0	6	4	Specialty Drugs	2		
H5850	004	0	1	01	01	H5850_004_0	6	3	Non-Preferred Brand	2		
H5850	006	0	1	01	01	H5850_006_0	6	1	Preferred Generic	1	1	
H5850	006	0	1	01	01	H5850_006_0	6	4	Specialty Drugs	2		
H5850	006	0	1	01	01	H5850_006_0	6	3	Non-Preferred Brand	2		
H5850	006	0	1	01	01	H5850_006_0	6	2	Preferred Brand	2		
H5850	007	0	1	01	01	H5850_007_0	6	2	Preferred Brand	2		
H5850	007	0	1	01	01	H5850_007_0	6	1	Preferred Generic	1	1	
H5850	007	0	1	01	01	H5850_007_0	6	4	Specialty Drugs	2		
H5850	007	0	1	01	01	H5850_007_0	6	3	Non-Preferred Brand	2		
H5850	012	0	1	01	01	H5850_012_0	6	3	Non-Preferred Brand	2		
H5850	012	0	1	01	01	H5850_012_0	6	2	Preferred Brand	2		
H5850	012	0	1	01	01	H5850_012_0	6	1	Preferred Generic	1	1	
H5850	012	0	1	01	01	H5850_012_0	6	4	Specialty Drugs	2		
H5850	015	0	1	01	01	H5850_015_0	5	4	Specialty Drugs	2		
H5850	015	0	1	01	01	H5850_015_0	5	3	Non-Preferred Brand	2		
H5850	015	0	1	01	01	H5850_015_0	5	2	Preferred Brand	2		
H5850	015	0	1	01	01	H5850_015_0	5	1	Preferred Generic	1	1	
H5850	016	0	1	01	01	H5850_016_0	5	1	Preferred Generic	1	1	
H5850	016	0	1	01	01	H5850_016_0	5	2	Preferred Brand	2		
H5850	016	0	1	01	01	H5850_016_0	5	3	Non-Preferred Brand	2		
H5850	016	0	1	01	01	H5850_016_0	5	4	Specialty Drugs	2		
H5850	017	0	1	02	01	H5850_017_0	7	1	Preferred Generic	1	1	
H5850	017	0	1	02	01	H5850_017_0	7	2	Preferred Brand	2		
H5850	017	0	1	02	01	H5850_017_0	7	3	Non-Preferred Brand	2		
H5850	017	0	1	02	01	H5850_017_0	7	4	Specialty Drugs	2		
H5850	020	0	1	01	01	H5850_020_0	5	3	Non-Preferred Brand	2		
H5850	020	0	1	01	01	H5850_020_0	5	4	Specialty Drugs	2		
H5850	020	0	1	01	01	H5850_020_0	5	2	Preferred Brand	2		
H5850	020	0	1	01	01	H5850_020_0	5	1	Preferred Generic	1	1	
H5850	021	0	1	01	01	H5850_021_0	5	3	Non-Preferred Brand	2		
H5850	021	0	1	01	01	H5850_021_0	5	1	Preferred Generic	1	1	
H5850	021	0	1	01	01	H5850_021_0	5	2	Preferred Brand	2		
H5850	021	0	1	01	01	H5850_021_0	5	4	Specialty Drugs	2		
H5854	002	0	1	01	01	H5854_002_0	7	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5854	002	0	1	01	01	H5854_002_0	7	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5854	002	0	1	01	01	H5854_002_0	7	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5854	002	0	1	01	01	H5854_002_0	7	1	Tier 1 Preferred Generic Drugs	1	1	
H5854	002	0	1	01	01	H5854_002_0	7	5	Tier 5 Specialty Drugs	2		
H5854	003	0	1	01	01	H5854_003_0	7	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5854	003	0	1	01	01	H5854_003_0	7	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5854	003	0	1	01	01	H5854_003_0	7	5	Tier 5 Specialty Drugs	2		
H5854	003	0	1	01	01	H5854_003_0	7	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5854	003	0	1	01	01	H5854_003_0	7	1	Tier 1 Preferred Generic Drugs	1	1	
H5854	005	0	1	01	01	H5854_005_0	7	4	Tier 4 Non-Specialty Injectable Drugs	2		
H5854	005	0	1	01	01	H5854_005_0	7	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H5854	005	0	1	01	01	H5854_005_0	7	1	Tier 1 Preferred Generic Drugs	1	1	
H5854	005	0	1	01	01	H5854_005_0	7	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H5854	005	0	1	01	01	H5854_005_0	7	5	Tier 5 Specialty Drugs	2		
H5859	003	0	1	01	01	H5859_003_0	3	3	3	2		
H5859	003	0	1	01	01	H5859_003_0	3	2	2	2		
H5859	003	0	1	01	01	H5859_003_0	3	1	1	1	1	
H5868	001	0	1	04	01	H5868_001_0	7	1	Preferred Generic	1	2	00001000
H5868	001	0	1	04	01	H5868_001_0	7	4	Specialty	1	2	10001000
H5868	001	0	1	04	01	H5868_001_0	7	3	Non-Preferred Brand	1	2	10000000
H5868	001	0	1	04	01	H5868_001_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5883	003	1	1	01	01	H5883_003_1	10	5	Injectable	2		
H5883	003	1	1	01	01	H5883_003_1	10	4	Specialty	2		
H5883	003	1	1	01	01	H5883_003_1	10	3	Non-Preferred	2		
H5883	003	1	1	01	01	H5883_003_1	10	1	Preferred Generic	1	1	
H5883	003	1	1	01	01	H5883_003_1	10	2	Preferred Brand	2		
H5883	003	2	1	01	01	H5883_003_2	10	4	Specialty	2		
H5883	003	2	1	01	01	H5883_003_2	10	1	Preferred Generic	1	1	
H5883	003	2	1	01	01	H5883_003_2	10	5	Injectable	2		
H5883	003	2	1	01	01	H5883_003_2	10	3	Non-Preferred	2		
H5883	003	2	1	01	01	H5883_003_2	10	2	Preferred Brand	2		
H5883	003	3	1	01	01	H5883_003_3	10	2	Preferred Brand	2		
H5883	003	3	1	01	01	H5883_003_3	10	3	Non-Preferred	2		
H5883	003	3	1	01	01	H5883_003_3	10	4	Specialty	2		
H5883	003	3	1	01	01	H5883_003_3	10	5	Injectable	2		
H5883	003	3	1	01	01	H5883_003_3	10	1	Preferred Generic	1	1	
H5883	003	4	1	01	01	H5883_003_4	10	5	Injectable	2		
H5883	003	4	1	01	01	H5883_003_4	10	4	Specialty	2		
H5883	003	4	1	01	01	H5883_003_4	10	3	Non-Preferred	2		
H5883	003	4	1	01	01	H5883_003_4	10	1	Preferred Generic	1	1	
H5883	003	4	1	01	01	H5883_003_4	10	2	Preferred Brand	2		
H5883	003	5	1	01	01	H5883_003_5	10	4	Specialty	2		
H5883	003	5	1	01	01	H5883_003_5	10	1	Preferred Generic	1	1	
H5883	003	5	1	01	01	H5883_003_5	10	2	Preferred Brand	2		
H5883	003	5	1	01	01	H5883_003_5	10	3	Non-Preferred	2		
H5883	003	5	1	01	01	H5883_003_5	10	5	Injectable	2		
H5887	001	0	1	01	01	H5887_001_0	5	3	3	2		
H5887	001	0	1	01	01	H5887_001_0	5	2	2	2		
H5887	001	0	1	01	01	H5887_001_0	5	1	1	1	1	
H5887	001	0	1	01	01	H5887_001_0	5	4	4	1	2	01000000
H5887	006	0	1	01	01	H5887_006_0	5	3	3	2		
H5887	006	0	1	01	01	H5887_006_0	5	2	2	2		
H5887	006	0	1	01	01	H5887_006_0	5	1	1	1	1	
H5887	006	0	1	01	01	H5887_006_0	5	4	4	1	2	01000000
H5887	007	0	1	01	01	H5887_007_0	5	4	4	1	2	01000000
H5887	007	0	1	01	01	H5887_007_0	5	1	1	1	1	
H5887	007	0	1	01	01	H5887_007_0	5	2	2	2		
H5887	007	0	1	01	01	H5887_007_0	5	3	3	2		
H5896	007	0	1	01	01	H5896_007_0	5	5	Specialty Drugs	2		
H5896	007	0	1	01	01	H5896_007_0	5	4	Non-Preferred Brand Drugs	2		
H5896	007	0	1	01	01	H5896_007_0	5	3	Preferred Brand Drugs	2		
H5896	007	0	1	01	01	H5896_007_0	5	2	Non-Preferred Generic Drugs	2		
H5896	007	0	1	01	01	H5896_007_0	5	1	Preferred Generic Drugs	1	1	
H5896	008	0	1	01	01	H5896_008_0	4	4	Non-Preferred Brand Drugs	2		
H5896	008	0	1	01	01	H5896_008_0	4	5	Specialty Drugs	2		
H5896	008	0	1	01	01	H5896_008_0	4	3	Preferred Brand Drugs	2		
H5896	008	0	1	01	01	H5896_008_0	4	2	Non-Preferred Generic Drugs	2		
H5896	008	0	1	01	01	H5896_008_0	4	1	Preferred Generic Drugs	1	1	
H5896	012	0	1	02	01	H5896_012_0	6	1	Preferred Generic Drugs	1	1	
H5896	012	0	1	02	01	H5896_012_0	6	2	Non-Preferred Generic Drugs	2		
H5896	012	0	1	02	01	H5896_012_0	6	3	Preferred Brand Drugs	2		
H5896	012	0	1	02	01	H5896_012_0	6	4	Non-Preferred Brand Drugs	2		
H5896	012	0	1	02	01	H5896_012_0	6	5	Specialty Drugs	2		
H5928	002	0	1	01	01	H5928_002_0	8	3	Brand	2		
H5928	002	0	1	01	01	H5928_002_0	8	1	Preferred Generic	1	1	
H5928	002	0	1	01	01	H5928_002_0	8	2	Generic	1	1	
H5928	002	0	1	01	01	H5928_002_0	8	4	Other Non-Preferred	2		
H5928	002	0	1	01	01	H5928_002_0	8	5	Specialty	2		
H5928	004	0	1	01	01	H5928_004_0	7	1	Preferred Generic	1	1	
H5928	004	0	1	01	01	H5928_004_0	7	5	Specialty	2		
H5928	004	0	1	01	01	H5928_004_0	7	4	Other Non-Preferred	2		
H5928	004	0	1	01	01	H5928_004_0	7	2	Generic	1	1	
H5928	004	0	1	01	01	H5928_004_0	7	3	Brand	2		
H5928	006	0	1	01	01	H5928_006_0	4	4	Other Non-Preferred	2		
H5928	006	0	1	01	01	H5928_006_0	4	5	Specialty	2		
H5928	006	0	1	01	01	H5928_006_0	4	3	Brand	2		
H5928	006	0	1	01	01	H5928_006_0	4	1	Preferred Generic	1	1	
H5928	006	0	1	01	01	H5928_006_0	4	2	Generic	1	1	
H5928	008	0	1	01	01	H5928_008_0	5	5	Specialty	2		
H5928	008	0	1	01	01	H5928_008_0	5	4	Other Non-Preferred	2		
H5928	008	0	1	01	01	H5928_008_0	5	3	Brand	2		
H5928	008	0	1	01	01	H5928_008_0	5	2	Generic	1	1	
H5928	008	0	1	01	01	H5928_008_0	5	1	Preferred Generic	1	1	
H5928	010	0	1	01	01	H5928_010_0	6	4	Other Non-Preferred	2		
H5928	010	0	1	01	01	H5928_010_0	6	5	Specialty	2		
H5928	010	0	1	01	01	H5928_010_0	6	3	Brand	2		
H5928	010	0	1	01	01	H5928_010_0	6	2	Generic	1	1	
H5928	010	0	1	01	01	H5928_010_0	6	1	Preferred Generic	1	1	
H5928	012	0	1	01	01	H5928_012_0	6	4	Other Non-Preferred	2		
H5928	012	0	1	01	01	H5928_012_0	6	5	Specialty	2		
H5928	012	0	1	01	01	H5928_012_0	6	3	Brand	2		
H5928	012	0	1	01	01	H5928_012_0	6	2	Generic	1	1	
H5928	012	0	1	01	01	H5928_012_0	6	1	Preferred Generic	1	1	
H5928	013	0	1	01	01	H5928_013_0	8	5	Specialty	2		
H5928	013	0	1	01	01	H5928_013_0	8	3	Brand	2		
H5928	013	0	1	01	01	H5928_013_0	8	2	Generic	1	1	
H5928	013	0	1	01	01	H5928_013_0	8	1	Preferred Generic	1	1	
H5928	013	0	1	01	01	H5928_013_0	8	4	Other Non-Preferred	2		
H5938	006	0	1	01	01	H5938_006_0	9	4	Specialty Brand/Generic	2		
H5938	006	0	1	01	01	H5938_006_0	9	1	Generic	1	1	
H5938	006	0	1	01	01	H5938_006_0	9	3	Non-Preferred Brand	2		
H5938	006	0	1	01	01	H5938_006_0	9	2	Preferred Brand	2		
H5948	001	0	1	01	01	H5948_001_0	6	3	Tier 3	2		
H5948	001	0	1	01	01	H5948_001_0	6	2	Tier 2	1	1	
H5948	001	0	1	01	01	H5948_001_0	6	1	Tier 1	1	1	
H5948	001	0	1	01	01	H5948_001_0	6	4	Tier 4	2		
H5970	001	0	1	04	01	H5970_001_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5970	001	0	1	04	01	H5970_001_0	5	4	Specialty	1	2	10001000
H5970	001	0	1	04	01	H5970_001_0	5	3	Non-Preferred Brand	1	2	10000000
H5970	001	0	1	04	01	H5970_001_0	5	1	Preferred Generic	1	2	00001000
H5970	002	0	1	04	01	H5970_002_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H5970	002	0	1	04	01	H5970_002_0	5	3	Non-Preferred Brand	1	2	10000000
H5970	002	0	1	04	01	H5970_002_0	5	1	Preferred Generic	1	2	00001000
H5970	002	0	1	04	01	H5970_002_0	5	4	Specialty	1	2	10001000
H5980	006	0	1	01	01	H5980_006_0	18	4	Specialty	2		
H5980	006	0	1	01	01	H5980_006_0	18	3	Non-Preferred Brand	2		
H5980	006	0	1	01	01	H5980_006_0	18	2	Preferred Brand	2		
H5980	006	0	1	01	01	H5980_006_0	18	1	generic	1	1	
H5980	007	0	1	01	01	H5980_007_0	18	2	Preferred Brand	2		
H5980	007	0	1	01	01	H5980_007_0	18	3	Non-Preferred	2		
H5980	007	0	1	01	01	H5980_007_0	18	4	Specialty	2		
H5980	007	0	1	01	01	H5980_007_0	18	1	Generic	1	1	
H5985	001	0	1	01	01	H5985_001_0	5	2	Preferred Brand	2		
H5985	001	0	1	01	01	H5985_001_0	5	1	Generic	1	1	
H5985	001	0	1	01	01	H5985_001_0	5	4	Specialty	2		
H5985	001	0	1	01	01	H5985_001_0	5	3	Brand	2		
H6120	002	0	1	01	01	H6120_002_0	4	3	Tier 3	2		
H6120	002	0	1	01	01	H6120_002_0	4	2	Tier 2	2		
H6120	002	0	1	01	01	H6120_002_0	4	1	Tier 1	1	1	
H6120	002	0	1	01	01	H6120_002_0	4	4	Tier 4	2		
H6120	003	0	1	01	01	H6120_003_0	5	1	Tier 1	1	1	
H6120	003	0	1	01	01	H6120_003_0	5	2	Tier 2	1	1	
H6120	003	0	1	01	01	H6120_003_0	5	3	Tier 3	2		
H6120	003	0	1	01	01	H6120_003_0	5	4	Tier 4	2		
H6181	007	0	1	01	01	H6181_007_0	4	3	Preferred Brand Drugs	2		
H6181	007	0	1	01	01	H6181_007_0	4	2	Non-Preferred Generic Drugs	2		
H6181	007	0	1	01	01	H6181_007_0	4	1	Preferred Generic Drugs	1	1	
H6181	007	0	1	01	01	H6181_007_0	4	4	Non-Preferred Brand Drugs	2		
H6181	007	0	1	01	01	H6181_007_0	4	5	Specialty Drugs	2		
H6181	008	0	1	01	01	H6181_008_0	3	1	Preferred Generic Drugs	1	1	
H6181	008	0	1	01	01	H6181_008_0	3	2	Non-Preferred Generic Drugs	2		
H6181	008	0	1	01	01	H6181_008_0	3	3	Preferred Brand Drugs	2		
H6181	008	0	1	01	01	H6181_008_0	3	4	Non-Preferred Brand Drugs	2		
H6181	008	0	1	01	01	H6181_008_0	3	5	Specialty Drugs	2		
H6181	009	0	1	01	01	H6181_009_0	6	1	Preferred Generic Drugs	1	1	
H6181	009	0	1	01	01	H6181_009_0	6	2	Non-Preferred Generic Drugs	1	1	
H6181	009	0	1	01	01	H6181_009_0	6	3	Preferred Brand Drugs	2		
H6181	009	0	1	01	01	H6181_009_0	6	4	Non-Preferred Brand Drugs	2		
H6181	009	0	1	01	01	H6181_009_0	6	5	Specialty Drugs	2		
H6328	001	0	1	04	01	H6328_001_0	9	1	Preferred Generic	1	1	
H6328	001	0	1	04	01	H6328_001_0	9	2	Preferred Brand	2		
H6328	001	0	1	04	01	H6328_001_0	9	3	Non- Preferred Drugs	2		
H6328	001	0	1	04	01	H6328_001_0	9	4	Specialty	2		
H6328	002	0	1	04	01	H6328_002_0	8	4	Specialty	2		
H6328	002	0	1	04	01	H6328_002_0	8	3	Non- Preferred Drugs	2		
H6328	002	0	1	04	01	H6328_002_0	8	2	Preferred Brand	2		
H6328	002	0	1	04	01	H6328_002_0	8	1	Preferred Generic	1	1	
H6328	003	0	1	04	01	H6328_003_0	8	4	Specialty	2		
H6328	003	0	1	04	01	H6328_003_0	8	3	Non- Preferred Drugs	2		
H6328	003	0	1	04	01	H6328_003_0	8	1	Preferred Generic	1	1	
H6328	003	0	1	04	01	H6328_003_0	8	2	Preferred Brand	2		
H6360	001	0	1	18	06	H6360_001_0	4	1	Generic	1	1	
H6360	001	0	1	18	06	H6360_001_0	4	2	Brand	2		
H6360	001	0	1	18	06	H6360_001_0	4	3	Specialty	2		
H6360	002	0	1	18	06	H6360_002_0	3	2	Brand	2		
H6360	002	0	1	18	06	H6360_002_0	3	1	Generic	1	1	
H6360	002	0	1	18	06	H6360_002_0	3	3	Specialty	2		
H6360	009	0	2	18	06	H6360_009_0	3	1	Generic	1	1	
H6360	009	0	2	18	06	H6360_009_0	3	3	Specialty	2		
H6360	009	0	2	18	06	H6360_009_0	3	2	Brand	2		
H6411	002	0	1	04	01	H6411_002_0	5	3	Non-Preferred Brand	1	2	10000000
H6411	002	0	1	04	01	H6411_002_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6411	002	0	1	04	01	H6411_002_0	5	1	Preferred Generic	1	2	00001000
H6411	002	0	1	04	01	H6411_002_0	5	4	Specialty	1	2	10001000
H6411	007	0	1	04	01	H6411_007_0	4	4	Specialty	1	2	10001000
H6411	007	0	1	04	01	H6411_007_0	4	3	Non-Preferred Brand	1	2	10000000
H6411	007	0	1	04	01	H6411_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6411	007	0	1	04	01	H6411_007_0	4	1	Preferred Generic	1	2	00001000
H6609	001	0	1	04	01	H6609_001_0	6	4	Specialty	1	2	10001000
H6609	001	0	1	04	01	H6609_001_0	6	3	Non-Preferred Brand	1	2	10000000
H6609	001	0	1	04	01	H6609_001_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	001	0	1	04	01	H6609_001_0	6	1	Preferred Generic	1	2	00001000
H6609	003	0	1	04	01	H6609_003_0	6	4	Specialty	1	2	10001000
H6609	003	0	1	04	01	H6609_003_0	6	3	Non-Preferred Brand	1	2	10000000
H6609	003	0	1	04	01	H6609_003_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	003	0	1	04	01	H6609_003_0	6	1	Preferred Generic	1	2	00001000
H6609	005	0	1	04	01	H6609_005_0	6	3	Non-Preferred Brand	1	2	10000000
H6609	005	0	1	04	01	H6609_005_0	6	4	Specialty	1	2	10001000
H6609	005	0	1	04	01	H6609_005_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	005	0	1	04	01	H6609_005_0	6	1	Preferred Generic	1	2	00001000
H6609	007	0	1	04	01	H6609_007_0	6	4	Specialty	1	2	10001000
H6609	007	0	1	04	01	H6609_007_0	6	3	Non-Preferred Brand	1	2	10000000
H6609	007	0	1	04	01	H6609_007_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	007	0	1	04	01	H6609_007_0	6	1	Preferred Generic	1	2	00001000
H6609	009	0	1	04	01	H6609_009_0	7	1	Preferred Generic	1	2	00001000
H6609	009	0	1	04	01	H6609_009_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10000000
H6609	009	0	1	04	01	H6609_009_0	7	3	Non-Preferred Brand	1	2	10000000
H6609	009	0	1	04	01	H6609_009_0	7	4	Specialty	1	2	10001000
H6609	010	0	1	04	01	H6609_010_0	5	3	Non-Preferred Brand	1	2	10000000
H6609	010	0	1	04	01	H6609_010_0	5	4	Specialty	1	2	10001000
H6609	010	0	1	04	01	H6609_010_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10000000
H6609	010	0	1	04	01	H6609_010_0	5	1	Preferred Generic	1	2	00001000
H6609	011	0	1	04	01	H6609_011_0	5	3	Non-Preferred Brand	1	2	10000000
H6609	011	0	1	04	01	H6609_011_0	5	1	Preferred Generic	1	2	00001000
H6609	011	0	1	04	01	H6609_011_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10000000
H6609	011	0	1	04	01	H6609_011_0	5	4	Specialty	1	2	10001000
H6609	013	0	1	04	01	H6609_013_0	6	1	Preferred Generic	1	2	00001000
H6609	013	0	1	04	01	H6609_013_0	6	4	Specialty	1	2	10001000
H6609	013	0	1	04	01	H6609_013_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	013	0	1	04	01	H6609_013_0	6	3	Non-Preferred Brand	1	2	10000000
H6609	014	0	1	04	01	H6609_014_0	5	4	Specialty	1	2	10001000
H6609	014	0	1	04	01	H6609_014_0	5	3	Non-Preferred Brand	1	2	10000000
H6609	014	0	1	04	01	H6609_014_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	014	0	1	04	01	H6609_014_0	5	1	Preferred Generic	1	2	00001000
H6609	015	0	1	04	01	H6609_015_0	7	4	Specialty	1	2	10001000
H6609	015	0	1	04	01	H6609_015_0	7	1	Preferred Generic	1	2	00001000
H6609	015	0	1	04	01	H6609_015_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	015	0	1	04	01	H6609_015_0	7	3	Non-Preferred Brand	1	2	10000000
H6609	016	0	1	04	01	H6609_016_0	5	1	Preferred Generic	1	2	00001000
H6609	016	0	1	04	01	H6609_016_0	5	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6609	016	0	1	04	01	H6609_016_0	5	3	Non-Preferred Brand	1	2	10000000
H6609	016	0	1	04	01	H6609_016_0	5	4	Specialty	1	2	10001000
H6900	001	0	1	04	01	H6900_001_0	9	4	Specialty	1	2	10001000
H6900	001	0	1	04	01	H6900_001_0	9	3	Non-Preferred Brand	1	2	10000000
H6900	001	0	1	04	01	H6900_001_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6900	001	0	1	04	01	H6900_001_0	9	1	Preferred Generic	1	2	00001000
H6900	002	0	1	04	01	H6900_002_0	7	3	Non-Preferred Brand	1	2	10000000
H6900	002	0	1	04	01	H6900_002_0	7	4	Specialty	1	2	10001000
H6900	002	0	1	04	01	H6900_002_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6900	002	0	1	04	01	H6900_002_0	7	1	Preferred Generic	1	2	00001000
H6900	004	0	1	04	01	H6900_004_0	9	1	Preferred Generic	1	2	00001000
H6900	004	0	1	04	01	H6900_004_0	9	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H6900	004	0	1	04	01	H6900_004_0	9	3	Non-Preferred Brand	1	2	10000000
H6900	004	0	1	04	01	H6900_004_0	9	4	Specialty	1	2	10001000
H7002	002	0	1	04	01	H7002_002_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H7002	002	0	1	04	01	H7002_002_0	4	3	Non-Preferred Brand	1	2	10000000
H7002	002	0	1	04	01	H7002_002_0	4	1	Preferred Generic	1	2	00001000
H7002	002	0	1	04	01	H7002_002_0	4	4	Specialty	1	2	10001000
H7179	001	0	1	01	01	H7179_001_0	7	1	Tier 1 - Preferred Generic	1	1	
H7179	001	0	1	01	01	H7179_001_0	7	5	Tier 5 - Specialty	2		
H7179	001	0	1	01	01	H7179_001_0	7	4	Tier 4 - Non-Preferred Brand	2		
H7179	001	0	1	01	01	H7179_001_0	7	3	Tier 3 - Preferred Brand	2		
H7179	001	0	1	01	01	H7179_001_0	7	2	Tier 2 - Non-Preferred Generic	1	1	
H7179	002	0	1	01	01	H7179_002_0	6	1	Tier 1 - Preferred Generic	1	1	
H7179	002	0	1	01	01	H7179_002_0	6	2	Tier 2 - Non-Preferred Generic	1	1	
H7179	002	0	1	01	01	H7179_002_0	6	4	Tier 4 - Non-Preferred Brand	2		
H7179	002	0	1	01	01	H7179_002_0	6	5	Tier 5 - Specialty	2		
H7179	002	0	1	01	01	H7179_002_0	6	3	Tier 3 - Preferred Brand	2		
H7179	007	0	1	01	01	H7179_007_0	5	2	Tier 2 - Non-Preferred Generic	1	1	
H7179	007	0	1	01	01	H7179_007_0	5	1	Tier 1 - Preferred Generic	1	1	
H7179	007	0	1	01	01	H7179_007_0	5	3	Tier 3 - Preferred Brand	2		
H7179	007	0	1	01	01	H7179_007_0	5	5	Tier 5 - Specialty	2		
H7179	007	0	1	01	01	H7179_007_0	5	4	Tier 4 - Non-Preferred Brand	2		
H7179	009	0	1	02	01	H7179_009_0	8	4	Tier 4 - Non-Preferred Brand	2		
H7179	009	0	1	02	01	H7179_009_0	8	5	Tier 5 - Specialty	2		
H7179	009	0	1	02	01	H7179_009_0	8	3	Tier 3 - Preferred Brand	2		
H7179	009	0	1	02	01	H7179_009_0	8	2	Tier 2 - Non-Preferred Generic	1	1	
H7179	009	0	1	02	01	H7179_009_0	8	1	Tier 1 - Preferred Generic	1	1	
H7179	010	0	1	01	01	H7179_010_0	7	4	Tier 4 - Non-Preferred Brand	2		
H7179	010	0	1	01	01	H7179_010_0	7	5	Tier 5 - Specialty	2		
H7179	010	0	1	01	01	H7179_010_0	7	3	Tier 3 - Preferred Brand	2		
H7179	010	0	1	01	01	H7179_010_0	7	1	Tier 1 - Preferred Generic	1	1	
H7179	010	0	1	01	01	H7179_010_0	7	2	Tier 2 - Non-Preferred Generic	1	1	
H7179	011	0	1	01	01	H7179_011_0	8	1	Tier 1 - Preferred Generic	1	1	
H7179	011	0	1	01	01	H7179_011_0	8	2	Tier 2 - Non-Preferred Generic	1	1	
H7179	011	0	1	01	01	H7179_011_0	8	3	Tier 3 - Preferred Brand	2		
H7179	011	0	1	01	01	H7179_011_0	8	4	Tier 4 - Non-Preferred Brand	2		
H7179	011	0	1	01	01	H7179_011_0	8	5	Tier 5 - Specialty	2		
H7179	012	0	1	01	01	H7179_012_0	7	4	Tier 4 - Non-Preferred Brand	2		
H7179	012	0	1	01	01	H7179_012_0	7	5	Tier 5 - Specialty	2		
H7179	012	0	1	01	01	H7179_012_0	7	1	Tier 1 - Preferred Generic	1	1	
H7179	012	0	1	01	01	H7179_012_0	7	2	Tier 2 - Non-Preferred Generic	1	1	
H7179	012	0	1	01	01	H7179_012_0	7	3	Tier 3 - Preferred Brand	2		
H7188	003	0	1	04	01	H7188_003_0	8	4	Specialty	1	2	10001000
H7188	003	0	1	04	01	H7188_003_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H7188	003	0	1	04	01	H7188_003_0	8	3	Non-Preferred Brand	1	2	10000000
H7188	003	0	1	04	01	H7188_003_0	8	1	Preferred Generic	1	2	00001000
H7200	006	0	1	01	01	H7200_006_0	5	1	Preferred Generic Drugs	1	1	
H7200	006	0	1	01	01	H7200_006_0	5	4	Non-Preferred Brand Drugs	2		
H7200	006	0	1	01	01	H7200_006_0	5	5	Specialty Drugs	2		
H7200	006	0	1	01	01	H7200_006_0	5	2	Non-Preferred Generic Drugs	2		
H7200	006	0	1	01	01	H7200_006_0	5	3	Preferred Brand Drugs	2		
H7200	007	0	1	01	01	H7200_007_0	6	3	Preferred Brand Drugs	2		
H7200	007	0	1	01	01	H7200_007_0	6	4	Non-Preferred Brand Drugs	2		
H7200	007	0	1	01	01	H7200_007_0	6	2	Non-Preferred Generic Drugs	2		
H7200	007	0	1	01	01	H7200_007_0	6	1	Preferred Generic Drugs	1	1	
H7200	007	0	1	01	01	H7200_007_0	6	5	Specialty Drugs	2		
H7220	004	0	1	02	01	H7220_004_0	8	4	Specialty	2		
H7220	004	0	1	02	01	H7220_004_0	8	2	Preferred Brand	2		
H7220	004	0	1	02	01	H7220_004_0	8	1	Generic	1	1	
H7220	004	0	1	02	01	H7220_004_0	8	3	Non-Preferred Brand	2		
H7226	001	0	1	09	04	H7226_001_0	2	2	Tier 2	2		
H7226	001	0	1	09	04	H7226_001_0	2	1	Tier 1	1	1	
H7226	001	0	1	09	04	H7226_001_0	2	3	Tier 3	2		
H7226	007	0	1	09	04	H7226_007_0	2	1	Tier 1	1	1	
H7226	007	0	1	09	04	H7226_007_0	2	3	Tier 3	2		
H7226	007	0	1	09	04	H7226_007_0	2	2	Tier 2	2		
H7226	011	0	1	09	04	H7226_011_0	2	3	Tier 3	2		
H7226	011	0	1	09	04	H7226_011_0	2	1	Tier 1	1	1	
H7226	011	0	1	09	04	H7226_011_0	2	2	Tier 2	2		
H7252	002	0	1	01	01	H7252_002_0	4	3	Tier 3	2		
H7252	002	0	1	01	01	H7252_002_0	4	4	Tier 4	2		
H7252	002	0	1	01	01	H7252_002_0	4	2	Tier 2	2		
H7252	002	0	1	01	01	H7252_002_0	4	1	Tier 1	1	1	
H7252	003	0	1	01	01	H7252_003_0	4	2	Tier 2	2		
H7252	003	0	1	01	01	H7252_003_0	4	3	Tier 3	2		
H7252	003	0	1	01	01	H7252_003_0	4	4	Tier 4	2		
H7252	003	0	1	01	01	H7252_003_0	4	1	Tier 1	1	1	
H7281	005	0	1	01	01	H7281_005_0	3	1	Generic	2		
H7281	005	0	1	01	01	H7281_005_0	3	2	Preferred Brand	2		
H7281	005	0	1	01	01	H7281_005_0	3	3	Non-Preferred Brand	2		
H7281	005	0	1	01	01	H7281_005_0	3	5	Preferred Diabetic Drugs	1	1	
H7281	005	0	1	01	01	H7281_005_0	3	4	Specialty	2		
H7731	001	0	1	01	01	H7731_001_0	4	3	Tier 3	1	1	
H7731	001	0	1	01	01	H7731_001_0	4	4	Tier 4	1	1	
H7731	001	0	1	01	01	H7731_001_0	4	2	Tier 2	1	1	
H7731	001	0	1	01	01	H7731_001_0	4	1	Tier 1	1	1	
H7787	001	0	1	04	01	H7787_001_0	8	2	Generic	1	1	
H7787	001	0	1	04	01	H7787_001_0	8	5	Specialty	2		
H7787	001	0	1	04	01	H7787_001_0	8	4	Non-Preferred Brand	2		
H7787	001	0	1	04	01	H7787_001_0	8	3	Preferred Brand	2		
H7787	001	0	1	04	01	H7787_001_0	8	1	Preferred Generic	1	1	
H7787	003	0	1	04	01	H7787_003_0	4	2	Generic	1	1	
H7787	003	0	1	04	01	H7787_003_0	4	1	Preferred Generic	1	1	
H7787	003	0	1	04	01	H7787_003_0	4	5	Specialty	2		
H7787	003	0	1	04	01	H7787_003_0	4	3	Preferred Brand	2		
H7787	003	0	1	04	01	H7787_003_0	4	4	Non-Preferred Brand	2		
H7787	004	0	1	04	01	H7787_004_0	4	5	Specialty	2		
H7787	004	0	1	04	01	H7787_004_0	4	3	Preferred Brand	2		
H7787	004	0	1	04	01	H7787_004_0	4	4	Non-Preferred Brand	2		
H7787	004	0	1	04	01	H7787_004_0	4	1	Preferred Generic	1	1	
H7787	004	0	1	04	01	H7787_004_0	4	2	Generic	1	1	
H7787	005	0	1	04	01	H7787_005_0	5	1	Preferred Generic	1	1	
H7787	005	0	1	04	01	H7787_005_0	5	4	Non-Preferred Brand	2		
H7787	005	0	1	04	01	H7787_005_0	5	2	Generic	1	1	
H7787	005	0	1	04	01	H7787_005_0	5	3	Preferred Brand	2		
H7787	005	0	1	04	01	H7787_005_0	5	5	Specialty	2		
H8130	002	0	1	01	01	H8130_002_0	5	3	Non-Preferred Brand	2		
H8130	002	0	1	01	01	H8130_002_0	5	2	Preferred Brand	1	1	
H8130	002	0	1	01	01	H8130_002_0	5	1	Generic	1	1	
H8130	002	0	1	01	01	H8130_002_0	5	4	Specialty Drug	2		
H8130	003	0	1	01	01	H8130_003_0	3	3	Non-Preferred Brand	2		
H8130	003	0	1	01	01	H8130_003_0	3	2	Preferred Brand	2		
H8130	003	0	1	01	01	H8130_003_0	3	1	Generic	1	1	
H8130	003	0	1	01	01	H8130_003_0	3	4	Specialty Drug	2		
H8130	004	0	1	01	01	H8130_004_0	3	4	Specialty Drug	2		
H8130	004	0	1	01	01	H8130_004_0	3	1	Generic	1	1	
H8130	004	0	1	01	01	H8130_004_0	3	2	Preferred Brand	2		
H8130	004	0	1	01	01	H8130_004_0	3	3	Non-Preferred Brand	2		
H8578	001	0	1	01	01	H8578_001_0	3	3	Non-Preferred Brand	2		
H8578	001	0	1	01	01	H8578_001_0	3	2	Brand	2		
H8578	001	0	1	01	01	H8578_001_0	3	1	Generic	1	1	
H8578	001	0	1	01	01	H8578_001_0	3	4	Specialty	2		
H8578	004	0	1	01	01	H8578_004_0	5	3	Non-Preferred Brand	2		
H8578	004	0	1	01	01	H8578_004_0	5	2	Brand	2		
H8578	004	0	1	01	01	H8578_004_0	5	1	Generic	1	1	
H8578	004	0	1	01	01	H8578_004_0	5	4	Specialty	2		
H8578	007	0	1	01	01	H8578_007_0	3	1	Generic	1	1	
H8578	007	0	1	01	01	H8578_007_0	3	2	Brand	2		
H8578	007	0	1	01	01	H8578_007_0	3	3	Non-Preferred Brand	2		
H8578	007	0	1	01	01	H8578_007_0	3	4	Specialty	2		
H8578	010	0	1	02	01	H8578_010_0	3	3	Non-Preferred Brand	2		
H8578	010	0	1	02	01	H8578_010_0	3	4	Specialty	2		
H8578	010	0	1	02	01	H8578_010_0	3	1	Generic	1	1	
H8578	010	0	1	02	01	H8578_010_0	3	2	Brand	2		
H8604	001	0	1	04	01	H8604_001_0	5	3	Non-Preferred Brand	2		
H8604	001	0	1	04	01	H8604_001_0	5	2	Preferred Brand	2		
H8604	001	0	1	04	01	H8604_001_0	5	1	Generic	1	1	
H8604	001	0	1	04	01	H8604_001_0	5	4	Specialty	1	2	01000000
H8604	003	0	1	04	01	H8604_003_0	5	1	Generic	1	1	
H8604	003	0	1	04	01	H8604_003_0	5	2	Preferred Brand	2		
H8604	003	0	1	04	01	H8604_003_0	5	3	Non-Preferred Brand	2		
H8604	003	0	1	04	01	H8604_003_0	5	4	Specialty	1	2	01000000
H8644	003	0	1	04	01	H8644_003_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H8644	003	0	1	04	01	H8644_003_0	8	1	Preferred Generic	1	2	00001000
H8644	003	0	1	04	01	H8644_003_0	8	3	Non-Preferred Brand	1	2	10000000
H8644	003	0	1	04	01	H8644_003_0	8	4	Specialty	1	2	10001000
H8707	001	0	1	04	01	H8707_001_0	4	4	Specialty	1	2	10001000
H8707	001	0	1	04	01	H8707_001_0	4	3	Non-Preferred Brand	1	2	10000000
H8707	001	0	1	04	01	H8707_001_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H8707	001	0	1	04	01	H8707_001_0	4	1	Preferred Generic	1	2	00001000
H8707	003	0	1	04	01	H8707_003_0	4	4	Specialty	1	2	10001000
H8707	003	0	1	04	01	H8707_003_0	4	3	Non-Preferred Brand	1	2	10000000
H8707	003	0	1	04	01	H8707_003_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H8707	003	0	1	04	01	H8707_003_0	4	1	Preferred Generic	1	2	00001000
H8707	005	0	1	04	01	H8707_005_0	4	3	Non-Preferred Brand	1	2	10000000
H8707	005	0	1	04	01	H8707_005_0	4	4	Specialty	1	2	10001000
H8707	005	0	1	04	01	H8707_005_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H8707	005	0	1	04	01	H8707_005_0	4	1	Preferred Generic	1	2	00001000
H8707	006	0	1	04	01	H8707_006_0	4	3	Non-Preferred Brand	1	2	10000000
H8707	006	0	1	04	01	H8707_006_0	4	1	Preferred Generic	1	2	00001000
H8707	006	0	1	04	01	H8707_006_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H8707	006	0	1	04	01	H8707_006_0	4	4	Specialty	1	2	10001000
H8707	007	0	1	04	01	H8707_007_0	4	1	Preferred Generic	1	2	00001000
H8707	007	0	1	04	01	H8707_007_0	4	4	Specialty	1	2	10001000
H8707	007	0	1	04	01	H8707_007_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H8707	007	0	1	04	01	H8707_007_0	4	3	Non-Preferred Brand	1	2	10000000
H8742	008	0	1	01	01	H8742_008_0	9	4	Specialty	2		
H8742	008	0	1	01	01	H8742_008_0	9	3	Non-Preferred Brand	2		
H8742	008	0	1	01	01	H8742_008_0	9	2	Preferred Brand	1	2	10000000
H8742	008	0	1	01	01	H8742_008_0	9	1	Generic	1	1	
H8822	002	0	1	01	01	H8822_002_0	4	1	Preferred Generic	1	1	
H8822	002	0	1	01	01	H8822_002_0	4	2	Generic	1	1	
H8822	002	0	1	01	01	H8822_002_0	4	3	Preferred Brand	2		
H8822	002	0	1	01	01	H8822_002_0	4	4	Specialty	2		
H8822	002	0	1	01	01	H8822_002_0	4	5	Non-Preferred Agents	2		
H8822	004	0	1	01	01	H8822_004_0	3	1	Preferred Generic	1	1	
H8822	004	0	1	01	01	H8822_004_0	3	2	Generic	1	1	
H8822	004	0	1	01	01	H8822_004_0	3	3	Preferred Brand	2		
H8822	004	0	1	01	01	H8822_004_0	3	4	Specialty	2		
H8822	004	0	1	01	01	H8822_004_0	3	5	Non-Preferred Agents	2		
H8953	001	0	1	01	01	H8953_001_0	8	1	Preferred Generic	1	1	
H8953	001	0	1	01	01	H8953_001_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H8953	001	0	1	01	01	H8953_001_0	8	3	Non-Preferred Brand	1	2	10000000
H8953	001	0	1	01	01	H8953_001_0	8	4	Specialty	1	2	10001000
H8991	012	0	1	01	01	H8991_012_0	3	2	Non-Preferred Generic Drugs	1	1	
H8991	012	0	1	01	01	H8991_012_0	3	5	Specialty Drugs	2		
H8991	012	0	1	01	01	H8991_012_0	3	4	Non-Preferred Brand Drugs	2		
H8991	012	0	1	01	01	H8991_012_0	3	3	Preferred Brand Drugs	2		
H8991	012	0	1	01	01	H8991_012_0	3	1	Preferred Generic Drugs	1	1	
H8991	017	0	1	01	01	H8991_017_0	3	5	Specialty Drugs	2		
H8991	017	0	1	01	01	H8991_017_0	3	4	Non-Preferred Brand Drugs	2		
H8991	017	0	1	01	01	H8991_017_0	3	3	Preferred Brand Drugs	2		
H8991	017	0	1	01	01	H8991_017_0	3	2	Non-Preferred Generic Drugs	2		
H8991	017	0	1	01	01	H8991_017_0	3	1	Preferred Generic Drugs	1	1	
H8991	018	0	1	01	01	H8991_018_0	4	5	Specialty Drugs	2		
H8991	018	0	1	01	01	H8991_018_0	4	4	Non-Preferred Brand Drugs	2		
H8991	018	0	1	01	01	H8991_018_0	4	1	Preferred Generic Drugs	1	1	
H8991	018	0	1	01	01	H8991_018_0	4	2	Non-Preferred Generic Drugs	2		
H8991	018	0	1	01	01	H8991_018_0	4	3	Preferred Brand Drugs	2		
H8991	022	0	1	01	01	H8991_022_0	3	5	Specialty Drugs	2		
H8991	022	0	1	01	01	H8991_022_0	3	2	Non-Preferred Generic Drugs	2		
H8991	022	0	1	01	01	H8991_022_0	3	3	Preferred Brand Drugs	2		
H8991	022	0	1	01	01	H8991_022_0	3	4	Non-Preferred Brand Drugs	2		
H8991	022	0	1	01	01	H8991_022_0	3	1	Preferred Generic Drugs	1	1	
H9003	001	0	1	01	01	H9003_001_0	5	1	Generic	1	1	
H9003	001	0	1	01	01	H9003_001_0	5	3	Specialty	2		
H9003	001	0	1	01	01	H9003_001_0	5	2	Brand	2		
H9003	006	0	1	01	01	H9003_006_0	5	3	Specialty	2		
H9003	006	0	1	01	01	H9003_006_0	5	1	Generic	1	1	
H9003	006	0	1	01	01	H9003_006_0	5	2	Brand	2		
H9011	003	0	1	01	01	H9011_003_0	4	4	Tier 4 Specialty	2		
H9011	003	0	1	01	01	H9011_003_0	4	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
H9011	003	0	1	01	01	H9011_003_0	4	2	Tier 2 Generic  Preferred Brand	2		
H9011	003	0	1	01	01	H9011_003_0	4	1	Tier 1 Preferred Generic  Brand	1	1	
H9101	007	0	1	01	01	H9101_007_0	3	1	Generic	1	1	
H9101	007	0	1	01	01	H9101_007_0	3	4	Specialty	2		
H9101	007	0	1	01	01	H9101_007_0	3	3	Brand	2		
H9101	007	0	1	01	01	H9101_007_0	3	2	Preferred	2		
H9103	001	0	1	01	01	H9103_001_0	4	3	Specialty	2		
H9103	001	0	1	01	01	H9103_001_0	4	2	Brand	2		
H9103	001	0	1	01	01	H9103_001_0	4	1	Generic	1	1	
H9104	006	0	1	01	01	H9104_006_0	6	1	Select Generic	1	1	
H9104	006	0	1	01	01	H9104_006_0	6	5	Specialty	2		
H9104	006	0	1	01	01	H9104_006_0	6	4	Additional Brand	2		
H9104	006	0	1	01	01	H9104_006_0	6	3	Brand	2		
H9104	006	0	1	01	01	H9104_006_0	6	2	Generic	1	1	
H9104	007	0	1	01	01	H9104_007_0	5	1	Select Generic	1	1	
H9104	007	0	1	01	01	H9104_007_0	5	2	Generic	1	1	
H9104	007	0	1	01	01	H9104_007_0	5	5	Specialty	2		
H9104	007	0	1	01	01	H9104_007_0	5	4	Additional Brand	2		
H9104	007	0	1	01	01	H9104_007_0	5	3	Brand	2		
H9104	008	0	1	01	01	H9104_008_0	6	1	Select Generic	1	1	
H9104	008	0	1	01	01	H9104_008_0	6	2	Generic	1	1	
H9104	008	0	1	01	01	H9104_008_0	6	3	Brand	2		
H9104	008	0	1	01	01	H9104_008_0	6	4	Additional Brand	2		
H9104	008	0	1	01	01	H9104_008_0	6	5	Specialty	2		
H9104	009	0	1	01	01	H9104_009_0	5	1	Select Generic	1	1	
H9104	009	0	1	01	01	H9104_009_0	5	4	Additional Brand	2		
H9104	009	0	1	01	01	H9104_009_0	5	3	Brand	2		
H9104	009	0	1	01	01	H9104_009_0	5	2	Generic	1	1	
H9104	009	0	1	01	01	H9104_009_0	5	5	Specialty	2		
H9302	001	0	1	01	01	H9302_001_0	4	1	Tier I	1	1	
H9302	001	0	1	01	01	H9302_001_0	4	2	Tier II	2		
H9302	001	0	1	01	01	H9302_001_0	4	4	Tier IV	2		
H9302	001	0	1	01	01	H9302_001_0	4	3	Tier III	2		
H9302	005	0	1	01	01	H9302_005_0	4	1	Tier I	1	1	
H9302	005	0	1	01	01	H9302_005_0	4	2	Tier II	2		
H9302	005	0	1	01	01	H9302_005_0	4	3	Tier III	2		
H9302	005	0	1	01	01	H9302_005_0	4	4	Tier IV	2		
H9302	008	0	1	02	01	H9302_008_0	4	3	Tier III	2		
H9302	008	0	1	02	01	H9302_008_0	4	1	Tier I	1	1	
H9302	008	0	1	02	01	H9302_008_0	4	2	Tier II	2		
H9302	008	0	1	02	01	H9302_008_0	4	4	Tier IV	2		
H9313	012	1	1	02	01	H9313_012_1	6	1	Preferred Generic	1	1	
H9313	012	1	1	02	01	H9313_012_1	6	5	Specialty Tier	2		
H9313	012	1	1	02	01	H9313_012_1	6	4	Non-Preferred Brand	2		
H9313	012	1	1	02	01	H9313_012_1	6	3	Preferred Brand	2		
H9313	012	1	1	02	01	H9313_012_1	6	2	Non-Preferred Generic	1	1	
H9313	012	2	1	02	01	H9313_012_2	6	1	Preferred Generic	1	1	
H9313	012	2	1	02	01	H9313_012_2	6	5	Specialty Tier	2		
H9313	012	2	1	02	01	H9313_012_2	6	4	Non-Preferred Brand	2		
H9313	012	2	1	02	01	H9313_012_2	6	3	Preferred Brand	2		
H9313	012	2	1	02	01	H9313_012_2	6	2	Non-Preferred Generic	1	1	
H9385	002	0	1	01	01	H9385_002_0	6	3	Specialty	2		
H9385	002	0	1	01	01	H9385_002_0	6	2	Brand	2		
H9385	002	0	1	01	01	H9385_002_0	6	1	Generic	1	1	
H9452	002	0	1	09	04	H9452_002_0	13	1	Tier 1 Preferred Generic Drugs	1	1	
H9452	002	0	1	09	04	H9452_002_0	13	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
H9452	002	0	1	09	04	H9452_002_0	13	5	Tier 5 Specialty Drugs	2		
H9452	002	0	1	09	04	H9452_002_0	13	4	Tier 4 Non-Specialty Injectable Drugs	2		
H9452	002	0	1	09	04	H9452_002_0	13	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
H9503	001	0	1	04	01	H9503_001_0	8	3	Non-Preferred Brand	1	2	10000000
H9503	001	0	1	04	01	H9503_001_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H9503	001	0	1	04	01	H9503_001_0	8	1	Preferred Generic	1	2	00001000
H9503	001	0	1	04	01	H9503_001_0	8	4	Specialty	1	2	10001000
H9503	003	0	1	04	01	H9503_003_0	8	3	Non-Preferred Brand	1	2	10000000
H9503	003	0	1	04	01	H9503_003_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
H9503	003	0	1	04	01	H9503_003_0	8	1	Preferred Generic	1	2	00001000
H9503	003	0	1	04	01	H9503_003_0	8	4	Specialty	1	2	10001000
H9519	001	0	1	09	04	H9519_001_0	6	1	Tier 1	1	2	10001000
H9519	001	0	1	09	04	H9519_001_0	6	2	Tier 2	2		
H9519	001	0	1	09	04	H9519_001_0	6	3	Tier 3	2		
H9519	001	0	1	09	04	H9519_001_0	6	4	Specialty Tier 4	2		
H9519	003	0	1	09	04	H9519_003_0	9	1	Tier 1	1	2	10001000
H9519	003	0	1	09	04	H9519_003_0	9	2	Tier 2	2		
H9519	003	0	1	09	04	H9519_003_0	9	3	Tier 3	2		
H9519	003	0	1	09	04	H9519_003_0	9	4	Specialty Tier 4	2		
H9615	002	0	1	04	01	H9615_002_0	11	2	Tier 2	2		
H9615	002	0	1	04	01	H9615_002_0	11	3	Tier 3	2		
H9615	002	0	1	04	01	H9615_002_0	11	4	Tier 4	2		
H9615	002	0	1	04	01	H9615_002_0	11	5	Tier 5	2		
H9615	002	0	1	04	01	H9615_002_0	11	1	Tier 1	1	1	
H9615	004	0	1	04	01	H9615_004_0	10	1	Tier 1	1	1	
H9615	004	0	1	04	01	H9615_004_0	10	2	Tier 2	2		
H9615	004	0	1	04	01	H9615_004_0	10	3	Tier 3	2		
H9615	004	0	1	04	01	H9615_004_0	10	4	Tier 4	2		
H9615	004	0	1	04	01	H9615_004_0	10	5	Tier 5	2		
H9670	001	0	1	04	01	H9670_001_0	6	1	Tier 1 - Generic	1	1	
H9670	001	0	1	04	01	H9670_001_0	6	2	Tier 2 - Preferred Brand	2		
H9670	001	0	1	04	01	H9670_001_0	6	3	Tier 3 - Non-Preferred Brand	2		
H9670	001	0	1	04	01	H9670_001_0	6	4	Tier 4 - Specialty	2		
H9670	002	0	1	04	01	H9670_002_0	6	1	Tier 1 - Generic	1	1	
H9670	002	0	1	04	01	H9670_002_0	6	4	Tier 4 - Specialty	2		
H9670	002	0	1	04	01	H9670_002_0	6	3	Tier 3 - Non-Preferred Brand	2		
H9670	002	0	1	04	01	H9670_002_0	6	2	Tier 2 - Preferred Brand	2		
H9779	001	0	1	04	01	H9779_001_0	11	1	Generic	1	1	
H9779	001	0	1	04	01	H9779_001_0	11	2	Preferred Generic	1	1	
H9779	001	0	1	04	01	H9779_001_0	11	5	Non-Preferred Brand	2		
H9779	001	0	1	04	01	H9779_001_0	11	4	Preferred Brand	2		
H9779	001	0	1	04	01	H9779_001_0	11	3	Non-Preferred Generic	2		
H9779	001	0	1	04	01	H9779_001_0	11	6	Specialty	2		
R5826	002	0	1	31	11	R5826_002_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	002	0	1	31	11	R5826_002_0	7	3	Non-Preferred Brand	1	2	10000000
R5826	002	0	1	31	11	R5826_002_0	7	4	Specialty	1	2	10001000
R5826	002	0	1	31	11	R5826_002_0	7	1	Preferred Generic	1	2	00001000
R5826	003	0	1	31	11	R5826_003_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	003	0	1	31	11	R5826_003_0	3	1	Preferred Generic	1	2	00001000
R5826	003	0	1	31	11	R5826_003_0	3	4	Specialty	1	2	10001000
R5826	003	0	1	31	11	R5826_003_0	3	3	Non-Preferred Brand	1	2	10000000
R5826	004	0	1	31	11	R5826_004_0	4	3	Non-Preferred Brand	1	2	10000000
R5826	004	0	1	31	11	R5826_004_0	4	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	004	0	1	31	11	R5826_004_0	4	1	Preferred Generic	1	2	00001000
R5826	004	0	1	31	11	R5826_004_0	4	4	Specialty	1	2	10001000
R5826	005	0	1	31	11	R5826_005_0	7	1	Preferred Generic	1	2	00001000
R5826	005	0	1	31	11	R5826_005_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	005	0	1	31	11	R5826_005_0	7	3	Non-Preferred Brand	1	2	10000000
R5826	005	0	1	31	11	R5826_005_0	7	4	Specialty	1	2	10001000
R5826	006	0	1	31	11	R5826_006_0	6	4	Specialty	1	2	10001000
R5826	006	0	1	31	11	R5826_006_0	6	3	Non-Preferred Brand	1	2	10000000
R5826	006	0	1	31	11	R5826_006_0	6	1	Preferred Generic	1	2	00001000
R5826	006	0	1	31	11	R5826_006_0	6	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	007	0	1	31	11	R5826_007_0	7	3	Non-Preferred Brand	1	2	10000000
R5826	007	0	1	31	11	R5826_007_0	7	4	Specialty	1	2	10001000
R5826	007	0	1	31	11	R5826_007_0	7	1	Preferred Generic	1	2	00001000
R5826	007	0	1	31	11	R5826_007_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	008	0	1	31	11	R5826_008_0	8	4	Specialty	1	2	10001000
R5826	008	0	1	31	11	R5826_008_0	8	1	Preferred Generic	1	2	00001000
R5826	008	0	1	31	11	R5826_008_0	8	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	008	0	1	31	11	R5826_008_0	8	3	Non-Preferred Brand	1	2	10000000
R5826	011	0	1	31	11	R5826_011_0	3	3	Non-Preferred Brand	1	2	10000000
R5826	011	0	1	31	11	R5826_011_0	3	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	011	0	1	31	11	R5826_011_0	3	1	Preferred Generic	1	2	00001000
R5826	011	0	1	31	11	R5826_011_0	3	4	Specialty	1	2	10001000
R5826	012	0	1	31	11	R5826_012_0	7	3	Non-Preferred Brand	1	2	10000000
R5826	012	0	1	31	11	R5826_012_0	7	4	Specialty	1	2	10001000
R5826	012	0	1	31	11	R5826_012_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	012	0	1	31	11	R5826_012_0	7	1	Preferred Generic	1	2	00001000
R5826	014	0	1	31	11	R5826_014_0	7	3	Non-Preferred Brand	1	2	10000000
R5826	014	0	1	31	11	R5826_014_0	7	4	Specialty	1	2	10001000
R5826	014	0	1	31	11	R5826_014_0	7	2	Non-Preferred Generic/Preferred Brand	1	2	10001000
R5826	014	0	1	31	11	R5826_014_0	7	1	Preferred Generic	1	2	00001000
R5941	001	0	1	31	11	R5941_001_0	10	5	Tier 5 Specialty Drugs	2		
R5941	001	0	1	31	11	R5941_001_0	10	1	Tier 1 Preferred Generic Drugs	1	1	
R5941	001	0	1	31	11	R5941_001_0	10	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
R5941	001	0	1	31	11	R5941_001_0	10	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
R5941	001	0	1	31	11	R5941_001_0	10	4	Tier 4 Non-Specialty Injectable Drugs	2		
R5941	003	0	1	31	11	R5941_003_0	11	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
R5941	003	0	1	31	11	R5941_003_0	11	1	Tier 1 Preferred Generic Drugs	1	1	
R5941	003	0	1	31	11	R5941_003_0	11	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
R5941	003	0	1	31	11	R5941_003_0	11	5	Tier 5 Specialty Drugs	2		
R5941	003	0	1	31	11	R5941_003_0	11	4	Tier 4 Non-Specialty Injectable Drugs	2		
R5941	008	0	1	31	11	R5941_008_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
R5941	008	0	1	31	11	R5941_008_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
R5941	008	0	1	31	11	R5941_008_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
R5941	008	0	1	31	11	R5941_008_0	9	4	Tier 4 Non-Specialty Injectable Drugs	2		
R5941	008	0	1	31	11	R5941_008_0	9	5	Tier 5 Specialty Drugs	2		
R5941	009	0	1	31	11	R5941_009_0	8	1	Tier 1 Preferred Generic Drugs	1	1	
R5941	009	0	1	31	11	R5941_009_0	8	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
R5941	009	0	1	31	11	R5941_009_0	8	5	Tier 5 Specialty Drugs	2		
R5941	009	0	1	31	11	R5941_009_0	8	4	Tier 4 Non-Specialty Injectable Drugs	2		
R5941	009	0	1	31	11	R5941_009_0	8	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
R9943	001	0	1	31	11	R9943_001_0	9	4	Tier 4 Non-Specialty Injectable Drugs	2		
R9943	001	0	1	31	11	R9943_001_0	9	5	Tier 5 Specialty Drugs	2		
R9943	001	0	1	31	11	R9943_001_0	9	1	Tier 1 Preferred Generic Drugs	1	1	
R9943	001	0	1	31	11	R9943_001_0	9	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
R9943	001	0	1	31	11	R9943_001_0	9	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
R9943	003	0	1	31	11	R9943_003_0	11	1	Preferred Generic Drugs	1	1	
R9943	003	0	1	31	11	R9943_003_0	11	2	Preferred Brand  Certain Generic Drugs	2		
R9943	003	0	1	31	11	R9943_003_0	11	5	Specialty Drugs	2		
R9943	003	0	1	31	11	R9943_003_0	11	4	Non-Specialty Injectable Drugs	2		
R9943	003	0	1	31	11	R9943_003_0	11	3	Non-Preferred Brand  Certain Generic Drugs	2		
S0043	013	0		29	10	S0043_013_0	3	2	Brand	2		
S0043	013	0		29	10	S0043_013_0	3	4	Specialty	2		
S0043	013	0		29	10	S0043_013_0	3	3	Non-Preferred Brand	2		
S0043	013	0		29	10	S0043_013_0	3	1	Generic	1	2	00001000
S0197	005	0		29	10	S0197_005_0	2	2	Generics	2		
S0197	005	0		29	10	S0197_005_0	2	3	Preferred Brand	2		
S0197	005	0		29	10	S0197_005_0	2	4	Non-Preferred Brand	2		
S0197	005	0		29	10	S0197_005_0	2	5	Specialty - Generic and Brand	2		
S0197	005	0		29	10	S0197_005_0	2	1	Preferred Generic	1	1	
S0655	003	0		29	10	S0655_003_0	2	2	Tier 2	2		
S0655	003	0		29	10	S0655_003_0	2	4	Tier 4	2		
S0655	003	0		29	10	S0655_003_0	2	1	Tier 1	1	1	
S0655	003	0		29	10	S0655_003_0	2	3	Tier 3	2		
S1030	001	0		29	10	S1030_001_0	2	1	Tier 1	1	1	
S1030	001	0		29	10	S1030_001_0	2	2	Tier 2	2		
S1030	001	0		29	10	S1030_001_0	2	5	Tier 5	2		
S1030	001	0		29	10	S1030_001_0	2	4	Tier 4	2		
S1030	001	0		29	10	S1030_001_0	2	3	Tier 3	2		
S2321	002	0		29	10	S2321_002_0	2	5	Specialty	2		
S2321	002	0		29	10	S2321_002_0	2	2	Non-Preferred Generic	1	1	
S2321	002	0		29	10	S2321_002_0	2	1	Preferred Generic	1	1	
S2321	002	0		29	10	S2321_002_0	2	3	Preferred Brand	2		
S2321	002	0		29	10	S2321_002_0	2	4	Non-Preferred Brand	2		
S2873	003	0		29	10	S2873_003_0	4	4	Specialty	2		
S2873	003	0		29	10	S2873_003_0	4	1	Generic	1	1	
S2873	003	0		29	10	S2873_003_0	4	2	Preferred Brand	2		
S2873	003	0		29	10	S2873_003_0	4	3	Non-Preferred Brand	2		
S2893	003	0		29	10	S2893_003_0	1	4	Tier 4	2		
S2893	003	0		29	10	S2893_003_0	1	3	Tier 3	2		
S2893	003	0		29	10	S2893_003_0	1	1	Tier 1	1	1	
S2893	003	0		29	10	S2893_003_0	1	2	Tier 2	2		
S5540	004	0		29	10	S5540_004_0	4	2	Tier 2 - Preferred Brand	2		
S5540	004	0		29	10	S5540_004_0	4	1	Tier 1 - Generic	1	1	
S5540	004	0		29	10	S5540_004_0	4	4	Tier 4 - Specialty	2		
S5540	004	0		29	10	S5540_004_0	4	3	Tier 3 - Non-preferred	2		
S5552	002	0		29	10	S5552_002_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5552	002	0		29	10	S5552_002_0	2	4	Specialty	2		
S5552	002	0		29	10	S5552_002_0	2	3	Non-Preferred Brand	2		
S5552	002	0		29	10	S5552_002_0	2	1	Preferred Generic	1	1	
S5557	009	0		29	10	S5557_009_0	2	3	Tier 3	2		
S5557	009	0		29	10	S5557_009_0	2	2	Tier 2	2		
S5557	009	0		29	10	S5557_009_0	2	4	Tier 4	2		
S5557	009	0		29	10	S5557_009_0	2	1	Tier 1	1	1	
S5557	009	0		29	10	S5557_009_0	2	5	Tier 5	2		
S5557	011	0		29	10	S5557_011_0	2	3	Tier 3	2		
S5557	011	0		29	10	S5557_011_0	2	2	Tier 2	2		
S5557	011	0		29	10	S5557_011_0	2	1	Tier 1	1	1	
S5557	011	0		29	10	S5557_011_0	2	4	Tier 4	2		
S5557	011	0		29	10	S5557_011_0	2	5	Tier 5	2		
S5557	013	0		29	10	S5557_013_0	2	2	Tier 2	2		
S5557	013	0		29	10	S5557_013_0	2	1	Tier 1	1	1	
S5557	013	0		29	10	S5557_013_0	2	3	Tier 3	2		
S5557	013	0		29	10	S5557_013_0	2	4	Tier 4	2		
S5557	013	0		29	10	S5557_013_0	2	5	Tier 5	2		
S5557	015	0		29	10	S5557_015_0	2	2	Tier 2	2		
S5557	015	0		29	10	S5557_015_0	2	1	Tier 1	1	1	
S5557	015	0		29	10	S5557_015_0	2	3	Tier 3	2		
S5557	015	0		29	10	S5557_015_0	2	5	Tier 5	2		
S5557	015	0		29	10	S5557_015_0	2	4	Tier 4	2		
S5557	017	0		29	10	S5557_017_0	2	1	Tier 1	1	1	
S5557	017	0		29	10	S5557_017_0	2	2	Tier 2	2		
S5557	017	0		29	10	S5557_017_0	2	4	Tier 4	2		
S5557	017	0		29	10	S5557_017_0	2	3	Tier 3	2		
S5557	017	0		29	10	S5557_017_0	2	5	Tier 5	2		
S5557	019	0		29	10	S5557_019_0	2	3	Tier 3	2		
S5557	019	0		29	10	S5557_019_0	2	4	Tier 4	2		
S5557	019	0		29	10	S5557_019_0	2	5	Tier 5	2		
S5557	019	0		29	10	S5557_019_0	2	1	Tier 1	1	1	
S5557	019	0		29	10	S5557_019_0	2	2	Tier 2	2		
S5557	021	0		29	10	S5557_021_0	2	1	Tier 1	1	1	
S5557	021	0		29	10	S5557_021_0	2	2	Tier 2	2		
S5557	021	0		29	10	S5557_021_0	2	5	Tier 5	2		
S5557	021	0		29	10	S5557_021_0	2	4	Tier 4	2		
S5557	021	0		29	10	S5557_021_0	2	3	Tier 3	2		
S5566	003	0		29	10	S5566_003_0	3	1	Generic	1	1	
S5566	003	0		29	10	S5566_003_0	3	4	Specialty	1	2	01000000
S5566	003	0		29	10	S5566_003_0	3	3	Brand	2		
S5566	003	0		29	10	S5566_003_0	3	2	Preferred Brand	2		
S5584	002	0		29	10	S5584_002_0	3	1	Generic	1	1	
S5584	002	0		29	10	S5584_002_0	3	2	Preferred Brand	2		
S5584	002	0		29	10	S5584_002_0	3	5	Non Self Administered Injectable	2		
S5584	002	0		29	10	S5584_002_0	3	4	Specialty	2		
S5584	002	0		29	10	S5584_002_0	3	3	Non Preferred	2		
S5593	003	0		29	10	S5593_003_0	6	3	Non-Preferred Brand	2		
S5593	003	0		29	10	S5593_003_0	6	4	Specialty Tier	2		
S5593	003	0		29	10	S5593_003_0	6	1	Generic	1	1	
S5593	003	0		29	10	S5593_003_0	6	2	Preferred Brand	2		
S5596	003	0		29	10	S5596_003_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	003	0		29	10	S5596_003_0	4	5	Tier 5 Specialty Drugs	2		
S5596	003	0		29	10	S5596_003_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	003	0		29	10	S5596_003_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	003	0		29	10	S5596_003_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	007	0		29	10	S5596_007_0	4	5	Tier 5 Specialty Drugs	2		
S5596	007	0		29	10	S5596_007_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	007	0		29	10	S5596_007_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	007	0		29	10	S5596_007_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	007	0		29	10	S5596_007_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	011	0		29	10	S5596_011_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	011	0		29	10	S5596_011_0	4	5	Tier 5 Specialty Drugs	2		
S5596	011	0		29	10	S5596_011_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	011	0		29	10	S5596_011_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	011	0		29	10	S5596_011_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	015	0		29	10	S5596_015_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	015	0		29	10	S5596_015_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	015	0		29	10	S5596_015_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	015	0		29	10	S5596_015_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	015	0		29	10	S5596_015_0	4	5	Tier 5 Specialty Drugs	2		
S5596	019	0		29	10	S5596_019_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	019	0		29	10	S5596_019_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	019	0		29	10	S5596_019_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	019	0		29	10	S5596_019_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	019	0		29	10	S5596_019_0	4	5	Tier 5 Specialty Drugs	2		
S5596	023	0		29	10	S5596_023_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	023	0		29	10	S5596_023_0	4	5	Tier 5 Specialty Drugs	2		
S5596	023	0		29	10	S5596_023_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	023	0		29	10	S5596_023_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	023	0		29	10	S5596_023_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	027	0		29	10	S5596_027_0	4	5	Tier 5 Specialty Drugs	2		
S5596	027	0		29	10	S5596_027_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	027	0		29	10	S5596_027_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	027	0		29	10	S5596_027_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	027	0		29	10	S5596_027_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	031	0		29	10	S5596_031_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	031	0		29	10	S5596_031_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	031	0		29	10	S5596_031_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	031	0		29	10	S5596_031_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	031	0		29	10	S5596_031_0	4	5	Tier 5 Specialty Drugs	2		
S5596	035	0		29	10	S5596_035_0	5	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	035	0		29	10	S5596_035_0	5	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	035	0		29	10	S5596_035_0	5	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	035	0		29	10	S5596_035_0	5	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	035	0		29	10	S5596_035_0	5	5	Tier 5 Specialty Drugs	2		
S5596	045	0		29	10	S5596_045_0	4	1	Tier 1 Preferred Generic Drugs	1	1	
S5596	045	0		29	10	S5596_045_0	4	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5596	045	0		29	10	S5596_045_0	4	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5596	045	0		29	10	S5596_045_0	4	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5596	045	0		29	10	S5596_045_0	4	5	Tier 5 Specialty Drugs	2		
S5601	072	0		29	10	S5601_072_0	2	1	Value Generic Tier	1	1	
S5601	072	0		29	10	S5601_072_0	2	2	Generic Tier	1	1	
S5601	072	0		29	10	S5601_072_0	2	3	Preferred Brand Tier	2		
S5601	072	0		29	10	S5601_072_0	2	4	Non-Preferred Brand Tier	2		
S5601	072	0		29	10	S5601_072_0	2	5	Specialty Tier	2		
S5601	073	0		29	10	S5601_073_0	2	4	Non-Preferred Brand Tier	2		
S5601	073	0		29	10	S5601_073_0	2	3	Preferred Brand Tier	2		
S5601	073	0		29	10	S5601_073_0	2	2	Generic Tier	1	1	
S5601	073	0		29	10	S5601_073_0	2	1	Value Generic Tier	1	1	
S5601	073	0		29	10	S5601_073_0	2	5	Specialty Tier	2		
S5601	074	0		29	10	S5601_074_0	2	1	Value Generic Tier	1	1	
S5601	074	0		29	10	S5601_074_0	2	2	Generic Tier	1	1	
S5601	074	0		29	10	S5601_074_0	2	3	Preferred Brand Tier	2		
S5601	074	0		29	10	S5601_074_0	2	4	Non-Preferred Brand Tier	2		
S5601	074	0		29	10	S5601_074_0	2	5	Specialty Tier	2		
S5601	075	0		29	10	S5601_075_0	3	1	Value Generic Tier	1	1	
S5601	075	0		29	10	S5601_075_0	3	2	Generic Tier	1	1	
S5601	075	0		29	10	S5601_075_0	3	3	Preferred Brand Tier	2		
S5601	075	0		29	10	S5601_075_0	3	4	Non-Preferred Brand Tier	2		
S5601	075	0		29	10	S5601_075_0	3	5	Specialty Tier	2		
S5601	076	0		29	10	S5601_076_0	2	5	Specialty Tier	2		
S5601	076	0		29	10	S5601_076_0	2	4	Non-Preferred Brand Tier	2		
S5601	076	0		29	10	S5601_076_0	2	3	Preferred Brand Tier	2		
S5601	076	0		29	10	S5601_076_0	2	1	Value Generic Tier	1	1	
S5601	076	0		29	10	S5601_076_0	2	2	Generic Tier	1	1	
S5601	077	0		29	10	S5601_077_0	2	4	Non-Preferred Brand Tier	2		
S5601	077	0		29	10	S5601_077_0	2	3	Preferred Brand Tier	2		
S5601	077	0		29	10	S5601_077_0	2	2	Generic Tier	1	1	
S5601	077	0		29	10	S5601_077_0	2	1	Value Generic Tier	1	1	
S5601	077	0		29	10	S5601_077_0	2	5	Specialty Tier	2		
S5601	078	0		29	10	S5601_078_0	2	4	Non-Preferred Brand Tier	2		
S5601	078	0		29	10	S5601_078_0	2	3	Preferred Brand Tier	2		
S5601	078	0		29	10	S5601_078_0	2	2	Generic Tier	1	1	
S5601	078	0		29	10	S5601_078_0	2	1	Value Generic Tier	1	1	
S5601	078	0		29	10	S5601_078_0	2	5	Specialty Tier	2		
S5601	079	0		29	10	S5601_079_0	2	3	Preferred Brand Tier	2		
S5601	079	0		29	10	S5601_079_0	2	4	Non-Preferred Brand Tier	2		
S5601	079	0		29	10	S5601_079_0	2	5	Specialty Tier	2		
S5601	079	0		29	10	S5601_079_0	2	1	Value Generic Tier	1	1	
S5601	079	0		29	10	S5601_079_0	2	2	Generic Tier	1	1	
S5601	080	0		29	10	S5601_080_0	2	3	Preferred Brand Tier	2		
S5601	080	0		29	10	S5601_080_0	2	2	Generic Tier	1	1	
S5601	080	0		29	10	S5601_080_0	2	1	Value Generic Tier	1	1	
S5601	080	0		29	10	S5601_080_0	2	5	Specialty Tier	2		
S5601	080	0		29	10	S5601_080_0	2	4	Non-Preferred Brand Tier	2		
S5601	081	0		29	10	S5601_081_0	2	5	Specialty Tier	2		
S5601	081	0		29	10	S5601_081_0	2	4	Non-Preferred Brand Tier	2		
S5601	081	0		29	10	S5601_081_0	2	2	Generic Tier	1	1	
S5601	081	0		29	10	S5601_081_0	2	1	Value Generic Tier	1	1	
S5601	081	0		29	10	S5601_081_0	2	3	Preferred Brand Tier	2		
S5601	082	0		29	10	S5601_082_0	2	3	Preferred Brand Tier	2		
S5601	082	0		29	10	S5601_082_0	2	4	Non-Preferred Brand Tier	2		
S5601	082	0		29	10	S5601_082_0	2	5	Specialty Tier	2		
S5601	082	0		29	10	S5601_082_0	2	2	Generic Tier	1	1	
S5601	082	0		29	10	S5601_082_0	2	1	Value Generic Tier	1	1	
S5601	083	0		29	10	S5601_083_0	2	2	Generic Tier	1	1	
S5601	083	0		29	10	S5601_083_0	2	3	Preferred Brand Tier	2		
S5601	083	0		29	10	S5601_083_0	2	4	Non-Preferred Brand Tier	2		
S5601	083	0		29	10	S5601_083_0	2	5	Specialty Tier	2		
S5601	083	0		29	10	S5601_083_0	2	1	Value Generic Tier	1	1	
S5601	084	0		29	10	S5601_084_0	2	1	Value Generic Tier	1	1	
S5601	084	0		29	10	S5601_084_0	2	2	Generic Tier	1	1	
S5601	084	0		29	10	S5601_084_0	2	5	Specialty Tier	2		
S5601	084	0		29	10	S5601_084_0	2	4	Non-Preferred Brand Tier	2		
S5601	084	0		29	10	S5601_084_0	2	3	Preferred Brand Tier	2		
S5601	085	0		29	10	S5601_085_0	2	1	Value Generic Tier	1	1	
S5601	085	0		29	10	S5601_085_0	2	2	Generic Tier	1	1	
S5601	085	0		29	10	S5601_085_0	2	3	Preferred Brand Tier	2		
S5601	085	0		29	10	S5601_085_0	2	4	Non-Preferred Brand Tier	2		
S5601	085	0		29	10	S5601_085_0	2	5	Specialty Tier	2		
S5601	086	0		29	10	S5601_086_0	2	4	Non-Preferred Brand Tier	2		
S5601	086	0		29	10	S5601_086_0	2	5	Specialty Tier	2		
S5601	086	0		29	10	S5601_086_0	2	3	Preferred Brand Tier	2		
S5601	086	0		29	10	S5601_086_0	2	2	Generic Tier	1	1	
S5601	086	0		29	10	S5601_086_0	2	1	Value Generic Tier	1	1	
S5601	087	0		29	10	S5601_087_0	2	1	Value Generic Tier	1	1	
S5601	087	0		29	10	S5601_087_0	2	2	Generic Tier	1	1	
S5601	087	0		29	10	S5601_087_0	2	3	Preferred Brand Tier	2		
S5601	087	0		29	10	S5601_087_0	2	4	Non-Preferred Brand Tier	2		
S5601	087	0		29	10	S5601_087_0	2	5	Specialty Tier	2		
S5601	088	0		29	10	S5601_088_0	2	4	Non-Preferred Brand Tier	2		
S5601	088	0		29	10	S5601_088_0	2	5	Specialty Tier	2		
S5601	088	0		29	10	S5601_088_0	2	3	Preferred Brand Tier	2		
S5601	088	0		29	10	S5601_088_0	2	2	Generic Tier	1	1	
S5601	088	0		29	10	S5601_088_0	2	1	Value Generic Tier	1	1	
S5601	089	0		29	10	S5601_089_0	2	1	Value Generic Tier	1	1	
S5601	089	0		29	10	S5601_089_0	2	2	Generic Tier	1	1	
S5601	089	0		29	10	S5601_089_0	2	3	Preferred Brand Tier	2		
S5601	089	0		29	10	S5601_089_0	2	4	Non-Preferred Brand Tier	2		
S5601	089	0		29	10	S5601_089_0	2	5	Specialty Tier	2		
S5601	090	0		29	10	S5601_090_0	2	2	Generic Tier	1	1	
S5601	090	0		29	10	S5601_090_0	2	1	Value Generic Tier	1	1	
S5601	090	0		29	10	S5601_090_0	2	3	Preferred Brand Tier	2		
S5601	090	0		29	10	S5601_090_0	2	4	Non-Preferred Brand Tier	2		
S5601	090	0		29	10	S5601_090_0	2	5	Specialty Tier	2		
S5601	091	0		29	10	S5601_091_0	2	2	Generic Tier	1	1	
S5601	091	0		29	10	S5601_091_0	2	1	Value Generic Tier	1	1	
S5601	091	0		29	10	S5601_091_0	2	3	Preferred Brand Tier	2		
S5601	091	0		29	10	S5601_091_0	2	5	Specialty Tier	2		
S5601	091	0		29	10	S5601_091_0	2	4	Non-Preferred Brand Tier	2		
S5601	092	0		29	10	S5601_092_0	2	1	Value Generic Tier	1	1	
S5601	092	0		29	10	S5601_092_0	2	2	Generic Tier	1	1	
S5601	092	0		29	10	S5601_092_0	2	4	Non-Preferred Brand Tier	2		
S5601	092	0		29	10	S5601_092_0	2	3	Preferred Brand Tier	2		
S5601	092	0		29	10	S5601_092_0	2	5	Specialty Tier	2		
S5601	093	0		29	10	S5601_093_0	2	5	Specialty Tier	2		
S5601	093	0		29	10	S5601_093_0	2	4	Non-Preferred Brand Tier	2		
S5601	093	0		29	10	S5601_093_0	2	3	Preferred Brand Tier	2		
S5601	093	0		29	10	S5601_093_0	2	1	Value Generic Tier	1	1	
S5601	093	0		29	10	S5601_093_0	2	2	Generic Tier	1	1	
S5601	094	0		29	10	S5601_094_0	2	5	Specialty Tier	2		
S5601	094	0		29	10	S5601_094_0	2	4	Non-Preferred Brand Tier	2		
S5601	094	0		29	10	S5601_094_0	2	3	Preferred Brand Tier	2		
S5601	094	0		29	10	S5601_094_0	2	2	Generic Tier	1	1	
S5601	094	0		29	10	S5601_094_0	2	1	Value Generic Tier	1	1	
S5601	095	0		29	10	S5601_095_0	2	5	Specialty Tier	2		
S5601	095	0		29	10	S5601_095_0	2	4	Non-Preferred Brand Tier	2		
S5601	095	0		29	10	S5601_095_0	2	3	Preferred Brand Tier	2		
S5601	095	0		29	10	S5601_095_0	2	2	Generic Tier	1	1	
S5601	095	0		29	10	S5601_095_0	2	1	Value Generic Tier	1	1	
S5601	096	0		29	10	S5601_096_0	2	1	Value Generic Tier	1	1	
S5601	096	0		29	10	S5601_096_0	2	5	Specialty Tier	2		
S5601	096	0		29	10	S5601_096_0	2	4	Non-Preferred Brand Tier	2		
S5601	096	0		29	10	S5601_096_0	2	3	Preferred Brand Tier	2		
S5601	096	0		29	10	S5601_096_0	2	2	Generic Tier	1	1	
S5601	097	0		29	10	S5601_097_0	2	5	Specialty Tier	2		
S5601	097	0		29	10	S5601_097_0	2	4	Non-Preferred Brand Tier	2		
S5601	097	0		29	10	S5601_097_0	2	3	Preferred Brand Tier	2		
S5601	097	0		29	10	S5601_097_0	2	2	Generic Tier	1	1	
S5601	097	0		29	10	S5601_097_0	2	1	Value Generic Tier	1	1	
S5601	098	0		29	10	S5601_098_0	2	5	Specialty Tier	2		
S5601	098	0		29	10	S5601_098_0	2	4	Non-Preferred Brand Tier	2		
S5601	098	0		29	10	S5601_098_0	2	3	Preferred Brand Tier	2		
S5601	098	0		29	10	S5601_098_0	2	2	Generic Tier	1	1	
S5601	098	0		29	10	S5601_098_0	2	1	Value Generic Tier	1	1	
S5601	099	0		29	10	S5601_099_0	2	1	Value Generic Tier	1	1	
S5601	099	0		29	10	S5601_099_0	2	2	Generic Tier	1	1	
S5601	099	0		29	10	S5601_099_0	2	3	Preferred Brand Tier	2		
S5601	099	0		29	10	S5601_099_0	2	4	Non-Preferred Brand Tier	2		
S5601	099	0		29	10	S5601_099_0	2	5	Specialty Tier	2		
S5601	100	0		29	10	S5601_100_0	2	1	Value Generic Tier	1	1	
S5601	100	0		29	10	S5601_100_0	2	2	Generic Tier	1	1	
S5601	100	0		29	10	S5601_100_0	2	3	Preferred Brand Tier	2		
S5601	100	0		29	10	S5601_100_0	2	4	Non-Preferred Brand Tier	2		
S5601	100	0		29	10	S5601_100_0	2	5	Specialty Tier	2		
S5601	101	0		29	10	S5601_101_0	2	1	Value Generic Tier	1	1	
S5601	101	0		29	10	S5601_101_0	2	2	Generic Tier	1	1	
S5601	101	0		29	10	S5601_101_0	2	3	Preferred Brand Tier	2		
S5601	101	0		29	10	S5601_101_0	2	4	Non-Preferred Brand Tier	2		
S5601	101	0		29	10	S5601_101_0	2	5	Specialty Tier	2		
S5601	102	0		29	10	S5601_102_0	2	1	Value Generic Tier	1	1	
S5601	102	0		29	10	S5601_102_0	2	2	Generic Tier	1	1	
S5601	102	0		29	10	S5601_102_0	2	3	Preferred Brand Tier	2		
S5601	102	0		29	10	S5601_102_0	2	4	Non-Preferred Brand Tier	2		
S5601	102	0		29	10	S5601_102_0	2	5	Specialty Tier	2		
S5601	103	0		29	10	S5601_103_0	2	3	Preferred Brand Tier	2		
S5601	103	0		29	10	S5601_103_0	2	4	Non-Preferred Brand Tier	2		
S5601	103	0		29	10	S5601_103_0	2	2	Generic Tier	1	1	
S5601	103	0		29	10	S5601_103_0	2	1	Value Generic Tier	1	1	
S5601	103	0		29	10	S5601_103_0	2	5	Specialty Tier	2		
S5601	104	0		29	10	S5601_104_0	2	2	Generic Tier	1	1	
S5601	104	0		29	10	S5601_104_0	2	1	Value Generic Tier	1	1	
S5601	104	0		29	10	S5601_104_0	2	3	Preferred Brand Tier	2		
S5601	104	0		29	10	S5601_104_0	2	5	Specialty Tier	2		
S5601	104	0		29	10	S5601_104_0	2	4	Non-Preferred Brand Tier	2		
S5601	105	0		29	10	S5601_105_0	2	1	Value Generic Tier	1	1	
S5601	105	0		29	10	S5601_105_0	2	2	Generic Tier	1	1	
S5601	105	0		29	10	S5601_105_0	2	3	Preferred Brand Tier	2		
S5601	105	0		29	10	S5601_105_0	2	5	Specialty Tier	2		
S5601	105	0		29	10	S5601_105_0	2	4	Non-Preferred Brand Tier	2		
S5601	106	0		29	10	S5601_106_0	2	5	Specialty Tier	2		
S5601	106	0		29	10	S5601_106_0	2	4	Non-Preferred Brand Tier	2		
S5601	106	0		29	10	S5601_106_0	2	2	Generic Tier	1	1	
S5601	106	0		29	10	S5601_106_0	2	1	Value Generic Tier	1	1	
S5601	106	0		29	10	S5601_106_0	2	3	Preferred Brand Tier	2		
S5609	002	0		29	10	S5609_002_0	3	1	Generic	1	1	
S5609	002	0		29	10	S5609_002_0	3	2	Preferred Brand	2		
S5609	002	0		29	10	S5609_002_0	3	3	Non-Preferred Brand	2		
S5609	002	0		29	10	S5609_002_0	3	4	Miscellaneous Injectables	2		
S5609	002	0		29	10	S5609_002_0	3	5	Specialty	2		
S5617	171	0		29	10	S5617_171_0	1	1	Tier 1	1	2	00001000
S5617	171	0		29	10	S5617_171_0	1	2	Tier 2	2		
S5617	171	0		29	10	S5617_171_0	1	4	Tier 4	2		
S5617	171	0		29	10	S5617_171_0	1	3	Tier 3	2		
S5617	172	0		29	10	S5617_172_0	1	1	Tier 1	1	2	00001000
S5617	172	0		29	10	S5617_172_0	1	2	Tier 2	2		
S5617	172	0		29	10	S5617_172_0	1	3	Tier 3	2		
S5617	172	0		29	10	S5617_172_0	1	4	Tier 4	2		
S5617	173	0		29	10	S5617_173_0	1	1	Tier 1	1	2	00001000
S5617	173	0		29	10	S5617_173_0	1	3	Tier 3	2		
S5617	173	0		29	10	S5617_173_0	1	2	Tier 2	2		
S5617	173	0		29	10	S5617_173_0	1	4	Tier 4	2		
S5617	174	0		29	10	S5617_174_0	1	3	Tier 3	2		
S5617	174	0		29	10	S5617_174_0	1	2	Tier 2	2		
S5617	174	0		29	10	S5617_174_0	1	4	Tier 4	2		
S5617	174	0		29	10	S5617_174_0	1	1	Tier 1	1	2	00001000
S5617	175	0		29	10	S5617_175_0	1	4	Tier 4	2		
S5617	175	0		29	10	S5617_175_0	1	2	Tier 2	2		
S5617	175	0		29	10	S5617_175_0	1	3	Tier 3	2		
S5617	175	0		29	10	S5617_175_0	1	1	Tier 1	1	2	00001000
S5617	176	0		29	10	S5617_176_0	1	2	Tier 2	2		
S5617	176	0		29	10	S5617_176_0	1	1	Tier 1	1	2	00001000
S5617	176	0		29	10	S5617_176_0	1	3	Tier 3	2		
S5617	176	0		29	10	S5617_176_0	1	4	Tier 4	2		
S5617	177	0		29	10	S5617_177_0	1	4	Tier 4	2		
S5617	177	0		29	10	S5617_177_0	1	1	Tier 1	1	2	00001000
S5617	177	0		29	10	S5617_177_0	1	2	Tier 2	2		
S5617	177	0		29	10	S5617_177_0	1	3	Tier 3	2		
S5617	178	0		29	10	S5617_178_0	1	4	Tier 4	2		
S5617	178	0		29	10	S5617_178_0	1	2	Tier 2	2		
S5617	178	0		29	10	S5617_178_0	1	3	Tier 3	2		
S5617	178	0		29	10	S5617_178_0	1	1	Tier 1	1	2	00001000
S5617	179	0		29	10	S5617_179_0	1	2	Tier 2	2		
S5617	179	0		29	10	S5617_179_0	1	1	Tier 1	1	2	00001000
S5617	179	0		29	10	S5617_179_0	1	4	Tier 4	2		
S5617	179	0		29	10	S5617_179_0	1	3	Tier 3	2		
S5617	180	0		29	10	S5617_180_0	1	4	Tier 4	2		
S5617	180	0		29	10	S5617_180_0	1	3	Tier 3	2		
S5617	180	0		29	10	S5617_180_0	1	2	Tier 2	2		
S5617	180	0		29	10	S5617_180_0	1	1	Tier 1	1	2	00001000
S5617	181	0		29	10	S5617_181_0	1	4	Tier 4	2		
S5617	181	0		29	10	S5617_181_0	1	2	Tier 2	2		
S5617	181	0		29	10	S5617_181_0	1	1	Tier 1	1	2	00001000
S5617	181	0		29	10	S5617_181_0	1	3	Tier 3	2		
S5617	182	0		29	10	S5617_182_0	1	1	Tier 1	1	2	00001000
S5617	182	0		29	10	S5617_182_0	1	2	Tier 2	2		
S5617	182	0		29	10	S5617_182_0	1	4	Tier 4	2		
S5617	182	0		29	10	S5617_182_0	1	3	Tier 3	2		
S5617	183	0		29	10	S5617_183_0	1	1	Tier 1	1	2	00001000
S5617	183	0		29	10	S5617_183_0	1	2	Tier 2	2		
S5617	183	0		29	10	S5617_183_0	1	3	Tier 3	2		
S5617	183	0		29	10	S5617_183_0	1	4	Tier 4	2		
S5617	184	0		29	10	S5617_184_0	1	3	Tier 3	2		
S5617	184	0		29	10	S5617_184_0	1	2	Tier 2	2		
S5617	184	0		29	10	S5617_184_0	1	1	Tier 1	1	2	00001000
S5617	184	0		29	10	S5617_184_0	1	4	Tier 4	2		
S5617	185	0		29	10	S5617_185_0	1	4	Tier 4	2		
S5617	185	0		29	10	S5617_185_0	1	1	Tier 1	1	2	00001000
S5617	185	0		29	10	S5617_185_0	1	2	Tier 2	2		
S5617	185	0		29	10	S5617_185_0	1	3	Tier 3	2		
S5617	186	0		29	10	S5617_186_0	1	1	Tier 1	1	2	00001000
S5617	186	0		29	10	S5617_186_0	1	2	Tier 2	2		
S5617	186	0		29	10	S5617_186_0	1	4	Tier 4	2		
S5617	186	0		29	10	S5617_186_0	1	3	Tier 3	2		
S5617	187	0		29	10	S5617_187_0	1	2	Tier 2	2		
S5617	187	0		29	10	S5617_187_0	1	3	Tier 3	2		
S5617	187	0		29	10	S5617_187_0	1	1	Tier 1	1	2	00001000
S5617	187	0		29	10	S5617_187_0	1	4	Tier 4	2		
S5617	188	0		29	10	S5617_188_0	1	2	Tier 2	2		
S5617	188	0		29	10	S5617_188_0	1	1	Tier 1	1	2	00001000
S5617	188	0		29	10	S5617_188_0	1	3	Tier 3	2		
S5617	188	0		29	10	S5617_188_0	1	4	Tier 4	2		
S5617	189	0		29	10	S5617_189_0	1	4	Tier 4	2		
S5617	189	0		29	10	S5617_189_0	1	3	Tier 3	2		
S5617	189	0		29	10	S5617_189_0	1	2	Tier 2	2		
S5617	189	0		29	10	S5617_189_0	1	1	Tier 1	1	2	00001000
S5617	190	0		29	10	S5617_190_0	1	2	Tier 2	2		
S5617	190	0		29	10	S5617_190_0	1	4	Tier 4	2		
S5617	190	0		29	10	S5617_190_0	1	3	Tier 3	2		
S5617	190	0		29	10	S5617_190_0	1	1	Tier 1	1	2	00001000
S5617	191	0		29	10	S5617_191_0	1	4	Tier 4	2		
S5617	191	0		29	10	S5617_191_0	1	3	Tier 3	2		
S5617	191	0		29	10	S5617_191_0	1	1	Tier 1	1	2	00001000
S5617	191	0		29	10	S5617_191_0	1	2	Tier 2	2		
S5617	192	0		29	10	S5617_192_0	1	4	Tier 4	2		
S5617	192	0		29	10	S5617_192_0	1	1	Tier 1	1	2	00001000
S5617	192	0		29	10	S5617_192_0	1	2	Tier 2	2		
S5617	192	0		29	10	S5617_192_0	1	3	Tier 3	2		
S5617	193	0		29	10	S5617_193_0	1	4	Tier 4	2		
S5617	193	0		29	10	S5617_193_0	1	1	Tier 1	1	2	00001000
S5617	193	0		29	10	S5617_193_0	1	3	Tier 3	2		
S5617	193	0		29	10	S5617_193_0	1	2	Tier 2	2		
S5617	194	0		29	10	S5617_194_0	1	1	Tier 1	1	2	00001000
S5617	194	0		29	10	S5617_194_0	1	3	Tier 3	2		
S5617	194	0		29	10	S5617_194_0	1	2	Tier 2	2		
S5617	194	0		29	10	S5617_194_0	1	4	Tier 4	2		
S5617	195	0		29	10	S5617_195_0	1	1	Tier 1	1	2	00001000
S5617	195	0		29	10	S5617_195_0	1	2	Tier 2	2		
S5617	195	0		29	10	S5617_195_0	1	3	Tier 3	2		
S5617	195	0		29	10	S5617_195_0	1	4	Tier 4	2		
S5617	196	0		29	10	S5617_196_0	1	4	Tier 4	2		
S5617	196	0		29	10	S5617_196_0	1	3	Tier 3	2		
S5617	196	0		29	10	S5617_196_0	1	2	Tier 2	2		
S5617	196	0		29	10	S5617_196_0	1	1	Tier 1	1	2	00001000
S5617	197	0		29	10	S5617_197_0	1	1	Tier 1	1	2	00001000
S5617	197	0		29	10	S5617_197_0	1	4	Tier 4	2		
S5617	197	0		29	10	S5617_197_0	1	3	Tier 3	2		
S5617	197	0		29	10	S5617_197_0	1	2	Tier 2	2		
S5617	198	0		29	10	S5617_198_0	1	3	Tier 3	2		
S5617	198	0		29	10	S5617_198_0	1	4	Tier 4	2		
S5617	198	0		29	10	S5617_198_0	1	2	Tier 2	2		
S5617	198	0		29	10	S5617_198_0	1	1	Tier 1	1	2	00001000
S5617	199	0		29	10	S5617_199_0	1	3	Tier 3	2		
S5617	199	0		29	10	S5617_199_0	1	4	Tier 4	2		
S5617	199	0		29	10	S5617_199_0	1	1	Tier 1	1	2	00001000
S5617	199	0		29	10	S5617_199_0	1	2	Tier 2	2		
S5617	200	0		29	10	S5617_200_0	1	1	Tier 1	1	2	00001000
S5617	200	0		29	10	S5617_200_0	1	4	Tier 4	2		
S5617	200	0		29	10	S5617_200_0	1	3	Tier 3	2		
S5617	200	0		29	10	S5617_200_0	1	2	Tier 2	2		
S5617	201	0		29	10	S5617_201_0	1	1	Tier 1	1	2	00001000
S5617	201	0		29	10	S5617_201_0	1	2	Tier 2	2		
S5617	201	0		29	10	S5617_201_0	1	3	Tier 3	2		
S5617	201	0		29	10	S5617_201_0	1	4	Tier 4	2		
S5617	202	0		29	10	S5617_202_0	1	3	Tier 3	2		
S5617	202	0		29	10	S5617_202_0	1	4	Tier 4	2		
S5617	202	0		29	10	S5617_202_0	1	2	Tier 2	2		
S5617	202	0		29	10	S5617_202_0	1	1	Tier 1	1	2	00001000
S5617	203	0		29	10	S5617_203_0	1	4	Tier 4	2		
S5617	203	0		29	10	S5617_203_0	1	3	Tier 3	2		
S5617	203	0		29	10	S5617_203_0	1	1	Tier 1	1	2	00001000
S5617	203	0		29	10	S5617_203_0	1	2	Tier 2	2		
S5617	204	0		29	10	S5617_204_0	1	2	Tier 2	2		
S5617	204	0		29	10	S5617_204_0	1	1	Tier 1	1	2	00001000
S5617	204	0		29	10	S5617_204_0	1	4	Tier 4	2		
S5617	204	0		29	10	S5617_204_0	1	3	Tier 3	2		
S5660	172	0		29	10	S5660_172_0	3	4	Specialty	2		
S5660	172	0		29	10	S5660_172_0	3	2	Preferred Brand	2		
S5660	172	0		29	10	S5660_172_0	3	1	Generic	1	1	
S5660	172	0		29	10	S5660_172_0	3	3	Non-Preferred Brand	2		
S5660	173	0		29	10	S5660_173_0	3	3	Non-Preferred Brand	2		
S5660	173	0		29	10	S5660_173_0	3	4	Specialty	2		
S5660	173	0		29	10	S5660_173_0	3	2	Preferred Brand	2		
S5660	173	0		29	10	S5660_173_0	3	1	Generic	1	1	
S5660	174	0		29	10	S5660_174_0	3	2	Preferred Brand	2		
S5660	174	0		29	10	S5660_174_0	3	1	Generic	1	1	
S5660	174	0		29	10	S5660_174_0	3	3	Non-Preferred Brand	2		
S5660	174	0		29	10	S5660_174_0	3	4	Specialty	2		
S5660	175	0		29	10	S5660_175_0	3	2	Preferred Brand	2		
S5660	175	0		29	10	S5660_175_0	3	1	Generic	1	1	
S5660	175	0		29	10	S5660_175_0	3	4	Specialty	2		
S5660	175	0		29	10	S5660_175_0	3	3	Non-Preferred Brand	2		
S5660	176	0		29	10	S5660_176_0	3	4	Specialty	2		
S5660	176	0		29	10	S5660_176_0	3	3	Non-Preferred Brand	2		
S5660	176	0		29	10	S5660_176_0	3	1	Generic	1	1	
S5660	176	0		29	10	S5660_176_0	3	2	Preferred Brand	2		
S5660	177	0		29	10	S5660_177_0	3	3	Non-Preferred Brand	2		
S5660	177	0		29	10	S5660_177_0	3	1	Generic	1	1	
S5660	177	0		29	10	S5660_177_0	3	2	Preferred Brand	2		
S5660	177	0		29	10	S5660_177_0	3	4	Specialty	2		
S5660	178	0		29	10	S5660_178_0	3	1	Generic	1	1	
S5660	178	0		29	10	S5660_178_0	3	4	Specialty	2		
S5660	178	0		29	10	S5660_178_0	3	2	Preferred Brand	2		
S5660	178	0		29	10	S5660_178_0	3	3	Non-Preferred Brand	2		
S5660	179	0		29	10	S5660_179_0	3	3	Non-Preferred Brand	2		
S5660	179	0		29	10	S5660_179_0	3	2	Preferred Brand	2		
S5660	179	0		29	10	S5660_179_0	3	1	Generic	1	1	
S5660	179	0		29	10	S5660_179_0	3	4	Specialty	2		
S5660	180	0		29	10	S5660_180_0	3	2	Preferred Brand	2		
S5660	180	0		29	10	S5660_180_0	3	3	Non-Preferred Brand	2		
S5660	180	0		29	10	S5660_180_0	3	4	Specialty	2		
S5660	180	0		29	10	S5660_180_0	3	1	Generic	1	1	
S5660	181	0		29	10	S5660_181_0	3	3	Non-Preferred Brand	2		
S5660	181	0		29	10	S5660_181_0	3	2	Preferred Brand	2		
S5660	181	0		29	10	S5660_181_0	3	1	Generic	1	1	
S5660	181	0		29	10	S5660_181_0	3	4	Specialty	2		
S5660	182	0		29	10	S5660_182_0	3	3	Non-Preferred Brand	2		
S5660	182	0		29	10	S5660_182_0	3	2	Preferred Brand	2		
S5660	182	0		29	10	S5660_182_0	3	1	Generic	1	1	
S5660	182	0		29	10	S5660_182_0	3	4	Specialty	2		
S5660	183	0		29	10	S5660_183_0	3	1	Generic	1	1	
S5660	183	0		29	10	S5660_183_0	3	2	Preferred Brand	2		
S5660	183	0		29	10	S5660_183_0	3	3	Non-Preferred Brand	2		
S5660	183	0		29	10	S5660_183_0	3	4	Specialty	2		
S5660	184	0		29	10	S5660_184_0	3	1	Generic	1	1	
S5660	184	0		29	10	S5660_184_0	3	2	Preferred Brand	2		
S5660	184	0		29	10	S5660_184_0	3	3	Non-Preferred Brand	2		
S5660	184	0		29	10	S5660_184_0	3	4	Specialty	2		
S5660	185	0		29	10	S5660_185_0	3	4	Specialty	2		
S5660	185	0		29	10	S5660_185_0	3	3	Non-Preferred Brand	2		
S5660	185	0		29	10	S5660_185_0	3	2	Preferred Brand	2		
S5660	185	0		29	10	S5660_185_0	3	1	Generic	1	1	
S5660	186	0		29	10	S5660_186_0	3	4	Specialty	2		
S5660	186	0		29	10	S5660_186_0	3	3	Non-Preferred Brand	2		
S5660	186	0		29	10	S5660_186_0	3	2	Preferred Brand	2		
S5660	186	0		29	10	S5660_186_0	3	1	Generic	1	1	
S5660	187	0		29	10	S5660_187_0	3	4	Specialty	2		
S5660	187	0		29	10	S5660_187_0	3	3	Non-Preferred Brand	2		
S5660	187	0		29	10	S5660_187_0	3	1	Generic	1	1	
S5660	187	0		29	10	S5660_187_0	3	2	Preferred Brand	2		
S5660	188	0		29	10	S5660_188_0	3	3	Non-Preferred Brand	2		
S5660	188	0		29	10	S5660_188_0	3	2	Preferred Brand	2		
S5660	188	0		29	10	S5660_188_0	3	1	Generic	1	1	
S5660	188	0		29	10	S5660_188_0	3	4	Specialty	2		
S5660	189	0		29	10	S5660_189_0	3	4	Specialty	2		
S5660	189	0		29	10	S5660_189_0	3	3	Non-Preferred Brand	2		
S5660	189	0		29	10	S5660_189_0	3	1	Generic	1	1	
S5660	189	0		29	10	S5660_189_0	3	2	Preferred Brand	2		
S5660	190	0		29	10	S5660_190_0	3	3	Non-Preferred Brand	2		
S5660	190	0		29	10	S5660_190_0	3	2	Preferred Brand	2		
S5660	190	0		29	10	S5660_190_0	3	1	Generic	1	1	
S5660	190	0		29	10	S5660_190_0	3	4	Specialty	2		
S5660	191	0		29	10	S5660_191_0	3	4	Specialty	2		
S5660	191	0		29	10	S5660_191_0	3	3	Non-Preferred Brand	2		
S5660	191	0		29	10	S5660_191_0	3	1	Generic	1	1	
S5660	191	0		29	10	S5660_191_0	3	2	Preferred Brand	2		
S5660	192	0		29	10	S5660_192_0	3	3	Non-Preferred Brand	2		
S5660	192	0		29	10	S5660_192_0	3	2	Preferred Brand	2		
S5660	192	0		29	10	S5660_192_0	3	4	Specialty	2		
S5660	192	0		29	10	S5660_192_0	3	1	Generic	1	1	
S5660	193	0		29	10	S5660_193_0	3	4	Specialty	2		
S5660	193	0		29	10	S5660_193_0	3	1	Generic	1	1	
S5660	193	0		29	10	S5660_193_0	3	2	Preferred Brand	2		
S5660	193	0		29	10	S5660_193_0	3	3	Non-Preferred Brand	2		
S5660	194	0		29	10	S5660_194_0	3	1	Generic	1	1	
S5660	194	0		29	10	S5660_194_0	3	3	Non-Preferred Brand	2		
S5660	194	0		29	10	S5660_194_0	3	2	Preferred Brand	2		
S5660	194	0		29	10	S5660_194_0	3	4	Specialty	2		
S5660	195	0		29	10	S5660_195_0	3	2	Preferred Brand	2		
S5660	195	0		29	10	S5660_195_0	3	3	Non-Preferred Brand	2		
S5660	195	0		29	10	S5660_195_0	3	4	Specialty	2		
S5660	195	0		29	10	S5660_195_0	3	1	Generic	1	1	
S5660	196	0		29	10	S5660_196_0	3	1	Generic	1	1	
S5660	196	0		29	10	S5660_196_0	3	2	Preferred Brand	2		
S5660	196	0		29	10	S5660_196_0	3	3	Non-Preferred Brand	2		
S5660	196	0		29	10	S5660_196_0	3	4	Specialty	2		
S5660	197	0		29	10	S5660_197_0	3	1	Generic	1	1	
S5660	197	0		29	10	S5660_197_0	3	2	Preferred Brand	2		
S5660	197	0		29	10	S5660_197_0	3	3	Non-Preferred Brand	2		
S5660	197	0		29	10	S5660_197_0	3	4	Specialty	2		
S5660	198	0		29	10	S5660_198_0	3	1	Generic	1	1	
S5660	198	0		29	10	S5660_198_0	3	2	Preferred Brand	2		
S5660	198	0		29	10	S5660_198_0	3	4	Specialty	2		
S5660	198	0		29	10	S5660_198_0	3	3	Non-Preferred Brand	2		
S5660	199	0		29	10	S5660_199_0	3	1	Generic	1	1	
S5660	199	0		29	10	S5660_199_0	3	3	Non-Preferred Brand	2		
S5660	199	0		29	10	S5660_199_0	3	2	Preferred Brand	2		
S5660	199	0		29	10	S5660_199_0	3	4	Specialty	2		
S5660	200	0		29	10	S5660_200_0	3	3	Non-Preferred Brand	2		
S5660	200	0		29	10	S5660_200_0	3	2	Preferred Brand	2		
S5660	200	0		29	10	S5660_200_0	3	1	Generic	1	1	
S5660	200	0		29	10	S5660_200_0	3	4	Specialty	2		
S5660	201	0		29	10	S5660_201_0	3	1	Generic	1	1	
S5660	201	0		29	10	S5660_201_0	3	2	Preferred Brand	2		
S5660	201	0		29	10	S5660_201_0	3	3	Non-Preferred Brand	2		
S5660	201	0		29	10	S5660_201_0	3	4	Specialty	2		
S5660	202	0		29	10	S5660_202_0	3	3	Non-Preferred Brand	2		
S5660	202	0		29	10	S5660_202_0	3	2	Preferred Brand	2		
S5660	202	0		29	10	S5660_202_0	3	1	Generic	1	1	
S5660	202	0		29	10	S5660_202_0	3	4	Specialty	2		
S5660	203	0		29	10	S5660_203_0	3	1	Generic	1	1	
S5660	203	0		29	10	S5660_203_0	3	2	Preferred Brand	2		
S5660	203	0		29	10	S5660_203_0	3	3	Non-Preferred Brand	2		
S5660	203	0		29	10	S5660_203_0	3	4	Specialty	2		
S5660	204	0		29	10	S5660_204_0	3	1	Generic	1	1	
S5660	204	0		29	10	S5660_204_0	3	2	Preferred Brand	2		
S5660	204	0		29	10	S5660_204_0	3	4	Specialty	2		
S5660	204	0		29	10	S5660_204_0	3	3	Non-Preferred Brand	2		
S5660	205	0		29	10	S5660_205_0	3	1	Generic	1	1	
S5660	205	0		29	10	S5660_205_0	3	3	Non-Preferred Brand	2		
S5660	205	0		29	10	S5660_205_0	3	2	Preferred Brand	2		
S5660	205	0		29	10	S5660_205_0	3	4	Specialty	2		
S5670	030	0		29	10	S5670_030_0	3	1	Preferred Generic	1	1	
S5670	030	0		29	10	S5670_030_0	3	2	Generics	2		
S5670	030	0		29	10	S5670_030_0	3	3	Preferred Brand	2		
S5670	030	0		29	10	S5670_030_0	3	4	Non-Preferred Brand	2		
S5670	030	0		29	10	S5670_030_0	3	5	Specialty - Generic and Brand	2		
S5670	036	0		29	10	S5670_036_0	3	1	Preferred Generic	1	1	
S5670	036	0		29	10	S5670_036_0	3	2	Generics	2		
S5670	036	0		29	10	S5670_036_0	3	3	Preferred Brand	2		
S5670	036	0		29	10	S5670_036_0	3	4	Non-Preferred Brand	2		
S5670	036	0		29	10	S5670_036_0	3	5	Specialty - Generic and Brand	2		
S5670	042	0		29	10	S5670_042_0	3	5	Specialty - Generic and Brand	2		
S5670	042	0		29	10	S5670_042_0	3	4	Non-Preferred Brand	2		
S5670	042	0		29	10	S5670_042_0	3	3	Preferred Brand	2		
S5670	042	0		29	10	S5670_042_0	3	2	Generics	2		
S5670	042	0		29	10	S5670_042_0	3	1	Preferred Generic	1	1	
S5670	048	0		29	10	S5670_048_0	3	5	Specialty - Generic and Brand	2		
S5670	048	0		29	10	S5670_048_0	3	4	Non-Preferred Brand	2		
S5670	048	0		29	10	S5670_048_0	3	3	Preferred Brand	2		
S5670	048	0		29	10	S5670_048_0	3	2	Generics	2		
S5670	048	0		29	10	S5670_048_0	3	1	Preferred Generic	1	1	
S5670	054	0		29	10	S5670_054_0	3	5	Specialty - Generic and Brand	2		
S5670	054	0		29	10	S5670_054_0	3	2	Generics	2		
S5670	054	0		29	10	S5670_054_0	3	3	Preferred Brand	2		
S5670	054	0		29	10	S5670_054_0	3	4	Non-Preferred Brand	2		
S5670	054	0		29	10	S5670_054_0	3	1	Preferred Generic	1	1	
S5670	060	0		29	10	S5670_060_0	3	5	Specialty - Generic and Brand	2		
S5670	060	0		29	10	S5670_060_0	3	3	Preferred Brand	2		
S5670	060	0		29	10	S5670_060_0	3	4	Non-Preferred Brand	2		
S5670	060	0		29	10	S5670_060_0	3	2	Generics	2		
S5670	060	0		29	10	S5670_060_0	3	1	Preferred Generic	1	1	
S5670	066	0		29	10	S5670_066_0	3	1	Preferred Generic	1	1	
S5670	066	0		29	10	S5670_066_0	3	2	Generics	2		
S5670	066	0		29	10	S5670_066_0	3	3	Preferred Brand	2		
S5670	066	0		29	10	S5670_066_0	3	4	Non-Preferred Brand	2		
S5670	066	0		29	10	S5670_066_0	3	5	Specialty - Generic and Brand	2		
S5670	072	0		29	10	S5670_072_0	3	1	Preferred Generic	1	1	
S5670	072	0		29	10	S5670_072_0	3	2	Generics	2		
S5670	072	0		29	10	S5670_072_0	3	4	Non-Preferred Brand	2		
S5670	072	0		29	10	S5670_072_0	3	5	Specialty - Generic and Brand	2		
S5670	072	0		29	10	S5670_072_0	3	3	Preferred Brand	2		
S5670	078	0		29	10	S5670_078_0	3	5	Specialty - Generic and Brand	2		
S5670	078	0		29	10	S5670_078_0	3	4	Non-Preferred Brand	2		
S5670	078	0		29	10	S5670_078_0	3	3	Preferred Brand	2		
S5670	078	0		29	10	S5670_078_0	3	2	Generics	2		
S5670	078	0		29	10	S5670_078_0	3	1	Preferred Generic	1	1	
S5670	084	0		29	10	S5670_084_0	3	4	Non-Preferred Brand	2		
S5670	084	0		29	10	S5670_084_0	3	5	Specialty - Generic and Brand	2		
S5670	084	0		29	10	S5670_084_0	3	3	Preferred Brand	2		
S5670	084	0		29	10	S5670_084_0	3	2	Generics	2		
S5670	084	0		29	10	S5670_084_0	3	1	Preferred Generic	1	1	
S5670	090	0		29	10	S5670_090_0	3	1	Preferred Generic	1	1	
S5670	090	0		29	10	S5670_090_0	3	4	Non-Preferred Brand	2		
S5670	090	0		29	10	S5670_090_0	3	5	Specialty - Generic and Brand	2		
S5670	090	0		29	10	S5670_090_0	3	2	Generics	2		
S5670	090	0		29	10	S5670_090_0	3	3	Preferred Brand	2		
S5670	096	0		29	10	S5670_096_0	3	5	Specialty - Generic and Brand	2		
S5670	096	0		29	10	S5670_096_0	3	4	Non-Preferred Brand	2		
S5670	096	0		29	10	S5670_096_0	3	3	Preferred Brand	2		
S5670	096	0		29	10	S5670_096_0	3	1	Preferred Generic	1	1	
S5670	096	0		29	10	S5670_096_0	3	2	Generics	2		
S5670	102	0		29	10	S5670_102_0	3	1	Preferred Generic	1	1	
S5670	102	0		29	10	S5670_102_0	3	2	Generics	2		
S5670	102	0		29	10	S5670_102_0	3	3	Preferred Brand	2		
S5670	102	0		29	10	S5670_102_0	3	4	Non-Preferred Brand	2		
S5670	102	0		29	10	S5670_102_0	3	5	Specialty - Generic and Brand	2		
S5670	108	0		29	10	S5670_108_0	3	1	Preferred Generic	1	1	
S5670	108	0		29	10	S5670_108_0	3	2	Generics	2		
S5670	108	0		29	10	S5670_108_0	3	3	Preferred Brand	2		
S5670	108	0		29	10	S5670_108_0	3	4	Non-Preferred Brand	2		
S5670	108	0		29	10	S5670_108_0	3	5	Specialty - Generic and Brand	2		
S5670	114	0		29	10	S5670_114_0	3	4	Non-Preferred Brand	2		
S5670	114	0		29	10	S5670_114_0	3	5	Specialty - Generic and Brand	2		
S5670	114	0		29	10	S5670_114_0	3	3	Preferred Brand	2		
S5670	114	0		29	10	S5670_114_0	3	2	Generics	2		
S5670	114	0		29	10	S5670_114_0	3	1	Preferred Generic	1	1	
S5670	120	0		29	10	S5670_120_0	3	5	Specialty - Generic and Brand	2		
S5670	120	0		29	10	S5670_120_0	3	4	Non-Preferred Brand	2		
S5670	120	0		29	10	S5670_120_0	3	3	Preferred Brand	2		
S5670	120	0		29	10	S5670_120_0	3	2	Generics	2		
S5670	120	0		29	10	S5670_120_0	3	1	Preferred Generic	1	1	
S5670	126	0		29	10	S5670_126_0	3	2	Generics	2		
S5670	126	0		29	10	S5670_126_0	3	1	Preferred Generic	1	1	
S5670	126	0		29	10	S5670_126_0	3	3	Preferred Brand	2		
S5670	126	0		29	10	S5670_126_0	3	4	Non-Preferred Brand	2		
S5670	126	0		29	10	S5670_126_0	3	5	Specialty - Generic and Brand	2		
S5670	132	0		29	10	S5670_132_0	3	5	Specialty - Generic and Brand	2		
S5670	132	0		29	10	S5670_132_0	3	4	Non-Preferred Brand	2		
S5670	132	0		29	10	S5670_132_0	3	3	Preferred Brand	2		
S5670	132	0		29	10	S5670_132_0	3	2	Generics	2		
S5670	132	0		29	10	S5670_132_0	3	1	Preferred Generic	1	1	
S5670	138	0		29	10	S5670_138_0	3	5	Specialty - Generic and Brand	2		
S5670	138	0		29	10	S5670_138_0	3	3	Preferred Brand	2		
S5670	138	0		29	10	S5670_138_0	3	2	Generics	2		
S5670	138	0		29	10	S5670_138_0	3	1	Preferred Generic	1	1	
S5670	138	0		29	10	S5670_138_0	3	4	Non-Preferred Brand	2		
S5670	144	0		29	10	S5670_144_0	3	5	Specialty - Generic and Brand	2		
S5670	144	0		29	10	S5670_144_0	3	1	Preferred Generic	1	1	
S5670	144	0		29	10	S5670_144_0	3	2	Generics	2		
S5670	144	0		29	10	S5670_144_0	3	3	Preferred Brand	2		
S5670	144	0		29	10	S5670_144_0	3	4	Non-Preferred Brand	2		
S5670	150	0		29	10	S5670_150_0	3	1	Preferred Generic	1	1	
S5670	150	0		29	10	S5670_150_0	3	2	Generics	2		
S5670	150	0		29	10	S5670_150_0	3	5	Specialty - Generic and Brand	2		
S5670	150	0		29	10	S5670_150_0	3	4	Non-Preferred Brand	2		
S5670	150	0		29	10	S5670_150_0	3	3	Preferred Brand	2		
S5674	005	0		29	10	S5674_005_0	2	5	Specialty - Generic and Brand	2		
S5674	005	0		29	10	S5674_005_0	2	4	Non-Preferred Brand	2		
S5674	005	0		29	10	S5674_005_0	2	3	Preferred Brand	2		
S5674	005	0		29	10	S5674_005_0	2	1	Preferred Generic	1	1	
S5674	005	0		29	10	S5674_005_0	2	2	Generics	2		
S5674	011	0		29	10	S5674_011_0	2	1	Preferred Generic	1	1	
S5674	011	0		29	10	S5674_011_0	2	5	Specialty - Generic and Brand	2		
S5674	011	0		29	10	S5674_011_0	2	4	Non-Preferred Brand	2		
S5674	011	0		29	10	S5674_011_0	2	3	Preferred Brand	2		
S5674	011	0		29	10	S5674_011_0	2	2	Generics	2		
S5674	017	0		29	10	S5674_017_0	2	1	Preferred Generic	1	1	
S5674	017	0		29	10	S5674_017_0	2	3	Preferred Brand	2		
S5674	017	0		29	10	S5674_017_0	2	4	Non-Preferred Brand	2		
S5674	017	0		29	10	S5674_017_0	2	5	Specialty - Generic and Brand	2		
S5674	017	0		29	10	S5674_017_0	2	2	Generics	2		
S5674	023	0		29	10	S5674_023_0	2	4	Non-Preferred Brand	2		
S5674	023	0		29	10	S5674_023_0	2	3	Preferred Brand	2		
S5674	023	0		29	10	S5674_023_0	2	2	Generics	2		
S5674	023	0		29	10	S5674_023_0	2	1	Preferred Generic	1	1	
S5674	023	0		29	10	S5674_023_0	2	5	Specialty - Generic and Brand	2		
S5674	029	0		29	10	S5674_029_0	2	4	Non-Preferred Brand	2		
S5674	029	0		29	10	S5674_029_0	2	3	Preferred Brand	2		
S5674	029	0		29	10	S5674_029_0	2	2	Generics	2		
S5674	029	0		29	10	S5674_029_0	2	1	Preferred Generic	1	1	
S5674	029	0		29	10	S5674_029_0	2	5	Specialty - Generic and Brand	2		
S5674	035	0		29	10	S5674_035_0	2	1	Preferred Generic	1	1	
S5674	035	0		29	10	S5674_035_0	2	3	Preferred Brand	2		
S5674	035	0		29	10	S5674_035_0	2	5	Specialty - Generic and Brand	2		
S5674	035	0		29	10	S5674_035_0	2	4	Non-Preferred Brand	2		
S5674	035	0		29	10	S5674_035_0	2	2	Generics	2		
S5674	041	0		29	10	S5674_041_0	2	2	Generics	2		
S5674	041	0		29	10	S5674_041_0	2	4	Non-Preferred Brand	2		
S5674	041	0		29	10	S5674_041_0	2	5	Specialty - Generic and Brand	2		
S5674	041	0		29	10	S5674_041_0	2	3	Preferred Brand	2		
S5674	041	0		29	10	S5674_041_0	2	1	Preferred Generic	1	1	
S5674	047	0		29	10	S5674_047_0	2	1	Preferred Generic	1	1	
S5674	047	0		29	10	S5674_047_0	2	5	Specialty - Generic and Brand	2		
S5674	047	0		29	10	S5674_047_0	2	4	Non-Preferred Brand	2		
S5674	047	0		29	10	S5674_047_0	2	2	Generics	2		
S5674	047	0		29	10	S5674_047_0	2	3	Preferred Brand	2		
S5674	053	0		29	10	S5674_053_0	2	4	Non-Preferred Brand	2		
S5674	053	0		29	10	S5674_053_0	2	3	Preferred Brand	2		
S5674	053	0		29	10	S5674_053_0	2	2	Generics	2		
S5674	053	0		29	10	S5674_053_0	2	1	Preferred Generic	1	1	
S5674	053	0		29	10	S5674_053_0	2	5	Specialty - Generic and Brand	2		
S5674	059	0		29	10	S5674_059_0	2	2	Generics	2		
S5674	059	0		29	10	S5674_059_0	2	1	Preferred Generic	1	1	
S5674	059	0		29	10	S5674_059_0	2	3	Preferred Brand	2		
S5674	059	0		29	10	S5674_059_0	2	4	Non-Preferred Brand	2		
S5674	059	0		29	10	S5674_059_0	2	5	Specialty - Generic and Brand	2		
S5674	065	0		29	10	S5674_065_0	2	1	Preferred Generic	1	1	
S5674	065	0		29	10	S5674_065_0	2	5	Specialty - Generic and Brand	2		
S5674	065	0		29	10	S5674_065_0	2	2	Generics	2		
S5674	065	0		29	10	S5674_065_0	2	3	Preferred Brand	2		
S5674	065	0		29	10	S5674_065_0	2	4	Non-Preferred Brand	2		
S5674	071	0		29	10	S5674_071_0	2	5	Specialty - Generic and Brand	2		
S5674	071	0		29	10	S5674_071_0	2	4	Non-Preferred Brand	2		
S5674	071	0		29	10	S5674_071_0	2	3	Preferred Brand	2		
S5674	071	0		29	10	S5674_071_0	2	2	Generics	2		
S5674	071	0		29	10	S5674_071_0	2	1	Preferred Generic	1	1	
S5715	002	0		29	10	S5715_002_0	3	3	Brand	2		
S5715	002	0		29	10	S5715_002_0	3	4	Specialty	1	2	01000000
S5715	002	0		29	10	S5715_002_0	3	1	Generic	1	1	
S5715	002	0		29	10	S5715_002_0	3	2	Preferred Brand	2		
S5715	004	0		29	10	S5715_004_0	3	2	Preferred Brand	2		
S5715	004	0		29	10	S5715_004_0	3	3	Brand	2		
S5715	004	0		29	10	S5715_004_0	3	4	Specialty	1	2	01000000
S5715	004	0		29	10	S5715_004_0	3	1	Generic	1	1	
S5715	006	0		29	10	S5715_006_0	3	4	Specialty	1	2	01000000
S5715	006	0		29	10	S5715_006_0	3	3	Brand	2		
S5715	006	0		29	10	S5715_006_0	3	2	Preferred Brand	2		
S5715	006	0		29	10	S5715_006_0	3	1	Generic	1	1	
S5726	015	0		29	10	S5726_015_0	3	5	Tier 5 Specialty Drugs	2		
S5726	015	0		29	10	S5726_015_0	3	4	Tier 4 Non-Specialty Injectable Drugs	2		
S5726	015	0		29	10	S5726_015_0	3	3	Tier 3 Non-Preferred Brand  Certain Generic Drugs	2		
S5726	015	0		29	10	S5726_015_0	3	1	Tier 1 Preferred Generic Drugs	1	1	
S5726	015	0		29	10	S5726_015_0	3	2	Tier 2 Preferred Brand  Certain Generic Drugs	2		
S5741	003	0		29	10	S5741_003_0	3	1	Tier #1	1	1	
S5741	003	0		29	10	S5741_003_0	3	2	Tier #2	2		
S5741	003	0		29	10	S5741_003_0	3	3	Tier #3	2		
S5741	003	0		29	10	S5741_003_0	3	4	Tier #4	2		
S5743	004	0		29	10	S5743_004_0	2	4	Covered Specialty	2		
S5743	004	0		29	10	S5743_004_0	2	3	Level 3: Covered Brand	2		
S5743	004	0		29	10	S5743_004_0	2	2	Level 2: Covered Preferred Brand	2		
S5743	004	0		29	10	S5743_004_0	2	1	Level 1: Covered Generic	1	1	
S5753	007	0		29	10	S5753_007_0	2	4	Non-Preferred Brand	2		
S5753	007	0		29	10	S5753_007_0	2	3	Preferred Brand	2		
S5753	007	0		29	10	S5753_007_0	2	2	Non-Preferred Generic	1	1	
S5753	007	0		29	10	S5753_007_0	2	1	Preferred Generic	1	1	
S5753	007	0		29	10	S5753_007_0	2	5	Specialty Brand	2		
S5766	003	0		29	10	S5766_003_0	4	3	Non-Preferred Brand	2		
S5766	003	0		29	10	S5766_003_0	4	4	Non-Self Injectables	2		
S5766	003	0		29	10	S5766_003_0	4	2	Preferred Brand	2		
S5766	003	0		29	10	S5766_003_0	4	1	Generic	1	1	
S5775	003	0		29	10	S5775_003_0	2	1	Nivel 1/ Genricos	1	1	
S5775	003	0		29	10	S5775_003_0	2	3	Nivel 3/ No Preferidos	2		
S5775	003	0		29	10	S5775_003_0	2	2	Nivel 2/ Preferidos	2		
S5775	003	0		29	10	S5775_003_0	2	4	Nivel 4/ Especializados	2		
S5795	002	0		29	10	S5795_002_0	4	4	Specialty	2		
S5795	002	0		29	10	S5795_002_0	4	3	Non-Preferred Brand	2		
S5795	002	0		29	10	S5795_002_0	4	2	Preferred Brand	2		
S5795	002	0		29	10	S5795_002_0	4	1	Generic	1	1	
S5803	218	0		29	10	S5803_218_0	3	1	Generic	1	1	
S5803	218	0		29	10	S5803_218_0	3	2	Preferred Brand	2		
S5803	218	0		29	10	S5803_218_0	3	3	Non-Preferred Brand	2		
S5803	218	0		29	10	S5803_218_0	3	4	Specialty	2		
S5803	219	0		29	10	S5803_219_0	3	1	Generic	1	1	
S5803	219	0		29	10	S5803_219_0	3	2	Preferred Brand	2		
S5803	219	0		29	10	S5803_219_0	3	4	Specialty	2		
S5803	219	0		29	10	S5803_219_0	3	3	Non-Preferred Brand	2		
S5803	221	0		29	10	S5803_221_0	3	3	Non-Preferred Brand	2		
S5803	221	0		29	10	S5803_221_0	3	1	Generic	1	1	
S5803	221	0		29	10	S5803_221_0	3	2	Preferred Brand	2		
S5803	221	0		29	10	S5803_221_0	3	4	Specialty	2		
S5803	222	0		29	10	S5803_222_0	3	3	Non-Preferred Brand	2		
S5803	222	0		29	10	S5803_222_0	3	2	Preferred Brand	2		
S5803	222	0		29	10	S5803_222_0	3	1	Generic	1	1	
S5803	222	0		29	10	S5803_222_0	3	4	Specialty	2		
S5803	223	0		29	10	S5803_223_0	3	1	Generic	1	1	
S5803	223	0		29	10	S5803_223_0	3	2	Preferred Brand	2		
S5803	223	0		29	10	S5803_223_0	3	3	Non-Preferred Brand	2		
S5803	223	0		29	10	S5803_223_0	3	4	Specialty	2		
S5803	224	0		29	10	S5803_224_0	3	4	Specialty	2		
S5803	224	0		29	10	S5803_224_0	3	3	Non-Preferred Brand	2		
S5803	224	0		29	10	S5803_224_0	3	2	Preferred Brand	2		
S5803	224	0		29	10	S5803_224_0	3	1	Generic	1	1	
S5803	225	0		29	10	S5803_225_0	3	1	Generic	1	1	
S5803	225	0		29	10	S5803_225_0	3	2	Preferred Brand	2		
S5803	225	0		29	10	S5803_225_0	3	3	Non-Preferred Brand	2		
S5803	225	0		29	10	S5803_225_0	3	4	Specialty	2		
S5803	226	0		29	10	S5803_226_0	3	2	Preferred Brand	2		
S5803	226	0		29	10	S5803_226_0	3	4	Specialty	2		
S5803	226	0		29	10	S5803_226_0	3	3	Non-Preferred Brand	2		
S5803	226	0		29	10	S5803_226_0	3	1	Generic	1	1	
S5803	227	0		29	10	S5803_227_0	3	1	Generic	1	1	
S5803	227	0		29	10	S5803_227_0	3	2	Preferred Brand	2		
S5803	227	0		29	10	S5803_227_0	3	3	Non-Preferred Brand	2		
S5803	227	0		29	10	S5803_227_0	3	4	Specialty	2		
S5803	228	0		29	10	S5803_228_0	3	3	Non-Preferred Brand	2		
S5803	228	0		29	10	S5803_228_0	3	2	Preferred Brand	2		
S5803	228	0		29	10	S5803_228_0	3	1	Generic	1	1	
S5803	228	0		29	10	S5803_228_0	3	4	Specialty	2		
S5803	229	0		29	10	S5803_229_0	4	3	Non-Preferred Brand	2		
S5803	229	0		29	10	S5803_229_0	4	2	Preferred Brand	2		
S5803	229	0		29	10	S5803_229_0	4	1	Generic	1	1	
S5803	229	0		29	10	S5803_229_0	4	4	Specialty	2		
S5803	230	0		29	10	S5803_230_0	4	2	Preferred Brand	2		
S5803	230	0		29	10	S5803_230_0	4	3	Non-Preferred Brand	2		
S5803	230	0		29	10	S5803_230_0	4	4	Specialty	2		
S5803	230	0		29	10	S5803_230_0	4	1	Generic	1	1	
S5803	231	0		29	10	S5803_231_0	4	1	Generic	1	1	
S5803	231	0		29	10	S5803_231_0	4	2	Preferred Brand	2		
S5803	231	0		29	10	S5803_231_0	4	3	Non-Preferred Brand	2		
S5803	231	0		29	10	S5803_231_0	4	4	Specialty	2		
S5803	232	0		29	10	S5803_232_0	4	4	Specialty	2		
S5803	232	0		29	10	S5803_232_0	4	3	Non-Preferred Brand	2		
S5803	232	0		29	10	S5803_232_0	4	2	Preferred Brand	2		
S5803	232	0		29	10	S5803_232_0	4	1	Generic	1	1	
S5803	233	0		29	10	S5803_233_0	4	1	Generic	1	1	
S5803	233	0		29	10	S5803_233_0	4	2	Preferred Brand	2		
S5803	233	0		29	10	S5803_233_0	4	3	Non-Preferred Brand	2		
S5803	233	0		29	10	S5803_233_0	4	4	Specialty	2		
S5803	234	0		29	10	S5803_234_0	4	4	Specialty	2		
S5803	234	0		29	10	S5803_234_0	4	3	Non-Preferred Brand	2		
S5803	234	0		29	10	S5803_234_0	4	1	Generic	1	1	
S5803	234	0		29	10	S5803_234_0	4	2	Preferred Brand	2		
S5803	235	0		29	10	S5803_235_0	4	4	Specialty	2		
S5803	235	0		29	10	S5803_235_0	4	3	Non-Preferred Brand	2		
S5803	235	0		29	10	S5803_235_0	4	2	Preferred Brand	2		
S5803	235	0		29	10	S5803_235_0	4	1	Generic	1	1	
S5803	236	0		29	10	S5803_236_0	3	1	Generic	1	1	
S5803	236	0		29	10	S5803_236_0	3	2	Preferred Brand	2		
S5803	236	0		29	10	S5803_236_0	3	3	Non-Preferred Brand	2		
S5803	236	0		29	10	S5803_236_0	3	4	Specialty	2		
S5803	237	0		29	10	S5803_237_0	3	3	Non-Preferred Brand	2		
S5803	237	0		29	10	S5803_237_0	3	2	Preferred Brand	2		
S5803	237	0		29	10	S5803_237_0	3	1	Generic	1	1	
S5803	237	0		29	10	S5803_237_0	3	4	Specialty	2		
S5803	238	0		29	10	S5803_238_0	3	3	Non-Preferred Brand	2		
S5803	238	0		29	10	S5803_238_0	3	2	Preferred Brand	2		
S5803	238	0		29	10	S5803_238_0	3	1	Generic	1	1	
S5803	238	0		29	10	S5803_238_0	3	4	Specialty	2		
S5803	239	0		29	10	S5803_239_0	3	4	Specialty	2		
S5803	239	0		29	10	S5803_239_0	3	3	Non-Preferred Brand	2		
S5803	239	0		29	10	S5803_239_0	3	2	Preferred Brand	2		
S5803	239	0		29	10	S5803_239_0	3	1	Generic	1	1	
S5803	240	0		29	10	S5803_240_0	3	1	Generic	1	1	
S5803	240	0		29	10	S5803_240_0	3	2	Preferred Brand	2		
S5803	240	0		29	10	S5803_240_0	3	3	Non-Preferred Brand	2		
S5803	240	0		29	10	S5803_240_0	3	4	Specialty	2		
S5803	241	0		29	10	S5803_241_0	3	4	Specialty	2		
S5803	241	0		29	10	S5803_241_0	3	3	Non-Preferred Brand	2		
S5803	241	0		29	10	S5803_241_0	3	2	Preferred Brand	2		
S5803	241	0		29	10	S5803_241_0	3	1	Generic	1	1	
S5803	242	0		29	10	S5803_242_0	3	4	Specialty	2		
S5803	242	0		29	10	S5803_242_0	3	3	Non-Preferred Brand	2		
S5803	242	0		29	10	S5803_242_0	3	2	Preferred Brand	2		
S5803	242	0		29	10	S5803_242_0	3	1	Generic	1	1	
S5803	243	0		29	10	S5803_243_0	3	1	Generic	1	1	
S5803	243	0		29	10	S5803_243_0	3	2	Preferred Brand	2		
S5803	243	0		29	10	S5803_243_0	3	4	Specialty	2		
S5803	243	0		29	10	S5803_243_0	3	3	Non-Preferred Brand	2		
S5803	244	0		29	10	S5803_244_0	3	2	Preferred Brand	2		
S5803	244	0		29	10	S5803_244_0	3	4	Specialty	2		
S5803	244	0		29	10	S5803_244_0	3	3	Non-Preferred Brand	2		
S5803	244	0		29	10	S5803_244_0	3	1	Generic	1	1	
S5803	245	0		29	10	S5803_245_0	3	1	Generic	1	1	
S5803	245	0		29	10	S5803_245_0	3	2	Preferred Brand	2		
S5803	245	0		29	10	S5803_245_0	3	3	Non-Preferred Brand	2		
S5803	245	0		29	10	S5803_245_0	3	4	Specialty	2		
S5803	246	0		29	10	S5803_246_0	3	1	Generic	1	1	
S5803	246	0		29	10	S5803_246_0	3	2	Preferred Brand	2		
S5803	246	0		29	10	S5803_246_0	3	4	Specialty	2		
S5803	246	0		29	10	S5803_246_0	3	3	Non-Preferred Brand	2		
S5803	247	0		29	10	S5803_247_0	3	3	Non-Preferred Brand	2		
S5803	247	0		29	10	S5803_247_0	3	4	Specialty	2		
S5803	247	0		29	10	S5803_247_0	3	1	Generic	1	1	
S5803	247	0		29	10	S5803_247_0	3	2	Preferred Brand	2		
S5803	248	0		29	10	S5803_248_0	3	1	Generic	1	1	
S5803	248	0		29	10	S5803_248_0	3	2	Preferred Brand	2		
S5803	248	0		29	10	S5803_248_0	3	4	Specialty	2		
S5803	248	0		29	10	S5803_248_0	3	3	Non-Preferred Brand	2		
S5803	249	0		29	10	S5803_249_0	3	3	Non-Preferred Brand	2		
S5803	249	0		29	10	S5803_249_0	3	4	Specialty	2		
S5803	249	0		29	10	S5803_249_0	3	2	Preferred Brand	2		
S5803	249	0		29	10	S5803_249_0	3	1	Generic	1	1	
S5803	250	0		29	10	S5803_250_0	3	3	Non-Preferred Brand	2		
S5803	250	0		29	10	S5803_250_0	3	2	Preferred Brand	2		
S5803	250	0		29	10	S5803_250_0	3	1	Generic	1	1	
S5803	250	0		29	10	S5803_250_0	3	4	Specialty	2		
S5803	251	0		29	10	S5803_251_0	3	3	Non-Preferred Brand	2		
S5803	251	0		29	10	S5803_251_0	3	2	Preferred Brand	2		
S5803	251	0		29	10	S5803_251_0	3	1	Generic	1	1	
S5803	251	0		29	10	S5803_251_0	3	4	Specialty	2		
S5803	252	0		29	10	S5803_252_0	4	1	Generic	1	1	
S5803	252	0		29	10	S5803_252_0	4	2	Preferred Brand	2		
S5803	252	0		29	10	S5803_252_0	4	3	Non-Preferred Brand	2		
S5803	252	0		29	10	S5803_252_0	4	4	Specialty	2		
S5803	253	0		29	10	S5803_253_0	3	1	Generic	1	1	
S5803	253	0		29	10	S5803_253_0	3	2	Preferred Brand	2		
S5803	253	0		29	10	S5803_253_0	3	3	Non-Preferred Brand	2		
S5803	253	0		29	10	S5803_253_0	3	4	Specialty	2		
S5810	171	0		29	10	S5810_171_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	171	0		29	10	S5810_171_0	4	3	Tier 3 - Preferred Brand	2		
S5810	171	0		29	10	S5810_171_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	171	0		29	10	S5810_171_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	171	0		29	10	S5810_171_0	4	5	Tier 5 - Specialty	2		
S5810	172	0		29	10	S5810_172_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	172	0		29	10	S5810_172_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	172	0		29	10	S5810_172_0	4	5	Tier 5 - Specialty	2		
S5810	172	0		29	10	S5810_172_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	172	0		29	10	S5810_172_0	4	3	Tier 3 - Preferred Brand	2		
S5810	173	0		29	10	S5810_173_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	173	0		29	10	S5810_173_0	4	3	Tier 3 - Preferred Brand	2		
S5810	173	0		29	10	S5810_173_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	173	0		29	10	S5810_173_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	173	0		29	10	S5810_173_0	4	5	Tier 5 - Specialty	2		
S5810	174	0		29	10	S5810_174_0	4	5	Tier 5 - Specialty	2		
S5810	174	0		29	10	S5810_174_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	174	0		29	10	S5810_174_0	4	3	Tier 3 - Preferred Brand	2		
S5810	174	0		29	10	S5810_174_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	174	0		29	10	S5810_174_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	175	0		29	10	S5810_175_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	175	0		29	10	S5810_175_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	175	0		29	10	S5810_175_0	4	3	Tier 3 - Preferred Brand	2		
S5810	175	0		29	10	S5810_175_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	175	0		29	10	S5810_175_0	4	5	Tier 5 - Specialty	2		
S5810	176	0		29	10	S5810_176_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	176	0		29	10	S5810_176_0	4	3	Tier 3 - Preferred Brand	2		
S5810	176	0		29	10	S5810_176_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	176	0		29	10	S5810_176_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	176	0		29	10	S5810_176_0	4	5	Tier 5 - Specialty	2		
S5810	177	0		29	10	S5810_177_0	4	5	Tier 5 - Specialty	2		
S5810	177	0		29	10	S5810_177_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	177	0		29	10	S5810_177_0	4	3	Tier 3 - Preferred Brand	2		
S5810	177	0		29	10	S5810_177_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	177	0		29	10	S5810_177_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	178	0		29	10	S5810_178_0	4	5	Tier 5 - Specialty	2		
S5810	178	0		29	10	S5810_178_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	178	0		29	10	S5810_178_0	4	3	Tier 3 - Preferred Brand	2		
S5810	178	0		29	10	S5810_178_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	178	0		29	10	S5810_178_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	179	0		29	10	S5810_179_0	4	5	Tier 5 - Specialty	2		
S5810	179	0		29	10	S5810_179_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	179	0		29	10	S5810_179_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	179	0		29	10	S5810_179_0	4	3	Tier 3 - Preferred Brand	2		
S5810	179	0		29	10	S5810_179_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	180	0		29	10	S5810_180_0	4	5	Tier 5 - Specialty	2		
S5810	180	0		29	10	S5810_180_0	4	3	Tier 3 - Preferred Brand	2		
S5810	180	0		29	10	S5810_180_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	180	0		29	10	S5810_180_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	180	0		29	10	S5810_180_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	181	0		29	10	S5810_181_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	181	0		29	10	S5810_181_0	4	5	Tier 5 - Specialty	2		
S5810	181	0		29	10	S5810_181_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	181	0		29	10	S5810_181_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	181	0		29	10	S5810_181_0	4	3	Tier 3 - Preferred Brand	2		
S5810	182	0		29	10	S5810_182_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	182	0		29	10	S5810_182_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	182	0		29	10	S5810_182_0	4	3	Tier 3 - Preferred Brand	2		
S5810	182	0		29	10	S5810_182_0	4	5	Tier 5 - Specialty	2		
S5810	182	0		29	10	S5810_182_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	183	0		29	10	S5810_183_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	183	0		29	10	S5810_183_0	4	5	Tier 5 - Specialty	2		
S5810	183	0		29	10	S5810_183_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	183	0		29	10	S5810_183_0	4	3	Tier 3 - Preferred Brand	2		
S5810	183	0		29	10	S5810_183_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	184	0		29	10	S5810_184_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	184	0		29	10	S5810_184_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	184	0		29	10	S5810_184_0	4	3	Tier 3 - Preferred Brand	2		
S5810	184	0		29	10	S5810_184_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	184	0		29	10	S5810_184_0	4	5	Tier 5 - Specialty	2		
S5810	185	0		29	10	S5810_185_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	185	0		29	10	S5810_185_0	4	5	Tier 5 - Specialty	2		
S5810	185	0		29	10	S5810_185_0	4	3	Tier 3 - Preferred Brand	2		
S5810	185	0		29	10	S5810_185_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	185	0		29	10	S5810_185_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	186	0		29	10	S5810_186_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	186	0		29	10	S5810_186_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	186	0		29	10	S5810_186_0	4	3	Tier 3 - Preferred Brand	2		
S5810	186	0		29	10	S5810_186_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	186	0		29	10	S5810_186_0	4	5	Tier 5 - Specialty	2		
S5810	187	0		29	10	S5810_187_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	187	0		29	10	S5810_187_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	187	0		29	10	S5810_187_0	4	3	Tier 3 - Preferred Brand	2		
S5810	187	0		29	10	S5810_187_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	187	0		29	10	S5810_187_0	4	5	Tier 5 - Specialty	2		
S5810	188	0		29	10	S5810_188_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	188	0		29	10	S5810_188_0	4	3	Tier 3 - Preferred Brand	2		
S5810	188	0		29	10	S5810_188_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	188	0		29	10	S5810_188_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	188	0		29	10	S5810_188_0	4	5	Tier 5 - Specialty	2		
S5810	189	0		29	10	S5810_189_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	189	0		29	10	S5810_189_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	189	0		29	10	S5810_189_0	4	3	Tier 3 - Preferred Brand	2		
S5810	189	0		29	10	S5810_189_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	189	0		29	10	S5810_189_0	4	5	Tier 5 - Specialty	2		
S5810	190	0		29	10	S5810_190_0	4	5	Tier 5 - Specialty	2		
S5810	190	0		29	10	S5810_190_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	190	0		29	10	S5810_190_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	190	0		29	10	S5810_190_0	4	3	Tier 3 - Preferred Brand	2		
S5810	190	0		29	10	S5810_190_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	191	0		29	10	S5810_191_0	4	5	Tier 5 - Specialty	2		
S5810	191	0		29	10	S5810_191_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	191	0		29	10	S5810_191_0	4	3	Tier 3 - Preferred Brand	2		
S5810	191	0		29	10	S5810_191_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	191	0		29	10	S5810_191_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	192	0		29	10	S5810_192_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	192	0		29	10	S5810_192_0	4	3	Tier 3 - Preferred Brand	2		
S5810	192	0		29	10	S5810_192_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	192	0		29	10	S5810_192_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	192	0		29	10	S5810_192_0	4	5	Tier 5 - Specialty	2		
S5810	193	0		29	10	S5810_193_0	4	5	Tier 5 - Specialty	2		
S5810	193	0		29	10	S5810_193_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	193	0		29	10	S5810_193_0	4	3	Tier 3 - Preferred Brand	2		
S5810	193	0		29	10	S5810_193_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	193	0		29	10	S5810_193_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	194	0		29	10	S5810_194_0	4	5	Tier 5 - Specialty	2		
S5810	194	0		29	10	S5810_194_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	194	0		29	10	S5810_194_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	194	0		29	10	S5810_194_0	4	3	Tier 3 - Preferred Brand	2		
S5810	194	0		29	10	S5810_194_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	195	0		29	10	S5810_195_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	195	0		29	10	S5810_195_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	195	0		29	10	S5810_195_0	4	3	Tier 3 - Preferred Brand	2		
S5810	195	0		29	10	S5810_195_0	4	5	Tier 5 - Specialty	2		
S5810	195	0		29	10	S5810_195_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	196	0		29	10	S5810_196_0	4	5	Tier 5 - Specialty	2		
S5810	196	0		29	10	S5810_196_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	196	0		29	10	S5810_196_0	4	3	Tier 3 - Preferred Brand	2		
S5810	196	0		29	10	S5810_196_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	196	0		29	10	S5810_196_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	197	0		29	10	S5810_197_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	197	0		29	10	S5810_197_0	4	3	Tier 3 - Preferred Brand	2		
S5810	197	0		29	10	S5810_197_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	197	0		29	10	S5810_197_0	4	5	Tier 5 - Specialty	2		
S5810	197	0		29	10	S5810_197_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	198	0		29	10	S5810_198_0	4	5	Tier 5 - Specialty	2		
S5810	198	0		29	10	S5810_198_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	198	0		29	10	S5810_198_0	4	3	Tier 3 - Preferred Brand	2		
S5810	198	0		29	10	S5810_198_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	198	0		29	10	S5810_198_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	199	0		29	10	S5810_199_0	4	5	Tier 5 - Specialty	2		
S5810	199	0		29	10	S5810_199_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	199	0		29	10	S5810_199_0	4	3	Tier 3 - Preferred Brand	2		
S5810	199	0		29	10	S5810_199_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	199	0		29	10	S5810_199_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	200	0		29	10	S5810_200_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	200	0		29	10	S5810_200_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	200	0		29	10	S5810_200_0	4	3	Tier 3 - Preferred Brand	2		
S5810	200	0		29	10	S5810_200_0	4	5	Tier 5 - Specialty	2		
S5810	200	0		29	10	S5810_200_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	201	0		29	10	S5810_201_0	4	5	Tier 5 - Specialty	2		
S5810	201	0		29	10	S5810_201_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	201	0		29	10	S5810_201_0	4	3	Tier 3 - Preferred Brand	2		
S5810	201	0		29	10	S5810_201_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	201	0		29	10	S5810_201_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	202	0		29	10	S5810_202_0	4	5	Tier 5 - Specialty	2		
S5810	202	0		29	10	S5810_202_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	202	0		29	10	S5810_202_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	202	0		29	10	S5810_202_0	4	3	Tier 3 - Preferred Brand	2		
S5810	202	0		29	10	S5810_202_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	203	0		29	10	S5810_203_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	203	0		29	10	S5810_203_0	4	5	Tier 5 - Specialty	2		
S5810	203	0		29	10	S5810_203_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	203	0		29	10	S5810_203_0	4	3	Tier 3 - Preferred Brand	2		
S5810	203	0		29	10	S5810_203_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	204	0		29	10	S5810_204_0	4	2	Tier 2 - Non-Preferred Generic	2		
S5810	204	0		29	10	S5810_204_0	4	3	Tier 3 - Preferred Brand	2		
S5810	204	0		29	10	S5810_204_0	4	4	Tier 4 - Non-Preferred Brand	2		
S5810	204	0		29	10	S5810_204_0	4	1	Tier 1 - Preferred Generic	1	1	
S5810	204	0		29	10	S5810_204_0	4	5	Tier 5 - Specialty	2		
S5820	142	0		29	10	S5820_142_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5820	142	0		29	10	S5820_142_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5820	142	0		29	10	S5820_142_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5820	142	0		29	10	S5820_142_0	2	4	Tier 4 Specialty	2		
S5820	143	0		29	10	S5820_143_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5820	143	0		29	10	S5820_143_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5820	143	0		29	10	S5820_143_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5820	143	0		29	10	S5820_143_0	2	4	Tier 4 Specialty	2		
S5820	144	0		29	10	S5820_144_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5820	144	0		29	10	S5820_144_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5820	144	0		29	10	S5820_144_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5820	144	0		29	10	S5820_144_0	2	4	Tier 4 Specialty	2		
S5820	145	0		29	10	S5820_145_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5820	145	0		29	10	S5820_145_0	2	4	Tier 4 Specialty	2		
S5820	145	0		29	10	S5820_145_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5820	145	0		29	10	S5820_145_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5820	146	0		29	10	S5820_146_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5820	146	0		29	10	S5820_146_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5820	146	0		29	10	S5820_146_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5820	146	0		29	10	S5820_146_0	2	4	Tier 4 Specialty	2		
S5825	085	0		29	10	S5825_085_0	3	1	Generic	1	1	
S5825	085	0		29	10	S5825_085_0	3	2	Preferred Brand	2		
S5825	085	0		29	10	S5825_085_0	3	3	Non-Preferred Brand	2		
S5825	085	0		29	10	S5825_085_0	3	4	Specialty	2		
S5840	002	0		29	10	S5840_002_0	3	1	1	1	1	
S5840	002	0		29	10	S5840_002_0	3	4	4	1	2	01000000
S5840	002	0		29	10	S5840_002_0	3	3	3	2		
S5840	002	0		29	10	S5840_002_0	3	2	2	2		
S5884	031	0		29	10	S5884_031_0	2	4	Specialty	2		
S5884	031	0		29	10	S5884_031_0	2	3	Non-Preferred Brand	2		
S5884	031	0		29	10	S5884_031_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	031	0		29	10	S5884_031_0	2	1	Preferred Generic	1	1	
S5884	032	0		29	10	S5884_032_0	2	1	Preferred Generic	1	1	
S5884	032	0		29	10	S5884_032_0	2	4	Specialty	2		
S5884	032	0		29	10	S5884_032_0	2	3	Non-Preferred Brand	2		
S5884	032	0		29	10	S5884_032_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	033	0		29	10	S5884_033_0	2	3	Non-Preferred Brand	2		
S5884	033	0		29	10	S5884_033_0	2	4	Specialty	2		
S5884	033	0		29	10	S5884_033_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	033	0		29	10	S5884_033_0	2	1	Preferred Generic	1	1	
S5884	034	0		29	10	S5884_034_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	034	0		29	10	S5884_034_0	2	3	Non-Preferred Brand	2		
S5884	034	0		29	10	S5884_034_0	2	4	Specialty	2		
S5884	034	0		29	10	S5884_034_0	2	1	Preferred Generic	1	1	
S5884	035	0		29	10	S5884_035_0	2	4	Specialty	2		
S5884	035	0		29	10	S5884_035_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	035	0		29	10	S5884_035_0	2	1	Preferred Generic	1	1	
S5884	035	0		29	10	S5884_035_0	2	3	Non-Preferred Brand	2		
S5884	036	0		29	10	S5884_036_0	2	1	Preferred Generic	1	1	
S5884	036	0		29	10	S5884_036_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	036	0		29	10	S5884_036_0	2	4	Specialty	2		
S5884	036	0		29	10	S5884_036_0	2	3	Non-Preferred Brand	2		
S5884	037	0		29	10	S5884_037_0	2	3	Non-Preferred Brand	2		
S5884	037	0		29	10	S5884_037_0	2	4	Specialty	2		
S5884	037	0		29	10	S5884_037_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	037	0		29	10	S5884_037_0	2	1	Preferred Generic	1	1	
S5884	038	0		29	10	S5884_038_0	2	1	Preferred Generic	1	1	
S5884	038	0		29	10	S5884_038_0	2	3	Non-Preferred Brand	2		
S5884	038	0		29	10	S5884_038_0	2	4	Specialty	2		
S5884	038	0		29	10	S5884_038_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	039	0		29	10	S5884_039_0	2	1	Preferred Generic	1	1	
S5884	039	0		29	10	S5884_039_0	2	4	Specialty	2		
S5884	039	0		29	10	S5884_039_0	2	3	Non-Preferred Brand	2		
S5884	039	0		29	10	S5884_039_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	040	0		29	10	S5884_040_0	2	1	Preferred Generic	1	1	
S5884	040	0		29	10	S5884_040_0	2	4	Specialty	2		
S5884	040	0		29	10	S5884_040_0	2	3	Non-Preferred Brand	2		
S5884	040	0		29	10	S5884_040_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	041	0		29	10	S5884_041_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	041	0		29	10	S5884_041_0	2	1	Preferred Generic	1	1	
S5884	041	0		29	10	S5884_041_0	2	4	Specialty	2		
S5884	041	0		29	10	S5884_041_0	2	3	Non-Preferred Brand	2		
S5884	042	0		29	10	S5884_042_0	2	3	Non-Preferred Brand	2		
S5884	042	0		29	10	S5884_042_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	042	0		29	10	S5884_042_0	2	1	Preferred Generic	1	1	
S5884	042	0		29	10	S5884_042_0	2	4	Specialty	2		
S5884	043	0		29	10	S5884_043_0	2	4	Specialty	2		
S5884	043	0		29	10	S5884_043_0	2	1	Preferred Generic	1	1	
S5884	043	0		29	10	S5884_043_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	043	0		29	10	S5884_043_0	2	3	Non-Preferred Brand	2		
S5884	044	0		29	10	S5884_044_0	2	1	Preferred Generic	1	1	
S5884	044	0		29	10	S5884_044_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	044	0		29	10	S5884_044_0	2	4	Specialty	2		
S5884	044	0		29	10	S5884_044_0	2	3	Non-Preferred Brand	2		
S5884	045	0		29	10	S5884_045_0	2	4	Specialty	2		
S5884	045	0		29	10	S5884_045_0	2	3	Non-Preferred Brand	2		
S5884	045	0		29	10	S5884_045_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	045	0		29	10	S5884_045_0	2	1	Preferred Generic	1	1	
S5884	046	0		29	10	S5884_046_0	2	3	Non-Preferred Brand	2		
S5884	046	0		29	10	S5884_046_0	2	4	Specialty	2		
S5884	046	0		29	10	S5884_046_0	2	1	Preferred Generic	1	1	
S5884	046	0		29	10	S5884_046_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	047	0		29	10	S5884_047_0	2	1	Preferred Generic	1	1	
S5884	047	0		29	10	S5884_047_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	047	0		29	10	S5884_047_0	2	3	Non-Preferred Brand	2		
S5884	047	0		29	10	S5884_047_0	2	4	Specialty	2		
S5884	048	0		29	10	S5884_048_0	2	4	Specialty	2		
S5884	048	0		29	10	S5884_048_0	2	3	Non-Preferred Brand	2		
S5884	048	0		29	10	S5884_048_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	048	0		29	10	S5884_048_0	2	1	Preferred Generic	1	1	
S5884	049	0		29	10	S5884_049_0	2	1	Preferred Generic	1	1	
S5884	049	0		29	10	S5884_049_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	049	0		29	10	S5884_049_0	2	3	Non-Preferred Brand	2		
S5884	049	0		29	10	S5884_049_0	2	4	Specialty	2		
S5884	050	0		29	10	S5884_050_0	2	4	Specialty	2		
S5884	050	0		29	10	S5884_050_0	2	3	Non-Preferred Brand	2		
S5884	050	0		29	10	S5884_050_0	2	1	Preferred Generic	1	1	
S5884	050	0		29	10	S5884_050_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	051	0		29	10	S5884_051_0	2	3	Non-Preferred Brand	2		
S5884	051	0		29	10	S5884_051_0	2	4	Specialty	2		
S5884	051	0		29	10	S5884_051_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	051	0		29	10	S5884_051_0	2	1	Preferred Generic	1	1	
S5884	052	0		29	10	S5884_052_0	2	4	Specialty	2		
S5884	052	0		29	10	S5884_052_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	052	0		29	10	S5884_052_0	2	1	Preferred Generic	1	1	
S5884	052	0		29	10	S5884_052_0	2	3	Non-Preferred Brand	2		
S5884	053	0		29	10	S5884_053_0	2	4	Specialty	2		
S5884	053	0		29	10	S5884_053_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	053	0		29	10	S5884_053_0	2	1	Preferred Generic	1	1	
S5884	053	0		29	10	S5884_053_0	2	3	Non-Preferred Brand	2		
S5884	058	0		29	10	S5884_058_0	2	3	Non-Preferred Brand	2		
S5884	058	0		29	10	S5884_058_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	058	0		29	10	S5884_058_0	2	1	Preferred Generic	1	1	
S5884	058	0		29	10	S5884_058_0	2	4	Specialty	2		
S5884	059	0		29	10	S5884_059_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	059	0		29	10	S5884_059_0	2	4	Specialty	2		
S5884	059	0		29	10	S5884_059_0	2	3	Non-Preferred Brand	2		
S5884	059	0		29	10	S5884_059_0	2	1	Preferred Generic	1	1	
S5884	060	0		29	10	S5884_060_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	060	0		29	10	S5884_060_0	2	4	Specialty	2		
S5884	060	0		29	10	S5884_060_0	2	3	Non-Preferred Brand	2		
S5884	060	0		29	10	S5884_060_0	2	1	Preferred Generic	1	1	
S5884	099	0		29	10	S5884_099_0	2	2	Non-Preferred Generic/Preferred Brand	2		
S5884	099	0		29	10	S5884_099_0	2	1	Preferred Generic	1	1	
S5884	099	0		29	10	S5884_099_0	2	4	Specialty	2		
S5884	099	0		29	10	S5884_099_0	2	3	Non-Preferred Brand	2		
S5904	002	0		29	10	S5904_002_0	2	4	Tier S - Covered Specialty	1	2	01000000
S5904	002	0		29	10	S5904_002_0	2	3	Tier 3 - Covered Brand	2		
S5904	002	0		29	10	S5904_002_0	2	2	Tier 2 - Covered Preferred Brand	2		
S5904	002	0		29	10	S5904_002_0	2	1	Tier 1 - Covered Generic	1	1	
S5915	002	0		29	10	S5915_002_0	5	3	Non-Preferred Brand or Generic	2		
S5915	002	0		29	10	S5915_002_0	5	2	Preferred Brand	2		
S5915	002	0		29	10	S5915_002_0	5	1	Preferred Generic	1	1	
S5915	002	0		29	10	S5915_002_0	5	4	Specialty	2		
S5916	002	0		29	10	S5916_002_0	3	4	Miscellaneous Injectables	2		
S5916	002	0		29	10	S5916_002_0	3	3	Non-Preferred Brand	2		
S5916	002	0		29	10	S5916_002_0	3	2	Preferred Brand	2		
S5916	002	0		29	10	S5916_002_0	3	1	Generic	1	1	
S5916	002	0		29	10	S5916_002_0	3	5	Specialty	2		
S5921	003	0		29	10	S5921_003_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	003	0		29	10	S5921_003_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	003	0		29	10	S5921_003_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	003	0		29	10	S5921_003_0	2	4	Tier 4 Specialty	2		
S5921	013	0		29	10	S5921_013_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	013	0		29	10	S5921_013_0	2	4	Tier 4 Specialty	2		
S5921	013	0		29	10	S5921_013_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	013	0		29	10	S5921_013_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	023	0		29	10	S5921_023_0	2	4	Tier 4 Specialty	2		
S5921	023	0		29	10	S5921_023_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	023	0		29	10	S5921_023_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	023	0		29	10	S5921_023_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	033	0		29	10	S5921_033_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	033	0		29	10	S5921_033_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	033	0		29	10	S5921_033_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	033	0		29	10	S5921_033_0	2	4	Tier 4 Specialty	2		
S5921	043	0		29	10	S5921_043_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	043	0		29	10	S5921_043_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	043	0		29	10	S5921_043_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	043	0		29	10	S5921_043_0	2	4	Tier 4 Specialty	2		
S5921	053	0		29	10	S5921_053_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	053	0		29	10	S5921_053_0	2	4	Tier 4 Specialty	2		
S5921	053	0		29	10	S5921_053_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	053	0		29	10	S5921_053_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	063	0		29	10	S5921_063_0	2	4	Tier 4 Specialty	2		
S5921	063	0		29	10	S5921_063_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	063	0		29	10	S5921_063_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	063	0		29	10	S5921_063_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	073	0		29	10	S5921_073_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	073	0		29	10	S5921_073_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	073	0		29	10	S5921_073_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	073	0		29	10	S5921_073_0	2	4	Tier 4 Specialty	2		
S5921	083	0		29	10	S5921_083_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	083	0		29	10	S5921_083_0	2	4	Tier 4 Specialty	2		
S5921	083	0		29	10	S5921_083_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	083	0		29	10	S5921_083_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	093	0		29	10	S5921_093_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	093	0		29	10	S5921_093_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	093	0		29	10	S5921_093_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	093	0		29	10	S5921_093_0	2	4	Tier 4 Specialty	2		
S5921	103	0		29	10	S5921_103_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	103	0		29	10	S5921_103_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	103	0		29	10	S5921_103_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	103	0		29	10	S5921_103_0	2	4	Tier 4 Specialty	2		
S5921	113	0		29	10	S5921_113_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	113	0		29	10	S5921_113_0	2	4	Tier 4 Specialty	2		
S5921	113	0		29	10	S5921_113_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	113	0		29	10	S5921_113_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	123	0		29	10	S5921_123_0	2	4	Tier 4 Specialty	2		
S5921	123	0		29	10	S5921_123_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	123	0		29	10	S5921_123_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	123	0		29	10	S5921_123_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	133	0		29	10	S5921_133_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	133	0		29	10	S5921_133_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	133	0		29	10	S5921_133_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	133	0		29	10	S5921_133_0	2	4	Tier 4 Specialty	2		
S5921	143	0		29	10	S5921_143_0	2	4	Tier 4 Specialty	2		
S5921	143	0		29	10	S5921_143_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	143	0		29	10	S5921_143_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	143	0		29	10	S5921_143_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	153	0		29	10	S5921_153_0	2	4	Tier 4 Specialty	2		
S5921	153	0		29	10	S5921_153_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	153	0		29	10	S5921_153_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	153	0		29	10	S5921_153_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	163	0		29	10	S5921_163_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	163	0		29	10	S5921_163_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	163	0		29	10	S5921_163_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	163	0		29	10	S5921_163_0	2	4	Tier 4 Specialty	2		
S5921	173	0		29	10	S5921_173_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	173	0		29	10	S5921_173_0	2	4	Tier 4 Specialty	2		
S5921	173	0		29	10	S5921_173_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	173	0		29	10	S5921_173_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	183	0		29	10	S5921_183_0	2	4	Tier 4 Specialty	2		
S5921	183	0		29	10	S5921_183_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	183	0		29	10	S5921_183_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	183	0		29	10	S5921_183_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	193	0		29	10	S5921_193_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	193	0		29	10	S5921_193_0	2	4	Tier 4 Specialty	2		
S5921	193	0		29	10	S5921_193_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	193	0		29	10	S5921_193_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	213	0		29	10	S5921_213_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	213	0		29	10	S5921_213_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	213	0		29	10	S5921_213_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	213	0		29	10	S5921_213_0	2	4	Tier 4 Specialty	2		
S5921	223	0		29	10	S5921_223_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	223	0		29	10	S5921_223_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	223	0		29	10	S5921_223_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	223	0		29	10	S5921_223_0	2	4	Tier 4 Specialty	2		
S5921	233	0		29	10	S5921_233_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	233	0		29	10	S5921_233_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	233	0		29	10	S5921_233_0	2	4	Tier 4 Specialty	2		
S5921	233	0		29	10	S5921_233_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	235	0		29	10	S5921_235_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	235	0		29	10	S5921_235_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	235	0		29	10	S5921_235_0	2	4	Tier 4 Specialty	2		
S5921	235	0		29	10	S5921_235_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	239	0		29	10	S5921_239_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	239	0		29	10	S5921_239_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	239	0		29	10	S5921_239_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	239	0		29	10	S5921_239_0	2	4	Tier 4 Specialty	2		
S5921	249	0		29	10	S5921_249_0	2	4	Tier 4 Specialty	2		
S5921	249	0		29	10	S5921_249_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	249	0		29	10	S5921_249_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	249	0		29	10	S5921_249_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	263	0		29	10	S5921_263_0	2	4	Tier 4 Specialty	2		
S5921	263	0		29	10	S5921_263_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	263	0		29	10	S5921_263_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	263	0		29	10	S5921_263_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	273	0		29	10	S5921_273_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	273	0		29	10	S5921_273_0	2	4	Tier 4 Specialty	2		
S5921	273	0		29	10	S5921_273_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	273	0		29	10	S5921_273_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	283	0		29	10	S5921_283_0	2	4	Tier 4 Specialty	2		
S5921	283	0		29	10	S5921_283_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	283	0		29	10	S5921_283_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	283	0		29	10	S5921_283_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	293	0		29	10	S5921_293_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	293	0		29	10	S5921_293_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	293	0		29	10	S5921_293_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	293	0		29	10	S5921_293_0	2	4	Tier 4 Specialty	2		
S5921	303	0		29	10	S5921_303_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	303	0		29	10	S5921_303_0	2	4	Tier 4 Specialty	2		
S5921	303	0		29	10	S5921_303_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	303	0		29	10	S5921_303_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	313	0		29	10	S5921_313_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	313	0		29	10	S5921_313_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	313	0		29	10	S5921_313_0	2	4	Tier 4 Specialty	2		
S5921	313	0		29	10	S5921_313_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	323	0		29	10	S5921_323_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	323	0		29	10	S5921_323_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5921	323	0		29	10	S5921_323_0	2	4	Tier 4 Specialty	2		
S5921	323	0		29	10	S5921_323_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	333	0		29	10	S5921_333_0	2	3	Tier 3 Non-Preferred Generic  Non-Preferred Brand	2		
S5921	333	0		29	10	S5921_333_0	2	4	Tier 4 Specialty	2		
S5921	333	0		29	10	S5921_333_0	2	2	Tier 2 Generic  Preferred Brand	2		
S5921	333	0		29	10	S5921_333_0	2	1	Tier 1 Preferred Generic  Brand	1	1	
S5953	002	0		29	10	S5953_002_0	2	5	Specialty	2		
S5953	002	0		29	10	S5953_002_0	2	4	Non-Preferred Brand	2		
S5953	002	0		29	10	S5953_002_0	2	3	Preferred Brand	2		
S5953	002	0		29	10	S5953_002_0	2	1	Value Generics	1	1	
S5953	002	0		29	10	S5953_002_0	2	2	Generics	1	1	
S5954	005	0		29	10	S5954_005_0	1	4	Tier 4	2		
S5954	005	0		29	10	S5954_005_0	1	3	Tier 3	2		
S5954	005	0		29	10	S5954_005_0	1	2	Tier 2	2		
S5954	005	0		29	10	S5954_005_0	1	1	Tier 1	1	1	
S5983	005	0		29	10	S5983_005_0	3	1	Generic	1	1	
S5983	005	0		29	10	S5983_005_0	3	2	Preferred Brand	2		
S5983	005	0		29	10	S5983_005_0	3	3	Non-Preferred Brand	2		
S5983	005	0		29	10	S5983_005_0	3	4	Specialty	2		
S5993	003	0		29	10	S5993_003_0	4	4	Specialty	2		
S5993	003	0		29	10	S5993_003_0	4	1	Generic	1	1	
S5993	003	0		29	10	S5993_003_0	4	2	Preferred Brand	2		
S5993	003	0		29	10	S5993_003_0	4	3	Non-Preferred	2		
S8067	003	0		29	10	S8067_003_0	6	1	Generic Drugs	1	1	
S8067	003	0		29	10	S8067_003_0	6	4	Specialty Drugs	2		
S8067	003	0		29	10	S8067_003_0	6	3	Non-Preferred Brand Drugs	2		
S8067	003	0		29	10	S8067_003_0	6	2	Preferred Brand Drugs	2		
