pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_c_pos_outpt_group_num_id	pbp_c_pos_group_lbl	pbp_c_pos_oupt_bencat_bens	pbp_c_pos_outpt_mc_bencats	pbp_c_pos_outpt_nmc_bencats	pbp_c_pos_outpt_coins_yn	pbp_c_pos_outpt_coins_min_pct	pbp_c_pos_outpt_coins_max_pct	pbp_c_pos_outpt_copay_yn	pbp_c_pos_outpt_copay_min_amt	pbp_c_pos_outpt_copay_max_amt	pbp_c_pos_outpt_maxplan_yn	pbp_c_pos_outpt_maxplan_amt	pbp_c_pos_outpt_maxplan_per	pbp_c_pos_outpt_deduct_yn	pbp_c_pos_outpt_deduct_amt	pbp_c_pos_outpt_cost_share	pbp_c_pos_outpt_cs_coins_yn	pbp_c_pos_outpt_cs_coins_min	pbp_c_pos_outpt_cs_coins_max	pbp_c_pos_outpt_cs_copay_yn	pbp_c_pos_outpt_cs_copay_min	pbp_c_pos_outpt_cs_copay_max
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H2320	007	0	1	02	01	H2320_007_0	10	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	007	0	1	02	01	H2320_007_0	10	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100001	2			2			2			2								
H2320	007	0	1	02	01	H2320_007_0	10	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	007	0	1	02	01	H2320_007_0	10	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	007	0	1	02	01	H2320_007_0	10	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	008	0	1	02	01	H2320_008_0	8	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	008	0	1	02	01	H2320_008_0	8	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	008	0	1	02	01	H2320_008_0	8	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100001	2			2			2			2								
H2320	008	0	1	02	01	H2320_008_0	8	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	008	0	1	02	01	H2320_008_0	8	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	011	0	1	02	01	H2320_011_0	10	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	011	0	1	02	01	H2320_011_0	10	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100000	2			2			2			2								
H2320	011	0	1	02	01	H2320_011_0	10	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	011	0	1	02	01	H2320_011_0	10	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	011	0	1	02	01	H2320_011_0	10	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	012	0	1	02	01	H2320_012_0	9	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	012	0	1	02	01	H2320_012_0	9	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	012	0	1	02	01	H2320_012_0	9	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100000	2			2			2			2								
H2320	012	0	1	02	01	H2320_012_0	9	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	012	0	1	02	01	H2320_012_0	9	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	013	0	1	02	01	H2320_013_0	8	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	013	0	1	02	01	H2320_013_0	8	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	013	0	1	02	01	H2320_013_0	8	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100001	2			2			2			2								
H2320	013	0	1	02	01	H2320_013_0	8	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	013	0	1	02	01	H2320_013_0	8	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	015	0	1	02	01	H2320_015_0	8	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	015	0	1	02	01	H2320_015_0	8	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	015	0	1	02	01	H2320_015_0	8	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	015	0	1	02	01	H2320_015_0	8	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100000	2			2			2			2								
H2320	015	0	1	02	01	H2320_015_0	8	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	016	0	1	02	01	H2320_016_0	8	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	016	0	1	02	01	H2320_016_0	8	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100001	2			2			2			2								
H2320	016	0	1	02	01	H2320_016_0	8	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	016	0	1	02	01	H2320_016_0	8	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	016	0	1	02	01	H2320_016_0	8	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	018	0	1	02	01	H2320_018_0	8	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100000	2			2			2			2								
H2320	018	0	1	02	01	H2320_018_0	8	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	018	0	1	02	01	H2320_018_0	8	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	018	0	1	02	01	H2320_018_0	8	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	018	0	1	02	01	H2320_018_0	8	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	019	0	1	02	01	H2320_019_0	8	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	019	0	1	02	01	H2320_019_0	8	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	019	0	1	02	01	H2320_019_0	8	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100001	2			2			2			2								
H2320	019	0	1	02	01	H2320_019_0	8	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	019	0	1	02	01	H2320_019_0	8	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	021	0	1	02	01	H2320_021_0	8	2	20% Coinsurance	01	0000000000000000000000000000000010000		1	20	20	2			2			2								
H2320	021	0	1	02	01	H2320_021_0	8	3	$0 Copayment	11	0000010000000000000000000000000000000	000000000100000000000000100000	2			2			2			2								
H2320	021	0	1	02	01	H2320_021_0	8	5	$100 Copayment	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2320	021	0	1	02	01	H2320_021_0	8	4	40% Coinsurance	01	0000100000000000000000000000000000000		1	40	40	2			2			2								
H2320	021	0	1	02	01	H2320_021_0	8	1	30% Coinsurance	11	0111001111111111111111110111111100101	000000000000000000000100000000	1	30	30	2			2			2		2						
H2320	802	0	1	02	01	H2320_802_0	5	1	20% Coinsurance	01	0111111111111111111111111111011101111		1	20	20	2			2			2		2						
H2320	803	0	1	02	01	H2320_803_0	5	1	20% Coinsurance	01	0111111111111111111111111111011101111		1	20	20	2			2			2		2						
H2354	001	0	1	02	01	H2354_001_0	7	1	30% Coinsurance	01	0000000000000000000000000110000010000		1	30	30	2			1	1000.00	3	2								
H2354	001	0	1	02	01	H2354_001_0	7	2	20% Coinsurance	11	0111111111111111111111111001110100101	000000000100000000000010000000	1	20	20	2			1	1000.00	3	2		2						
H2354	013	0	1	02	01	H2354_013_0	6	1	30% Coinsurance	01	0000000000000000000000000110000010000		1	30	30	2			1	1500.00	3	2								
H2354	013	0	1	02	01	H2354_013_0	6	2	20% Coinsurance	11	0111111111111111111111111001110100001	000000000000000000000010000000	1	20	20	2			1	1500.00	3	2		2						
H2354	015	0	1	02	01	H2354_015_0	6	3	50% Group	01	0000000000000000000000000110000010000		1	50	50	2			2			2								
H2354	015	0	1	02	01	H2354_015_0	6	2	20% Coinsurance	11	0111111101111101100000110001110100000	000000000000000000000010000000	1	20	20	2			1	1000.00	3	2		2						
H2354	015	0	1	02	01	H2354_015_0	6	1	30% Coinsurance	01	0000000010000010011111000000100000000		1	30	30	2			1	1000.00	3	2		2						
H2354	801	0	1	02	01	H2354_801_0	3	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H2354	801	0	1	02	01	H2354_801_0	3	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H2354	802	0	1	02	01	H2354_802_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H2354	802	0	1	02	01	H2354_802_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H2354	805	0	1	02	01	H2354_805_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H2354	805	0	1	02	01	H2354_805_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H2425	002	0	1	02	01	H2425_002_0	6	1	Group 1	11	0111111111111111111111111111011111111	000000000000000000000100001010	1	40	40	2			2			2		2						
H2425	002	0	1	02	01	H2425_002_0	6	2	Group 2	01	0000000000000000000000000000110000000		1	0	40	2			2			2								
H2425	801	0	1	02	01	H2425_801_0	2	1	Group 1	01	0111111111111111111111111111001111111		1	50	50	2			2			2		2						
H2425	801	0	1	02	01	H2425_801_0	2	2	Group 2	01	0000000000000000000000000000110000000		1	0	50	2			2			2								
H2459	001	0	1	02	01	H2459_001_0	7	4	Group 4	01	0000000000000000000000000000010000000		1	0	20	2			2			2								
H2459	001	0	1	02	01	H2459_001_0	7	3	Group 3	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2459	001	0	1	02	01	H2459_001_0	7	1	Group 1	01	0111111011111111011111110111001111101		1	20	20	2			2			2		2						
H2459	001	0	1	02	01	H2459_001_0	7	2	Group 2	01	0000000000000000100000000000100000000		2			2			2			2		2						
H2459	002	0	1	02	01	H2459_002_0	6	3	Group 3	01	0000000000000000000000000000010000000		1	0	20	2			2			2								
H2459	002	0	1	02	01	H2459_002_0	6	4	Group 4	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2459	002	0	1	02	01	H2459_002_0	6	2	Group 2	11	0000000000000000100000000000100000000	000000000000000000000000100100	2			2			2			2		2						
H2459	002	0	1	02	01	H2459_002_0	6	1	Group 1	01	0111111011111111011111110111001111101		1	20	20	2			2			2		2						
H2459	013	0	1	02	01	H2459_013_0	9	4	Group 4	01	0000000000000000000000000000010000000		1	0	20	2			2			2								
H2459	013	0	1	02	01	H2459_013_0	9	3	Group 3	01	0000000000000000000000001000000000000		2			1	100.00	100.00	2			2								
H2459	013	0	1	02	01	H2459_013_0	9	1	Group 1	01	0111111011111111011111110111001111101		1	20	20	2			2			2		2						
H2459	013	0	1	02	01	H2459_013_0	9	2	Group 2	01	0000000000000000100000000000100000000		2			2			2			2		2						
H2459	019	0	1	02	01	H2459_019_0	9	1	Group 1	01	0111111011111111011111110111001111101		1	20	20	2			2			2		2						
H2459	019	0	1	02	01	H2459_019_0	9	4	Group 4	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H2459	019	0	1	02	01	H2459_019_0	9	3	Goup 3	11	0000000000000000100000000000100000000	000000000000000000000000110000	2			2			2			2		2						
H2459	019	0	1	02	01	H2459_019_0	9	2	Group 2	01	0000000000000000000000000000010000000		1	0	20	2			2			2								
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H2459	801	0	1	02	01	H2459_801_0	6	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H2459	805	0	1	02	01	H2459_805_0	3	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
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H2491	004	0	1	02	01	H2491_004_0	4	1		01	0111010111011011111111011011001110000		1	20	20	2			2			2		2						
H2610	014	0	1	02	01	H2610_014_0	6	2	group 2_0	01	0000000000000000000000001000011000000		2			2			2			2								
H2610	014	0	1	02	01	H2610_014_0	6	1	group 1_20	01	0111110111111111111111110111100110000		1	20	20	2			2			2		2						
H2649	021	0	1	02	01	H2649_021_0	6	7		01	0000000000000000000000100000000010010		1	30	30	2			2			2								
H2649	021	0	1	02	01	H2649_021_0	6	6		01	0000000000000000000010000000000000000		1	20	30	2			2			2								
H2649	021	0	1	02	01	H2649_021_0	6	1		11	0000000000000000000000010000000000000	000000000100000000000000000000	2			1	0.00	0.00	2			2								
H2649	021	0	1	02	01	H2649_021_0	6	4		01	0000000101111100000000000000000001101		2			1	50.00	50.00	2			2		2						
H2649	021	0	1	02	01	H2649_021_0	6	3		01	0000000000000000000000000000001000000		2			1	20.00	50.00	2			2								
H2649	021	0	1	02	01	H2649_021_0	6	2		11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	20.00	20.00	2			2								
H2649	021	0	1	02	01	H2649_021_0	6	11		01	0111000010000010001000000000000000000		1	30	30	1	50.00	50.00	2			2		2						
H2649	021	0	1	02	01	H2649_021_0	6	10		01	0000000000000000010000000000000000000		1	30	30	1	275.00	275.00	2			2		2						
H2649	021	0	1	02	01	H2649_021_0	6	8		01	0000000000000000000000000000010000000		1	30	30	1	0.00	50.00	2			2								
H2649	021	0	1	02	01	H2649_021_0	6	9		01	0000000000000001100100000000000100000		1	30	30	1	20.00	50.00	2			2		2						
H2649	021	0	1	02	01	H2649_021_0	6	5		01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H2649	030	0	1	02	01	H2649_030_0	7	8		01	0000000000000001100100000000000000000		1	30	30	1	35.00	35.00	2			2		2						
H2649	030	0	1	02	01	H2649_030_0	7	9		10		000000000010000000000000000000	1	50	50	2			2			2								
H2649	030	0	1	02	01	H2649_030_0	7	7		01	0000000001001000000000000000000000000		1	30	30	1	15.00	15.00	2			2								
H2649	030	0	1	02	01	H2649_030_0	7	6		01	0111110110110110011001100111001111111		1	30	30	2			2			2		2						
H2649	030	0	1	02	01	H2649_030_0	7	5		01	0000000000000000000010000000000000000		1	20	30	1	15.00	15.00	2			2								
H2649	030	0	1	02	01	H2649_030_0	7	4		01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H2649	030	0	1	02	01	H2649_030_0	7	3		01	0000000000000000000000000000010000000		1	0	30	2			2			2								
H2649	030	0	1	02	01	H2649_030_0	7	2		01	0000000000000000000000001000000000000		2			1	225.00	225.00	2			2								
H2649	030	0	1	02	01	H2649_030_0	7	1		11	0000000000000000000000010000000000000	000000000100000000000000001100	2			1	0.00	0.00	2			2								
H2654	013	0	1	02	01	H2654_013_0	6	1	Group 1	01	0111000010000010000001000000000000000		1	35	35	2			2			2								
H2654	013	0	1	02	01	H2654_013_0	6	2	Group 2	01	0000000000000001111110000000000000000		1	35	35	1	13.00	21.00	2			2		2						
H2654	013	0	1	02	01	H2654_013_0	6	3	Group 3	10		000000000000000000000010000000	2			1	0.00	0.00	2			2								
H2654	013	0	1	02	01	H2654_013_0	6	4	Group 4	01	0000000000100100000000100000000000000		2			1	35.00	45.00	2			2								
H2663	002	0	1	02	01	H2663_002_0	11	2	Ambulance	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H2663	002	0	1	02	01	H2663_002_0	11	1	Out of Network Coinsurance	11	0111111111111111111111110111010111101	000000010000000000000000000000	1	30	30	2			2			2		2						
H2663	015	0	1	02	01	H2663_015_0	10	4	Ambulance	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H2663	015	0	1	02	01	H2663_015_0	10	3	Preventative Dental	10		000000000000000000000000100000	1	50	50	2			2			2								
H2663	015	0	1	02	01	H2663_015_0	10	1	Out of Network Co-Insurance	11	0111111111111111111111110111011111101	000000010000000000000000000000	1	30	30	2			2			2		2						
H2663	015	0	1	02	01	H2663_015_0	10	2	Fitness	10		000000000000000000000010000000	2			1	50.00	50.00	2			2								
H2667	017	0	1	02	01	H2667_017_0	6	2		01	0000100001100100000011110000000000000		1	40	40	2			2			2								
H2667	017	0	1	02	01	H2667_017_0	6	1		11	0000000000000001111100000000000000000	000000000100000000000000000000	1	40	40	2			2			2		1	1	40	40	2		
H2911	001	0	1	02	01	H2911_001_0	8	1	40% coinsurance	11	0111111111111111111111110111011111111	000000000100000000000000000000	1	40	40	2			2			2		2						
H2911	001	0	1	02	01	H2911_001_0	8	2	Non Medicare Preventive Dental	10		000000000000000000000000100000	2			2			1	150.00	3	2								
H2911	001	0	1	02	01	H2911_001_0	8	3	Non Medicare Eye Exams	10		000000000000000000000000001000	2			2			1	50.00	3	2								
H2911	001	0	1	02	01	H2911_001_0	8	7	Ambulance	01	0000000000000000000000001000000000000		2			1	250.00	250.00	2			2								
H2911	001	0	1	02	01	H2911_001_0	8	5	Non Medicare Hearing Exams	10		000000000000000000000000000010	2			2			1	30.00	6	2								
H2911	001	0	1	02	01	H2911_001_0	8	6	ESRD	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H2911	001	0	1	02	01	H2911_001_0	8	4	Non Medicare Eye Wear	10		000000000000000000000000000100	1	20	20	2			1	100.00	3	2								
H3107	807	0	1	02	01	H3107_807_0	2	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3107	807	0	1	02	01	H3107_807_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
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H3154	802	0	1	02	01	H3154_802_0	5	1		11	0111111111111111111111111111111111111	000000000100000000000000001010	1	35	35	2			2			2		2						
H3154	805	0	1	02	01	H3154_805_0	6	1		11	0111111111111111111111111111111111111	000000000100000000000000001010	1	35	35	2			2			2		2						
H3251	021	0	1	02	01	H3251_021_0	9	1	Group 1 - 20%	01	0111110010100111111100110111000000000		1	20	20	2			2			2		2						
H3251	021	0	1	02	01	H3251_021_0	9	2	Group 2 - $45	01	0000000000010000000000000000000000000		2			1	45.00	45.00	2			2								
H3251	021	0	1	02	01	H3251_021_0	9	3	Group 3 - $400	01	0000000000000000000011000000000000000		2			1	400.00	400.00	2			2								
H3251	021	0	1	02	01	H3251_021_0	9	7	Group 7 - $40	01	0000000001001000000000000000000000000		2			1	40.00	40.00	2			2								
H3251	021	0	1	02	01	H3251_021_0	9	5	Group 5 - $20	01	0000001000000000000000000000000000000		2			1	20.00	20.00	2			2								
H3251	021	0	1	02	01	H3251_021_0	9	6	Group 6 - $0	01	0000000000000000000000000000011100000		2			2			2			2		2						
H3251	021	0	1	02	01	H3251_021_0	9	4	Group 4 - $130	01	0000000000000000000000001000000000000		2			1	130.00	130.00	2			2								
H3305	007	0	1	02	01	H3305_007_0	4	1	30% Coins	01	0111101111010011111111010110000000100		1	30	30	2			1	5000.00	3	2		2						
H3305	007	0	1	02	01	H3305_007_0	4	2	Ambulance	01	0000000000000000000000001000000000000		2			1	75.00	75.00	1	5000.00	3	2								
H3305	011	0	1	02	01	H3305_011_0	7	1	30% Coins	01	0111101111010011111111010110000000100		1	30	30	2			1	5000.00	3	2		2						
H3305	011	0	1	02	01	H3305_011_0	7	2	Ambulance	01	0000000000000000000000001000000000000		2			1	75.00	75.00	1	5000.00	3	2								
H3305	015	0	1	02	01	H3305_015_0	7	1	30% Coins	01	0111101111010011111111010110000000100		1	30	30	2			1	5000.00	3	2		2						
H3305	015	0	1	02	01	H3305_015_0	7	2	Ambulance	01	0000000000000000000000001000000000000		2			1	125.00	125.00	1	5000.00	3	2								
H3305	801	0	1	02	01	H3305_801_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3305	801	0	1	02	01	H3305_801_0	2	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3305	803	0	1	02	01	H3305_803_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3305	803	0	1	02	01	H3305_803_0	2	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3307	807	0	1	02	01	H3307_807_0	2	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3307	807	0	1	02	01	H3307_807_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3327	038	0	1	02	01	H3327_038_0	6	1		11	0111111111111111111111111111011100101	000000010100000000000010001010	1	22	22	2			2			2		2						
H3327	039	0	1	02	01	H3327_039_0	3	1		11	0111111111111111111111111111011100101	000000010100000000000010001010	1	20	20	2			2			2		2						
H3328	001	0	1	02	01	H3328_001_0	7	2	Specialty Services & ASC & Outpatient SA	01	0111100111111110000001100000000000000		1	50	50	2			2			2								
H3328	001	0	1	02	01	H3328_001_0	7	3	Outpatient Diagnostic	01	0000000000000001100000000000000000000		1	0	50	2			2			2		1	1	50	50	2		
H3328	001	0	1	02	01	H3328_001_0	7	1	Preventive Services	01	0000000000000000000000010000011100000		2			2			2			2		2						
H3328	003	0	1	02	01	H3328_003_0	10	3	Outpatient Diagnostic	01	0000000000000001100000000000000000000		1	0	50	2			2			2		1	1	50	50	2		
H3328	003	0	1	02	01	H3328_003_0	10	1	Preventive Services	01	0000000000000000000000010000011100000		2			2			2			2		2						
H3328	003	0	1	02	01	H3328_003_0	10	2	Specialty Services & ASC & Outpatient SA	01	0111100111111110000001100000000000000		1	50	50	2			2			2								
H3328	801	0	1	02	01	H3328_801_0	7	1	Medicare Covered	01	0111111111111111111111111111011100101		1	20	20	2			2			2		2						
H3328	802	0	1	02	01	H3328_802_0	7	1	Medicare Covered	01	0111111111111111111111111111011100101		1	20	20	2			2			2		2						
H3328	803	0	1	02	01	H3328_803_0	6	1	Medicare Covered	01	0111111111111111111111111111011100101		1	20	20	2			2			2		2						
H3351	001	0	1	02	01	H3351_001_0	5	1	POS Group #1	01	0111011111011011111111011111011110101		1	30	30	2			2			2		2						
H3351	002	0	1	02	01	H3351_002_0	6	1	POS Group #1	01	0111011111011011111111011111011110101		1	30	30	2			2			2		2						
H3351	006	0	1	02	01	H3351_006_0	6	1	POS Group #1	01	0111011111011011111111011111011110101		1	30	30	2			2			2		2						
H3351	007	0	1	02	01	H3351_007_0	5	1	POS Group #1	01	0111011111011011111111011111011110101		1	30	30	2			2			2		2						
H3351	801	0	1	02	01	H3351_801_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3351	801	0	1	02	01	H3351_801_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3351	802	0	1	02	01	H3351_802_0	3	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3351	802	0	1	02	01	H3351_802_0	3	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3351	803	0	1	02	01	H3351_803_0	3	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3351	803	0	1	02	01	H3351_803_0	3	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3351	804	0	1	02	01	H3351_804_0	3	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3351	804	0	1	02	01	H3351_804_0	3	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3351	805	0	1	02	01	H3351_805_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3351	805	0	1	02	01	H3351_805_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3351	806	0	1	02	01	H3351_806_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3351	806	0	1	02	01	H3351_806_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3361	099	0	1	02	01	H3361_099_0	5	1		01	0111010111011011111111011011001110000		1	20	20	2			2			2		2						
H3361	106	0	1	02	01	H3361_106_0	5	1		01	0111010111011011111111011011001110000		1	20	20	2			2			2		2						
H3361	132	0	1	02	01	H3361_132_0	5	1		01	0111010111011011111111011011001110000		1	20	20	2			2			2		2						
H3362	026	0	1	02	01	H3362_026_0	5	1	$45 POS OON copayment	01	0000001001001000000000000000000000000		2			1	45.00	45.00	1	1500.00	3	2								
H3362	026	0	1	02	01	H3362_026_0	5	2	POS OON 20%	01	0000000000000000100000000000000000000		1	20	20	2			2			2		1	2			1	45.00	45.00
H3362	807	0	1	02	01	H3362_807_0	3	1	20%	01	0111111111111111111111111111111111111		1	20	20	2			2			2		2						
H3362	817	0	1	02	01	H3362_817_0	2	1	20%	01	0111111111111111111111111111111111111		1	20	20	2			2			2		2						
H3362	819	0	1	02	01	H3362_819_0	3	1	20%	01	0111111111111111111111111111111111111		1	20	20	2			2			2		2						
H3384	057	0	1	02	01	H3384_057_0	6	1	POS Benefit	01	0000001011000011110100000000000000000		1	30	30	2			1	5000.00	3	2		2						
H3384	058	0	1	02	01	H3384_058_0	6	1	POS Benefit	01	0000001011000011110100000000000000000		1	20	20	2			1	1700.00	3	2		2						
H3384	059	0	1	02	01	H3384_059_0	6	1	POS Benefit	01	0000001011000011110100000000000000000		1	20	20	2			1	1700.00	3	2		2						
H3456	808	0	1	02	01	H3456_808_0	2	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3456	808	0	1	02	01	H3456_808_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3528	006	0	1	02	01	H3528_006_0	7	1	$40	11	0000001111011010000000000000000000101	000000000000000000000000001010	2			1	40.00	40.00	2			2		2						
H3528	006	0	1	02	01	H3528_006_0	7	2	$0	11	0111000000000000000000010000010000000	000000000100000000000100000000	2			2			2			2								
H3528	006	0	1	02	01	H3528_006_0	7	3	20%	01	0000000000000001111111000110100010000		1	20	20	2			2			2		2						
H3528	006	0	1	02	01	H3528_006_0	7	4	$200	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H3528	008	0	1	02	01	H3528_008_0	7	1	20%	11	0000001111011011111111000110100010101	000000000000000000000000001010	1	20	20	2			2			2		2						
H3528	008	0	1	02	01	H3528_008_0	7	2	$0	11	0111000000000000000000010000010000000	000000000100000000000100000000	2			2			2			2								
H3528	008	0	1	02	01	H3528_008_0	7	3	$275	01	0000000000000000000000001000000000000		2			1	275.00	275.00	2			2								
H3528	806	0	1	02	01	H3528_806_0	6	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3528	806	0	1	02	01	H3528_806_0	6	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3528	807	0	1	02	01	H3528_807_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3528	807	0	1	02	01	H3528_807_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3659	058	0	1	02	01	H3659_058_0	5	1	Group 1	11	0111111111111110000001111111001111101	000000010100000000000000001000	1	30	30	2			2			2		2						
H3659	058	0	1	02	01	H3659_058_0	5	2	Group 2	01	0000000000000000000010000000010000000		1	0	30	2			2			2								
H3659	058	0	1	02	01	H3659_058_0	5	3	Group 3	11	0000000000000000000000000000000000010	000000000000000000000000000100	2			1	0.00	0.00	2			2								
H3659	058	0	1	02	01	H3659_058_0	5	4	Group 4	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H3659	058	0	1	02	01	H3659_058_0	5	5	Group 5	01	0000000000000001111100000000000000000		1	0	30	2			2			2		1	1	30	30	2		
H3659	807	0	1	02	01	H3659_807_0	2	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3659	807	0	1	02	01	H3659_807_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3660	028	0	1	02	01	H3660_028_0	6	5	Group 5: 30% Coinsurance	01	0000000000000000000000000111000000000		1	30	30	2			2			2								
H3660	028	0	1	02	01	H3660_028_0	6	4	Group 4: $200 Copayment	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H3660	028	0	1	02	01	H3660_028_0	6	3	Group 3: $40 Copayment	01	0111100111111110000000100000000001101		2			1	40.00	40.00	2			2		2						
H3660	028	0	1	02	01	H3660_028_0	6	1	Group 1: 20% Coinsurance	01	0000010000000001111111010000100010000		1	20	20	2			2			2		2						
H3660	028	0	1	02	01	H3660_028_0	6	2	Group 2: $15 Copayment	01	0000001000000000000000000000011100000		2			1	15.00	15.00	2			2		2						
H3660	029	0	1	02	01	H3660_029_0	5	5	Group 5 $250 Copayment	01	0000000000000000000000001000000000000		2			1	250.00	250.00	2			2								
H3660	029	0	1	02	01	H3660_029_0	5	1	Group 1 20% Coinsurance	01	0000010000000001111111010000100010000		1	20	20	2			2			2		2						
H3660	029	0	1	02	01	H3660_029_0	5	2	Group 2 $15 copayment	01	0000001000000000000000000000011100000		2			1	15.00	15.00	2			2		2						
H3660	029	0	1	02	01	H3660_029_0	5	3	Group 3 $50 Copayment	01	0111100111111110000000100000000001101		2			1	50.00	50.00	2			2		2						
H3660	029	0	1	02	01	H3660_029_0	5	4	Group 4 30% Coinsurance	01	0000000000000000000000000111000000000		1	30	30	2			2			2								
H3660	048	0	1	02	01	H3660_048_0	5	2	Group 2: $15 copayment	01	0000001000000000000000000000011100000		2			1	15.00	15.00	2			2		2						
H3660	048	0	1	02	01	H3660_048_0	5	1	Group 1: 20% Coinsurance	01	0000010000000001111111010000100010000		1	20	20	2			2			2		2						
H3660	048	0	1	02	01	H3660_048_0	5	5	Group 5: $250 Copayment	01	0000000000000000000000001000000000000		2			1	250.00	250.00	2			2								
H3660	048	0	1	02	01	H3660_048_0	5	4	Group 4: 30% Coinsurance	01	0000000000000000000000000111000000000		1	30	30	2			2			2								
H3660	048	0	1	02	01	H3660_048_0	5	3	Group 3: $50 Copayment	01	0111100111111110000000100000000001101		2			1	50.00	50.00	2			2		2						
H3660	805	0	1	02	01	H3660_805_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3660	805	0	1	02	01	H3660_805_0	2	2		01	0000000000100100000000000000000000000		1	35	35	2			2			2								
H3660	805	0	1	02	01	H3660_805_0	2	3		01	0111101111011011111111111111101111111		1	20	20	2			2			2		2						
H3660	806	0	1	02	01	H3660_806_0	2	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3660	806	0	1	02	01	H3660_806_0	2	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3664	014	0	1	02	01	H3664_014_0	3	1	Fitness Partners	10		000000000000000000000010000000	2			2			1	120.00	3	2								
H3664	017	0	1	02	01	H3664_017_0	4	1	Fitness Partners	10		000000000000000000000010000000	2			2			1	120.00	3	2								
H3664	020	0	1	02	01	H3664_020_0	4	1	Fitness Partners	10		000000000000000000000010000000	2			2			1	120.00	3	2								
H3664	801	0	1	02	01	H3664_801_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3664	801	0	1	02	01	H3664_801_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3664	802	0	1	02	01	H3664_802_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3664	802	0	1	02	01	H3664_802_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3664	803	0	1	02	01	H3664_803_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3664	803	0	1	02	01	H3664_803_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3664	805	0	2	02	01	H3664_805_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3664	805	0	2	02	01	H3664_805_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3664	806	0	2	02	01	H3664_806_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H3664	806	0	2	02	01	H3664_806_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H3822	005	0	1	02	01	H3822_005_0	12	1	40% Coinsurance	01	0111110110111111111111110111101111111		1	40	40	2			2			2		2						
H3822	005	0	1	02	01	H3822_005_0	12	4	$200 Copay	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H3822	005	0	1	02	01	H3822_005_0	12	3	$0 Copay	01	0000000000000000000000000000010000000		2			1	0.00	0.00	2			2								
H3822	005	0	1	02	01	H3822_005_0	12	2	$50 Copay	01	0000001001000000000000000000000000000		2			1	50.00	50.00	2			2								
H3822	007	0	1	02	01	H3822_007_0	14	2	$75 Copay	01	0000001001000000000000000000000000000		2			1	75.00	75.00	2			2								
H3822	007	0	1	02	01	H3822_007_0	14	3	$200 Copay	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H3822	007	0	1	02	01	H3822_007_0	14	1	40% Coinsurance	01	0111110110111111101111110111001111111		1	40	40	2			2			2		2						
H3822	007	0	1	02	01	H3822_007_0	14	4	20% Coinsurance	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H3822	007	0	1	02	01	H3822_007_0	14	5	$400 copay	01	0000000000000000010000000000000000000		2			1	400.00	400.00	2			2		2						
H3822	008	0	1	02	01	H3822_008_0	16	5	$400.00 Copay	01	0000000000000000010000000000000000000		2			1	400.00	400.00	2			2		2						
H3822	008	0	1	02	01	H3822_008_0	16	3	$200 Copay	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H3822	008	0	1	02	01	H3822_008_0	16	2	$75 Copay	01	0000001001000000000000000000000000000		2			1	75.00	75.00	2			2								
H3822	008	0	1	02	01	H3822_008_0	16	4	20% Coinsurance	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H3822	008	0	1	02	01	H3822_008_0	16	1	40% Coinsurance	01	0111110110111111101111110111001111111		1	40	40	2			2			2		2						
H3887	001	0	1	02	01	H3887_001_0	5	5	Group 5	01	0000000000000001111100000000000000000		1	0	30	2			2			2		1	1	30	30	2		
H3887	001	0	1	02	01	H3887_001_0	5	4	Group 4	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H3887	001	0	1	02	01	H3887_001_0	5	3	Group 3	11	0000000000000000000000000000000000010	000000000000000000000000000100	2			1	0.00	0.00	2			2								
H3887	001	0	1	02	01	H3887_001_0	5	2	Group 2	01	0000000000000000000010000000010000000		1	0	30	2			2			2								
H3887	001	0	1	02	01	H3887_001_0	5	1	Group 1	11	0111111111111110000001111111001111101	000000010100000000000000001000	1	30	30	2			2			2		2						
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H3887	003	0	1	02	01	H3887_003_0	5	1	Group 1	01	0000000000000000000001000011001010010		1	40	40	2			2			2								
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H3887	003	0	1	02	01	H3887_003_0	5	4	Group 4	01	0000100000000000000000000000000000000		2			1	75.00	75.00	2			2								
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H3945	003	0	1	02	01	H3945_003_0	5	2	Air Ambulance	01	0000000000000000000000001000000000000		1	20	20	2			2			2								
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H3949	027	0	1	02	01	H3949_027_0	2	1	20% Group	01	0000011111001010000011011000100010000		1	20	20	2			2			2								
H3949	027	0	1	02	01	H3949_027_0	2	2	30% Group	01	0000100000100100000000100000000000000		1	30	30	2			2			2								
H3949	027	0	1	02	01	H3949_027_0	2	3	0% Group	01	0000000000000000000000000000011100000		2			1	0.00	0.00	2			2		2						
H3949	027	0	1	02	01	H3949_027_0	2	4	20% Group with Separate Cost Sharing	01	0000000000000001111100000000000000000		1	20	20	2			2			2		1	1	20	20	2		
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H3954	140	0	1	02	01	H3954_140_0	3	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3954	140	0	1	02	01	H3954_140_0	3	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	140	0	1	02	01	H3954_140_0	3	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	140	0	1	02	01	H3954_140_0	3	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	140	0	1	02	01	H3954_140_0	3	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	140	0	1	02	01	H3954_140_0	3	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	140	0	1	02	01	H3954_140_0	3	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	141	0	1	02	01	H3954_141_0	4	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	141	0	1	02	01	H3954_141_0	4	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	141	0	1	02	01	H3954_141_0	4	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	141	0	1	02	01	H3954_141_0	4	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3954	141	0	1	02	01	H3954_141_0	4	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	141	0	1	02	01	H3954_141_0	4	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	141	0	1	02	01	H3954_141_0	4	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	142	0	1	02	01	H3954_142_0	3	1	Primary Care Physician	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	142	0	1	02	01	H3954_142_0	3	2	Other professional services	11	0000000011011010000000000000000000101	000000010000000000000000001010	2			1	30.00	30.00	2			2		2						
H3954	142	0	1	02	01	H3954_142_0	3	3	Other POS benefits	11	0000100000100101110011110000011101010	000000010000000000000010100000	1	15	15	2			2			2		2						
H3954	142	0	1	02	01	H3954_142_0	3	4	Other POS $25	01	0111000100000000000100000000000000000		2			1	25.00	25.00	2			2		2						
H3954	142	0	1	02	01	H3954_142_0	3	7	other POS 25%	01	0000010000000000000000000000100000000		1	25	25	2			2			2								
H3954	142	0	1	02	01	H3954_142_0	3	6	Hearing Aid	10		000000000000000000000000000001	2			1	0.00	0.00	1	1000.00	1	2								
H3954	142	0	1	02	01	H3954_142_0	3	5	Routine Eyewear	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	142	0	1	02	01	H3954_142_0	3	8	Other POS 20%	01	0000000000000000010000000111000000000		1	20	20	2			2			2		2						
H3954	143	0	1	02	01	H3954_143_0	4	6	Hearing Aid	10		000000000000000000000000000001	2			1	0.00	0.00	1	1000.00	1	2								
H3954	143	0	1	02	01	H3954_143_0	4	5	Routine Eyewear	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	143	0	1	02	01	H3954_143_0	4	4	Other POS $25	01	0111000100000000000100000000000000000		2			1	25.00	25.00	2			2		2						
H3954	143	0	1	02	01	H3954_143_0	4	3	Other POS benefits	11	0000100000100101110011110000011101010	000000010000000000000010100000	1	15	15	2			2			2		2						
H3954	143	0	1	02	01	H3954_143_0	4	2	Other professional services	11	0000000011011010000000000000000000101	000000010000000000000000001010	2			1	30.00	30.00	2			2		2						
H3954	143	0	1	02	01	H3954_143_0	4	1	Primary Care Physician	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	143	0	1	02	01	H3954_143_0	4	7	other POS 25%	01	0000010000000000000000000000100000000		1	25	25	2			2			2								
H3954	143	0	1	02	01	H3954_143_0	4	8	Other POS 20%	01	0000000000000000010000000111000000000		1	20	20	2			2			2		2						
H3954	150	0	1	02	01	H3954_150_0	3	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	150	0	1	02	01	H3954_150_0	3	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	150	0	1	02	01	H3954_150_0	3	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3954	150	0	1	02	01	H3954_150_0	3	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	150	0	1	02	01	H3954_150_0	3	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	150	0	1	02	01	H3954_150_0	3	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	150	0	1	02	01	H3954_150_0	3	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	151	0	1	02	01	H3954_151_0	4	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	151	0	1	02	01	H3954_151_0	4	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	151	0	1	02	01	H3954_151_0	4	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3954	151	0	1	02	01	H3954_151_0	4	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	151	0	1	02	01	H3954_151_0	4	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	151	0	1	02	01	H3954_151_0	4	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	151	0	1	02	01	H3954_151_0	4	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	152	0	1	02	01	H3954_152_0	3	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	152	0	1	02	01	H3954_152_0	3	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	152	0	1	02	01	H3954_152_0	3	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	152	0	1	02	01	H3954_152_0	3	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3954	152	0	1	02	01	H3954_152_0	3	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	152	0	1	02	01	H3954_152_0	3	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	152	0	1	02	01	H3954_152_0	3	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	153	0	1	02	01	H3954_153_0	4	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	153	0	1	02	01	H3954_153_0	4	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	153	0	1	02	01	H3954_153_0	4	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	153	0	1	02	01	H3954_153_0	4	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3954	153	0	1	02	01	H3954_153_0	4	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	153	0	1	02	01	H3954_153_0	4	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	153	0	1	02	01	H3954_153_0	4	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	154	0	1	02	01	H3954_154_0	3	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	154	0	1	02	01	H3954_154_0	3	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	154	0	1	02	01	H3954_154_0	3	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	154	0	1	02	01	H3954_154_0	3	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	154	0	1	02	01	H3954_154_0	3	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3954	154	0	1	02	01	H3954_154_0	3	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	154	0	1	02	01	H3954_154_0	3	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	155	0	1	02	01	H3954_155_0	4	1	POS 20% Coinsurance Group	11	0111110110111111110111111111101101101	000000010000000000000010101010	1	20	20	2			2			2		2						
H3954	155	0	1	02	01	H3954_155_0	4	2	POS $0 Copay Group	01	0000000000000000000000000000000000010		2			1	0.00	0.00	2			2								
H3954	155	0	1	02	01	H3954_155_0	4	3	Routine Eyewear Group	10		000000000000000000000000000100	2			1	0.00	0.00	1	200.00	2	2								
H3954	155	0	1	02	01	H3954_155_0	4	7	$30 Copay Group	01	0000000001000000000000000000000000000		2			1	30.00	30.00	2			2								
H3954	155	0	1	02	01	H3954_155_0	4	5	PCP and Routine Annual Physical	11	0000001000000000000000000000000000000	000000000000000000000100000000	2			1	15.00	15.00	2			2								
H3954	155	0	1	02	01	H3954_155_0	4	6	$25 Copay Group	11	0000000000000000000000000000010000000	000000000000000000000010000000	2			1	25.00	25.00	2			2								
H3954	155	0	1	02	01	H3954_155_0	4	4	Hearing Aid including Eval and Fitting	10		000000000000000000000000000001	2			1	0.00	0.00	1	800.00	1	2								
H3979	002	0	1	02	01	H3979_002_0	12	1	$50 Copay	01	0000001001000000000000000000000000000		2			1	50.00	50.00	2			2								
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H3979	002	0	1	02	01	H3979_002_0	12	3	$0 Copay	01	0000000000000000000000000000010000000		2			1	0.00	0.00	2			2								
H3979	002	0	1	02	01	H3979_002_0	12	2	$200 Copay	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H4003	001	0	1	02	01	H4003_001_0	8	1		11	0111111111111111111111111111011101111	000000000010000000000010100001	1	20	20	2			2			2		2						
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H4003	807	0	1	02	01	H4003_807_0	5	1		01	0111111111111111111111111111011101111		1	20	20	2			2			2		2						
H4004	015	0	1	02	01	H4004_015_0	7	1		11	0111111111111111111111111111011101111	000000000010000000000010100001	1	20	20	2			2			2		2						
H4004	053	0	1	02	01	H4004_053_0	9	1		11	0111111111111111111111111111011101111	000000000010000000000010100001	1	20	20	2			2			2		2						
H4006	008	0	1	02	01	H4006_008_0	14	1		11	0111111111111111111111110001010100000	000000000000000000000000111111	1	0	25	2			2			2		2						
H4123	001	0	1	02	01	H4123_001_0	6	1	Cardiac and Pulmonary Rehab	01	0111000000000000000000000000000000000		2			1	40.00	40.00	2			2								
H4123	001	0	1	02	01	H4123_001_0	6	2	Health Care Professional Services	01	0000001101111100000000000000000000000		2			1	40.00	40.00	2			2								
H4123	001	0	1	02	01	H4123_001_0	6	3	Labs and X-Rays	01	0000000000000001100100000000000000000		1	10	10	2			2			2		1	2			1	40.00	40.00
H4123	001	0	1	02	01	H4123_001_0	6	5	Diagnostic Radiology (CAT, PET, MRI)	01	0000000000000000010000000000000000000		2			1	100.00	100.00	2			2		1	2			1	40.00	40.00
H4123	001	0	1	02	01	H4123_001_0	6	6	Therapies: PT, OT, ST	01	0000000010000010000000000000000000000		2			1	40.00	40.00	2			2								
H4123	001	0	1	02	01	H4123_001_0	6	7	Home Health	01	0000010000000000000000000000000000000		2			2			2			2								
H4123	001	0	1	02	01	H4123_001_0	6	8	Diabetic supplies and services	01	0000000000000000000000000001000000000		1	20	20	2			2			2								
H4123	001	0	1	02	01	H4123_001_0	6	4	Outpatient or Ambulatory Surgery	01	0000000000000000000011000000000000000		1	20	20	2			2			2								
H4123	003	0	1	02	01	H4123_003_0	5	3	Labs and X-Rays	01	0000000000000001100100000000000000000		1	10	10	2			2			2		1	2			1	35.00	35.00
H4123	003	0	1	02	01	H4123_003_0	5	4	Outpatient or Ambulatory Surgery	01	0000000000000000000011000000000000000		1	20	20	2			2			2								
H4123	003	0	1	02	01	H4123_003_0	5	5	Diagnostic Radiology (CAT, PET, MRI)	01	0000000000000000010000000000000000000		2			1	100.00	100.00	2			2		1	2			1	35.00	35.00
H4123	003	0	1	02	01	H4123_003_0	5	6	Therapies: PT, OT, ST	01	0000000010000010000000000000000000000		2			1	35.00	35.00	2			2								
H4123	003	0	1	02	01	H4123_003_0	5	7	Home Health	01	0000010000000000000000000000000000000		2			2			2			2								
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H4123	003	0	1	02	01	H4123_003_0	5	1	Cardiac and Pulmonary Rehab	01	0111000000000000000000000000000000000		2			1	40.00	40.00	2			2								
H4123	003	0	1	02	01	H4123_003_0	5	2	Health Care Professional Services	01	0000001101111100000000000000000000000		2			1	35.00	35.00	2			2								
H4123	004	0	1	02	01	H4123_004_0	8	1	Cardiac and Pulmonary Rehab	01	0111000000000000000000000000000000000		2			1	40.00	40.00	2			2								
H4123	004	0	1	02	01	H4123_004_0	8	2	Health Care Professional Services	01	0000001101111100000000000000000000000		2			1	30.00	30.00	2			2								
H4123	004	0	1	02	01	H4123_004_0	8	3	Labs and X-Rays	01	0000000000000001100100000000000000000		1	10	10	2			2			2		1	2			1	25.00	25.00
H4123	004	0	1	02	01	H4123_004_0	8	4	Outpatient or Ambulatory Surgery	01	0000000000000000000011000000000000000		2			1	150.00	150.00	2			2								
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H4123	004	0	1	02	01	H4123_004_0	8	6	Therapies: PT, OT, ST	01	0000000010000010000000000000000000000		2			1	30.00	30.00	2			2								
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H4506	029	0	1	02	01	H4506_029_0	8	9		01	0000000000000000000000000000000000100		2			1	50.00	50.00	2			2		1	2			1	35.00	50.00
H4506	029	0	1	02	01	H4506_029_0	8	8		01	0000000000000001111000000000000100000		1	40	40	2			2			2		1	2			1	35.00	50.00
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H4506	029	0	1	02	01	H4506_029_0	8	5		01	0000000000000000000100000000000000000		2			1	21.00	21.00	2			2		1	2			1	35.00	50.00
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H5211	001	0	1	02	01	H5211_001_0	10	1	OOP-Hospital Inpatient and SNF Inclusive	11	0111111111111111111111110111001110101	000000000100001000000000001010	1	20	20	2			2			1	1500.00	2						
H5211	002	0	1	02	01	H5211_002_0	13	1	OOP-Hospital Inpatient and SNF Inclusive	11	0111111111111111111111110111001110101	000000000100001000000001001010	1	20	20	2			2			1	1500.00	2						
H5211	003	0	1	02	01	H5211_003_0	10	1	OOP-Hospital Inpatient and SNF Inclusive	11	0111111111111111111111110111001110101	000000000100001000000000001010	1	20	20	2			2			1	1500.00	2						
H5211	004	0	1	02	01	H5211_004_0	13	1	OOP-Hospital Inpatient and SNF Inclusive	11	0111111111111111111111110111001110101	000000000100001000000001001010	1	20	20	2			2			1	1500.00	2						
H5211	005	0	1	02	01	H5211_005_0	13	1	OOP-Hospital Inpatient and SNF Inclusive	11	0111111111111111111111110111001110101	000000000100001000000001001010	1	20	20	2			2			1	1500.00	2						
H5211	006	0	1	02	01	H5211_006_0	10	1	OOP-Hospital Inpatient and SNF Inclusive	11	0111111111111111111111110111001110101	000000000100001000000000001010	1	20	20	2			2			1	1500.00	2						
H5253	007	0	1	02	01	H5253_007_0	5	1	Group 1	11	0111111111111110000001111111001111101	000000010100000000000000001010	1	30	30	2			2			2		2						
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H5302	003	0	1	02	01	H5302_003_0	9	5	40%	01	0000000000000000000000000110000000000		1	40	40	2			2			2								
H5302	003	0	1	02	01	H5302_003_0	9	3	$200	01	0000000000000000000000001000000000000		2			1	200.00	200.00	2			2								
H5302	003	0	1	02	01	H5302_003_0	9	2	30%	01	0000000000000000000100000000000000000		1	30	30	2			2			2		2						
H5302	003	0	1	02	01	H5302_003_0	9	1	20%	01	0000000000000000000000000000100010000		1	20	20	2			2			2								
H5302	003	0	1	02	01	H5302_003_0	9	4	$50	01	0000000000000000000000100000000000000		2			1	50.00	50.00	2			2								
H5302	003	0	1	02	01	H5302_003_0	9	6	$0-30%	01	0000000000000000000000000001000000000		1	0	30	2			2			2								
H5302	809	0	1	02	01	H5302_809_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
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H5302	810	0	1	02	01	H5302_810_0	3	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H5302	810	0	1	02	01	H5302_810_0	3	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H5302	811	0	1	02	01	H5302_811_0	3	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H5302	811	0	1	02	01	H5302_811_0	3	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H5322	001	0	1	02	01	H5322_001_0	6	1	Group 1	11	0111111111111110000001111111001111101	000000010100000000000000001000	1	30	30	2			2			2		2						
H5322	001	0	1	02	01	H5322_001_0	6	5	Group 5	01	0000000000000001111100000000000000000		1	0	30	2			2			2		1	1	30	30	2		
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H5322	001	0	1	02	01	H5322_001_0	6	3	Group 3	11	0000000000000000000000000000000000010	000000000000000000000000000100	2			1	0.00	0.00	2			2								
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H5322	004	0	1	02	01	H5322_004_0	5	1	Group 1	11	0111111111111110000001111111001111101	000000010100000000000000001010	1	30	30	2			2			2		2						
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H5322	004	0	1	02	01	H5322_004_0	5	3	Group 3	11	0000000000000000000000000000000000010	000000000000000000000000000101	2			1	0.00	0.00	2			2								
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H5322	004	0	1	02	01	H5322_004_0	5	5	Group 5	01	0000000000000001111100000000000000000		1	0	30	2			2			2		1	1	30	30	2		
H5322	011	0	1	02	01	H5322_011_0	5	1	Group 1	11	0111111111111110000001111111001111101	000000010100000000000000001010	1	30	30	2			2			2		2						
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H5322	011	0	1	02	01	H5322_011_0	5	3	Group 3	11	0000000000000000000000000000000000010	000000000000000000000000000101	2			1	0.00	0.00	2			2								
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H5322	011	0	1	02	01	H5322_011_0	5	5	Group 5	01	0000000000000001111100000000000000000		1	0	30	2			2			2		1	1	30	30	2		
H5322	017	0	1	02	01	H5322_017_0	5	1	Group 1	11	0111111011111110000001111111001111101	000000010100000000000100001010	1	30	30	2			2			2		2						
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H5322	017	0	1	02	01	H5322_017_0	5	5	Group 5	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
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H5322	018	0	1	02	01	H5322_018_0	3	3	Group 3	11	0000000000000000000000000000000000010	000000000000000000000000000100	2			1	0.00	0.00	2			2								
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H5322	018	0	1	02	01	H5322_018_0	3	5	Group 5	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H5322	018	0	1	02	01	H5322_018_0	3	1	Group 1	11	0111111011111110000001111111001111101	000000010100000000000100001010	1	30	30	2			2			2		2						
H5322	018	0	1	02	01	H5322_018_0	3	6	Group 6	01	0000000000000001111100000000000000000		1	0	30	2			2			2		1	1	30	30	2		
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H5322	019	0	1	02	01	H5322_019_0	5	1	Group 1	11	0111111111111110000001111111001111101	000000010100000000000000001010	1	30	30	2			2			2		2						
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H5322	020	0	1	02	01	H5322_020_0	5	1	Group 1	11	0111111011111110000001111111001111101	000000010100000000000000001010	1	30	30	2			2			2		2						
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H5322	021	0	1	02	01	H5322_021_0	4	7	Group 7	01	0000000000000000000010000000000000000		1	30	30	1	10.00	10.00	2			2								
H5322	021	0	1	02	01	H5322_021_0	4	1	Group 1	11	0111111011111110000001111111001111101	000000010100000000000100001010	1	30	30	2			2			2		2						
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H5322	023	0	1	02	01	H5322_023_0	6	6	Group 6	01	0000100000000000000000000000000000000		2			1	75.00	75.00	2			2								
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H5410	018	0	1	02	01	H5410_018_0	4	1	30% Coinsurance	01	0111101111111111111111110110100010000		1	30	30	2			2			2		2						
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H5471	003	0	1	02	01	H5471_003_0	6	1	$0 Co_Pay	01	0000000101010000000000000000000000000		2			2			2			2								
H5471	015	0	1	02	01	H5471_015_0	6	1	$10 Co_Pay	01	0000000101010000000000000000000000000		2			1	10.00	10.00	2			2								
H5471	033	0	1	02	01	H5471_033_0	5	1	Outpatient Specialist/Facility Services	01	0000000001000000000010000000000000000		1	20	20	2			2			2								
H5471	034	0	1	02	01	H5471_034_0	5	1	Outpatient Specialist/Facility Services	01	0000000001000000000010000000000000000		1	20	20	2			2			2								
H5576	006	0	1	02	01	H5576_006_0	8	1	40% coinsurance	11	0111111111111111111111110111011111111	000000000100000000000000000000	1	40	40	2			2			2		2						
H5576	006	0	1	02	01	H5576_006_0	8	2	Non Medicare Preventive Dental	10		000000000000000000000000100000	2			2			1	200.00	3	2								
H5576	006	0	1	02	01	H5576_006_0	8	3	Non Medicare Eye Exams	10		000000000000000000000000001000	2			2			1	50.00	3	2								
H5576	006	0	1	02	01	H5576_006_0	8	4	Non Medicare Eye Wear	10		000000000000000000000000000100	1	20	20	2			1	100.00	3	2								
H5576	006	0	1	02	01	H5576_006_0	8	5	Non Medicare Hearing Exams	10		000000000000000000000000000010	2			2			1	30.00	6	2								
H5576	006	0	1	02	01	H5576_006_0	8	6	ESRD	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H5576	006	0	1	02	01	H5576_006_0	8	7	Ambulance	01	0000000000000000000000001000000000000		2			1	250.00	250.00	2			2								
H5576	007	0	1	02	01	H5576_007_0	8	1	40% coinsurance	11	0111111111111111111111110111011111111	000000000100000000000000000000	1	40	40	2			2			2		2						
H5576	007	0	1	02	01	H5576_007_0	8	2	Non Medicare Preventive Dental	10		000000000000000000000000100000	2			2			1	150.00	3	2								
H5576	007	0	1	02	01	H5576_007_0	8	3	Non Medicare Eye Exams	10		000000000000000000000000001000	2			2			1	50.00	3	2								
H5576	007	0	1	02	01	H5576_007_0	8	4	Non Medicare Eye Wear	10		000000000000000000000000000100	1	20	20	2			1	100.00	3	2								
H5576	007	0	1	02	01	H5576_007_0	8	5	Non Medicare Hearing Exams	10		000000000000000000000000000010	2			2			1	30.00	6	2								
H5576	007	0	1	02	01	H5576_007_0	8	6	ESRD	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H5576	007	0	1	02	01	H5576_007_0	8	7	Ambulance	01	0000000000000000000000001000000000000		2			1	250.00	250.00	2			2								
H5576	009	0	1	02	01	H5576_009_0	9	7	Ambulance	01	0000000000000000000000001000000000000		2			1	250.00	250.00	2			2								
H5576	009	0	1	02	01	H5576_009_0	9	6	ESRD	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H5576	009	0	1	02	01	H5576_009_0	9	5	Non Medicare Hearing Exams	10		000000000000000000000000000010	2			2			1	30.00	6	2								
H5576	009	0	1	02	01	H5576_009_0	9	4	Non Medicare Eye Wear	10		000000000000000000000000000100	1	20	20	2			1	100.00	3	2								
H5576	009	0	1	02	01	H5576_009_0	9	3	Non Medicare Eye Exams	10		000000000000000000000000001000	2			2			1	50.00	3	2								
H5576	009	0	1	02	01	H5576_009_0	9	2	Non Medicare Preventive Dental	10		000000000000000000000000100000	2			2			1	200.00	3	2								
H5576	009	0	1	02	01	H5576_009_0	9	1	40% coinsurance	11	0111111111111111111111110111011111111	000000000100000000000000000000	1	40	40	2			2			2		2						
H5576	012	0	1	02	01	H5576_012_0	8	4	Non Medicare Eye Wear	10		000000000000000000000000000100	1	20	20	2			1	100.00	3	2								
H5576	012	0	1	02	01	H5576_012_0	8	2	Non Medicare Preventive Dental	10		000000000000000000000000100000	2			2			1	100.00	4	2								
H5576	012	0	1	02	01	H5576_012_0	8	1	40% coinsurance	11	0111111111111111111111110111011111111	000000000100000000000000000000	1	40	40	2			2			2		2						
H5576	012	0	1	02	01	H5576_012_0	8	7	Ambulance	01	0000000000000000000000001000000000000		2			1	250.00	250.00	2			2								
H5576	012	0	1	02	01	H5576_012_0	8	5	Non Medicare Hearing Exams	10		000000000000000000000000000010	2			2			1	30.00	6	2								
H5576	012	0	1	02	01	H5576_012_0	8	3	Non Medicare Eye Exams	10		000000000000000000000000001000	2			2			1	50.00	3	2								
H5576	012	0	1	02	01	H5576_012_0	8	6	ESRD	01	0000000000000000000000000000100000000		1	20	20	2			2			2								
H5576	801	0	1	02	01	H5576_801_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H5576	801	0	1	02	01	H5576_801_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H5576	802	0	1	02	01	H5576_802_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H5576	802	0	1	02	01	H5576_802_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H5576	803	0	1	02	01	H5576_803_0	4	1		01	0000010000000000000000000000010000000		1	0	0	2			2			2								
H5576	803	0	1	02	01	H5576_803_0	4	2		01	0111101111111111111111111111101111111		1	20	20	2			2			2		2						
H5577	008	0	1	02	01	H5577_008_0	12	1		11	0111111111111111111111110001010100000	000000000000000000000000111110	1	0	25	2			2			2		2						
H5591	001	0	1	02	01	H5591_001_0	10	4	Group 4	01	0000000000000000000001000000000000000		2			1	200.00	200.00	2			2								
H5591	001	0	1	02	01	H5591_001_0	10	3	Group 3	11	0000001111110110000000100000000001101	000000000000000000000000001000	2			1	25.00	40.00	2			2		2						
H5591	001	0	1	02	01	H5591_001_0	10	2	Group 2	01	0000000000000000011000000110000000000		1	30	30	2			2			2		2						
H5591	001	0	1	02	01	H5591_001_0	10	1	Group 1	01	0000000000000000000000000001100010000		1	20	20	2			2			2								
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H5591	001	0	1	02	01	H5591_001_0	10	7		11	0000000000000001100100010000001100000	000000000100000000000000000000	2			1	0.00	75.00	2			2		2						
H5591	001	0	1	02	01	H5591_001_0	10	6	Group 6	01	0000000000000000000000001000000000000		2			1	175.00	175.00	2			2								
H5591	004	0	1	02	01	H5591_004_0	9	1	Group 1	01	0000000000000000000000000001100010000		1	20	20	2			2			2								
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H5591	004	0	1	02	01	H5591_004_0	9	3	Group 3	11	0000001111110110000000100000000001101	000000000000000000000000001000	2			1	25.00	40.00	2			2		2						
H5591	004	0	1	02	01	H5591_004_0	9	4	Group 4	01	0000000000000000000001000000000000000		2			1	200.00	200.00	2			2								
H5591	004	0	1	02	01	H5591_004_0	9	5	Group 5	01	0000000000000000000010000000000000000		2			1	0.00	325.00	2			2								
H5591	004	0	1	02	01	H5591_004_0	9	6	Group 6	01	0000000000000000000000001000000000000		2			1	175.00	175.00	2			2								
H5591	004	0	1	02	01	H5591_004_0	9	7		11	0000000000000001100100010000001100000	000000000100000000000000000000	2			1	0.00	75.00	2			2		2						
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H5594	019	0	1	02	01	H5594_019_0	5	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	022	0	1	02	01	H5594_022_0	5	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	026	0	1	02	01	H5594_026_0	7	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	027	0	1	02	01	H5594_027_0	5	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	028	0	1	02	01	H5594_028_0	6	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	029	0	1	02	01	H5594_029_0	7	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	030	0	1	02	01	H5594_030_0	7	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	031	0	1	02	01	H5594_031_0	8	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	032	0	1	02	01	H5594_032_0	4	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
H5594	033	0	1	02	01	H5594_033_0	4	1	physician specialist services	01	0000000001000000000000000000000000000		1	30	30	2			2			2								
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H5656	017	0	1	02	01	H5656_017_0	9	6		01	0000000000000000000000001000000000000		2			1	150.00	150.00	2			2								
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H5656	017	0	1	02	01	H5656_017_0	9	5		01	0000000000000000000100000000000000000		2			1	21.00	21.00	2			2		1	2			1	35.00	50.00
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