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_label_list	mrx_tier_drug_type	mrx_tier_gap_cost_share
H0022	001	0	1	48	05	H0022_001_0	4	1	Generic Drugs	010000	
H0022	001	0	1	48	05	H0022_001_0	4	2	Brand Drugs	000010	
H0022	001	0	1	48	05	H0022_001_0	4	3	Non-Medicare Rx/OTC Drugs	010010	
H0028	001	0	1	01	01	H0028_001_0	5	2	Non-Preferred Generic	000101	
H0028	001	0	1	01	01	H0028_001_0	5	5	Specialty Tier	010010	2
H0028	001	0	1	01	01	H0028_001_0	5	4	Non-Preferred Brand	110000	2
H0028	001	0	1	01	01	H0028_001_0	5	3	Preferred Brand	000101	2
H0028	001	0	1	01	01	H0028_001_0	5	2	Non-Preferred Generic	000101	2
H0028	001	0	1	01	01	H0028_001_0	5	1	Preferred Generic	001010	2
H0028	001	0	1	01	01	H0028_001_0	5	5	Specialty Tier	010010	
H0028	001	0	1	01	01	H0028_001_0	5	4	Non-Preferred Brand	110000	
H0028	001	0	1	01	01	H0028_001_0	5	3	Preferred Brand	000101	
H0028	001	0	1	01	01	H0028_001_0	5	1	Preferred Generic	001010	
H0028	002	0	1	01	01	H0028_002_0	6	1	Preferred Generic	001010	
H0028	002	0	1	01	01	H0028_002_0	6	4	Non-Preferred Brand	110000	2
H0028	002	0	1	01	01	H0028_002_0	6	5	Specialty Tier	010010	2
H0028	002	0	1	01	01	H0028_002_0	6	3	Preferred Brand	000101	2
H0028	002	0	1	01	01	H0028_002_0	6	2	Non-Preferred Generic	000101	
H0028	002	0	1	01	01	H0028_002_0	6	1	Preferred Generic	001010	2
H0028	002	0	1	01	01	H0028_002_0	6	5	Specialty Tier	010010	
H0028	002	0	1	01	01	H0028_002_0	6	4	Non-Preferred Brand	110000	
H0028	002	0	1	01	01	H0028_002_0	6	3	Preferred Brand	000101	
H0028	002	0	1	01	01	H0028_002_0	6	2	Non-Preferred Generic	000101	2
H0028	003	0	1	01	01	H0028_003_0	4	4	Non-Preferred Brand	110000	2
H0028	003	0	1	01	01	H0028_003_0	4	5	Specialty Tier	010010	2
H0028	003	0	1	01	01	H0028_003_0	4	1	Preferred Generic	001010	
H0028	003	0	1	01	01	H0028_003_0	4	2	Non-Preferred Generic	000101	
H0028	003	0	1	01	01	H0028_003_0	4	3	Preferred Brand	000101	
H0028	003	0	1	01	01	H0028_003_0	4	4	Non-Preferred Brand	110000	
H0028	003	0	1	01	01	H0028_003_0	4	5	Specialty Tier	010010	
H0028	003	0	1	01	01	H0028_003_0	4	1	Preferred Generic	001010	2
H0028	003	0	1	01	01	H0028_003_0	4	2	Non-Preferred Generic	000101	2
H0028	003	0	1	01	01	H0028_003_0	4	3	Preferred Brand	000101	2
H0028	004	0	1	01	01	H0028_004_0	4	5	Specialty Tier	010010	2
H0028	004	0	1	01	01	H0028_004_0	4	1	Preferred Generic	001010	
H0028	004	0	1	01	01	H0028_004_0	4	2	Non-Preferred Generic	000101	
H0028	004	0	1	01	01	H0028_004_0	4	3	Preferred Brand	000101	
H0028	004	0	1	01	01	H0028_004_0	4	2	Non-Preferred Generic	000101	2
H0028	004	0	1	01	01	H0028_004_0	4	5	Specialty Tier	010010	
H0028	004	0	1	01	01	H0028_004_0	4	1	Preferred Generic	001010	2
H0028	004	0	1	01	01	H0028_004_0	4	4	Non-Preferred Brand	110000	2
H0028	004	0	1	01	01	H0028_004_0	4	3	Preferred Brand	000101	2
H0028	004	0	1	01	01	H0028_004_0	4	4	Non-Preferred Brand	110000	
H0028	005	0	1	01	01	H0028_005_0	5	1	Preferred Generic	001010	
H0028	005	0	1	01	01	H0028_005_0	5	2	Non-Preferred Generic	000101	
H0028	005	0	1	01	01	H0028_005_0	5	3	Preferred Brand	000101	
H0028	005	0	1	01	01	H0028_005_0	5	4	Non-Preferred Brand	110000	
H0028	005	0	1	01	01	H0028_005_0	5	5	Specialty Tier	010010	
H0084	001	0	1	04	01	H0084_001_0	6	4	Non-Preferred Brand	100100	
H0084	001	0	1	04	01	H0084_001_0	6	3	Preferred Brand	010001	
H0084	001	0	1	04	01	H0084_001_0	6	2	Non-Preferred Generic	000100	
H0084	001	0	1	04	01	H0084_001_0	6	5	Specialty Tier	010010	
H0084	001	0	1	04	01	H0084_001_0	6	1	Preferred Generic	001000	
H0084	004	0	1	04	01	H0084_004_0	5	4	Non-Preferred Brand	100100	
H0084	004	0	1	04	01	H0084_004_0	5	2	Non-Preferred Generic	000100	
H0084	004	0	1	04	01	H0084_004_0	5	1	Preferred Generic	001000	
H0084	004	0	1	04	01	H0084_004_0	5	3	Preferred Brand	010001	
H0084	004	0	1	04	01	H0084_004_0	5	5	Specialty Tier	010010	
H0084	064	0	1	04	01	H0084_064_0	5	3	Preferred Brand	010001	
H0084	064	0	1	04	01	H0084_064_0	5	2	Non-Preferred Generic	000100	
H0084	064	0	1	04	01	H0084_064_0	5	1	Preferred Generic	001000	
H0084	064	0	1	04	01	H0084_064_0	5	4	Non-Preferred Brand	100100	
H0084	064	0	1	04	01	H0084_064_0	5	5	Specialty Tier	010010	
H0084	065	0	1	04	01	H0084_065_0	5	2	Non-Preferred Generic	000100	
H0084	065	0	1	04	01	H0084_065_0	5	3	Preferred Brand	010001	
H0084	065	0	1	04	01	H0084_065_0	5	4	Non-Preferred Brand	100100	
H0084	065	0	1	04	01	H0084_065_0	5	5	Specialty Tier	010010	
H0084	065	0	1	04	01	H0084_065_0	5	1	Preferred Generic	001000	
H0104	010	1	1	04	01	H0104_010_1	4	1	Preferred Generic	001000	
H0104	010	1	1	04	01	H0104_010_1	4	2	Non-Preferred Generic	000100	
H0104	010	1	1	04	01	H0104_010_1	4	3	Preferred Brand	000001	
H0104	010	1	1	04	01	H0104_010_1	4	4	Non-Preferred Brand	110000	
H0104	010	1	1	04	01	H0104_010_1	4	5	Specialty Tier	010010	
H0104	010	2	1	04	01	H0104_010_2	4	1	Preferred Generic	001000	
H0104	010	2	1	04	01	H0104_010_2	4	2	Non-Preferred Generic	000100	
H0104	010	2	1	04	01	H0104_010_2	4	3	Preferred Brand	000001	
H0104	010	2	1	04	01	H0104_010_2	4	4	Non-Preferred Brand	110000	
H0104	010	2	1	04	01	H0104_010_2	4	5	Specialty Tier	010010	
H0104	010	3	1	04	01	H0104_010_3	4	2	Non-Preferred Generic	000100	
H0104	010	3	1	04	01	H0104_010_3	4	1	Preferred Generic	001000	
H0104	010	3	1	04	01	H0104_010_3	4	3	Preferred Brand	000001	
H0104	010	3	1	04	01	H0104_010_3	4	5	Specialty Tier	010010	
H0104	010	3	1	04	01	H0104_010_3	4	4	Non-Preferred Brand	110000	
H0104	010	4	1	04	01	H0104_010_4	4	1	Preferred Generic	001000	
H0104	010	4	1	04	01	H0104_010_4	4	2	Non-Preferred Generic	000100	
H0104	010	4	1	04	01	H0104_010_4	4	3	Preferred Brand	000001	
H0104	010	4	1	04	01	H0104_010_4	4	4	Non-Preferred Brand	110000	
H0104	010	4	1	04	01	H0104_010_4	4	5	Specialty Tier	010010	
H0104	010	5	1	04	01	H0104_010_5	4	1	Preferred Generic	001000	
H0104	010	5	1	04	01	H0104_010_5	4	2	Non-Preferred Generic	000100	
H0104	010	5	1	04	01	H0104_010_5	4	4	Non-Preferred Brand	110000	
H0104	010	5	1	04	01	H0104_010_5	4	3	Preferred Brand	000001	
H0104	010	5	1	04	01	H0104_010_5	4	5	Specialty Tier	010010	
H0104	011	1	1	04	01	H0104_011_1	4	2	Non-Preferred Generic	000100	
H0104	011	1	1	04	01	H0104_011_1	4	1	Preferred Generic	001000	
H0104	011	1	1	04	01	H0104_011_1	4	3	Preferred Brand	000001	
H0104	011	1	1	04	01	H0104_011_1	4	5	Specialty Tier	010010	
H0104	011	1	1	04	01	H0104_011_1	4	4	Non-Preferred Brand	110000	
H0104	011	2	1	04	01	H0104_011_2	4	2	Non-Preferred Generic	000100	
H0104	011	2	1	04	01	H0104_011_2	4	1	Preferred Generic	001000	
H0104	011	2	1	04	01	H0104_011_2	4	3	Preferred Brand	000001	
H0104	011	2	1	04	01	H0104_011_2	4	4	Non-Preferred Brand	110000	
H0104	011	2	1	04	01	H0104_011_2	4	5	Specialty Tier	010010	
H0104	011	3	1	04	01	H0104_011_3	4	1	Preferred Generic	001000	
H0104	011	3	1	04	01	H0104_011_3	4	2	Non-Preferred Generic	000100	
H0104	011	3	1	04	01	H0104_011_3	4	3	Preferred Brand	000001	
H0104	011	3	1	04	01	H0104_011_3	4	4	Non-Preferred Brand	110000	
H0104	011	3	1	04	01	H0104_011_3	4	5	Specialty Tier	010010	
H0104	011	4	1	04	01	H0104_011_4	4	2	Non-Preferred Generic	000100	
H0104	011	4	1	04	01	H0104_011_4	4	1	Preferred Generic	001000	
H0104	011	4	1	04	01	H0104_011_4	4	3	Preferred Brand	000001	
H0104	011	4	1	04	01	H0104_011_4	4	5	Specialty Tier	010010	
H0104	011	4	1	04	01	H0104_011_4	4	4	Non-Preferred Brand	110000	
H0104	011	5	1	04	01	H0104_011_5	4	1	Preferred Generic	001000	
H0104	011	5	1	04	01	H0104_011_5	4	2	Non-Preferred Generic	000100	
H0104	011	5	1	04	01	H0104_011_5	4	3	Preferred Brand	000001	
H0104	011	5	1	04	01	H0104_011_5	4	4	Non-Preferred Brand	110000	
H0104	011	5	1	04	01	H0104_011_5	4	5	Specialty Tier	010010	
H0104	011	6	1	04	01	H0104_011_6	5	1	Preferred Generic	001000	
H0104	011	6	1	04	01	H0104_011_6	5	2	Non-Preferred Generic	000100	
H0104	011	6	1	04	01	H0104_011_6	5	3	Preferred Brand	000001	
H0104	011	6	1	04	01	H0104_011_6	5	4	Non-Preferred Brand	110000	
H0104	011	6	1	04	01	H0104_011_6	5	5	Specialty Tier	010010	
H0107	001	0	1	04	01	H0107_001_0	10	2	Non-Preferred Generic	000100	
H0107	001	0	1	04	01	H0107_001_0	10	1	Preferred Generic	001000	
H0107	001	0	1	04	01	H0107_001_0	10	5	Specialty Tier	010010	
H0107	001	0	1	04	01	H0107_001_0	10	4	Non-Preferred Brand	110000	
H0107	001	0	1	04	01	H0107_001_0	10	3	Preferred Brand	000001	
H0107	002	0	1	04	01	H0107_002_0	11	5	Specialty Tier	010010	
H0107	002	0	1	04	01	H0107_002_0	11	4	Non-Preferred Brand	110000	
H0107	002	0	1	04	01	H0107_002_0	11	2	Non-Preferred Generic	000100	
H0107	002	0	1	04	01	H0107_002_0	11	1	Preferred Generic	001000	
H0107	002	0	1	04	01	H0107_002_0	11	3	Preferred Brand	000001	
H0108	004	0	1	01	01	H0108_004_0	7	1	Preferred Generic	001010	
H0108	004	0	1	01	01	H0108_004_0	7	5	Specialty Tier	010010	2
H0108	004	0	1	01	01	H0108_004_0	7	4	Non-Preferred Brand	110000	2
H0108	004	0	1	01	01	H0108_004_0	7	3	Preferred Brand	000101	2
H0108	004	0	1	01	01	H0108_004_0	7	2	Non-Preferred Generic	000101	
H0108	004	0	1	01	01	H0108_004_0	7	1	Preferred Generic	001010	2
H0108	004	0	1	01	01	H0108_004_0	7	5	Specialty Tier	010010	
H0108	004	0	1	01	01	H0108_004_0	7	4	Non-Preferred Brand	110000	
H0108	004	0	1	01	01	H0108_004_0	7	3	Preferred Brand	000101	
H0108	004	0	1	01	01	H0108_004_0	7	2	Non-Preferred Generic	000101	2
H0108	005	0	1	01	01	H0108_005_0	7	1	Preferred Generic	001010	
H0108	005	0	1	01	01	H0108_005_0	7	3	Preferred Brand	000101	
H0108	005	0	1	01	01	H0108_005_0	7	4	Non-Preferred Brand	110000	
H0108	005	0	1	01	01	H0108_005_0	7	5	Specialty Tier	010010	
H0108	005	0	1	01	01	H0108_005_0	7	1	Preferred Generic	001010	1
H0108	005	0	1	01	01	H0108_005_0	7	2	Non-Preferred Generic	000101	1
H0108	005	0	1	01	01	H0108_005_0	7	3	Preferred Brand	000101	2
H0108	005	0	1	01	01	H0108_005_0	7	4	Non-Preferred Brand	110000	2
H0108	005	0	1	01	01	H0108_005_0	7	2	Non-Preferred Generic	000101	
H0108	005	0	1	01	01	H0108_005_0	7	5	Specialty Tier	010010	2
H0108	006	0	1	01	01	H0108_006_0	4	1	Preferred Generic	001010	
H0108	006	0	1	01	01	H0108_006_0	4	4	Non-Preferred Brand	110000	
H0108	006	0	1	01	01	H0108_006_0	4	5	Specialty Tier	010010	
H0108	006	0	1	01	01	H0108_006_0	4	1	Preferred Generic	001010	1
H0108	006	0	1	01	01	H0108_006_0	4	2	Non-Preferred Generic	000101	1
H0108	006	0	1	01	01	H0108_006_0	4	3	Preferred Brand	000101	2
H0108	006	0	1	01	01	H0108_006_0	4	4	Non-Preferred Brand	110000	2
H0108	006	0	1	01	01	H0108_006_0	4	2	Non-Preferred Generic	000101	
H0108	006	0	1	01	01	H0108_006_0	4	3	Preferred Brand	000101	
H0108	006	0	1	01	01	H0108_006_0	4	5	Specialty Tier	010010	2
H0108	008	0	1	01	01	H0108_008_0	7	4	Non-Preferred Brand	110000	2
H0108	008	0	1	01	01	H0108_008_0	7	5	Specialty Tier	010010	2
H0108	008	0	1	01	01	H0108_008_0	7	3	Preferred Brand	000101	2
H0108	008	0	1	01	01	H0108_008_0	7	2	Non-Preferred Generic	000101	1
H0108	008	0	1	01	01	H0108_008_0	7	1	Preferred Generic	001010	1
H0108	008	0	1	01	01	H0108_008_0	7	5	Specialty Tier	010010	
H0108	008	0	1	01	01	H0108_008_0	7	4	Non-Preferred Brand	110000	
H0108	008	0	1	01	01	H0108_008_0	7	3	Preferred Brand	000101	
H0108	008	0	1	01	01	H0108_008_0	7	2	Non-Preferred Generic	000101	
H0108	008	0	1	01	01	H0108_008_0	7	1	Preferred Generic	001010	
H0108	009	0	1	02	01	H0108_009_0	8	5	Specialty Tier	010010	2
H0108	009	0	1	02	01	H0108_009_0	8	5	Specialty Tier	010010	
H0108	009	0	1	02	01	H0108_009_0	8	4	Non-Preferred Brand	110000	
H0108	009	0	1	02	01	H0108_009_0	8	3	Preferred Brand	000101	
H0108	009	0	1	02	01	H0108_009_0	8	2	Non-Preferred Generic	000101	
H0108	009	0	1	02	01	H0108_009_0	8	1	Preferred Generic	001010	
H0108	009	0	1	02	01	H0108_009_0	8	1	Preferred Generic	001010	1
H0108	009	0	1	02	01	H0108_009_0	8	4	Non-Preferred Brand	110000	2
H0108	009	0	1	02	01	H0108_009_0	8	3	Preferred Brand	000101	2
H0108	009	0	1	02	01	H0108_009_0	8	2	Non-Preferred Generic	000101	1
H0108	010	0	1	01	01	H0108_010_0	4	5	Specialty Tier	010010	2
H0108	010	0	1	01	01	H0108_010_0	4	2	Non-Preferred Generic	000101	
H0108	010	0	1	01	01	H0108_010_0	4	3	Preferred Brand	000101	
H0108	010	0	1	01	01	H0108_010_0	4	1	Preferred Generic	001010	
H0108	010	0	1	01	01	H0108_010_0	4	4	Non-Preferred Brand	110000	
H0108	010	0	1	01	01	H0108_010_0	4	3	Preferred Brand	000101	2
H0108	010	0	1	01	01	H0108_010_0	4	2	Non-Preferred Generic	000101	1
H0108	010	0	1	01	01	H0108_010_0	4	1	Preferred Generic	001010	1
H0108	010	0	1	01	01	H0108_010_0	4	5	Specialty Tier	010010	
H0108	010	0	1	01	01	H0108_010_0	4	4	Non-Preferred Brand	110000	2
H0108	011	0	1	01	01	H0108_011_0	6	5	Specialty Tier	010010	
H0108	011	0	1	01	01	H0108_011_0	6	1	Preferred Generic	001010	1
H0108	011	0	1	01	01	H0108_011_0	6	2	Non-Preferred Generic	000101	1
H0108	011	0	1	01	01	H0108_011_0	6	3	Preferred Brand	000101	2
H0108	011	0	1	01	01	H0108_011_0	6	4	Non-Preferred Brand	110000	2
H0108	011	0	1	01	01	H0108_011_0	6	5	Specialty Tier	010010	2
H0108	011	0	1	01	01	H0108_011_0	6	1	Preferred Generic	001010	
H0108	011	0	1	01	01	H0108_011_0	6	2	Non-Preferred Generic	000101	
H0108	011	0	1	01	01	H0108_011_0	6	3	Preferred Brand	000101	
H0108	011	0	1	01	01	H0108_011_0	6	4	Non-Preferred Brand	110000	
H0108	013	0	1	01	01	H0108_013_0	6	1	Preferred Generic	001010	
H0108	013	0	1	01	01	H0108_013_0	6	2	Non-Preferred Generic	000101	
H0108	013	0	1	01	01	H0108_013_0	6	5	Specialty Tier	010010	2
H0108	013	0	1	01	01	H0108_013_0	6	4	Non-Preferred Brand	110000	2
H0108	013	0	1	01	01	H0108_013_0	6	3	Preferred Brand	000101	2
H0108	013	0	1	01	01	H0108_013_0	6	2	Non-Preferred Generic	000101	1
H0108	013	0	1	01	01	H0108_013_0	6	1	Preferred Generic	001010	1
H0108	013	0	1	01	01	H0108_013_0	6	5	Specialty Tier	010010	
H0108	013	0	1	01	01	H0108_013_0	6	4	Non-Preferred Brand	110000	
H0108	013	0	1	01	01	H0108_013_0	6	3	Preferred Brand	000101	
H0108	021	0	1	01	01	H0108_021_0	6	1	Preferred Generic	001010	
H0108	021	0	1	01	01	H0108_021_0	6	4	Non-Preferred Brand	110000	2
H0108	021	0	1	01	01	H0108_021_0	6	3	Preferred Brand	000101	2
H0108	021	0	1	01	01	H0108_021_0	6	2	Non-Preferred Generic	000101	1
H0108	021	0	1	01	01	H0108_021_0	6	5	Specialty Tier	010010	2
H0108	021	0	1	01	01	H0108_021_0	6	5	Specialty Tier	010010	
H0108	021	0	1	01	01	H0108_021_0	6	4	Non-Preferred Brand	110000	
H0108	021	0	1	01	01	H0108_021_0	6	3	Preferred Brand	000101	
H0108	021	0	1	01	01	H0108_021_0	6	2	Non-Preferred Generic	000101	
H0108	021	0	1	01	01	H0108_021_0	6	1	Preferred Generic	001010	1
H0108	022	0	1	01	01	H0108_022_0	6	1	Preferred Generic	001010	
H0108	022	0	1	01	01	H0108_022_0	6	2	Non-Preferred Generic	000101	
H0108	022	0	1	01	01	H0108_022_0	6	3	Preferred Brand	000101	
H0108	022	0	1	01	01	H0108_022_0	6	4	Non-Preferred Brand	110000	
H0108	022	0	1	01	01	H0108_022_0	6	5	Specialty Tier	010010	
H0108	022	0	1	01	01	H0108_022_0	6	1	Preferred Generic	001010	2
H0108	022	0	1	01	01	H0108_022_0	6	2	Non-Preferred Generic	000101	2
H0108	022	0	1	01	01	H0108_022_0	6	3	Preferred Brand	000101	2
H0108	022	0	1	01	01	H0108_022_0	6	4	Non-Preferred Brand	110000	2
H0108	022	0	1	01	01	H0108_022_0	6	5	Specialty Tier	010010	2
H0108	023	0	1	01	01	H0108_023_0	6	2	Non-Preferred Generic	000101	
H0108	023	0	1	01	01	H0108_023_0	6	5	Specialty Tier	010010	2
H0108	023	0	1	01	01	H0108_023_0	6	1	Preferred Generic	001010	
H0108	023	0	1	01	01	H0108_023_0	6	4	Non-Preferred Brand	110000	2
H0108	023	0	1	01	01	H0108_023_0	6	3	Preferred Brand	000101	2
H0108	023	0	1	01	01	H0108_023_0	6	2	Non-Preferred Generic	000101	1
H0108	023	0	1	01	01	H0108_023_0	6	1	Preferred Generic	001010	1
H0108	023	0	1	01	01	H0108_023_0	6	5	Specialty Tier	010010	
H0108	023	0	1	01	01	H0108_023_0	6	4	Non-Preferred Brand	110000	
H0108	023	0	1	01	01	H0108_023_0	6	3	Preferred Brand	000101	
H0108	024	0	1	01	01	H0108_024_0	4	2	Non-Preferred Generic	000101	
H0108	024	0	1	01	01	H0108_024_0	4	1	Preferred Generic	001010	
H0108	024	0	1	01	01	H0108_024_0	4	3	Preferred Brand	000101	
H0108	024	0	1	01	01	H0108_024_0	4	4	Non-Preferred Brand	110000	
H0108	024	0	1	01	01	H0108_024_0	4	5	Specialty Tier	010010	2
H0108	024	0	1	01	01	H0108_024_0	4	1	Preferred Generic	001010	2
H0108	024	0	1	01	01	H0108_024_0	4	2	Non-Preferred Generic	000101	2
H0108	024	0	1	01	01	H0108_024_0	4	3	Preferred Brand	000101	2
H0108	024	0	1	01	01	H0108_024_0	4	4	Non-Preferred Brand	110000	2
H0108	024	0	1	01	01	H0108_024_0	4	5	Specialty Tier	010010	
H0108	025	0	1	01	01	H0108_025_0	6	3	Preferred Brand	000101	2
H0108	025	0	1	01	01	H0108_025_0	6	5	Specialty Tier	010010	2
H0108	025	0	1	01	01	H0108_025_0	6	4	Non-Preferred Brand	110000	2
H0108	025	0	1	01	01	H0108_025_0	6	2	Non-Preferred Generic	000101	1
H0108	025	0	1	01	01	H0108_025_0	6	1	Preferred Generic	001010	1
H0108	025	0	1	01	01	H0108_025_0	6	5	Specialty Tier	010010	
H0108	025	0	1	01	01	H0108_025_0	6	4	Non-Preferred Brand	110000	
H0108	025	0	1	01	01	H0108_025_0	6	3	Preferred Brand	000101	
H0108	025	0	1	01	01	H0108_025_0	6	2	Non-Preferred Generic	000101	
H0108	025	0	1	01	01	H0108_025_0	6	1	Preferred Generic	001010	
H0108	026	0	1	01	01	H0108_026_0	6	4	Non-Preferred Brand	110000	2
H0108	026	0	1	01	01	H0108_026_0	6	5	Specialty Tier	010010	2
H0108	026	0	1	01	01	H0108_026_0	6	3	Preferred Brand	000101	2
H0108	026	0	1	01	01	H0108_026_0	6	2	Non-Preferred Generic	000101	2
H0108	026	0	1	01	01	H0108_026_0	6	1	Preferred Generic	001010	
H0108	026	0	1	01	01	H0108_026_0	6	5	Specialty Tier	010010	
H0108	026	0	1	01	01	H0108_026_0	6	4	Non-Preferred Brand	110000	
H0108	026	0	1	01	01	H0108_026_0	6	3	Preferred Brand	000101	
H0108	026	0	1	01	01	H0108_026_0	6	2	Non-Preferred Generic	000101	
H0108	026	0	1	01	01	H0108_026_0	6	1	Preferred Generic	001010	2
H0108	027	0	1	01	01	H0108_027_0	5	3	Preferred Brand	000101	2
H0108	027	0	1	01	01	H0108_027_0	5	4	Non-Preferred Brand	110000	2
H0108	027	0	1	01	01	H0108_027_0	5	5	Specialty Tier	010010	2
H0108	027	0	1	01	01	H0108_027_0	5	2	Non-Preferred Generic	000101	1
H0108	027	0	1	01	01	H0108_027_0	5	1	Preferred Generic	001010	1
H0108	027	0	1	01	01	H0108_027_0	5	5	Specialty Tier	010010	
H0108	027	0	1	01	01	H0108_027_0	5	4	Non-Preferred Brand	110000	
H0108	027	0	1	01	01	H0108_027_0	5	3	Preferred Brand	000101	
H0108	027	0	1	01	01	H0108_027_0	5	2	Non-Preferred Generic	000101	
H0108	027	0	1	01	01	H0108_027_0	5	1	Preferred Generic	001010	
H0108	028	0	1	01	01	H0108_028_0	5	2	Non-Preferred Generic	000101	
H0108	028	0	1	01	01	H0108_028_0	5	1	Preferred Generic	001010	
H0108	028	0	1	01	01	H0108_028_0	5	3	Preferred Brand	000101	
H0108	028	0	1	01	01	H0108_028_0	5	4	Non-Preferred Brand	110000	
H0108	028	0	1	01	01	H0108_028_0	5	5	Specialty Tier	010010	2
H0108	028	0	1	01	01	H0108_028_0	5	1	Preferred Generic	001010	2
H0108	028	0	1	01	01	H0108_028_0	5	2	Non-Preferred Generic	000101	2
H0108	028	0	1	01	01	H0108_028_0	5	3	Preferred Brand	000101	2
H0108	028	0	1	01	01	H0108_028_0	5	4	Non-Preferred Brand	110000	2
H0108	028	0	1	01	01	H0108_028_0	5	5	Specialty Tier	010010	
H0108	034	0	1	01	01	H0108_034_0	5	2	Non-Preferred Generic	000101	1
H0108	034	0	1	01	01	H0108_034_0	5	3	Preferred Brand	000101	2
H0108	034	0	1	01	01	H0108_034_0	5	4	Non-Preferred Brand	110000	2
H0108	034	0	1	01	01	H0108_034_0	5	5	Specialty Tier	010010	2
H0108	034	0	1	01	01	H0108_034_0	5	4	Non-Preferred Brand	110000	
H0108	034	0	1	01	01	H0108_034_0	5	5	Specialty Tier	010010	
H0108	034	0	1	01	01	H0108_034_0	5	1	Preferred Generic	001010	
H0108	034	0	1	01	01	H0108_034_0	5	2	Non-Preferred Generic	000101	
H0108	034	0	1	01	01	H0108_034_0	5	3	Preferred Brand	000101	
H0108	034	0	1	01	01	H0108_034_0	5	1	Preferred Generic	001010	1
H0108	035	0	1	01	01	H0108_035_0	5	5	Specialty Tier	010010	2
H0108	035	0	1	01	01	H0108_035_0	5	4	Non-Preferred Brand	110000	2
H0108	035	0	1	01	01	H0108_035_0	5	3	Preferred Brand	000101	2
H0108	035	0	1	01	01	H0108_035_0	5	2	Non-Preferred Generic	000101	2
H0108	035	0	1	01	01	H0108_035_0	5	1	Preferred Generic	001010	2
H0108	035	0	1	01	01	H0108_035_0	5	5	Specialty Tier	010010	
H0108	035	0	1	01	01	H0108_035_0	5	3	Preferred Brand	000101	
H0108	035	0	1	01	01	H0108_035_0	5	4	Non-Preferred Brand	110000	
H0108	035	0	1	01	01	H0108_035_0	5	2	Non-Preferred Generic	000101	
H0108	035	0	1	01	01	H0108_035_0	5	1	Preferred Generic	001010	
H0108	036	0	1	01	01	H0108_036_0	8	4	Non-Preferred Brand	110000	2
H0108	036	0	1	01	01	H0108_036_0	8	5	Specialty Tier	010010	2
H0108	036	0	1	01	01	H0108_036_0	8	4	Non-Preferred Brand	110000	
H0108	036	0	1	01	01	H0108_036_0	8	3	Preferred Brand	000101	
H0108	036	0	1	01	01	H0108_036_0	8	5	Specialty Tier	010010	
H0108	036	0	1	01	01	H0108_036_0	8	1	Preferred Generic	001010	
H0108	036	0	1	01	01	H0108_036_0	8	3	Preferred Brand	000101	2
H0108	036	0	1	01	01	H0108_036_0	8	2	Non-Preferred Generic	000101	2
H0108	036	0	1	01	01	H0108_036_0	8	1	Preferred Generic	001010	2
H0108	036	0	1	01	01	H0108_036_0	8	2	Non-Preferred Generic	000101	
H0108	037	0	1	01	01	H0108_037_0	5	1	Preferred Generic	001010	
H0108	037	0	1	01	01	H0108_037_0	5	2	Non-Preferred Generic	000101	
H0108	037	0	1	01	01	H0108_037_0	5	3	Preferred Brand	000101	
H0108	037	0	1	01	01	H0108_037_0	5	4	Non-Preferred Brand	110000	
H0108	037	0	1	01	01	H0108_037_0	5	5	Specialty Tier	010010	
H0108	037	0	1	01	01	H0108_037_0	5	1	Preferred Generic	001010	2
H0108	037	0	1	01	01	H0108_037_0	5	2	Non-Preferred Generic	000101	2
H0108	037	0	1	01	01	H0108_037_0	5	3	Preferred Brand	000101	2
H0108	037	0	1	01	01	H0108_037_0	5	4	Non-Preferred Brand	110000	2
H0108	037	0	1	01	01	H0108_037_0	5	5	Specialty Tier	010010	2
H0108	038	0	1	01	01	H0108_038_0	5	1	Preferred Generic	001010	
H0108	038	0	1	01	01	H0108_038_0	5	3	Preferred Brand	000101	
H0108	038	0	1	01	01	H0108_038_0	5	2	Non-Preferred Generic	000101	
H0108	038	0	1	01	01	H0108_038_0	5	4	Non-Preferred Brand	110000	
H0108	038	0	1	01	01	H0108_038_0	5	5	Specialty Tier	010010	
H0108	038	0	1	01	01	H0108_038_0	5	1	Preferred Generic	001010	2
H0108	038	0	1	01	01	H0108_038_0	5	2	Non-Preferred Generic	000101	2
H0108	038	0	1	01	01	H0108_038_0	5	3	Preferred Brand	000101	2
H0108	038	0	1	01	01	H0108_038_0	5	4	Non-Preferred Brand	110000	2
H0108	038	0	1	01	01	H0108_038_0	5	5	Specialty Tier	010010	2
H0108	039	0	1	01	01	H0108_039_0	5	3	Preferred Brand	000101	
H0108	039	0	1	01	01	H0108_039_0	5	2	Non-Preferred Generic	000101	
H0108	039	0	1	01	01	H0108_039_0	5	5	Specialty Tier	010010	
H0108	039	0	1	01	01	H0108_039_0	5	1	Preferred Generic	001010	
H0108	039	0	1	01	01	H0108_039_0	5	4	Non-Preferred Brand	110000	
H0108	040	0	1	01	01	H0108_040_0	5	5	Specialty Tier	010010	
H0108	040	0	1	01	01	H0108_040_0	5	4	Non-Preferred Brand	110000	
H0108	040	0	1	01	01	H0108_040_0	5	3	Preferred Brand	000101	
H0108	040	0	1	01	01	H0108_040_0	5	1	Preferred Generic	001010	
H0108	040	0	1	01	01	H0108_040_0	5	2	Non-Preferred Generic	000101	
H0108	041	0	1	01	01	H0108_041_0	5	5	Specialty Tier	010010	
H0108	041	0	1	01	01	H0108_041_0	5	3	Preferred Brand	000101	
H0108	041	0	1	01	01	H0108_041_0	5	4	Non-Preferred Brand	110000	
H0108	041	0	1	01	01	H0108_041_0	5	1	Preferred Generic	001010	
H0108	041	0	1	01	01	H0108_041_0	5	2	Non-Preferred Generic	000101	
H0108	042	0	1	01	01	H0108_042_0	5	5	Specialty Tier	010010	
H0108	042	0	1	01	01	H0108_042_0	5	3	Preferred Brand	000101	
H0108	042	0	1	01	01	H0108_042_0	5	4	Non-Preferred Brand	110000	
H0108	042	0	1	01	01	H0108_042_0	5	1	Preferred Generic	001010	
H0108	042	0	1	01	01	H0108_042_0	5	2	Non-Preferred Generic	000101	
H0108	043	0	1	01	01	H0108_043_0	4	3	Preferred Brand	000101	
H0108	043	0	1	01	01	H0108_043_0	4	2	Non-Preferred Generic	000101	
H0108	043	0	1	01	01	H0108_043_0	4	1	Preferred Generic	001010	
H0108	043	0	1	01	01	H0108_043_0	4	5	Specialty Tier	010010	
H0108	043	0	1	01	01	H0108_043_0	4	4	Non-Preferred Brand	110000	
H0108	044	0	1	01	01	H0108_044_0	4	5	Specialty Tier	010010	
H0108	044	0	1	01	01	H0108_044_0	4	4	Non-Preferred Brand	110000	
H0108	044	0	1	01	01	H0108_044_0	4	2	Non-Preferred Generic	000101	
H0108	044	0	1	01	01	H0108_044_0	4	3	Preferred Brand	000101	
H0108	044	0	1	01	01	H0108_044_0	4	1	Preferred Generic	001010	
H0108	045	0	1	01	01	H0108_045_0	6	4	Non-Preferred Brand	110000	2
H0108	045	0	1	01	01	H0108_045_0	6	5	Specialty Tier	010010	2
H0108	045	0	1	01	01	H0108_045_0	6	1	Preferred Generic	001010	
H0108	045	0	1	01	01	H0108_045_0	6	2	Non-Preferred Generic	000101	
H0108	045	0	1	01	01	H0108_045_0	6	3	Preferred Brand	000101	2
H0108	045	0	1	01	01	H0108_045_0	6	4	Non-Preferred Brand	110000	
H0108	045	0	1	01	01	H0108_045_0	6	5	Specialty Tier	010010	
H0108	045	0	1	01	01	H0108_045_0	6	1	Preferred Generic	001010	2
H0108	045	0	1	01	01	H0108_045_0	6	2	Non-Preferred Generic	000101	2
H0108	045	0	1	01	01	H0108_045_0	6	3	Preferred Brand	000101	
H0108	046	0	1	01	01	H0108_046_0	4	4	Non-Preferred Brand	110000	2
H0108	046	0	1	01	01	H0108_046_0	4	5	Specialty Tier	010010	2
H0108	046	0	1	01	01	H0108_046_0	4	1	Preferred Generic	001010	
H0108	046	0	1	01	01	H0108_046_0	4	2	Non-Preferred Generic	000101	
H0108	046	0	1	01	01	H0108_046_0	4	3	Preferred Brand	000101	
H0108	046	0	1	01	01	H0108_046_0	4	4	Non-Preferred Brand	110000	
H0108	046	0	1	01	01	H0108_046_0	4	5	Specialty Tier	010010	
H0108	046	0	1	01	01	H0108_046_0	4	3	Preferred Brand	000101	2
H0108	046	0	1	01	01	H0108_046_0	4	2	Non-Preferred Generic	000101	2
H0108	046	0	1	01	01	H0108_046_0	4	1	Preferred Generic	001010	2
H0117	005	0	1	01	01	H0117_005_0	7	1	Preferred Generic	001000	
H0117	005	0	1	01	01	H0117_005_0	7	2	Non-Preferred Generic	000100	
H0117	005	0	1	01	01	H0117_005_0	7	3	Preferred Brand	000001	
H0117	005	0	1	01	01	H0117_005_0	7	4	Non-Preferred Brand	100000	
H0117	005	0	1	01	01	H0117_005_0	7	5	Specialty Tier	010010	
H0117	007	0	1	01	01	H0117_007_0	5	1	Preferred Generic	001000	
H0117	007	0	1	01	01	H0117_007_0	5	2	Non-Preferred Generic	000100	
H0117	007	0	1	01	01	H0117_007_0	5	3	Preferred Brand	010001	
H0117	007	0	1	01	01	H0117_007_0	5	4	Non-Preferred Brand	110000	
H0117	007	0	1	01	01	H0117_007_0	5	5	Specialty Tier	010010	
H0137	001	0	1	48	05	H0137_001_0	2	1	Generic Drugs	010000	
H0137	001	0	1	48	05	H0137_001_0	2	2	Brand Drugs	000010	
H0137	001	0	1	48	05	H0137_001_0	2	6	Non-Medicare OTC Brand Drugs	000010	
H0137	001	0	1	48	05	H0137_001_0	2	4	Non-Medicare Rx Brand Drugs	000010	
H0137	001	0	1	48	05	H0137_001_0	2	5	Non-Medicare OTC Generic Drugs	010000	
H0137	001	0	1	48	05	H0137_001_0	2	3	Non-Medicare Rx Generic Drugs	010000	
H0141	001	0	1	01	01	H0141_001_0	13	2	Preferred Brand	000001	
H0141	001	0	1	01	01	H0141_001_0	13	1	Generic	010000	
H0141	001	0	1	01	01	H0141_001_0	13	3	Non-Preferred Brand	100000	
H0141	001	0	1	01	01	H0141_001_0	13	4	Specialty Tier	010010	
H0141	002	0	1	01	01	H0141_002_0	11	2	Preferred Brand	000001	
H0141	002	0	1	01	01	H0141_002_0	11	1	Generic	010000	
H0141	002	0	1	01	01	H0141_002_0	11	3	Non-Preferred Brand	100000	
H0141	002	0	1	01	01	H0141_002_0	11	4	Specialty Tier	010010	
H0147	001	0	1	48	05	H0147_001_0	8	5	Non-Medicare OTC Brand Drugs	010010	
H0147	001	0	1	48	05	H0147_001_0	8	4	Non-Medicare Rx Brand Drugs	000010	
H0147	001	0	1	48	05	H0147_001_0	8	1	Generic Drugs	001001	
H0147	001	0	1	48	05	H0147_001_0	8	2	Brand Drugs	100100	
H0147	001	0	1	48	05	H0147_001_0	8	3	Non-Medicare Rx Generic Drugs	010000	
H0148	001	0	1	48	05	H0148_001_0	5	3	Non-Medicare Rx/OTC Drugs	010010	
H0148	001	0	1	48	05	H0148_001_0	5	2	Brand Drugs	000010	
H0148	001	0	1	48	05	H0148_001_0	5	1	Generic Drugs	010000	
H0148	002	0	1	48	05	H0148_002_0	1	1	Generic Drugs	010000	
H0148	002	0	1	48	05	H0148_002_0	1	2	Brand Drugs	000010	
H0148	002	0	1	48	05	H0148_002_0	1	3	Non-Medicare Rx/OTC Drugs	010010	
H0150	001	0	1	01	01	H0150_001_0	3	1	Preferred Generic	001000	
H0150	001	0	1	01	01	H0150_001_0	3	2	Non-Preferred Generic	000100	
H0150	001	0	1	01	01	H0150_001_0	3	3	Preferred Brand	000001	
H0150	001	0	1	01	01	H0150_001_0	3	4	Non-Preferred Brand	100100	
H0150	001	0	1	01	01	H0150_001_0	3	2	Non-Preferred Generic	000100	1
H0150	001	0	1	01	01	H0150_001_0	3	1	Preferred Generic	001000	1
H0150	001	0	1	01	01	H0150_001_0	3	5	Specialty Tier	010010	
H0151	001	0	1	01	01	H0151_001_0	5	5	Specialty Tier	010010	
H0151	001	0	1	01	01	H0151_001_0	5	4	Non-Preferred Brand	100100	
H0151	001	0	1	01	01	H0151_001_0	5	3	Preferred Brand	010001	
H0151	001	0	1	01	01	H0151_001_0	5	1	Preferred Generic	001000	
H0151	001	0	1	01	01	H0151_001_0	5	2	Non-Preferred Generic	000100	
H0151	025	0	1	01	01	H0151_025_0	7	5	Specialty Tier	010010	
H0151	025	0	1	01	01	H0151_025_0	7	4	Non-Preferred Brand	100100	
H0151	025	0	1	01	01	H0151_025_0	7	3	Preferred Brand	010001	
H0151	025	0	1	01	01	H0151_025_0	7	1	Preferred Generic	001000	
H0151	025	0	1	01	01	H0151_025_0	7	2	Non-Preferred Generic	000100	
H0154	001	0	1	01	01	H0154_001_0	5	5	Specialty Tier	010010	
H0154	001	0	1	01	01	H0154_001_0	5	2	Non-Preferred Generic	000100	
H0154	001	0	1	01	01	H0154_001_0	5	3	Preferred Brand	000001	
H0154	001	0	1	01	01	H0154_001_0	5	4	Non-Preferred Brand	100000	
H0154	001	0	1	01	01	H0154_001_0	5	1	Preferred Generic	001000	
H0154	011	0	1	01	01	H0154_011_0	7	5	Specialty Tier	010010	
H0154	011	0	1	01	01	H0154_011_0	7	2	Non-Preferred Generic	000100	
H0154	011	0	1	01	01	H0154_011_0	7	3	Preferred Brand	000001	
H0154	011	0	1	01	01	H0154_011_0	7	4	Non-Preferred Brand	100000	
H0154	011	0	1	01	01	H0154_011_0	7	1	Preferred Generic	001000	1
H0154	011	0	1	01	01	H0154_011_0	7	1	Preferred Generic	001000	
H0154	014	0	1	01	01	H0154_014_0	4	1	Preferred Generic	001000	
H0154	014	0	1	01	01	H0154_014_0	4	5	Specialty Tier	010010	
H0154	014	0	1	01	01	H0154_014_0	4	4	Non-Preferred Brand	100000	
H0154	014	0	1	01	01	H0154_014_0	4	3	Preferred Brand	000001	
H0154	014	0	1	01	01	H0154_014_0	4	2	Non-Preferred Generic	000100	
H0248	001	0	1	04	01	H0248_001_0	5	4	Non-Preferred Brand	110000	2
H0248	001	0	1	04	01	H0248_001_0	5	3	Preferred Brand	000101	2
H0248	001	0	1	04	01	H0248_001_0	5	5	Specialty Tier	010010	2
H0248	001	0	1	04	01	H0248_001_0	5	1	Preferred Generic	001010	
H0248	001	0	1	04	01	H0248_001_0	5	2	Non-Preferred Generic	000101	2
H0248	001	0	1	04	01	H0248_001_0	5	3	Preferred Brand	000101	
H0248	001	0	1	04	01	H0248_001_0	5	4	Non-Preferred Brand	110000	
H0248	001	0	1	04	01	H0248_001_0	5	5	Specialty Tier	010010	
H0248	001	0	1	04	01	H0248_001_0	5	1	Preferred Generic	001010	2
H0248	001	0	1	04	01	H0248_001_0	5	2	Non-Preferred Generic	000101	
H0281	001	0	1	48	05	H0281_001_0	8	3	Non-Medicare Rx/OTC Drugs	010010	
H0281	001	0	1	48	05	H0281_001_0	8	1	Generic Drugs	010000	
H0281	001	0	1	48	05	H0281_001_0	8	2	Brand Drugs	000010	
H0294	002	0	1	04	01	H0294_002_0	6	1	Preferred Generic	001000	
H0294	002	0	1	04	01	H0294_002_0	6	2	Non-Preferred Generic	000100	
H0294	002	0	1	04	01	H0294_002_0	6	3	Preferred Brand	010001	
H0294	002	0	1	04	01	H0294_002_0	6	4	Non-Preferred Brand	100100	
H0294	002	0	1	04	01	H0294_002_0	6	5	Specialty Tier	010010	
H0294	004	0	1	04	01	H0294_004_0	6	1	Preferred Generic	001000	
H0294	004	0	1	04	01	H0294_004_0	6	2	Non-Preferred Generic	000100	
H0294	004	0	1	04	01	H0294_004_0	6	3	Preferred Brand	010001	
H0294	004	0	1	04	01	H0294_004_0	6	4	Non-Preferred Brand	100100	
H0294	004	0	1	04	01	H0294_004_0	6	5	Specialty Tier	010010	
H0302	001	0	1	01	01	H0302_001_0	8	1	Preferred Generic	001000	
H0302	001	0	1	01	01	H0302_001_0	8	2	Non-Preferred Generic	000100	
H0302	001	0	1	01	01	H0302_001_0	8	1	Preferred Generic	001000	2
H0302	001	0	1	01	01	H0302_001_0	8	5	Specialty Tier	100101	
H0302	001	0	1	01	01	H0302_001_0	8	4	Non-Preferred Brand	100000	
H0302	001	0	1	01	01	H0302_001_0	8	3	Preferred Brand	000001	
H0302	006	0	1	01	01	H0302_006_0	8	4	Non-Preferred Brand	100000	
H0302	006	0	1	01	01	H0302_006_0	8	5	Specialty Tier	100101	
H0302	006	0	1	01	01	H0302_006_0	8	1	Preferred Generic	001000	2
H0302	006	0	1	01	01	H0302_006_0	8	3	Preferred Brand	000001	
H0302	006	0	1	01	01	H0302_006_0	8	2	Non-Preferred Generic	000100	
H0302	006	0	1	01	01	H0302_006_0	8	1	Preferred Generic	001000	
H0302	007	0	1	01	01	H0302_007_0	7	1	Preferred Generic	001000	2
H0302	007	0	1	01	01	H0302_007_0	7	1	Preferred Generic	001000	
H0302	007	0	1	01	01	H0302_007_0	7	2	Non-Preferred Generic	000100	
H0302	007	0	1	01	01	H0302_007_0	7	3	Preferred Brand	000001	
H0302	007	0	1	01	01	H0302_007_0	7	4	Non-Preferred Brand	100000	
H0302	007	0	1	01	01	H0302_007_0	7	5	Specialty Tier	100101	
H0303	013	0	1	01	01	H0303_013_0	4	5	Specialty Tier	010010	
H0303	013	0	1	01	01	H0303_013_0	4	2	Non-Preferred Generic	000100	
H0303	013	0	1	01	01	H0303_013_0	4	1	Preferred Generic	001000	
H0303	013	0	1	01	01	H0303_013_0	4	3	Preferred Brand	010001	
H0303	013	0	1	01	01	H0303_013_0	4	4	Non-Preferred Brand	100100	
H0303	015	0	1	01	01	H0303_015_0	4	1	Preferred Generic	001000	
H0303	015	0	1	01	01	H0303_015_0	4	2	Non-Preferred Generic	000100	
H0303	015	0	1	01	01	H0303_015_0	4	3	Preferred Brand	010001	
H0303	015	0	1	01	01	H0303_015_0	4	4	Non-Preferred Brand	100100	
H0303	015	0	1	01	01	H0303_015_0	4	5	Specialty Tier	010010	
H0316	002	0	1	02	01	H0316_002_0	5	1	Preferred Generic	001000	
H0316	002	0	1	02	01	H0316_002_0	5	2	Non-Preferred Generic	000100	
H0316	002	0	1	02	01	H0316_002_0	5	3	Preferred Brand	010001	
H0316	002	0	1	02	01	H0316_002_0	5	4	Non-Preferred Brand	100100	
H0316	002	0	1	02	01	H0316_002_0	5	5	Specialty Tier	010010	
H0316	014	0	1	01	01	H0316_014_0	4	1	Preferred Generic	001000	
H0316	014	0	1	01	01	H0316_014_0	4	2	Non-Preferred Generic	000100	
H0316	014	0	1	01	01	H0316_014_0	4	3	Preferred Brand	010001	
H0316	014	0	1	01	01	H0316_014_0	4	4	Non-Preferred Brand	100100	
H0316	014	0	1	01	01	H0316_014_0	4	5	Specialty Tier	010010	
H0317	001	0	1	04	01	H0317_001_0	4	5	Specialty Tier	010010	2
H0317	001	0	1	04	01	H0317_001_0	4	4	Non-Preferred Brand	110000	2
H0317	001	0	1	04	01	H0317_001_0	4	3	Preferred Brand	000101	2
H0317	001	0	1	04	01	H0317_001_0	4	2	Non-Preferred Generic	000101	2
H0317	001	0	1	04	01	H0317_001_0	4	1	Preferred Generic	001010	2
H0317	001	0	1	04	01	H0317_001_0	4	5	Specialty Tier	010010	
H0317	001	0	1	04	01	H0317_001_0	4	4	Non-Preferred Brand	110000	
H0317	001	0	1	04	01	H0317_001_0	4	3	Preferred Brand	000101	
H0317	001	0	1	04	01	H0317_001_0	4	1	Preferred Generic	001010	
H0317	001	0	1	04	01	H0317_001_0	4	2	Non-Preferred Generic	000101	
H0317	004	0	1	04	01	H0317_004_0	6	5	Specialty Tier	010010	2
H0317	004	0	1	04	01	H0317_004_0	6	4	Non-Preferred Brand	110000	2
H0317	004	0	1	04	01	H0317_004_0	6	3	Preferred Brand	000101	2
H0317	004	0	1	04	01	H0317_004_0	6	2	Non-Preferred Generic	000101	2
H0317	004	0	1	04	01	H0317_004_0	6	1	Preferred Generic	001010	
H0317	004	0	1	04	01	H0317_004_0	6	5	Specialty Tier	010010	
H0317	004	0	1	04	01	H0317_004_0	6	4	Non-Preferred Brand	110000	
H0317	004	0	1	04	01	H0317_004_0	6	3	Preferred Brand	000101	
H0317	004	0	1	04	01	H0317_004_0	6	2	Non-Preferred Generic	000101	
H0317	004	0	1	04	01	H0317_004_0	6	1	Preferred Generic	001010	2
H0317	006	0	1	04	01	H0317_006_0	8	1	Preferred Generic	001010	
H0317	006	0	1	04	01	H0317_006_0	8	5	Specialty Tier	010010	2
H0317	006	0	1	04	01	H0317_006_0	8	4	Non-Preferred Brand	110000	2
H0317	006	0	1	04	01	H0317_006_0	8	3	Preferred Brand	000101	2
H0317	006	0	1	04	01	H0317_006_0	8	2	Non-Preferred Generic	000101	2
H0317	006	0	1	04	01	H0317_006_0	8	1	Preferred Generic	001010	2
H0317	006	0	1	04	01	H0317_006_0	8	5	Specialty Tier	010010	
H0317	006	0	1	04	01	H0317_006_0	8	4	Non-Preferred Brand	110000	
H0317	006	0	1	04	01	H0317_006_0	8	3	Preferred Brand	000101	
H0317	006	0	1	04	01	H0317_006_0	8	2	Non-Preferred Generic	000101	
H0317	007	0	1	04	01	H0317_007_0	6	5	Specialty Tier	010010	2
H0317	007	0	1	04	01	H0317_007_0	6	3	Preferred Brand	000101	
H0317	007	0	1	04	01	H0317_007_0	6	4	Non-Preferred Brand	110000	
H0317	007	0	1	04	01	H0317_007_0	6	5	Specialty Tier	010010	
H0317	007	0	1	04	01	H0317_007_0	6	1	Preferred Generic	001010	2
H0317	007	0	1	04	01	H0317_007_0	6	2	Non-Preferred Generic	000101	2
H0317	007	0	1	04	01	H0317_007_0	6	1	Preferred Generic	001010	
H0317	007	0	1	04	01	H0317_007_0	6	2	Non-Preferred Generic	000101	
H0317	007	0	1	04	01	H0317_007_0	6	4	Non-Preferred Brand	110000	2
H0317	007	0	1	04	01	H0317_007_0	6	3	Preferred Brand	000101	2
H0318	002	0	1	01	01	H0318_002_0	5	5	Select Care Drugs	010000	1
H0318	002	0	1	01	01	H0318_002_0	5	5	Select Care Drugs	010000	
H0318	002	0	1	01	01	H0318_002_0	5	4	Specialty Tier	010010	
H0318	002	0	1	01	01	H0318_002_0	5	3	Non-Preferred Brand	110000	
H0318	002	0	1	01	01	H0318_002_0	5	2	Preferred Brand	010001	
H0318	002	0	1	01	01	H0318_002_0	5	1	Generic	010000	
H0320	006	0	1	01	01	H0320_006_0	6	2	Non-Preferred Generic	000100	
H0320	006	0	1	01	01	H0320_006_0	6	1	Preferred Generic	001000	
H0320	006	0	1	01	01	H0320_006_0	6	3	Preferred Brand	000001	
H0320	006	0	1	01	01	H0320_006_0	6	4	Non-Preferred Brand	100000	
H0320	006	0	1	01	01	H0320_006_0	6	5	Specialty Tier	010010	
H0320	008	0	1	01	01	H0320_008_0	4	2	Non-Preferred Generic	000100	
H0320	008	0	1	01	01	H0320_008_0	4	1	Preferred Generic	001000	
H0320	008	0	1	01	01	H0320_008_0	4	3	Preferred Brand	000001	
H0320	008	0	1	01	01	H0320_008_0	4	5	Specialty Tier	010010	
H0320	008	0	1	01	01	H0320_008_0	4	4	Non-Preferred Brand	100000	
H0320	009	0	1	01	01	H0320_009_0	4	1	Preferred Generic	001000	
H0320	009	0	1	01	01	H0320_009_0	4	2	Non-Preferred Generic	000100	
H0320	009	0	1	01	01	H0320_009_0	4	4	Non-Preferred Brand	100000	
H0320	009	0	1	01	01	H0320_009_0	4	3	Preferred Brand	000001	
H0320	009	0	1	01	01	H0320_009_0	4	5	Specialty Tier	010010	
H0332	002	0	1	01	01	H0332_002_0	8	1	Preferred Generic	001000	
H0332	002	0	1	01	01	H0332_002_0	8	2	Non-Preferred Generic	000100	
H0332	002	0	1	01	01	H0332_002_0	8	1	Preferred Generic	001000	1
H0332	002	0	1	01	01	H0332_002_0	8	4	Non-Preferred Brand	100000	
H0332	002	0	1	01	01	H0332_002_0	8	5	Specialty Tier	100000	
H0332	002	0	1	01	01	H0332_002_0	8	3	Preferred Brand	000001	
H0332	004	0	1	02	01	H0332_004_0	9	1	Preferred Generic	001000	
H0332	004	0	1	02	01	H0332_004_0	9	2	Non-Preferred Generic	000100	
H0332	004	0	1	02	01	H0332_004_0	9	3	Preferred Brand	000001	
H0332	004	0	1	02	01	H0332_004_0	9	4	Non-Preferred Brand	100000	
H0332	004	0	1	02	01	H0332_004_0	9	5	Specialty Tier	100000	
H0332	004	0	1	02	01	H0332_004_0	9	1	Preferred Generic	001000	1
H0332	006	0	1	01	01	H0332_006_0	7	1	Preferred Generic	001000	
H0332	006	0	1	01	01	H0332_006_0	7	5	Specialty Tier	100000	
H0332	006	0	1	01	01	H0332_006_0	7	4	Non-Preferred Brand	100000	
H0332	006	0	1	01	01	H0332_006_0	7	3	Preferred Brand	000001	
H0332	006	0	1	01	01	H0332_006_0	7	1	Preferred Generic	001000	1
H0332	006	0	1	01	01	H0332_006_0	7	2	Non-Preferred Generic	000100	
H0336	001	0	1	48	05	H0336_001_0	8	4	Non-Medicare OTC Drugs	010010	
H0336	001	0	1	48	05	H0336_001_0	8	3	Non-Medicare Rx Drugs	010010	
H0336	001	0	1	48	05	H0336_001_0	8	2	Brand Drugs	000010	
H0336	001	0	1	48	05	H0336_001_0	8	1	Generic Drugs	010000	
H0351	029	0	1	01	01	H0351_029_0	6	4	Non-Preferred Brand	100000	
H0351	029	0	1	01	01	H0351_029_0	6	5	Specialty Tier	010010	
H0351	029	0	1	01	01	H0351_029_0	6	3	Preferred Brand	000001	
H0351	029	0	1	01	01	H0351_029_0	6	2	Non-Preferred Generic	000100	
H0351	029	0	1	01	01	H0351_029_0	6	1	Preferred Generic	001000	
H0351	029	0	1	01	01	H0351_029_0	6	6	Select Care Drugs	010010	
H0351	035	0	1	01	01	H0351_035_0	5	2	Non-Preferred Generic	000100	
H0351	035	0	1	01	01	H0351_035_0	5	1	Preferred Generic	001000	
H0351	035	0	1	01	01	H0351_035_0	5	3	Preferred Brand	000101	
H0351	035	0	1	01	01	H0351_035_0	5	6	Select Care Drugs	010010	
H0351	035	0	1	01	01	H0351_035_0	5	5	Specialty Tier	010010	
H0351	035	0	1	01	01	H0351_035_0	5	4	Non-Preferred Brand	100100	
H0351	036	0	1	01	01	H0351_036_0	5	1	Preferred Generic	001000	
H0351	036	0	1	01	01	H0351_036_0	5	2	Non-Preferred Generic	000100	
H0351	036	0	1	01	01	H0351_036_0	5	5	Specialty Tier	010010	
H0351	036	0	1	01	01	H0351_036_0	5	4	Non-Preferred Brand	100100	
H0351	036	0	1	01	01	H0351_036_0	5	3	Preferred Brand	000101	
H0351	036	0	1	01	01	H0351_036_0	5	6	Select Care Drugs	010010	
H0351	038	0	1	01	01	H0351_038_0	5	5	Specialty Tier	010010	
H0351	038	0	1	01	01	H0351_038_0	5	4	Non-Preferred Brand	100000	
H0351	038	0	1	01	01	H0351_038_0	5	3	Preferred Brand	000001	
H0351	038	0	1	01	01	H0351_038_0	5	2	Non-Preferred Generic	000100	
H0351	038	0	1	01	01	H0351_038_0	5	1	Preferred Generic	001000	
H0351	038	0	1	01	01	H0351_038_0	5	6	Select Care Drugs	010010	
H0351	040	0	1	01	01	H0351_040_0	7	5	Specialty Tier	010010	
H0351	040	0	1	01	01	H0351_040_0	7	4	Non-Preferred Brand	100000	
H0351	040	0	1	01	01	H0351_040_0	7	3	Preferred Brand	000001	
H0351	040	0	1	01	01	H0351_040_0	7	2	Non-Preferred Generic	000100	
H0351	040	0	1	01	01	H0351_040_0	7	1	Preferred Generic	001000	
H0351	040	0	1	01	01	H0351_040_0	7	6	Select Care Drugs	010010	
H0351	041	0	1	01	01	H0351_041_0	5	5	Specialty Tier	010010	
H0351	041	0	1	01	01	H0351_041_0	5	4	Non-Preferred Brand	100000	
H0351	041	0	1	01	01	H0351_041_0	5	3	Preferred Brand	000001	
H0351	041	0	1	01	01	H0351_041_0	5	2	Non-Preferred Generic	000100	
H0351	041	0	1	01	01	H0351_041_0	5	1	Preferred Generic	001000	
H0351	041	0	1	01	01	H0351_041_0	5	6	Select Care Drugs	010010	
H0351	042	0	1	01	01	H0351_042_0	5	1	Preferred Generic	001000	
H0351	042	0	1	01	01	H0351_042_0	5	2	Non-Preferred Generic	000100	
H0351	042	0	1	01	01	H0351_042_0	5	3	Preferred Brand	000001	
H0351	042	0	1	01	01	H0351_042_0	5	4	Non-Preferred Brand	100000	
H0351	042	0	1	01	01	H0351_042_0	5	5	Specialty Tier	010010	
H0351	042	0	1	01	01	H0351_042_0	5	6	Select Care Drugs	010010	
H0351	043	1	1	01	01	H0351_043_1	5	1	Preferred Generic	001000	
H0351	043	1	1	01	01	H0351_043_1	5	2	Non-Preferred Generic	000100	
H0351	043	1	1	01	01	H0351_043_1	5	3	Preferred Brand	000001	
H0351	043	1	1	01	01	H0351_043_1	5	4	Non-Preferred Brand	100000	
H0351	043	1	1	01	01	H0351_043_1	5	5	Specialty Tier	010010	
H0351	043	1	1	01	01	H0351_043_1	5	6	Select Care Drugs	010010	
H0351	043	2	1	01	01	H0351_043_2	5	3	Preferred Brand	000001	
H0351	043	2	1	01	01	H0351_043_2	5	4	Non-Preferred Brand	100000	
H0351	043	2	1	01	01	H0351_043_2	5	5	Specialty Tier	010010	
H0351	043	2	1	01	01	H0351_043_2	5	6	Select Care Drugs	010010	
H0351	043	2	1	01	01	H0351_043_2	5	1	Preferred Generic	001000	
H0351	043	2	1	01	01	H0351_043_2	5	2	Non-Preferred Generic	000100	
H0351	043	3	1	01	01	H0351_043_3	5	1	Preferred Generic	001000	
H0351	043	3	1	01	01	H0351_043_3	5	2	Non-Preferred Generic	000100	
H0351	043	3	1	01	01	H0351_043_3	5	3	Preferred Brand	000001	
H0351	043	3	1	01	01	H0351_043_3	5	4	Non-Preferred Brand	100000	
H0351	043	3	1	01	01	H0351_043_3	5	5	Specialty Tier	010010	
H0351	043	3	1	01	01	H0351_043_3	5	6	Select Care Drugs	010010	
H0354	001	0	1	01	01	H0354_001_0	9	1	Preferred Generic	001001	
H0354	001	0	1	01	01	H0354_001_0	9	2	Non-Preferred Generic	000101	1
H0354	001	0	1	01	01	H0354_001_0	9	1	Preferred Generic	001001	1
H0354	001	0	1	01	01	H0354_001_0	9	5	Specialty Tier	010010	
H0354	001	0	1	01	01	H0354_001_0	9	4	Non-Preferred Brand	100100	
H0354	001	0	1	01	01	H0354_001_0	9	3	Preferred Brand	000101	
H0354	001	0	1	01	01	H0354_001_0	9	2	Non-Preferred Generic	000101	
H0354	021	0	1	01	01	H0354_021_0	7	3	Preferred Brand	000101	
H0354	021	0	1	01	01	H0354_021_0	7	2	Non-Preferred Generic	000101	
H0354	021	0	1	01	01	H0354_021_0	7	1	Preferred Generic	001001	
H0354	021	0	1	01	01	H0354_021_0	7	4	Non-Preferred Brand	100100	
H0354	021	0	1	01	01	H0354_021_0	7	2	Non-Preferred Generic	000101	1
H0354	021	0	1	01	01	H0354_021_0	7	1	Preferred Generic	001001	1
H0354	021	0	1	01	01	H0354_021_0	7	5	Specialty Tier	010010	
H0435	002	0	1	01	01	H0435_002_0	7	1	Preferred Generic	001000	
H0435	002	0	1	01	01	H0435_002_0	7	2	Non-Preferred Generic	000100	
H0435	002	0	1	01	01	H0435_002_0	7	4	Specialty Tier	100000	
H0435	002	0	1	01	01	H0435_002_0	7	3	Preferred Brand	000001	
H0435	003	0	1	01	01	H0435_003_0	7	4	Specialty Tier	100000	
H0435	003	0	1	01	01	H0435_003_0	7	3	Preferred Brand	000001	
H0435	003	0	1	01	01	H0435_003_0	7	2	Non-Preferred Generic	000100	
H0435	003	0	1	01	01	H0435_003_0	7	1	Preferred Generic	001000	
H0439	001	0	1	01	01	H0439_001_0	6	4	Non-Preferred Brand	100100	
H0439	001	0	1	01	01	H0439_001_0	6	1	Preferred Generic	001000	1
H0439	001	0	1	01	01	H0439_001_0	6	2	Non-Preferred Generic	000100	1
H0439	001	0	1	01	01	H0439_001_0	6	5	Specialty Tier	010010	
H0439	001	0	1	01	01	H0439_001_0	6	1	Preferred Generic	001000	
H0439	001	0	1	01	01	H0439_001_0	6	2	Non-Preferred Generic	000100	
H0439	001	0	1	01	01	H0439_001_0	6	3	Preferred Brand	000001	
H0490	004	0	1	01	01	H0490_004_0	10	4	Specialty Tier	010010	
H0490	004	0	1	01	01	H0490_004_0	10	3	Non-Preferred Brand	100000	
H0490	004	0	1	01	01	H0490_004_0	10	2	Preferred Brand	000001	
H0490	004	0	1	01	01	H0490_004_0	10	1	Generic	010000	
H0504	015	0	1	01	01	H0504_015_0	7	2	Non-Preferred Generic	001100	
H0504	015	0	1	01	01	H0504_015_0	7	3	Preferred Brand	000101	
H0504	015	0	1	01	01	H0504_015_0	7	1	Preferred Generic	001000	
H0504	015	0	1	01	01	H0504_015_0	7	4	Non-Preferred Brand	100100	
H0504	015	0	1	01	01	H0504_015_0	7	5	Injectable Drugs	010010	
H0504	015	0	1	01	01	H0504_015_0	7	6	Specialty Tier	010010	
H0504	015	0	1	01	01	H0504_015_0	7	1	Preferred Generic	001000	1
H0504	015	0	1	01	01	H0504_015_0	7	2	Non-Preferred Generic	001100	1
H0504	017	0	1	01	01	H0504_017_0	7	2	Preferred Brand	000101	
H0504	017	0	1	01	01	H0504_017_0	7	1	Preferred Generic	001000	
H0504	017	0	1	01	01	H0504_017_0	7	3	Non-Preferred Brand	100100	
H0504	017	0	1	01	01	H0504_017_0	7	1	Preferred Generic	001000	1
H0504	017	0	1	01	01	H0504_017_0	7	5	Specialty Tier	010010	
H0504	017	0	1	01	01	H0504_017_0	7	4	Injectable Drugs	010010	
H0504	021	0	1	01	01	H0504_021_0	7	1	Preferred Generic	001010	
H0504	021	0	1	01	01	H0504_021_0	7	2	Preferred Brand	000101	
H0504	021	0	1	01	01	H0504_021_0	7	3	Non-Preferred Brand	100100	
H0504	021	0	1	01	01	H0504_021_0	7	1	Preferred Generic	001010	1
H0504	021	0	1	01	01	H0504_021_0	7	5	Specialty Tier	010010	
H0504	021	0	1	01	01	H0504_021_0	7	4	Injectable Drugs	010010	
H0504	021	0	1	01	01	H0504_021_0	7	2	Preferred Brand	000101	2
H0504	026	0	1	01	01	H0504_026_0	7	3	Non-Preferred Brand	100100	
H0504	026	0	1	01	01	H0504_026_0	7	2	Preferred Brand	000101	
H0504	026	0	1	01	01	H0504_026_0	7	1	Preferred Generic	001000	
H0504	026	0	1	01	01	H0504_026_0	7	4	Injectable Drugs	010010	
H0504	026	0	1	01	01	H0504_026_0	7	1	Preferred Generic	001000	1
H0504	026	0	1	01	01	H0504_026_0	7	5	Specialty Tier	010010	
H0504	027	0	1	01	01	H0504_027_0	7	5	Specialty Tier	010010	
H0504	027	0	1	01	01	H0504_027_0	7	4	Injectable Drugs	010010	
H0504	027	0	1	01	01	H0504_027_0	7	3	Non-Preferred Brand	100100	
H0504	027	0	1	01	01	H0504_027_0	7	2	Preferred Brand	000101	
H0504	027	0	1	01	01	H0504_027_0	7	1	Preferred Generic	001000	
H0504	028	0	1	01	01	H0504_028_0	6	5	Specialty Tier	010010	
H0504	028	0	1	01	01	H0504_028_0	6	4	Injectable Drugs	010010	
H0504	028	0	1	01	01	H0504_028_0	6	3	Non-Preferred Brand	100100	
H0504	028	0	1	01	01	H0504_028_0	6	2	Preferred Brand	000101	
H0504	028	0	1	01	01	H0504_028_0	6	1	Preferred Generic	001000	1
H0504	028	0	1	01	01	H0504_028_0	6	1	Preferred Generic	001000	
H0504	029	0	1	01	01	H0504_029_0	6	1	Preferred Generic	001000	
H0504	029	0	1	01	01	H0504_029_0	6	1	Preferred Generic	001000	1
H0504	029	0	1	01	01	H0504_029_0	6	5	Specialty Tier	010010	
H0504	029	0	1	01	01	H0504_029_0	6	4	Injectable Drugs	010010	
H0504	029	0	1	01	01	H0504_029_0	6	3	Non-Preferred Brand	100100	
H0504	029	0	1	01	01	H0504_029_0	6	2	Preferred Brand	000101	
H0504	030	0	1	01	01	H0504_030_0	7	4	Injectable Drugs	010010	
H0504	030	0	1	01	01	H0504_030_0	7	5	Specialty Tier	010010	
H0504	030	0	1	01	01	H0504_030_0	7	3	Non-Preferred Brand	100100	
H0504	030	0	1	01	01	H0504_030_0	7	2	Preferred Brand	000101	
H0504	030	0	1	01	01	H0504_030_0	7	1	Preferred Generic	001000	
H0504	030	0	1	01	01	H0504_030_0	7	1	Preferred Generic	001000	1
H0504	031	0	1	01	01	H0504_031_0	7	1	Preferred Generic	001000	
H0504	031	0	1	01	01	H0504_031_0	7	2	Preferred Brand	000101	
H0504	031	0	1	01	01	H0504_031_0	7	3	Non-Preferred Brand	100100	
H0504	031	0	1	01	01	H0504_031_0	7	4	Injectable Drugs	010010	
H0504	031	0	1	01	01	H0504_031_0	7	5	Specialty Tier	010010	
H0504	031	0	1	01	01	H0504_031_0	7	1	Preferred Generic	001000	1
H0504	032	0	1	01	01	H0504_032_0	7	1	Preferred Generic	001000	
H0504	032	0	1	01	01	H0504_032_0	7	2	Preferred Brand	000101	
H0504	032	0	1	01	01	H0504_032_0	7	3	Non-Preferred Brand	100100	
H0504	032	0	1	01	01	H0504_032_0	7	4	Injectable Drugs	010010	
H0504	032	0	1	01	01	H0504_032_0	7	5	Specialty Tier	010010	
H0504	032	0	1	01	01	H0504_032_0	7	1	Preferred Generic	001000	1
H0523	002	0	1	01	01	H0523_002_0	6	5	Select Care Drugs	010000	1
H0523	002	0	1	01	01	H0523_002_0	6	5	Select Care Drugs	010000	
H0523	002	0	1	01	01	H0523_002_0	6	4	Specialty Tier	010010	
H0523	002	0	1	01	01	H0523_002_0	6	3	Non-Preferred Brand	110000	
H0523	002	0	1	01	01	H0523_002_0	6	2	Preferred Brand	010001	
H0523	002	0	1	01	01	H0523_002_0	6	1	Generic	010000	
H0523	022	0	1	01	01	H0523_022_0	5	1	Generic	010000	
H0523	022	0	1	01	01	H0523_022_0	5	5	Select Care Drugs	010000	1
H0523	022	0	1	01	01	H0523_022_0	5	5	Select Care Drugs	010000	
H0523	022	0	1	01	01	H0523_022_0	5	4	Specialty Tier	010010	
H0523	022	0	1	01	01	H0523_022_0	5	3	Non-Preferred Brand	110000	
H0523	022	0	1	01	01	H0523_022_0	5	2	Preferred Brand	010001	
H0523	031	0	1	01	01	H0523_031_0	5	5	Select Care Drugs	010000	
H0523	031	0	1	01	01	H0523_031_0	5	4	Specialty Tier	010010	
H0523	031	0	1	01	01	H0523_031_0	5	3	Non-Preferred Brand	110000	
H0523	031	0	1	01	01	H0523_031_0	5	2	Preferred Brand	010001	
H0523	031	0	1	01	01	H0523_031_0	5	5	Select Care Drugs	010000	1
H0523	031	0	1	01	01	H0523_031_0	5	1	Generic	010000	
H0523	032	0	1	01	01	H0523_032_0	5	5	Select Care Drugs	010000	1
H0523	032	0	1	01	01	H0523_032_0	5	5	Select Care Drugs	010000	
H0523	032	0	1	01	01	H0523_032_0	5	4	Specialty Tier	010010	
H0523	032	0	1	01	01	H0523_032_0	5	2	Preferred Brand	010001	
H0523	032	0	1	01	01	H0523_032_0	5	3	Non-Preferred Brand	110000	
H0523	032	0	1	01	01	H0523_032_0	5	1	Generic	010000	
H0523	052	0	1	01	01	H0523_052_0	5	1	Generic	010000	
H0523	052	0	1	01	01	H0523_052_0	5	2	Preferred Brand	010001	
H0523	052	0	1	01	01	H0523_052_0	5	3	Non-Preferred Brand	110000	
H0523	052	0	1	01	01	H0523_052_0	5	4	Specialty Tier	010010	
H0523	052	0	1	01	01	H0523_052_0	5	5	Select Care Drugs	010000	
H0523	052	0	1	01	01	H0523_052_0	5	5	Select Care Drugs	010000	1
H0523	060	0	1	01	01	H0523_060_0	6	1	Generic	010000	
H0523	060	0	1	01	01	H0523_060_0	6	2	Preferred Brand	010001	
H0523	060	0	1	01	01	H0523_060_0	6	3	Non-Preferred Brand	110000	
H0523	060	0	1	01	01	H0523_060_0	6	4	Specialty Tier	010010	
H0523	060	0	1	01	01	H0523_060_0	6	5	Select Care Drugs	010000	
H0523	060	0	1	01	01	H0523_060_0	6	1	Generic	010000	1
H0523	060	0	1	01	01	H0523_060_0	6	5	Select Care Drugs	010000	1
H0524	002	0	2	01	01	H0524_002_0	5	6	Vaccines	000001	1
H0524	002	0	2	01	01	H0524_002_0	5	1	Preferred Generic	001000	1
H0524	002	0	2	01	01	H0524_002_0	5	6	Vaccines	000001	
H0524	002	0	2	01	01	H0524_002_0	5	5	Specialty Tier	100001	
H0524	002	0	2	01	01	H0524_002_0	5	4	Non-Preferred Brand	100000	
H0524	002	0	2	01	01	H0524_002_0	5	3	Preferred Brand	000001	
H0524	002	0	2	01	01	H0524_002_0	5	2	Non-Preferred Generic	000100	
H0524	002	0	2	01	01	H0524_002_0	5	1	Preferred Generic	001000	
H0524	002	0	2	01	01	H0524_002_0	5	2	Non-Preferred Generic	000100	1
H0524	003	0	1	01	01	H0524_003_0	5	1	Preferred Generic	001000	
H0524	003	0	1	01	01	H0524_003_0	5	2	Non-Preferred Generic	000100	
H0524	003	0	1	01	01	H0524_003_0	5	3	Preferred Brand	000001	
H0524	003	0	1	01	01	H0524_003_0	5	4	Non-Preferred Brand	100000	
H0524	003	0	1	01	01	H0524_003_0	5	6	Vaccines	000001	1
H0524	003	0	1	01	01	H0524_003_0	5	6	Vaccines	000001	
H0524	003	0	1	01	01	H0524_003_0	5	1	Preferred Generic	001000	1
H0524	003	0	1	01	01	H0524_003_0	5	2	Non-Preferred Generic	000100	1
H0524	003	0	1	01	01	H0524_003_0	5	5	Specialty Tier	100001	
H0524	008	0	1	01	01	H0524_008_0	5	6	Vaccines	000001	1
H0524	008	0	1	01	01	H0524_008_0	5	1	Preferred Generic	001000	
H0524	008	0	1	01	01	H0524_008_0	5	1	Preferred Generic	001000	1
H0524	008	0	1	01	01	H0524_008_0	5	6	Vaccines	000001	
H0524	008	0	1	01	01	H0524_008_0	5	5	Specialty Tier	100001	
H0524	008	0	1	01	01	H0524_008_0	5	4	Non-Preferred Brand	100000	
H0524	008	0	1	01	01	H0524_008_0	5	3	Preferred Brand	000001	
H0524	008	0	1	01	01	H0524_008_0	5	2	Non-Preferred Generic	000100	
H0524	008	0	1	01	01	H0524_008_0	5	2	Non-Preferred Generic	000100	1
H0524	010	0	2	01	01	H0524_010_0	7	1	Preferred Generic	001000	
H0524	010	0	2	01	01	H0524_010_0	7	2	Non-Preferred Generic	000100	
H0524	010	0	2	01	01	H0524_010_0	7	3	Preferred Brand	000001	
H0524	010	0	2	01	01	H0524_010_0	7	4	Non-Preferred Brand	100000	
H0524	010	0	2	01	01	H0524_010_0	7	5	Specialty Tier	100001	
H0524	010	0	2	01	01	H0524_010_0	7	6	Vaccines	000001	
H0524	010	0	2	01	01	H0524_010_0	7	1	Preferred Generic	001000	1
H0524	010	0	2	01	01	H0524_010_0	7	2	Non-Preferred Generic	000100	1
H0524	010	0	2	01	01	H0524_010_0	7	6	Vaccines	000001	1
H0524	013	0	1	01	01	H0524_013_0	5	1	Preferred Generic	001000	
H0524	013	0	1	01	01	H0524_013_0	5	2	Non-Preferred Generic	000100	
H0524	013	0	1	01	01	H0524_013_0	5	6	Vaccines	000001	1
H0524	013	0	1	01	01	H0524_013_0	5	2	Non-Preferred Generic	000100	1
H0524	013	0	1	01	01	H0524_013_0	5	1	Preferred Generic	001000	1
H0524	013	0	1	01	01	H0524_013_0	5	6	Vaccines	000001	
H0524	013	0	1	01	01	H0524_013_0	5	5	Specialty Tier	100001	
H0524	013	0	1	01	01	H0524_013_0	5	4	Non-Preferred Brand	100000	
H0524	013	0	1	01	01	H0524_013_0	5	3	Preferred Brand	000001	
H0524	015	0	1	01	01	H0524_015_0	5	1	Preferred Generic	001000	
H0524	015	0	1	01	01	H0524_015_0	5	2	Non-Preferred Generic	000100	1
H0524	015	0	1	01	01	H0524_015_0	5	1	Preferred Generic	001000	1
H0524	015	0	1	01	01	H0524_015_0	5	6	Vaccines	000001	
H0524	015	0	1	01	01	H0524_015_0	5	6	Vaccines	000001	1
H0524	015	0	1	01	01	H0524_015_0	5	4	Non-Preferred Brand	100000	
H0524	015	0	1	01	01	H0524_015_0	5	3	Preferred Brand	000001	
H0524	015	0	1	01	01	H0524_015_0	5	2	Non-Preferred Generic	000100	
H0524	015	0	1	01	01	H0524_015_0	5	5	Specialty Tier	100001	
H0524	029	0	1	01	01	H0524_029_0	6	1	Preferred Generic	001000	
H0524	029	0	1	01	01	H0524_029_0	6	2	Non-Preferred Generic	000100	
H0524	029	0	1	01	01	H0524_029_0	6	6	Vaccines	000001	
H0524	029	0	1	01	01	H0524_029_0	6	4	Non-Preferred Brand	100000	
H0524	029	0	1	01	01	H0524_029_0	6	5	Specialty Tier	100001	
H0524	029	0	1	01	01	H0524_029_0	6	3	Preferred Brand	000001	
H0524	030	0	1	01	01	H0524_030_0	7	1	Preferred Generic	001000	
H0524	030	0	1	01	01	H0524_030_0	7	2	Non-Preferred Generic	000100	
H0524	030	0	1	01	01	H0524_030_0	7	3	Preferred Brand	000001	
H0524	030	0	1	01	01	H0524_030_0	7	4	Non-Preferred Brand	100000	
H0524	030	0	1	01	01	H0524_030_0	7	5	Specialty Tier	100001	
H0524	030	0	1	01	01	H0524_030_0	7	6	Vaccines	000001	
H0524	031	0	1	01	01	H0524_031_0	5	5	Specialty Tier	100001	
H0524	031	0	1	01	01	H0524_031_0	5	4	Non-Preferred Brand	100000	
H0524	031	0	1	01	01	H0524_031_0	5	3	Preferred Brand	000001	
H0524	031	0	1	01	01	H0524_031_0	5	2	Non-Preferred Generic	000100	
H0524	031	0	1	01	01	H0524_031_0	5	1	Preferred Generic	001000	
H0524	031	0	1	01	01	H0524_031_0	5	6	Vaccines	000001	
H0524	031	0	1	01	01	H0524_031_0	5	6	Vaccines	000001	1
H0524	031	0	1	01	01	H0524_031_0	5	2	Non-Preferred Generic	000100	1
H0524	031	0	1	01	01	H0524_031_0	5	1	Preferred Generic	001000	1
H0524	032	0	1	01	01	H0524_032_0	5	1	Preferred Generic	001000	
H0524	032	0	1	01	01	H0524_032_0	5	2	Non-Preferred Generic	000100	
H0524	032	0	1	01	01	H0524_032_0	5	3	Preferred Brand	000001	
H0524	032	0	1	01	01	H0524_032_0	5	4	Non-Preferred Brand	100000	
H0524	032	0	1	01	01	H0524_032_0	5	6	Vaccines	000001	1
H0524	032	0	1	01	01	H0524_032_0	5	2	Non-Preferred Generic	000100	1
H0524	032	0	1	01	01	H0524_032_0	5	1	Preferred Generic	001000	1
H0524	032	0	1	01	01	H0524_032_0	5	6	Vaccines	000001	
H0524	032	0	1	01	01	H0524_032_0	5	5	Specialty Tier	100001	
H0524	033	0	1	01	01	H0524_033_0	5	5	Specialty Tier	100001	
H0524	033	0	1	01	01	H0524_033_0	5	4	Non-Preferred Brand	100000	
H0524	033	0	1	01	01	H0524_033_0	5	3	Preferred Brand	000001	
H0524	033	0	1	01	01	H0524_033_0	5	2	Non-Preferred Generic	000100	
H0524	033	0	1	01	01	H0524_033_0	5	1	Preferred Generic	001000	
H0524	033	0	1	01	01	H0524_033_0	5	6	Vaccines	000001	
H0524	033	0	1	01	01	H0524_033_0	5	6	Vaccines	000001	1
H0524	033	0	1	01	01	H0524_033_0	5	2	Non-Preferred Generic	000100	1
H0524	033	0	1	01	01	H0524_033_0	5	1	Preferred Generic	001000	1
H0524	034	0	1	01	01	H0524_034_0	5	4	Non-Preferred Brand	100000	
H0524	034	0	1	01	01	H0524_034_0	5	3	Preferred Brand	000001	
H0524	034	0	1	01	01	H0524_034_0	5	2	Non-Preferred Generic	000100	
H0524	034	0	1	01	01	H0524_034_0	5	1	Preferred Generic	001000	
H0524	034	0	1	01	01	H0524_034_0	5	6	Vaccines	000001	1
H0524	034	0	1	01	01	H0524_034_0	5	6	Vaccines	000001	
H0524	034	0	1	01	01	H0524_034_0	5	1	Preferred Generic	001000	1
H0524	034	0	1	01	01	H0524_034_0	5	2	Non-Preferred Generic	000100	1
H0524	034	0	1	01	01	H0524_034_0	5	5	Specialty Tier	100001	
H0524	035	0	1	01	01	H0524_035_0	5	4	Non-Preferred Brand	100000	
H0524	035	0	1	01	01	H0524_035_0	5	3	Preferred Brand	000001	
H0524	035	0	1	01	01	H0524_035_0	5	2	Non-Preferred Generic	000100	
H0524	035	0	1	01	01	H0524_035_0	5	1	Preferred Generic	001000	
H0524	035	0	1	01	01	H0524_035_0	5	5	Specialty Tier	100001	
H0524	035	0	1	01	01	H0524_035_0	5	6	Vaccines	000001	1
H0524	035	0	1	01	01	H0524_035_0	5	2	Non-Preferred Generic	000100	1
H0524	035	0	1	01	01	H0524_035_0	5	1	Preferred Generic	001000	1
H0524	035	0	1	01	01	H0524_035_0	5	6	Vaccines	000001	
H0524	036	0	1	01	01	H0524_036_0	5	1	Preferred Generic	001000	
H0524	036	0	1	01	01	H0524_036_0	5	2	Non-Preferred Generic	000100	
H0524	036	0	1	01	01	H0524_036_0	5	3	Preferred Brand	000001	
H0524	036	0	1	01	01	H0524_036_0	5	4	Non-Preferred Brand	100000	
H0524	036	0	1	01	01	H0524_036_0	5	6	Vaccines	000001	1
H0524	036	0	1	01	01	H0524_036_0	5	1	Preferred Generic	001000	1
H0524	036	0	1	01	01	H0524_036_0	5	2	Non-Preferred Generic	000100	1
H0524	036	0	1	01	01	H0524_036_0	5	5	Specialty Tier	100001	
H0524	036	0	1	01	01	H0524_036_0	5	6	Vaccines	000001	
H0524	037	0	1	01	01	H0524_037_0	5	1	Preferred Generic	001000	
H0524	037	0	1	01	01	H0524_037_0	5	2	Non-Preferred Generic	000100	
H0524	037	0	1	01	01	H0524_037_0	5	3	Preferred Brand	000001	
H0524	037	0	1	01	01	H0524_037_0	5	4	Non-Preferred Brand	100000	
H0524	037	0	1	01	01	H0524_037_0	5	5	Specialty Tier	100001	
H0524	037	0	1	01	01	H0524_037_0	5	6	Vaccines	000001	
H0524	037	0	1	01	01	H0524_037_0	5	1	Preferred Generic	001000	1
H0524	037	0	1	01	01	H0524_037_0	5	2	Non-Preferred Generic	000100	1
H0524	037	0	1	01	01	H0524_037_0	5	6	Vaccines	000001	1
H0524	038	0	1	01	01	H0524_038_0	5	1	Preferred Generic	001000	
H0524	038	0	1	01	01	H0524_038_0	5	2	Non-Preferred Generic	000100	
H0524	038	0	1	01	01	H0524_038_0	5	6	Vaccines	000001	1
H0524	038	0	1	01	01	H0524_038_0	5	2	Non-Preferred Generic	000100	1
H0524	038	0	1	01	01	H0524_038_0	5	1	Preferred Generic	001000	1
H0524	038	0	1	01	01	H0524_038_0	5	6	Vaccines	000001	
H0524	038	0	1	01	01	H0524_038_0	5	5	Specialty Tier	100001	
H0524	038	0	1	01	01	H0524_038_0	5	4	Non-Preferred Brand	100000	
H0524	038	0	1	01	01	H0524_038_0	5	3	Preferred Brand	000001	
H0524	039	0	1	01	01	H0524_039_0	3	1	Preferred Generic	001000	
H0524	039	0	1	01	01	H0524_039_0	3	2	Non-Preferred Generic	000100	1
H0524	039	0	1	01	01	H0524_039_0	3	1	Preferred Generic	001000	1
H0524	039	0	1	01	01	H0524_039_0	3	6	Vaccines	000001	
H0524	039	0	1	01	01	H0524_039_0	3	6	Vaccines	000001	1
H0524	039	0	1	01	01	H0524_039_0	3	4	Non-Preferred Brand	100000	
H0524	039	0	1	01	01	H0524_039_0	3	3	Preferred Brand	000001	
H0524	039	0	1	01	01	H0524_039_0	3	2	Non-Preferred Generic	000100	
H0524	039	0	1	01	01	H0524_039_0	3	5	Specialty Tier	100001	
H0524	040	0	1	01	01	H0524_040_0	6	4	Non-Preferred Brand	100000	
H0524	040	0	1	01	01	H0524_040_0	6	3	Preferred Brand	000001	
H0524	040	0	1	01	01	H0524_040_0	6	6	Vaccines	000001	1
H0524	040	0	1	01	01	H0524_040_0	6	2	Non-Preferred Generic	000100	1
H0524	040	0	1	01	01	H0524_040_0	6	1	Preferred Generic	001000	1
H0524	040	0	1	01	01	H0524_040_0	6	6	Vaccines	000001	
H0524	040	0	1	01	01	H0524_040_0	6	5	Specialty Tier	100001	
H0524	040	0	1	01	01	H0524_040_0	6	1	Preferred Generic	001000	
H0524	040	0	1	01	01	H0524_040_0	6	2	Non-Preferred Generic	000100	
H0524	041	0	1	01	01	H0524_041_0	6	1	Preferred Generic	001000	
H0524	041	0	1	01	01	H0524_041_0	6	2	Non-Preferred Generic	000100	1
H0524	041	0	1	01	01	H0524_041_0	6	1	Preferred Generic	001000	1
H0524	041	0	1	01	01	H0524_041_0	6	6	Vaccines	000001	
H0524	041	0	1	01	01	H0524_041_0	6	6	Vaccines	000001	1
H0524	041	0	1	01	01	H0524_041_0	6	4	Non-Preferred Brand	100000	
H0524	041	0	1	01	01	H0524_041_0	6	3	Preferred Brand	000001	
H0524	041	0	1	01	01	H0524_041_0	6	2	Non-Preferred Generic	000100	
H0524	041	0	1	01	01	H0524_041_0	6	5	Specialty Tier	100001	
H0524	042	0	1	01	01	H0524_042_0	5	4	Non-Preferred Brand	100000	
H0524	042	0	1	01	01	H0524_042_0	5	3	Preferred Brand	000001	
H0524	042	0	1	01	01	H0524_042_0	5	2	Non-Preferred Generic	000100	
H0524	042	0	1	01	01	H0524_042_0	5	1	Preferred Generic	001000	
H0524	042	0	1	01	01	H0524_042_0	5	5	Specialty Tier	100001	
H0524	042	0	1	01	01	H0524_042_0	5	6	Vaccines	000001	1
H0524	042	0	1	01	01	H0524_042_0	5	2	Non-Preferred Generic	000100	1
H0524	042	0	1	01	01	H0524_042_0	5	1	Preferred Generic	001000	1
H0524	042	0	1	01	01	H0524_042_0	5	6	Vaccines	000001	
H0524	043	0	1	01	01	H0524_043_0	4	1	Preferred Generic	001000	
H0524	043	0	1	01	01	H0524_043_0	4	2	Non-Preferred Generic	000100	
H0524	043	0	1	01	01	H0524_043_0	4	6	Vaccines	000001	1
H0524	043	0	1	01	01	H0524_043_0	4	2	Non-Preferred Generic	000100	1
H0524	043	0	1	01	01	H0524_043_0	4	1	Preferred Generic	001000	1
H0524	043	0	1	01	01	H0524_043_0	4	6	Vaccines	000001	
H0524	043	0	1	01	01	H0524_043_0	4	5	Specialty Tier	100001	
H0524	043	0	1	01	01	H0524_043_0	4	4	Non-Preferred Brand	100000	
H0524	043	0	1	01	01	H0524_043_0	4	3	Preferred Brand	000001	
H0524	046	0	1	01	01	H0524_046_0	4	1	Preferred Generic	001000	
H0524	046	0	1	01	01	H0524_046_0	4	5	Specialty Tier	100001	
H0524	046	0	1	01	01	H0524_046_0	4	6	Vaccines	000001	
H0524	046	0	1	01	01	H0524_046_0	4	1	Preferred Generic	001000	1
H0524	046	0	1	01	01	H0524_046_0	4	6	Vaccines	000001	1
H0524	046	0	1	01	01	H0524_046_0	4	4	Non-Preferred Brand	100000	
H0524	046	0	1	01	01	H0524_046_0	4	3	Preferred Brand	000001	
H0524	046	0	1	01	01	H0524_046_0	4	2	Non-Preferred Generic	000100	
H0524	046	0	1	01	01	H0524_046_0	4	2	Non-Preferred Generic	000100	1
H0543	001	0	1	01	01	H0543_001_0	5	1	Preferred Generic	001000	
H0543	001	0	1	01	01	H0543_001_0	5	2	Non-Preferred Generic	000100	
H0543	001	0	1	01	01	H0543_001_0	5	3	Preferred Brand	010001	
H0543	001	0	1	01	01	H0543_001_0	5	4	Non-Preferred Brand	100100	
H0543	001	0	1	01	01	H0543_001_0	5	5	Specialty Tier	010010	
H0543	001	0	1	01	01	H0543_001_0	5	1	Preferred Generic	001000	1
H0543	001	0	1	01	01	H0543_001_0	5	2	Non-Preferred Generic	000100	1
H0543	004	0	1	01	01	H0543_004_0	4	1	Preferred Generic	001000	
H0543	004	0	1	01	01	H0543_004_0	4	2	Non-Preferred Generic	000100	
H0543	004	0	1	01	01	H0543_004_0	4	3	Preferred Brand	010001	
H0543	004	0	1	01	01	H0543_004_0	4	4	Non-Preferred Brand	100100	
H0543	004	0	1	01	01	H0543_004_0	4	5	Specialty Tier	010010	
H0543	007	0	1	01	01	H0543_007_0	4	1	Preferred Generic	001000	1
H0543	007	0	1	01	01	H0543_007_0	4	2	Non-Preferred Generic	000100	1
H0543	007	0	1	01	01	H0543_007_0	4	1	Preferred Generic	001000	
H0543	007	0	1	01	01	H0543_007_0	4	2	Non-Preferred Generic	000100	
H0543	007	0	1	01	01	H0543_007_0	4	3	Preferred Brand	010001	
H0543	007	0	1	01	01	H0543_007_0	4	4	Non-Preferred Brand	100100	
H0543	007	0	1	01	01	H0543_007_0	4	5	Specialty Tier	010010	
H0543	013	0	1	01	01	H0543_013_0	4	4	Non-Preferred Brand	100100	
H0543	013	0	1	01	01	H0543_013_0	4	3	Preferred Brand	010001	
H0543	013	0	1	01	01	H0543_013_0	4	2	Non-Preferred Generic	000100	
H0543	013	0	1	01	01	H0543_013_0	4	1	Preferred Generic	001000	
H0543	013	0	1	01	01	H0543_013_0	4	5	Specialty Tier	010010	
H0543	013	0	1	01	01	H0543_013_0	4	1	Preferred Generic	001000	1
H0543	013	0	1	01	01	H0543_013_0	4	2	Non-Preferred Generic	000100	1
H0543	019	0	1	01	01	H0543_019_0	4	1	Preferred Generic	001000	
H0543	019	0	1	01	01	H0543_019_0	4	2	Non-Preferred Generic	000100	
H0543	019	0	1	01	01	H0543_019_0	4	3	Preferred Brand	010001	
H0543	019	0	1	01	01	H0543_019_0	4	4	Non-Preferred Brand	100100	
H0543	019	0	1	01	01	H0543_019_0	4	5	Specialty Tier	010010	
H0543	022	0	1	01	01	H0543_022_0	4	1	Preferred Generic	001000	
H0543	022	0	1	01	01	H0543_022_0	4	2	Non-Preferred Generic	000100	
H0543	022	0	1	01	01	H0543_022_0	4	5	Specialty Tier	010010	
H0543	022	0	1	01	01	H0543_022_0	4	4	Non-Preferred Brand	100100	
H0543	022	0	1	01	01	H0543_022_0	4	3	Preferred Brand	010001	
H0543	028	0	1	01	01	H0543_028_0	4	1	Preferred Generic	001000	
H0543	028	0	1	01	01	H0543_028_0	4	2	Non-Preferred Generic	000100	
H0543	028	0	1	01	01	H0543_028_0	4	3	Preferred Brand	010001	
H0543	028	0	1	01	01	H0543_028_0	4	4	Non-Preferred Brand	100100	
H0543	028	0	1	01	01	H0543_028_0	4	5	Specialty Tier	010010	
H0543	029	0	1	01	01	H0543_029_0	4	1	Preferred Generic	001000	
H0543	029	0	1	01	01	H0543_029_0	4	4	Non-Preferred Brand	100100	
H0543	029	0	1	01	01	H0543_029_0	4	3	Preferred Brand	010001	
H0543	029	0	1	01	01	H0543_029_0	4	2	Non-Preferred Generic	000100	
H0543	029	0	1	01	01	H0543_029_0	4	5	Specialty Tier	010010	
H0543	032	0	1	01	01	H0543_032_0	4	4	Non-Preferred Brand	100100	
H0543	032	0	1	01	01	H0543_032_0	4	3	Preferred Brand	010001	
H0543	032	0	1	01	01	H0543_032_0	4	2	Non-Preferred Generic	000100	
H0543	032	0	1	01	01	H0543_032_0	4	1	Preferred Generic	001000	
H0543	032	0	1	01	01	H0543_032_0	4	5	Specialty Tier	010010	
H0543	035	0	1	01	01	H0543_035_0	5	5	Specialty Tier	010010	
H0543	035	0	1	01	01	H0543_035_0	5	4	Non-Preferred Brand	100100	
H0543	035	0	1	01	01	H0543_035_0	5	3	Preferred Brand	010001	
H0543	035	0	1	01	01	H0543_035_0	5	2	Non-Preferred Generic	000100	
H0543	035	0	1	01	01	H0543_035_0	5	1	Preferred Generic	001000	
H0543	036	0	1	01	01	H0543_036_0	6	1	Preferred Generic	001000	
H0543	036	0	1	01	01	H0543_036_0	6	2	Non-Preferred Generic	000100	
H0543	036	0	1	01	01	H0543_036_0	6	3	Preferred Brand	010001	
H0543	036	0	1	01	01	H0543_036_0	6	4	Non-Preferred Brand	100100	
H0543	036	0	1	01	01	H0543_036_0	6	5	Specialty Tier	010010	
H0543	060	0	1	01	01	H0543_060_0	4	5	Specialty Tier	010010	
H0543	060	0	1	01	01	H0543_060_0	4	4	Non-Preferred Brand	100100	
H0543	060	0	1	01	01	H0543_060_0	4	3	Preferred Brand	010001	
H0543	060	0	1	01	01	H0543_060_0	4	2	Non-Preferred Generic	000100	
H0543	060	0	1	01	01	H0543_060_0	4	1	Preferred Generic	001000	
H0543	060	0	1	01	01	H0543_060_0	4	1	Preferred Generic	001000	1
H0543	060	0	1	01	01	H0543_060_0	4	2	Non-Preferred Generic	000100	1
H0543	070	0	1	01	01	H0543_070_0	4	2	Non-Preferred Generic	000100	
H0543	070	0	1	01	01	H0543_070_0	4	1	Preferred Generic	001000	
H0543	070	0	1	01	01	H0543_070_0	4	3	Preferred Brand	010001	
H0543	070	0	1	01	01	H0543_070_0	4	4	Non-Preferred Brand	100100	
H0543	070	0	1	01	01	H0543_070_0	4	5	Specialty Tier	010010	
H0543	086	0	1	01	01	H0543_086_0	4	2	Non-Preferred Generic	000100	
H0543	086	0	1	01	01	H0543_086_0	4	1	Preferred Generic	001000	
H0543	086	0	1	01	01	H0543_086_0	4	3	Preferred Brand	010001	
H0543	086	0	1	01	01	H0543_086_0	4	5	Specialty Tier	010010	
H0543	086	0	1	01	01	H0543_086_0	4	4	Non-Preferred Brand	100100	
H0543	089	0	1	01	01	H0543_089_0	4	1	Preferred Generic	001000	
H0543	089	0	1	01	01	H0543_089_0	4	2	Non-Preferred Generic	000100	
H0543	089	0	1	01	01	H0543_089_0	4	4	Non-Preferred Brand	100100	
H0543	089	0	1	01	01	H0543_089_0	4	3	Preferred Brand	010001	
H0543	089	0	1	01	01	H0543_089_0	4	5	Specialty Tier	010010	
H0543	138	0	1	01	01	H0543_138_0	6	1	Preferred Generic	001000	
H0543	138	0	1	01	01	H0543_138_0	6	2	Non-Preferred Generic	000100	
H0543	138	0	1	01	01	H0543_138_0	6	3	Preferred Brand	010001	
H0543	138	0	1	01	01	H0543_138_0	6	4	Non-Preferred Brand	100100	
H0543	138	0	1	01	01	H0543_138_0	6	5	Specialty Tier	010010	
H0543	138	0	1	01	01	H0543_138_0	6	1	Preferred Generic	001000	1
H0543	138	0	1	01	01	H0543_138_0	6	2	Non-Preferred Generic	000100	1
H0543	140	0	1	01	01	H0543_140_0	4	1	Preferred Generic	001000	
H0543	140	0	1	01	01	H0543_140_0	4	2	Non-Preferred Generic	000100	
H0543	140	0	1	01	01	H0543_140_0	4	3	Preferred Brand	010001	
H0543	140	0	1	01	01	H0543_140_0	4	4	Non-Preferred Brand	100100	
H0543	140	0	1	01	01	H0543_140_0	4	5	Specialty Tier	010010	
H0543	144	0	1	01	01	H0543_144_0	5	2	Non-Preferred Generic	000100	1
H0543	144	0	1	01	01	H0543_144_0	5	1	Preferred Generic	001000	1
H0543	144	0	1	01	01	H0543_144_0	5	1	Preferred Generic	001000	
H0543	144	0	1	01	01	H0543_144_0	5	2	Non-Preferred Generic	000100	
H0543	144	0	1	01	01	H0543_144_0	5	3	Preferred Brand	010001	
H0543	144	0	1	01	01	H0543_144_0	5	4	Non-Preferred Brand	100100	
H0543	144	0	1	01	01	H0543_144_0	5	5	Specialty Tier	010010	
H0543	145	0	1	01	01	H0543_145_0	4	1	Preferred Generic	001000	
H0543	145	0	1	01	01	H0543_145_0	4	4	Non-Preferred Brand	100100	
H0543	145	0	1	01	01	H0543_145_0	4	3	Preferred Brand	010001	
H0543	145	0	1	01	01	H0543_145_0	4	2	Non-Preferred Generic	000100	
H0543	145	0	1	01	01	H0543_145_0	4	5	Specialty Tier	010010	
H0543	145	0	1	01	01	H0543_145_0	4	1	Preferred Generic	001000	1
H0543	145	0	1	01	01	H0543_145_0	4	2	Non-Preferred Generic	000100	1
H0543	146	0	1	01	01	H0543_146_0	5	1	Preferred Generic	001000	
H0543	146	0	1	01	01	H0543_146_0	5	2	Non-Preferred Generic	000100	
H0543	146	0	1	01	01	H0543_146_0	5	5	Specialty Tier	010010	
H0543	146	0	1	01	01	H0543_146_0	5	4	Non-Preferred Brand	100100	
H0543	146	0	1	01	01	H0543_146_0	5	3	Preferred Brand	010001	
H0543	147	0	1	01	01	H0543_147_0	4	1	Preferred Generic	001000	
H0543	147	0	1	01	01	H0543_147_0	4	5	Specialty Tier	010010	
H0543	147	0	1	01	01	H0543_147_0	4	4	Non-Preferred Brand	100100	
H0543	147	0	1	01	01	H0543_147_0	4	2	Non-Preferred Generic	000100	
H0543	147	0	1	01	01	H0543_147_0	4	3	Preferred Brand	010001	
H0543	148	0	1	01	01	H0543_148_0	4	4	Non-Preferred Brand	100100	
H0543	148	0	1	01	01	H0543_148_0	4	3	Preferred Brand	010001	
H0543	148	0	1	01	01	H0543_148_0	4	2	Non-Preferred Generic	000100	
H0543	148	0	1	01	01	H0543_148_0	4	1	Preferred Generic	001000	
H0543	148	0	1	01	01	H0543_148_0	4	5	Specialty Tier	010010	
H0543	149	0	1	01	01	H0543_149_0	4	3	Preferred Brand	010001	
H0543	149	0	1	01	01	H0543_149_0	4	1	Preferred Generic	001000	
H0543	149	0	1	01	01	H0543_149_0	4	2	Non-Preferred Generic	000100	
H0543	149	0	1	01	01	H0543_149_0	4	5	Specialty Tier	010010	
H0543	149	0	1	01	01	H0543_149_0	4	4	Non-Preferred Brand	100100	
H0543	151	0	1	01	01	H0543_151_0	5	2	Non-Preferred Generic	000100	1
H0543	151	0	1	01	01	H0543_151_0	5	5	Specialty Tier	010010	
H0543	151	0	1	01	01	H0543_151_0	5	4	Non-Preferred Brand	100100	
H0543	151	0	1	01	01	H0543_151_0	5	3	Preferred Brand	010001	
H0543	151	0	1	01	01	H0543_151_0	5	2	Non-Preferred Generic	000100	
H0543	151	0	1	01	01	H0543_151_0	5	1	Preferred Generic	001000	
H0543	151	0	1	01	01	H0543_151_0	5	1	Preferred Generic	001000	1
H0543	152	0	1	01	01	H0543_152_0	4	2	Non-Preferred Generic	000100	
H0543	152	0	1	01	01	H0543_152_0	4	3	Preferred Brand	010001	
H0543	152	0	1	01	01	H0543_152_0	4	4	Non-Preferred Brand	100100	
H0543	152	0	1	01	01	H0543_152_0	4	5	Specialty Tier	010010	
H0543	152	0	1	01	01	H0543_152_0	4	1	Preferred Generic	001000	1
H0543	152	0	1	01	01	H0543_152_0	4	2	Non-Preferred Generic	000100	1
H0543	152	0	1	01	01	H0543_152_0	4	1	Preferred Generic	001000	
H0544	002	0	1	01	01	H0544_002_0	10	6	Select Care Drugs	000010	1
H0544	002	0	1	01	01	H0544_002_0	10	2	Non-Preferred Generic	000100	
H0544	002	0	1	01	01	H0544_002_0	10	3	Preferred Brand	000001	
H0544	002	0	1	01	01	H0544_002_0	10	4	Non-Preferred Brand	100000	
H0544	002	0	1	01	01	H0544_002_0	10	5	Specialty Tier	010010	
H0544	002	0	1	01	01	H0544_002_0	10	1	Preferred Generic	001000	
H0544	002	0	1	01	01	H0544_002_0	10	1	Preferred Generic	001000	1
H0544	002	0	1	01	01	H0544_002_0	10	2	Non-Preferred Generic	000100	1
H0544	002	0	1	01	01	H0544_002_0	10	3	Preferred Brand	000001	2
H0544	002	0	1	01	01	H0544_002_0	10	4	Non-Preferred Brand	100000	2
H0544	002	0	1	01	01	H0544_002_0	10	6	Select Care Drugs	000010	
H0544	003	0	1	01	01	H0544_003_0	8	6	Select Care Drugs	000010	1
H0544	003	0	1	01	01	H0544_003_0	8	1	Preferred Generic	001000	1
H0544	003	0	1	01	01	H0544_003_0	8	2	Non-Preferred Generic	000100	1
H0544	003	0	1	01	01	H0544_003_0	8	6	Select Care Drugs	000010	
H0544	003	0	1	01	01	H0544_003_0	8	5	Specialty Tier	010010	
H0544	003	0	1	01	01	H0544_003_0	8	4	Non-Preferred Brand	100000	
H0544	003	0	1	01	01	H0544_003_0	8	3	Preferred Brand	000001	
H0544	003	0	1	01	01	H0544_003_0	8	2	Non-Preferred Generic	000100	
H0544	003	0	1	01	01	H0544_003_0	8	1	Preferred Generic	001000	
H0544	004	0	1	01	01	H0544_004_0	9	4	Non-Preferred Brand	100000	2
H0544	004	0	1	01	01	H0544_004_0	9	6	Select Care Drugs	000010	1
H0544	004	0	1	01	01	H0544_004_0	9	1	Preferred Generic	001000	
H0544	004	0	1	01	01	H0544_004_0	9	3	Preferred Brand	000001	2
H0544	004	0	1	01	01	H0544_004_0	9	2	Non-Preferred Generic	000100	1
H0544	004	0	1	01	01	H0544_004_0	9	2	Non-Preferred Generic	000100	
H0544	004	0	1	01	01	H0544_004_0	9	6	Select Care Drugs	000010	
H0544	004	0	1	01	01	H0544_004_0	9	5	Specialty Tier	010010	
H0544	004	0	1	01	01	H0544_004_0	9	4	Non-Preferred Brand	100000	
H0544	004	0	1	01	01	H0544_004_0	9	3	Preferred Brand	000001	
H0544	004	0	1	01	01	H0544_004_0	9	1	Preferred Generic	001000	1
H0544	005	0	1	01	01	H0544_005_0	8	1	Preferred Generic	001000	
H0544	005	0	1	01	01	H0544_005_0	8	2	Non-Preferred Generic	000100	
H0544	005	0	1	01	01	H0544_005_0	8	3	Preferred Brand	000001	
H0544	005	0	1	01	01	H0544_005_0	8	4	Non-Preferred Brand	100000	
H0544	005	0	1	01	01	H0544_005_0	8	5	Specialty Tier	010010	
H0544	005	0	1	01	01	H0544_005_0	8	6	Select Care Drugs	000010	
H0544	005	0	1	01	01	H0544_005_0	8	1	Preferred Generic	001000	1
H0544	005	0	1	01	01	H0544_005_0	8	2	Non-Preferred Generic	000100	1
H0544	005	0	1	01	01	H0544_005_0	8	3	Preferred Brand	000001	2
H0544	005	0	1	01	01	H0544_005_0	8	4	Non-Preferred Brand	100000	2
H0544	005	0	1	01	01	H0544_005_0	8	6	Select Care Drugs	000010	1
H0544	007	0	1	01	01	H0544_007_0	9	2	Non-Preferred Generic	000100	
H0544	007	0	1	01	01	H0544_007_0	9	1	Preferred Generic	001000	
H0544	007	0	1	01	01	H0544_007_0	9	6	Select Care Drugs	000010	
H0544	007	0	1	01	01	H0544_007_0	9	5	Specialty Tier	010010	
H0544	007	0	1	01	01	H0544_007_0	9	4	Non-Preferred Brand	100000	
H0544	007	0	1	01	01	H0544_007_0	9	3	Preferred Brand	000001	
H0544	008	0	1	01	01	H0544_008_0	10	1	Preferred Generic	001000	1
H0544	008	0	1	01	01	H0544_008_0	10	2	Non-Preferred Generic	000100	1
H0544	008	0	1	01	01	H0544_008_0	10	6	Select Care Drugs	000010	
H0544	008	0	1	01	01	H0544_008_0	10	5	Specialty Tier	010010	
H0544	008	0	1	01	01	H0544_008_0	10	4	Non-Preferred Brand	100000	
H0544	008	0	1	01	01	H0544_008_0	10	3	Preferred Brand	000001	
H0544	008	0	1	01	01	H0544_008_0	10	6	Select Care Drugs	000010	2
H0544	008	0	1	01	01	H0544_008_0	10	1	Preferred Generic	001000	
H0544	008	0	1	01	01	H0544_008_0	10	2	Non-Preferred Generic	000100	
H0544	010	0	1	01	01	H0544_010_0	10	1	Preferred Generic	001000	
H0544	010	0	1	01	01	H0544_010_0	10	3	Preferred Brand	000001	2
H0544	010	0	1	01	01	H0544_010_0	10	3	Preferred Brand	000001	
H0544	010	0	1	01	01	H0544_010_0	10	4	Non-Preferred Brand	100000	
H0544	010	0	1	01	01	H0544_010_0	10	5	Specialty Tier	010010	
H0544	010	0	1	01	01	H0544_010_0	10	6	Select Care Drugs	000010	
H0544	010	0	1	01	01	H0544_010_0	10	1	Preferred Generic	001000	1
H0544	010	0	1	01	01	H0544_010_0	10	2	Non-Preferred Generic	000100	1
H0544	010	0	1	01	01	H0544_010_0	10	2	Non-Preferred Generic	000100	
H0544	010	0	1	01	01	H0544_010_0	10	4	Non-Preferred Brand	100000	2
H0544	010	0	1	01	01	H0544_010_0	10	6	Select Care Drugs	000010	1
H0544	012	0	1	01	01	H0544_012_0	9	1	Preferred Generic	001000	1
H0544	012	0	1	01	01	H0544_012_0	9	2	Non-Preferred Generic	000100	1
H0544	012	0	1	01	01	H0544_012_0	9	1	Preferred Generic	001000	
H0544	012	0	1	01	01	H0544_012_0	9	2	Non-Preferred Generic	000100	
H0544	012	0	1	01	01	H0544_012_0	9	6	Select Care Drugs	000010	2
H0544	012	0	1	01	01	H0544_012_0	9	4	Non-Preferred Brand	100000	
H0544	012	0	1	01	01	H0544_012_0	9	5	Specialty Tier	010010	
H0544	012	0	1	01	01	H0544_012_0	9	6	Select Care Drugs	000010	
H0544	012	0	1	01	01	H0544_012_0	9	3	Preferred Brand	000001	
H0544	013	0	1	01	01	H0544_013_0	9	1	Preferred Generic	001000	1
H0544	013	0	1	01	01	H0544_013_0	9	2	Non-Preferred Generic	000100	1
H0544	013	0	1	01	01	H0544_013_0	9	3	Preferred Brand	000001	2
H0544	013	0	1	01	01	H0544_013_0	9	4	Non-Preferred Brand	100000	2
H0544	013	0	1	01	01	H0544_013_0	9	6	Select Care Drugs	000010	1
H0544	013	0	1	01	01	H0544_013_0	9	5	Specialty Tier	010010	
H0544	013	0	1	01	01	H0544_013_0	9	4	Non-Preferred Brand	100000	
H0544	013	0	1	01	01	H0544_013_0	9	3	Preferred Brand	000001	
H0544	013	0	1	01	01	H0544_013_0	9	2	Non-Preferred Generic	000100	
H0544	013	0	1	01	01	H0544_013_0	9	6	Select Care Drugs	000010	
H0544	013	0	1	01	01	H0544_013_0	9	1	Preferred Generic	001000	
H0544	014	0	1	01	01	H0544_014_0	9	6	Select Care Drugs	000010	1
H0544	014	0	1	01	01	H0544_014_0	9	4	Non-Preferred Brand	100000	2
H0544	014	0	1	01	01	H0544_014_0	9	3	Preferred Brand	000001	2
H0544	014	0	1	01	01	H0544_014_0	9	2	Non-Preferred Generic	000100	1
H0544	014	0	1	01	01	H0544_014_0	9	1	Preferred Generic	001000	1
H0544	014	0	1	01	01	H0544_014_0	9	6	Select Care Drugs	000010	
H0544	014	0	1	01	01	H0544_014_0	9	5	Specialty Tier	010010	
H0544	014	0	1	01	01	H0544_014_0	9	4	Non-Preferred Brand	100000	
H0544	014	0	1	01	01	H0544_014_0	9	2	Non-Preferred Generic	000100	
H0544	014	0	1	01	01	H0544_014_0	9	3	Preferred Brand	000001	
H0544	014	0	1	01	01	H0544_014_0	9	1	Preferred Generic	001000	
H0544	015	0	1	01	01	H0544_015_0	10	4	Non-Preferred Brand	100000	2
H0544	015	0	1	01	01	H0544_015_0	10	6	Select Care Drugs	000010	1
H0544	015	0	1	01	01	H0544_015_0	10	1	Preferred Generic	001000	
H0544	015	0	1	01	01	H0544_015_0	10	2	Non-Preferred Generic	000100	
H0544	015	0	1	01	01	H0544_015_0	10	3	Preferred Brand	000001	
H0544	015	0	1	01	01	H0544_015_0	10	3	Preferred Brand	000001	2
H0544	015	0	1	01	01	H0544_015_0	10	5	Specialty Tier	010010	
H0544	015	0	1	01	01	H0544_015_0	10	6	Select Care Drugs	000010	
H0544	015	0	1	01	01	H0544_015_0	10	1	Preferred Generic	001000	1
H0544	015	0	1	01	01	H0544_015_0	10	2	Non-Preferred Generic	000100	1
H0544	015	0	1	01	01	H0544_015_0	10	4	Non-Preferred Brand	100000	
H0544	019	0	1	01	01	H0544_019_0	10	4	Non-Preferred Brand	100000	2
H0544	019	0	1	01	01	H0544_019_0	10	3	Preferred Brand	000001	2
H0544	019	0	1	01	01	H0544_019_0	10	1	Preferred Generic	001000	
H0544	019	0	1	01	01	H0544_019_0	10	2	Non-Preferred Generic	000100	
H0544	019	0	1	01	01	H0544_019_0	10	3	Preferred Brand	000001	
H0544	019	0	1	01	01	H0544_019_0	10	4	Non-Preferred Brand	100000	
H0544	019	0	1	01	01	H0544_019_0	10	5	Specialty Tier	010010	
H0544	019	0	1	01	01	H0544_019_0	10	6	Select Care Drugs	000010	
H0544	019	0	1	01	01	H0544_019_0	10	6	Select Care Drugs	000010	1
H0544	019	0	1	01	01	H0544_019_0	10	2	Non-Preferred Generic	000100	1
H0544	019	0	1	01	01	H0544_019_0	10	1	Preferred Generic	001000	1
H0544	020	0	1	01	01	H0544_020_0	9	6	Select Care Drugs	000010	1
H0544	020	0	1	01	01	H0544_020_0	9	3	Preferred Brand	000001	
H0544	020	0	1	01	01	H0544_020_0	9	3	Preferred Brand	000001	2
H0544	020	0	1	01	01	H0544_020_0	9	2	Non-Preferred Generic	000100	1
H0544	020	0	1	01	01	H0544_020_0	9	1	Preferred Generic	001000	1
H0544	020	0	1	01	01	H0544_020_0	9	6	Select Care Drugs	000010	
H0544	020	0	1	01	01	H0544_020_0	9	5	Specialty Tier	010010	
H0544	020	0	1	01	01	H0544_020_0	9	4	Non-Preferred Brand	100000	
H0544	020	0	1	01	01	H0544_020_0	9	4	Non-Preferred Brand	100000	2
H0544	020	0	1	01	01	H0544_020_0	9	2	Non-Preferred Generic	000100	
H0544	020	0	1	01	01	H0544_020_0	9	1	Preferred Generic	001000	
H0544	021	0	1	01	01	H0544_021_0	9	3	Preferred Brand	000001	
H0544	021	0	1	01	01	H0544_021_0	9	2	Non-Preferred Generic	000100	
H0544	021	0	1	01	01	H0544_021_0	9	1	Preferred Generic	001000	
H0544	021	0	1	01	01	H0544_021_0	9	4	Non-Preferred Brand	100000	
H0544	021	0	1	01	01	H0544_021_0	9	5	Specialty Tier	010010	
H0544	021	0	1	01	01	H0544_021_0	9	6	Select Care Drugs	000010	
H0544	024	0	1	01	01	H0544_024_0	9	3	Preferred Brand	000001	2
H0544	024	0	1	01	01	H0544_024_0	9	2	Non-Preferred Generic	000100	1
H0544	024	0	1	01	01	H0544_024_0	9	1	Preferred Generic	001000	1
H0544	024	0	1	01	01	H0544_024_0	9	6	Select Care Drugs	000010	
H0544	024	0	1	01	01	H0544_024_0	9	5	Specialty Tier	010010	
H0544	024	0	1	01	01	H0544_024_0	9	4	Non-Preferred Brand	100000	
H0544	024	0	1	01	01	H0544_024_0	9	3	Preferred Brand	000001	
H0544	024	0	1	01	01	H0544_024_0	9	1	Preferred Generic	001000	
H0544	024	0	1	01	01	H0544_024_0	9	2	Non-Preferred Generic	000100	
H0544	024	0	1	01	01	H0544_024_0	9	6	Select Care Drugs	000010	1
H0544	024	0	1	01	01	H0544_024_0	9	4	Non-Preferred Brand	100000	2
H0544	025	0	1	01	01	H0544_025_0	8	3	Preferred Brand	000001	
H0544	025	0	1	01	01	H0544_025_0	8	2	Non-Preferred Generic	000100	
H0544	025	0	1	01	01	H0544_025_0	8	1	Preferred Generic	001000	
H0544	025	0	1	01	01	H0544_025_0	8	6	Select Care Drugs	000010	1
H0544	025	0	1	01	01	H0544_025_0	8	4	Non-Preferred Brand	100000	2
H0544	025	0	1	01	01	H0544_025_0	8	6	Select Care Drugs	000010	
H0544	025	0	1	01	01	H0544_025_0	8	2	Non-Preferred Generic	000100	1
H0544	025	0	1	01	01	H0544_025_0	8	1	Preferred Generic	001000	1
H0544	025	0	1	01	01	H0544_025_0	8	4	Non-Preferred Brand	100000	
H0544	025	0	1	01	01	H0544_025_0	8	5	Specialty Tier	010010	
H0544	025	0	1	01	01	H0544_025_0	8	3	Preferred Brand	000001	2
H0544	027	0	1	01	01	H0544_027_0	9	2	Non-Preferred Generic	000100	1
H0544	027	0	1	01	01	H0544_027_0	9	1	Preferred Generic	001000	1
H0544	027	0	1	01	01	H0544_027_0	9	1	Preferred Generic	001000	
H0544	027	0	1	01	01	H0544_027_0	9	3	Preferred Brand	000001	
H0544	027	0	1	01	01	H0544_027_0	9	2	Non-Preferred Generic	000100	
H0544	027	0	1	01	01	H0544_027_0	9	4	Non-Preferred Brand	100000	
H0544	027	0	1	01	01	H0544_027_0	9	6	Select Care Drugs	000010	2
H0544	027	0	1	01	01	H0544_027_0	9	6	Select Care Drugs	000010	
H0544	027	0	1	01	01	H0544_027_0	9	5	Specialty Tier	010010	
H0544	031	0	1	01	01	H0544_031_0	9	1	Preferred Generic	001000	
H0544	031	0	1	01	01	H0544_031_0	9	2	Non-Preferred Generic	000100	
H0544	031	0	1	01	01	H0544_031_0	9	6	Select Care Drugs	000010	1
H0544	031	0	1	01	01	H0544_031_0	9	4	Non-Preferred Brand	100000	2
H0544	031	0	1	01	01	H0544_031_0	9	3	Preferred Brand	000001	2
H0544	031	0	1	01	01	H0544_031_0	9	2	Non-Preferred Generic	000100	1
H0544	031	0	1	01	01	H0544_031_0	9	1	Preferred Generic	001000	1
H0544	031	0	1	01	01	H0544_031_0	9	6	Select Care Drugs	000010	
H0544	031	0	1	01	01	H0544_031_0	9	5	Specialty Tier	010010	
H0544	031	0	1	01	01	H0544_031_0	9	4	Non-Preferred Brand	100000	
H0544	031	0	1	01	01	H0544_031_0	9	3	Preferred Brand	000001	
H0544	032	0	1	01	01	H0544_032_0	9	1	Preferred Generic	001000	
H0544	032	0	1	01	01	H0544_032_0	9	4	Non-Preferred Brand	100000	2
H0544	032	0	1	01	01	H0544_032_0	9	3	Preferred Brand	000001	2
H0544	032	0	1	01	01	H0544_032_0	9	2	Non-Preferred Generic	000100	1
H0544	032	0	1	01	01	H0544_032_0	9	1	Preferred Generic	001000	1
H0544	032	0	1	01	01	H0544_032_0	9	6	Select Care Drugs	000010	1
H0544	032	0	1	01	01	H0544_032_0	9	5	Specialty Tier	010010	
H0544	032	0	1	01	01	H0544_032_0	9	4	Non-Preferred Brand	100000	
H0544	032	0	1	01	01	H0544_032_0	9	3	Preferred Brand	000001	
H0544	032	0	1	01	01	H0544_032_0	9	2	Non-Preferred Generic	000100	
H0544	032	0	1	01	01	H0544_032_0	9	6	Select Care Drugs	000010	
H0544	036	0	1	01	01	H0544_036_0	9	1	Preferred Generic	001000	
H0544	036	0	1	01	01	H0544_036_0	9	2	Non-Preferred Generic	000100	
H0544	036	0	1	01	01	H0544_036_0	9	3	Preferred Brand	000001	
H0544	036	0	1	01	01	H0544_036_0	9	4	Non-Preferred Brand	100000	
H0544	036	0	1	01	01	H0544_036_0	9	5	Specialty Tier	010010	
H0544	036	0	1	01	01	H0544_036_0	9	6	Select Care Drugs	000010	
H0544	036	0	1	01	01	H0544_036_0	9	1	Preferred Generic	001000	1
H0544	036	0	1	01	01	H0544_036_0	9	2	Non-Preferred Generic	000100	1
H0544	036	0	1	01	01	H0544_036_0	9	3	Preferred Brand	000001	2
H0544	036	0	1	01	01	H0544_036_0	9	4	Non-Preferred Brand	100000	2
H0544	036	0	1	01	01	H0544_036_0	9	6	Select Care Drugs	000010	1
H0544	037	0	1	01	01	H0544_037_0	11	1	Preferred Generic	001000	
H0544	037	0	1	01	01	H0544_037_0	11	2	Non-Preferred Generic	000100	
H0544	037	0	1	01	01	H0544_037_0	11	3	Preferred Brand	000001	
H0544	037	0	1	01	01	H0544_037_0	11	4	Non-Preferred Brand	100000	
H0544	037	0	1	01	01	H0544_037_0	11	6	Select Care Drugs	000010	1
H0544	037	0	1	01	01	H0544_037_0	11	5	Specialty Tier	010010	
H0544	037	0	1	01	01	H0544_037_0	11	3	Preferred Brand	000001	2
H0544	037	0	1	01	01	H0544_037_0	11	2	Non-Preferred Generic	000100	1
H0544	037	0	1	01	01	H0544_037_0	11	1	Preferred Generic	001000	1
H0544	037	0	1	01	01	H0544_037_0	11	6	Select Care Drugs	000010	
H0544	037	0	1	01	01	H0544_037_0	11	4	Non-Preferred Brand	100000	2
H0544	038	0	1	01	01	H0544_038_0	11	6	Select Care Drugs	000010	1
H0544	038	0	1	01	01	H0544_038_0	11	4	Non-Preferred Brand	100000	2
H0544	038	0	1	01	01	H0544_038_0	11	3	Preferred Brand	000001	2
H0544	038	0	1	01	01	H0544_038_0	11	1	Preferred Generic	001000	1
H0544	038	0	1	01	01	H0544_038_0	11	2	Non-Preferred Generic	000100	1
H0544	038	0	1	01	01	H0544_038_0	11	6	Select Care Drugs	000010	
H0544	038	0	1	01	01	H0544_038_0	11	5	Specialty Tier	010010	
H0544	038	0	1	01	01	H0544_038_0	11	4	Non-Preferred Brand	100000	
H0544	038	0	1	01	01	H0544_038_0	11	3	Preferred Brand	000001	
H0544	038	0	1	01	01	H0544_038_0	11	2	Non-Preferred Generic	000100	
H0544	038	0	1	01	01	H0544_038_0	11	1	Preferred Generic	001000	
H0544	041	0	1	01	01	H0544_041_0	12	2	Non-Preferred Generic	000100	
H0544	041	0	1	01	01	H0544_041_0	12	6	Select Care Drugs	000010	1
H0544	041	0	1	01	01	H0544_041_0	12	1	Preferred Generic	001000	
H0544	041	0	1	01	01	H0544_041_0	12	2	Non-Preferred Generic	000100	1
H0544	041	0	1	01	01	H0544_041_0	12	1	Preferred Generic	001000	1
H0544	041	0	1	01	01	H0544_041_0	12	6	Select Care Drugs	000010	
H0544	041	0	1	01	01	H0544_041_0	12	5	Specialty Tier	010010	
H0544	041	0	1	01	01	H0544_041_0	12	4	Non-Preferred Brand	100000	
H0544	041	0	1	01	01	H0544_041_0	12	3	Preferred Brand	000001	
H0545	001	0	1	01	01	H0545_001_0	6	1	Preferred Generic	001000	
H0545	001	0	1	01	01	H0545_001_0	6	2	Non-Preferred Generic	000100	
H0545	001	0	1	01	01	H0545_001_0	6	3	Preferred Brand	000001	
H0545	001	0	1	01	01	H0545_001_0	6	4	Non-Preferred Brand	100000	
H0545	001	0	1	01	01	H0545_001_0	6	5	Specialty Tier	010010	
H0545	001	0	1	01	01	H0545_001_0	6	1	Preferred Generic	001000	1
H0545	011	0	1	01	01	H0545_011_0	5	1	Preferred Generic	001000	
H0545	011	0	1	01	01	H0545_011_0	5	2	Non-Preferred Generic	000100	
H0545	011	0	1	01	01	H0545_011_0	5	3	Preferred Brand	000001	
H0545	011	0	1	01	01	H0545_011_0	5	4	Non-Preferred Brand	100000	
H0545	011	0	1	01	01	H0545_011_0	5	5	Specialty Tier	010010	
H0545	012	0	1	01	01	H0545_012_0	8	1	Preferred Generic	001000	
H0545	012	0	1	01	01	H0545_012_0	8	2	Non-Preferred Generic	000100	1
H0545	012	0	1	01	01	H0545_012_0	8	1	Preferred Generic	001000	1
H0545	012	0	1	01	01	H0545_012_0	8	5	Specialty Tier	010010	
H0545	012	0	1	01	01	H0545_012_0	8	4	Non-Preferred Brand	100000	
H0545	012	0	1	01	01	H0545_012_0	8	3	Preferred Brand	000001	
H0545	012	0	1	01	01	H0545_012_0	8	2	Non-Preferred Generic	000100	
H0545	013	0	1	01	01	H0545_013_0	5	1	Preferred Generic	001000	
H0545	013	0	1	01	01	H0545_013_0	5	2	Non-Preferred Generic	000100	
H0545	013	0	1	01	01	H0545_013_0	5	3	Preferred Brand	000001	
H0545	013	0	1	01	01	H0545_013_0	5	4	Non-Preferred Brand	100000	
H0545	013	0	1	01	01	H0545_013_0	5	5	Specialty Tier	010010	
H0545	013	0	1	01	01	H0545_013_0	5	1	Preferred Generic	001000	1
H0562	009	0	1	01	01	H0562_009_0	4	6	Select Care Drugs	010010	
H0562	009	0	1	01	01	H0562_009_0	4	5	Specialty Tier	010010	
H0562	009	0	1	01	01	H0562_009_0	4	4	Non-Preferred Brand	100100	
H0562	009	0	1	01	01	H0562_009_0	4	3	Preferred Brand	000101	
H0562	009	0	1	01	01	H0562_009_0	4	2	Non-Preferred Generic	000100	
H0562	009	0	1	01	01	H0562_009_0	4	1	Preferred Generic	001000	
H0562	012	0	1	01	01	H0562_012_0	4	3	Preferred Brand	000101	
H0562	012	0	1	01	01	H0562_012_0	4	2	Non-Preferred Generic	000100	
H0562	012	0	1	01	01	H0562_012_0	4	4	Non-Preferred Brand	100100	
H0562	012	0	1	01	01	H0562_012_0	4	5	Specialty Tier	010010	
H0562	012	0	1	01	01	H0562_012_0	4	6	Select Care Drugs	010010	
H0562	012	0	1	01	01	H0562_012_0	4	1	Preferred Generic	001000	1
H0562	012	0	1	01	01	H0562_012_0	4	1	Preferred Generic	001000	
H0562	012	0	1	01	01	H0562_012_0	4	6	Select Care Drugs	010010	1
H0562	012	0	1	01	01	H0562_012_0	4	2	Non-Preferred Generic	000100	1
H0562	039	0	1	01	01	H0562_039_0	4	6	Select Care Drugs	010010	
H0562	039	0	1	01	01	H0562_039_0	4	5	Specialty Tier	010010	
H0562	039	0	1	01	01	H0562_039_0	4	4	Non-Preferred Brand	100100	
H0562	039	0	1	01	01	H0562_039_0	4	3	Preferred Brand	000101	
H0562	039	0	1	01	01	H0562_039_0	4	2	Non-Preferred Generic	000100	
H0562	039	0	1	01	01	H0562_039_0	4	1	Preferred Generic	001000	
H0562	040	0	1	01	01	H0562_040_0	3	2	Non-Preferred Generic	000100	
H0562	040	0	1	01	01	H0562_040_0	3	3	Preferred Brand	000101	
H0562	040	0	1	01	01	H0562_040_0	3	1	Preferred Generic	001000	
H0562	040	0	1	01	01	H0562_040_0	3	6	Select Care Drugs	010010	1
H0562	040	0	1	01	01	H0562_040_0	3	4	Non-Preferred Brand	100100	
H0562	040	0	1	01	01	H0562_040_0	3	1	Preferred Generic	001000	1
H0562	040	0	1	01	01	H0562_040_0	3	6	Select Care Drugs	010010	
H0562	040	0	1	01	01	H0562_040_0	3	5	Specialty Tier	010010	
H0562	040	0	1	01	01	H0562_040_0	3	2	Non-Preferred Generic	000100	1
H0562	053	0	1	01	01	H0562_053_0	4	4	Non-Preferred Brand	100100	
H0562	053	0	1	01	01	H0562_053_0	4	6	Select Care Drugs	010010	
H0562	053	0	1	01	01	H0562_053_0	4	5	Specialty Tier	010010	
H0562	053	0	1	01	01	H0562_053_0	4	3	Preferred Brand	000101	
H0562	053	0	1	01	01	H0562_053_0	4	2	Non-Preferred Generic	000100	
H0562	053	0	1	01	01	H0562_053_0	4	1	Preferred Generic	001000	
H0562	055	0	1	01	01	H0562_055_0	4	5	Specialty Tier	010010	
H0562	055	0	1	01	01	H0562_055_0	4	6	Select Care Drugs	010010	
H0562	055	0	1	01	01	H0562_055_0	4	4	Non-Preferred Brand	100000	
H0562	055	0	1	01	01	H0562_055_0	4	3	Preferred Brand	000001	
H0562	055	0	1	01	01	H0562_055_0	4	2	Non-Preferred Generic	000100	
H0562	055	0	1	01	01	H0562_055_0	4	1	Preferred Generic	001000	
H0562	068	0	1	01	01	H0562_068_0	4	4	Non-Preferred Brand	100100	
H0562	068	0	1	01	01	H0562_068_0	4	5	Specialty Tier	010010	
H0562	068	0	1	01	01	H0562_068_0	4	6	Select Care Drugs	010010	
H0562	068	0	1	01	01	H0562_068_0	4	3	Preferred Brand	000101	
H0562	068	0	1	01	01	H0562_068_0	4	2	Non-Preferred Generic	000100	
H0562	068	0	1	01	01	H0562_068_0	4	1	Preferred Generic	001000	
H0562	070	0	1	01	01	H0562_070_0	5	2	Non-Preferred Generic	000100	
H0562	070	0	1	01	01	H0562_070_0	5	1	Preferred Generic	001000	
H0562	070	0	1	01	01	H0562_070_0	5	3	Preferred Brand	000001	
H0562	070	0	1	01	01	H0562_070_0	5	4	Non-Preferred Brand	100000	
H0562	070	0	1	01	01	H0562_070_0	5	5	Specialty Tier	010010	
H0562	070	0	1	01	01	H0562_070_0	5	6	Select Care Drugs	010010	
H0562	079	0	1	01	01	H0562_079_0	4	1	Preferred Generic	001000	
H0562	079	0	1	01	01	H0562_079_0	4	2	Non-Preferred Generic	000100	
H0562	079	0	1	01	01	H0562_079_0	4	3	Preferred Brand	000001	
H0562	079	0	1	01	01	H0562_079_0	4	4	Non-Preferred Brand	100000	
H0562	079	0	1	01	01	H0562_079_0	4	5	Specialty Tier	010010	
H0562	079	0	1	01	01	H0562_079_0	4	6	Select Care Drugs	010010	
H0562	079	0	1	01	01	H0562_079_0	4	1	Preferred Generic	001000	1
H0562	079	0	1	01	01	H0562_079_0	4	2	Non-Preferred Generic	000100	1
H0562	079	0	1	01	01	H0562_079_0	4	6	Select Care Drugs	010010	1
H0562	084	0	1	01	01	H0562_084_0	4	4	Non-Preferred Brand	100100	
H0562	084	0	1	01	01	H0562_084_0	4	3	Preferred Brand	000101	
H0562	084	0	1	01	01	H0562_084_0	4	2	Non-Preferred Generic	000100	
H0562	084	0	1	01	01	H0562_084_0	4	1	Preferred Generic	001000	
H0562	084	0	1	01	01	H0562_084_0	4	5	Specialty Tier	010010	
H0562	084	0	1	01	01	H0562_084_0	4	6	Select Care Drugs	010010	
H0562	087	0	1	01	01	H0562_087_0	4	3	Preferred Brand	000101	
H0562	087	0	1	01	01	H0562_087_0	4	6	Select Care Drugs	010010	
H0562	087	0	1	01	01	H0562_087_0	4	5	Specialty Tier	010010	
H0562	087	0	1	01	01	H0562_087_0	4	4	Non-Preferred Brand	100100	
H0562	087	0	1	01	01	H0562_087_0	4	2	Non-Preferred Generic	000100	
H0562	087	0	1	01	01	H0562_087_0	4	1	Preferred Generic	001000	
H0562	089	0	1	01	01	H0562_089_0	4	6	Select Care Drugs	010010	
H0562	089	0	1	01	01	H0562_089_0	4	3	Preferred Brand	000101	
H0562	089	0	1	01	01	H0562_089_0	4	2	Non-Preferred Generic	000100	
H0562	089	0	1	01	01	H0562_089_0	4	1	Preferred Generic	001000	
H0562	089	0	1	01	01	H0562_089_0	4	5	Specialty Tier	010010	
H0562	089	0	1	01	01	H0562_089_0	4	4	Non-Preferred Brand	100100	
H0562	090	0	1	01	01	H0562_090_0	3	6	Select Care Drugs	010010	
H0562	090	0	1	01	01	H0562_090_0	3	2	Non-Preferred Generic	000100	
H0562	090	0	1	01	01	H0562_090_0	3	5	Specialty Tier	010010	
H0562	090	0	1	01	01	H0562_090_0	3	4	Non-Preferred Brand	100000	
H0562	090	0	1	01	01	H0562_090_0	3	3	Preferred Brand	000001	
H0562	090	0	1	01	01	H0562_090_0	3	1	Preferred Generic	001000	
H0562	091	0	1	01	01	H0562_091_0	4	4	Non-Preferred Brand	100100	
H0562	091	0	1	01	01	H0562_091_0	4	3	Preferred Brand	000101	
H0562	091	0	1	01	01	H0562_091_0	4	6	Select Care Drugs	010010	
H0562	091	0	1	01	01	H0562_091_0	4	2	Non-Preferred Generic	000100	
H0562	091	0	1	01	01	H0562_091_0	4	1	Preferred Generic	001000	
H0562	091	0	1	01	01	H0562_091_0	4	5	Specialty Tier	010010	
H0562	092	0	1	01	01	H0562_092_0	3	1	Preferred Generic	001000	
H0562	092	0	1	01	01	H0562_092_0	3	2	Non-Preferred Generic	000100	
H0562	092	0	1	01	01	H0562_092_0	3	6	Select Care Drugs	010010	1
H0562	092	0	1	01	01	H0562_092_0	3	4	Non-Preferred Brand	100000	
H0562	092	0	1	01	01	H0562_092_0	3	3	Preferred Brand	000001	
H0562	092	0	1	01	01	H0562_092_0	3	5	Specialty Tier	010010	
H0562	092	0	1	01	01	H0562_092_0	3	6	Select Care Drugs	010010	
H0562	092	0	1	01	01	H0562_092_0	3	1	Preferred Generic	001000	1
H0562	092	0	1	01	01	H0562_092_0	3	2	Non-Preferred Generic	000100	1
H0562	093	0	1	01	01	H0562_093_0	4	1	Preferred Generic	001000	
H0562	093	0	1	01	01	H0562_093_0	4	2	Non-Preferred Generic	000100	
H0562	093	0	1	01	01	H0562_093_0	4	3	Preferred Brand	000101	
H0562	093	0	1	01	01	H0562_093_0	4	4	Non-Preferred Brand	100100	
H0562	093	0	1	01	01	H0562_093_0	4	5	Specialty Tier	010010	
H0562	093	0	1	01	01	H0562_093_0	4	6	Select Care Drugs	010010	
H0562	094	0	1	01	01	H0562_094_0	3	6	Select Care Drugs	010010	
H0562	094	0	1	01	01	H0562_094_0	3	1	Preferred Generic	001000	
H0562	094	0	1	01	01	H0562_094_0	3	2	Non-Preferred Generic	000100	
H0562	094	0	1	01	01	H0562_094_0	3	3	Preferred Brand	000101	
H0562	094	0	1	01	01	H0562_094_0	3	4	Non-Preferred Brand	100100	
H0562	094	0	1	01	01	H0562_094_0	3	5	Specialty Tier	010010	
H0562	095	0	1	01	01	H0562_095_0	3	1	Preferred Generic	001000	
H0562	095	0	1	01	01	H0562_095_0	3	2	Non-Preferred Generic	000100	
H0562	095	0	1	01	01	H0562_095_0	3	3	Preferred Brand	000101	
H0562	095	0	1	01	01	H0562_095_0	3	4	Non-Preferred Brand	100100	
H0562	095	0	1	01	01	H0562_095_0	3	5	Specialty Tier	010010	
H0562	095	0	1	01	01	H0562_095_0	3	6	Select Care Drugs	010010	
H0562	096	0	1	01	01	H0562_096_0	3	1	Preferred Generic	001000	
H0562	096	0	1	01	01	H0562_096_0	3	2	Non-Preferred Generic	000100	
H0562	096	0	1	01	01	H0562_096_0	3	3	Preferred Brand	000101	
H0562	096	0	1	01	01	H0562_096_0	3	4	Non-Preferred Brand	100100	
H0562	096	0	1	01	01	H0562_096_0	3	5	Specialty Tier	010010	
H0562	096	0	1	01	01	H0562_096_0	3	6	Select Care Drugs	010010	
H0562	097	0	1	01	01	H0562_097_0	4	6	Select Care Drugs	010010	
H0562	097	0	1	01	01	H0562_097_0	4	1	Preferred Generic	001000	
H0562	097	0	1	01	01	H0562_097_0	4	2	Non-Preferred Generic	000100	
H0562	097	0	1	01	01	H0562_097_0	4	3	Preferred Brand	000101	
H0562	097	0	1	01	01	H0562_097_0	4	4	Non-Preferred Brand	100100	
H0562	097	0	1	01	01	H0562_097_0	4	5	Specialty Tier	010010	
H0562	098	1	1	01	01	H0562_098_1	3	6	Select Care Drugs	010010	
H0562	098	1	1	01	01	H0562_098_1	3	5	Specialty Tier	010010	
H0562	098	1	1	01	01	H0562_098_1	3	4	Non-Preferred Brand	100100	
H0562	098	1	1	01	01	H0562_098_1	3	3	Preferred Brand	000101	
H0562	098	1	1	01	01	H0562_098_1	3	1	Preferred Generic	001000	
H0562	098	1	1	01	01	H0562_098_1	3	2	Non-Preferred Generic	000100	
H0562	098	2	1	01	01	H0562_098_2	3	1	Preferred Generic	001000	
H0562	098	2	1	01	01	H0562_098_2	3	2	Non-Preferred Generic	000100	
H0562	098	2	1	01	01	H0562_098_2	3	3	Preferred Brand	000101	
H0562	098	2	1	01	01	H0562_098_2	3	4	Non-Preferred Brand	100100	
H0562	098	2	1	01	01	H0562_098_2	3	5	Specialty Tier	010010	
H0562	098	2	1	01	01	H0562_098_2	3	6	Select Care Drugs	010010	
H0562	099	1	1	01	01	H0562_099_1	3	6	Select Care Drugs	010010	
H0562	099	1	1	01	01	H0562_099_1	3	1	Preferred Generic	001000	
H0562	099	1	1	01	01	H0562_099_1	3	2	Non-Preferred Generic	000100	
H0562	099	1	1	01	01	H0562_099_1	3	3	Preferred Brand	000001	
H0562	099	1	1	01	01	H0562_099_1	3	4	Non-Preferred Brand	100000	
H0562	099	1	1	01	01	H0562_099_1	3	5	Specialty Tier	010010	
H0562	099	1	1	01	01	H0562_099_1	3	1	Preferred Generic	001000	1
H0562	099	1	1	01	01	H0562_099_1	3	2	Non-Preferred Generic	000100	1
H0562	099	1	1	01	01	H0562_099_1	3	6	Select Care Drugs	010010	1
H0562	099	2	1	01	01	H0562_099_2	3	6	Select Care Drugs	010010	
H0562	099	2	1	01	01	H0562_099_2	3	1	Preferred Generic	001000	1
H0562	099	2	1	01	01	H0562_099_2	3	2	Non-Preferred Generic	000100	1
H0562	099	2	1	01	01	H0562_099_2	3	3	Preferred Brand	000001	
H0562	099	2	1	01	01	H0562_099_2	3	2	Non-Preferred Generic	000100	
H0562	099	2	1	01	01	H0562_099_2	3	4	Non-Preferred Brand	100000	
H0562	099	2	1	01	01	H0562_099_2	3	5	Specialty Tier	010010	
H0562	099	2	1	01	01	H0562_099_2	3	1	Preferred Generic	001000	
H0562	099	2	1	01	01	H0562_099_2	3	6	Select Care Drugs	010010	1
H0562	100	1	1	01	01	H0562_100_1	3	5	Specialty Tier	010010	
H0562	100	1	1	01	01	H0562_100_1	3	4	Non-Preferred Brand	100000	
H0562	100	1	1	01	01	H0562_100_1	3	6	Select Care Drugs	010010	1
H0562	100	1	1	01	01	H0562_100_1	3	2	Non-Preferred Generic	000100	1
H0562	100	1	1	01	01	H0562_100_1	3	1	Preferred Generic	001000	1
H0562	100	1	1	01	01	H0562_100_1	3	6	Select Care Drugs	010010	
H0562	100	1	1	01	01	H0562_100_1	3	1	Preferred Generic	001000	
H0562	100	1	1	01	01	H0562_100_1	3	2	Non-Preferred Generic	000100	
H0562	100	1	1	01	01	H0562_100_1	3	3	Preferred Brand	000001	
H0562	100	2	1	01	01	H0562_100_2	3	1	Preferred Generic	001000	
H0562	100	2	1	01	01	H0562_100_2	3	2	Non-Preferred Generic	000100	1
H0562	100	2	1	01	01	H0562_100_2	3	1	Preferred Generic	001000	1
H0562	100	2	1	01	01	H0562_100_2	3	6	Select Care Drugs	010010	
H0562	100	2	1	01	01	H0562_100_2	3	6	Select Care Drugs	010010	1
H0562	100	2	1	01	01	H0562_100_2	3	4	Non-Preferred Brand	100000	
H0562	100	2	1	01	01	H0562_100_2	3	3	Preferred Brand	000001	
H0562	100	2	1	01	01	H0562_100_2	3	2	Non-Preferred Generic	000100	
H0562	100	2	1	01	01	H0562_100_2	3	5	Specialty Tier	010010	
H0562	101	1	1	01	01	H0562_101_1	3	5	Specialty Tier	010010	
H0562	101	1	1	01	01	H0562_101_1	3	4	Non-Preferred Brand	100000	
H0562	101	1	1	01	01	H0562_101_1	3	3	Preferred Brand	000001	
H0562	101	1	1	01	01	H0562_101_1	3	2	Non-Preferred Generic	000100	
H0562	101	1	1	01	01	H0562_101_1	3	1	Preferred Generic	001000	
H0562	101	1	1	01	01	H0562_101_1	3	6	Select Care Drugs	010010	
H0562	101	1	1	01	01	H0562_101_1	3	6	Select Care Drugs	010010	1
H0562	101	1	1	01	01	H0562_101_1	3	2	Non-Preferred Generic	000100	1
H0562	101	1	1	01	01	H0562_101_1	3	1	Preferred Generic	001000	1
H0562	101	2	1	01	01	H0562_101_2	3	1	Preferred Generic	001000	
H0562	101	2	1	01	01	H0562_101_2	3	2	Non-Preferred Generic	000100	
H0562	101	2	1	01	01	H0562_101_2	3	3	Preferred Brand	000001	
H0562	101	2	1	01	01	H0562_101_2	3	4	Non-Preferred Brand	100000	
H0562	101	2	1	01	01	H0562_101_2	3	6	Select Care Drugs	010010	1
H0562	101	2	1	01	01	H0562_101_2	3	6	Select Care Drugs	010010	
H0562	101	2	1	01	01	H0562_101_2	3	1	Preferred Generic	001000	1
H0562	101	2	1	01	01	H0562_101_2	3	2	Non-Preferred Generic	000100	1
H0562	101	2	1	01	01	H0562_101_2	3	5	Specialty Tier	010010	
H0562	102	0	1	01	01	H0562_102_0	4	1	Preferred Generic	001000	
H0562	102	0	1	01	01	H0562_102_0	4	2	Non-Preferred Generic	000100	
H0562	102	0	1	01	01	H0562_102_0	4	6	Select Care Drugs	010010	
H0562	102	0	1	01	01	H0562_102_0	4	5	Specialty Tier	010010	
H0562	102	0	1	01	01	H0562_102_0	4	4	Non-Preferred Brand	100100	
H0562	102	0	1	01	01	H0562_102_0	4	3	Preferred Brand	000101	
H0562	103	0	1	01	01	H0562_103_0	4	1	Preferred Generic	001000	
H0562	103	0	1	01	01	H0562_103_0	4	3	Preferred Brand	000101	
H0562	103	0	1	01	01	H0562_103_0	4	4	Non-Preferred Brand	100100	
H0562	103	0	1	01	01	H0562_103_0	4	5	Specialty Tier	010010	
H0562	103	0	1	01	01	H0562_103_0	4	2	Non-Preferred Generic	000100	
H0562	103	0	1	01	01	H0562_103_0	4	6	Select Care Drugs	010010	
H0564	006	0	1	01	01	H0564_006_0	7	5	Injectable Drugs	010010	
H0564	006	0	1	01	01	H0564_006_0	7	4	Non-Preferred Brand	100100	
H0564	006	0	1	01	01	H0564_006_0	7	3	Preferred Brand	000101	
H0564	006	0	1	01	01	H0564_006_0	7	2	Non-Preferred Generic	000100	
H0564	006	0	1	01	01	H0564_006_0	7	1	Preferred Generic	001000	
H0564	006	0	1	01	01	H0564_006_0	7	6	Specialty Tier	010010	
H0564	047	0	1	01	01	H0564_047_0	7	5	Injectable Drugs	010010	
H0564	047	0	1	01	01	H0564_047_0	7	4	Non-Preferred Brand	100100	
H0564	047	0	1	01	01	H0564_047_0	7	3	Preferred Brand	000101	
H0564	047	0	1	01	01	H0564_047_0	7	2	Non-Preferred Generic	000100	
H0564	047	0	1	01	01	H0564_047_0	7	1	Preferred Generic	001000	
H0564	047	0	1	01	01	H0564_047_0	7	6	Specialty Tier	010010	
H0564	052	0	1	01	01	H0564_052_0	6	1	Preferred Generic	001000	
H0564	052	0	1	01	01	H0564_052_0	6	2	Non-Preferred Generic	000100	
H0564	052	0	1	01	01	H0564_052_0	6	3	Preferred Brand	000101	
H0564	052	0	1	01	01	H0564_052_0	6	4	Non-Preferred Brand	100100	
H0564	052	0	1	01	01	H0564_052_0	6	5	Injectable Drugs	010010	
H0564	052	0	1	01	01	H0564_052_0	6	6	Specialty Tier	010010	
H0564	054	0	1	01	01	H0564_054_0	8	1	Preferred Generic	001000	
H0564	054	0	1	01	01	H0564_054_0	8	2	Non-Preferred Generic	000100	
H0564	054	0	1	01	01	H0564_054_0	8	3	Preferred Brand	000101	
H0564	054	0	1	01	01	H0564_054_0	8	4	Non-Preferred Brand	100100	
H0564	054	0	1	01	01	H0564_054_0	8	5	Injectable Drugs	010010	
H0564	054	0	1	01	01	H0564_054_0	8	6	Specialty Tier	010010	
H0571	001	0	1	01	01	H0571_001_0	6	1	Preferred Generic	001000	
H0571	001	0	1	01	01	H0571_001_0	6	2	Non-Preferred Generic	000100	
H0571	001	0	1	01	01	H0571_001_0	6	5	Specialty Tier	100001	
H0571	001	0	1	01	01	H0571_001_0	6	4	Non-Preferred Brand	100000	
H0571	001	0	1	01	01	H0571_001_0	6	3	Preferred Brand	000001	
H0602	017	0	1	18	06	H0602_017_0	7	2	Non-Preferred Generic	000110	
H0602	017	0	1	18	06	H0602_017_0	7	3	Preferred Brand	010001	
H0602	017	0	1	18	06	H0602_017_0	7	4	Non-Preferred Brand	110000	
H0602	017	0	1	18	06	H0602_017_0	7	1	Preferred Generic	001000	
H0602	017	0	1	18	06	H0602_017_0	7	5	Specialty Tier	010010	
H0602	019	0	1	18	06	H0602_019_0	6	3	Preferred Brand	010001	
H0602	019	0	1	18	06	H0602_019_0	6	2	Non-Preferred Generic	000110	
H0602	019	0	1	18	06	H0602_019_0	6	1	Preferred Generic	001000	
H0602	019	0	1	18	06	H0602_019_0	6	4	Non-Preferred Brand	110000	
H0602	019	0	1	18	06	H0602_019_0	6	2	Non-Preferred Generic	000110	1
H0602	019	0	1	18	06	H0602_019_0	6	1	Preferred Generic	001000	1
H0602	019	0	1	18	06	H0602_019_0	6	5	Specialty Tier	010010	
H0602	020	0	1	18	06	H0602_020_0	7	1	Preferred Generic	001000	
H0602	020	0	1	18	06	H0602_020_0	7	4	Non-Preferred Brand	110000	
H0602	020	0	1	18	06	H0602_020_0	7	3	Preferred Brand	010001	
H0602	020	0	1	18	06	H0602_020_0	7	2	Non-Preferred Generic	000110	
H0602	020	0	1	18	06	H0602_020_0	7	5	Specialty Tier	010010	
H0602	022	0	1	18	06	H0602_022_0	6	4	Non-Preferred Brand	110000	
H0602	022	0	1	18	06	H0602_022_0	6	3	Preferred Brand	010001	
H0602	022	0	1	18	06	H0602_022_0	6	2	Non-Preferred Generic	000110	
H0602	022	0	1	18	06	H0602_022_0	6	1	Preferred Generic	001000	
H0602	022	0	1	18	06	H0602_022_0	6	5	Specialty Tier	010010	
H0602	039	0	1	18	06	H0602_039_0	7	1	Preferred Generic	001000	
H0602	039	0	1	18	06	H0602_039_0	7	2	Non-Preferred Generic	000110	
H0602	039	0	1	18	06	H0602_039_0	7	3	Preferred Brand	010001	
H0602	039	0	1	18	06	H0602_039_0	7	4	Non-Preferred Brand	110000	
H0602	039	0	1	18	06	H0602_039_0	7	5	Specialty Tier	010010	
H0602	043	0	1	18	06	H0602_043_0	6	1	Preferred Generic	001000	
H0602	043	0	1	18	06	H0602_043_0	6	2	Non-Preferred Generic	000110	
H0602	043	0	1	18	06	H0602_043_0	6	3	Preferred Brand	010001	
H0602	043	0	1	18	06	H0602_043_0	6	4	Non-Preferred Brand	110000	
H0602	043	0	1	18	06	H0602_043_0	6	5	Specialty Tier	010010	
H0609	002	0	1	01	01	H0609_002_0	5	1	Preferred Generic	001000	
H0609	002	0	1	01	01	H0609_002_0	5	2	Non-Preferred Generic	000100	1
H0609	002	0	1	01	01	H0609_002_0	5	1	Preferred Generic	001000	1
H0609	002	0	1	01	01	H0609_002_0	5	5	Specialty Tier	010010	
H0609	002	0	1	01	01	H0609_002_0	5	4	Non-Preferred Brand	100100	
H0609	002	0	1	01	01	H0609_002_0	5	2	Non-Preferred Generic	000100	
H0609	002	0	1	01	01	H0609_002_0	5	3	Preferred Brand	010001	
H0609	007	0	1	01	01	H0609_007_0	4	2	Non-Preferred Generic	000100	
H0609	007	0	1	01	01	H0609_007_0	4	1	Preferred Generic	001000	
H0609	007	0	1	01	01	H0609_007_0	4	4	Non-Preferred Brand	100100	
H0609	007	0	1	01	01	H0609_007_0	4	3	Preferred Brand	010001	
H0609	007	0	1	01	01	H0609_007_0	4	5	Specialty Tier	010010	
H0609	012	0	1	01	01	H0609_012_0	4	2	Non-Preferred Generic	000100	
H0609	012	0	1	01	01	H0609_012_0	4	3	Preferred Brand	010001	
H0609	012	0	1	01	01	H0609_012_0	4	4	Non-Preferred Brand	100100	
H0609	012	0	1	01	01	H0609_012_0	4	5	Specialty Tier	010010	
H0609	012	0	1	01	01	H0609_012_0	4	1	Preferred Generic	001000	
H0609	020	0	1	01	01	H0609_020_0	4	1	Preferred Generic	001000	
H0609	020	0	1	01	01	H0609_020_0	4	2	Non-Preferred Generic	000100	
H0609	020	0	1	01	01	H0609_020_0	4	5	Specialty Tier	010010	
H0609	020	0	1	01	01	H0609_020_0	4	4	Non-Preferred Brand	100100	
H0609	020	0	1	01	01	H0609_020_0	4	3	Preferred Brand	010001	
H0621	006	0	1	01	01	H0621_006_0	10	1	Preferred Generic	001000	
H0621	006	0	1	01	01	H0621_006_0	10	2	Non-Preferred Generic	000100	
H0621	006	0	1	01	01	H0621_006_0	10	3	Preferred Brand	000001	
H0621	006	0	1	01	01	H0621_006_0	10	4	Non-Preferred Brand	100000	
H0621	006	0	1	01	01	H0621_006_0	10	5	Specialty Tier	010010	
H0621	010	0	1	01	01	H0621_010_0	8	1	Preferred Generic	001000	
H0621	010	0	1	01	01	H0621_010_0	8	2	Non-Preferred Generic	000100	
H0621	010	0	1	01	01	H0621_010_0	8	3	Preferred Brand	000001	
H0621	010	0	1	01	01	H0621_010_0	8	4	Non-Preferred Brand	100000	
H0621	010	0	1	01	01	H0621_010_0	8	5	Specialty Tier	010010	
H0630	013	0	1	01	01	H0630_013_0	6	4	Non-Preferred Brand	100000	
H0630	013	0	1	01	01	H0630_013_0	6	3	Preferred Brand	000001	
H0630	013	0	1	01	01	H0630_013_0	6	6	Vaccines	000001	1
H0630	013	0	1	01	01	H0630_013_0	6	2	Non-Preferred Generic	000100	1
H0630	013	0	1	01	01	H0630_013_0	6	1	Preferred Generic	001000	1
H0630	013	0	1	01	01	H0630_013_0	6	6	Vaccines	000001	
H0630	013	0	1	01	01	H0630_013_0	6	5	Specialty Tier	100001	
H0630	013	0	1	01	01	H0630_013_0	6	1	Preferred Generic	001000	
H0630	013	0	1	01	01	H0630_013_0	6	2	Non-Preferred Generic	000100	
H0630	015	0	1	01	01	H0630_015_0	6	1	Preferred Generic	001000	
H0630	015	0	1	01	01	H0630_015_0	6	2	Non-Preferred Generic	000100	1
H0630	015	0	1	01	01	H0630_015_0	6	1	Preferred Generic	001000	1
H0630	015	0	1	01	01	H0630_015_0	6	6	Vaccines	000001	
H0630	015	0	1	01	01	H0630_015_0	6	6	Vaccines	000001	1
H0630	015	0	1	01	01	H0630_015_0	6	4	Non-Preferred Brand	100000	
H0630	015	0	1	01	01	H0630_015_0	6	3	Preferred Brand	000001	
H0630	015	0	1	01	01	H0630_015_0	6	2	Non-Preferred Generic	000100	
H0630	015	0	1	01	01	H0630_015_0	6	5	Specialty Tier	100001	
H0630	016	0	1	01	01	H0630_016_0	5	4	Non-Preferred Brand	100000	
H0630	016	0	1	01	01	H0630_016_0	5	3	Preferred Brand	000001	
H0630	016	0	1	01	01	H0630_016_0	5	2	Non-Preferred Generic	000100	
H0630	016	0	1	01	01	H0630_016_0	5	1	Preferred Generic	001000	
H0630	016	0	1	01	01	H0630_016_0	5	5	Specialty Tier	100001	
H0630	016	0	1	01	01	H0630_016_0	5	6	Vaccines	000001	1
H0630	016	0	1	01	01	H0630_016_0	5	2	Non-Preferred Generic	000100	1
H0630	016	0	1	01	01	H0630_016_0	5	1	Preferred Generic	001000	1
H0630	016	0	1	01	01	H0630_016_0	5	6	Vaccines	000001	
H0630	017	0	1	01	01	H0630_017_0	7	1	Preferred Generic	001000	
H0630	017	0	1	01	01	H0630_017_0	7	2	Non-Preferred Generic	000100	
H0630	017	0	1	01	01	H0630_017_0	7	6	Vaccines	000001	1
H0630	017	0	1	01	01	H0630_017_0	7	2	Non-Preferred Generic	000100	1
H0630	017	0	1	01	01	H0630_017_0	7	1	Preferred Generic	001000	1
H0630	017	0	1	01	01	H0630_017_0	7	6	Vaccines	000001	
H0630	017	0	1	01	01	H0630_017_0	7	5	Specialty Tier	100001	
H0630	017	0	1	01	01	H0630_017_0	7	4	Non-Preferred Brand	100000	
H0630	017	0	1	01	01	H0630_017_0	7	3	Preferred Brand	000001	
H0630	018	0	1	01	01	H0630_018_0	5	1	Preferred Generic	001000	
H0630	018	0	1	01	01	H0630_018_0	5	5	Specialty Tier	100001	
H0630	018	0	1	01	01	H0630_018_0	5	6	Vaccines	000001	
H0630	018	0	1	01	01	H0630_018_0	5	1	Preferred Generic	001000	1
H0630	018	0	1	01	01	H0630_018_0	5	6	Vaccines	000001	1
H0630	018	0	1	01	01	H0630_018_0	5	4	Non-Preferred Brand	100000	
H0630	018	0	1	01	01	H0630_018_0	5	3	Preferred Brand	000001	
H0630	018	0	1	01	01	H0630_018_0	5	2	Non-Preferred Generic	000100	
H0630	018	0	1	01	01	H0630_018_0	5	2	Non-Preferred Generic	000100	1
H0630	019	0	1	02	01	H0630_019_0	5	2	Non-Preferred Generic	000100	
H0630	019	0	1	02	01	H0630_019_0	5	3	Preferred Brand	000001	
H0630	019	0	1	02	01	H0630_019_0	5	4	Non-Preferred Brand	100000	
H0630	019	0	1	02	01	H0630_019_0	5	5	Specialty Tier	100001	
H0630	019	0	1	02	01	H0630_019_0	5	6	Vaccines	000001	
H0630	019	0	1	02	01	H0630_019_0	5	1	Preferred Generic	001000	1
H0630	019	0	1	02	01	H0630_019_0	5	2	Non-Preferred Generic	000100	1
H0630	019	0	1	02	01	H0630_019_0	5	6	Vaccines	000001	1
H0630	019	0	1	02	01	H0630_019_0	5	1	Preferred Generic	001000	
H0630	020	0	1	01	01	H0630_020_0	5	1	Preferred Generic	001000	
H0630	020	0	1	01	01	H0630_020_0	5	2	Non-Preferred Generic	000100	
H0630	020	0	1	01	01	H0630_020_0	5	6	Vaccines	000001	1
H0630	020	0	1	01	01	H0630_020_0	5	2	Non-Preferred Generic	000100	1
H0630	020	0	1	01	01	H0630_020_0	5	1	Preferred Generic	001000	1
H0630	020	0	1	01	01	H0630_020_0	5	6	Vaccines	000001	
H0630	020	0	1	01	01	H0630_020_0	5	5	Specialty Tier	100001	
H0630	020	0	1	01	01	H0630_020_0	5	4	Non-Preferred Brand	100000	
H0630	020	0	1	01	01	H0630_020_0	5	3	Preferred Brand	000001	
H0630	021	0	1	01	01	H0630_021_0	5	1	Preferred Generic	001000	
H0630	021	0	1	01	01	H0630_021_0	5	2	Non-Preferred Generic	000100	1
H0630	021	0	1	01	01	H0630_021_0	5	1	Preferred Generic	001000	1
H0630	021	0	1	01	01	H0630_021_0	5	6	Vaccines	000001	
H0630	021	0	1	01	01	H0630_021_0	5	6	Vaccines	000001	1
H0630	021	0	1	01	01	H0630_021_0	5	4	Non-Preferred Brand	100000	
H0630	021	0	1	01	01	H0630_021_0	5	3	Preferred Brand	000001	
H0630	021	0	1	01	01	H0630_021_0	5	2	Non-Preferred Generic	000100	
H0630	021	0	1	01	01	H0630_021_0	5	5	Specialty Tier	100001	
H0712	001	0	1	02	01	H0712_001_0	5	2	Non-Preferred Generic	000100	
H0712	001	0	1	02	01	H0712_001_0	5	3	Preferred Brand	010001	
H0712	001	0	1	02	01	H0712_001_0	5	1	Preferred Generic	001000	
H0712	001	0	1	02	01	H0712_001_0	5	4	Non-Preferred Brand	110000	
H0712	001	0	1	02	01	H0712_001_0	5	5	Specialty Tier	010010	
H0712	005	0	1	01	01	H0712_005_0	3	2	Non-Preferred Generic	000100	
H0712	005	0	1	01	01	H0712_005_0	3	1	Preferred Generic	001000	
H0712	005	0	1	01	01	H0712_005_0	3	3	Preferred Brand	010001	
H0712	005	0	1	01	01	H0712_005_0	3	5	Specialty Tier	010010	
H0712	005	0	1	01	01	H0712_005_0	3	4	Non-Preferred Brand	110000	
H0712	019	0	1	01	01	H0712_019_0	6	1	Preferred Generic	001000	
H0712	019	0	1	01	01	H0712_019_0	6	2	Non-Preferred Generic	000100	
H0712	019	0	1	01	01	H0712_019_0	6	4	Non-Preferred Brand	110000	
H0712	019	0	1	01	01	H0712_019_0	6	3	Preferred Brand	010001	
H0712	019	0	1	01	01	H0712_019_0	6	5	Specialty Tier	010010	
H0712	020	0	1	01	01	H0712_020_0	5	3	Preferred Brand	010001	
H0712	020	0	1	01	01	H0712_020_0	5	2	Non-Preferred Generic	000100	
H0712	020	0	1	01	01	H0712_020_0	5	1	Preferred Generic	001000	
H0712	020	0	1	01	01	H0712_020_0	5	4	Non-Preferred Brand	110000	
H0712	020	0	1	01	01	H0712_020_0	5	5	Specialty Tier	010010	
H0755	030	0	1	01	01	H0755_030_0	5	1	Preferred Generic	001000	1
H0755	030	0	1	01	01	H0755_030_0	5	5	Specialty Tier	010010	
H0755	030	0	1	01	01	H0755_030_0	5	4	Non-Preferred Brand	100100	
H0755	030	0	1	01	01	H0755_030_0	5	3	Preferred Brand	010001	
H0755	030	0	1	01	01	H0755_030_0	5	2	Non-Preferred Generic	000100	
H0755	030	0	1	01	01	H0755_030_0	5	1	Preferred Generic	001000	
H0755	031	0	1	01	01	H0755_031_0	5	4	Non-Preferred Brand	100100	
H0755	031	0	1	01	01	H0755_031_0	5	5	Specialty Tier	010010	
H0755	031	0	1	01	01	H0755_031_0	5	3	Preferred Brand	010001	
H0755	031	0	1	01	01	H0755_031_0	5	2	Non-Preferred Generic	000100	
H0755	031	0	1	01	01	H0755_031_0	5	1	Preferred Generic	001000	
H0773	001	0	1	48	05	H0773_001_0	7	1	Generic Drugs	010000	
H0773	001	0	1	48	05	H0773_001_0	7	2	Brand Drugs	000010	
H0773	001	0	1	48	05	H0773_001_0	7	3	Non-Medicare Rx Generic Drugs	010000	
H0773	001	0	1	48	05	H0773_001_0	7	4	Non-Medicare Rx Brand Drugs	000010	
H0773	001	0	1	48	05	H0773_001_0	7	5	Non-Medicare OTC Generic Drugs	010000	
H0773	001	0	1	48	05	H0773_001_0	7	6	Non-Medicare OTC Brand Drugs	000010	
H0838	022	0	1	01	01	H0838_022_0	7	2	Non-Preferred Generic	000100	1
H0838	022	0	1	01	01	H0838_022_0	7	3	Preferred Brand	000001	
H0838	022	0	1	01	01	H0838_022_0	7	5	Specialty Tier	100000	
H0838	022	0	1	01	01	H0838_022_0	7	4	Non-Preferred Brand	100000	
H0838	022	0	1	01	01	H0838_022_0	7	1	Preferred Generic	001000	1
H0838	022	0	1	01	01	H0838_022_0	7	2	Non-Preferred Generic	000100	
H0838	022	0	1	01	01	H0838_022_0	7	1	Preferred Generic	001000	
H0838	025	0	1	01	01	H0838_025_0	7	3	Preferred Brand	000001	
H0838	025	0	1	01	01	H0838_025_0	7	1	Preferred Generic	001000	1
H0838	025	0	1	01	01	H0838_025_0	7	1	Preferred Generic	001000	
H0838	025	0	1	01	01	H0838_025_0	7	2	Non-Preferred Generic	000100	
H0838	025	0	1	01	01	H0838_025_0	7	5	Specialty Tier	100000	
H0838	025	0	1	01	01	H0838_025_0	7	4	Non-Preferred Brand	100000	
H0838	026	0	1	01	01	H0838_026_0	6	4	Non-Preferred Brand	100000	
H0838	026	0	1	01	01	H0838_026_0	6	2	Non-Preferred Generic	000100	1
H0838	026	0	1	01	01	H0838_026_0	6	1	Preferred Generic	001000	
H0838	026	0	1	01	01	H0838_026_0	6	2	Non-Preferred Generic	000100	
H0838	026	0	1	01	01	H0838_026_0	6	3	Preferred Brand	000001	
H0838	026	0	1	01	01	H0838_026_0	6	5	Specialty Tier	100000	
H0838	026	0	1	01	01	H0838_026_0	6	1	Preferred Generic	001000	1
H0838	028	0	1	01	01	H0838_028_0	6	1	Preferred Generic	001000	
H0838	028	0	1	01	01	H0838_028_0	6	2	Non-Preferred Generic	000100	1
H0838	028	0	1	01	01	H0838_028_0	6	1	Preferred Generic	001000	1
H0838	028	0	1	01	01	H0838_028_0	6	5	Specialty Tier	100000	
H0838	028	0	1	01	01	H0838_028_0	6	4	Non-Preferred Brand	100000	
H0838	028	0	1	01	01	H0838_028_0	6	3	Preferred Brand	000001	
H0838	028	0	1	01	01	H0838_028_0	6	2	Non-Preferred Generic	000100	
H0840	001	0	1	04	01	H0840_001_0	16	5	Specialty Tier	010010	
H0840	001	0	1	04	01	H0840_001_0	16	4	Non-Preferred Brand	100100	
H0840	001	0	1	04	01	H0840_001_0	16	3	Preferred Brand	000101	
H0840	001	0	1	04	01	H0840_001_0	16	1	Preferred Generic	001001	
H0840	001	0	1	04	01	H0840_001_0	16	2	Non-Preferred Generic	000101	
H0879	001	0	1	04	01	H0879_001_0	14	5	Specialty Tier	100000	
H0879	001	0	1	04	01	H0879_001_0	14	1	Preferred Generic	001000	
H0879	001	0	1	04	01	H0879_001_0	14	2	Non-Preferred Generic	000100	
H0879	001	0	1	04	01	H0879_001_0	14	3	Preferred Brand	000001	
H0879	001	0	1	04	01	H0879_001_0	14	4	Non-Preferred Brand	100000	
H0879	002	0	1	04	01	H0879_002_0	14	5	Specialty Tier	100000	
H0879	002	0	1	04	01	H0879_002_0	14	1	Preferred Generic	001000	
H0879	002	0	1	04	01	H0879_002_0	14	2	Non-Preferred Generic	000100	
H0879	002	0	1	04	01	H0879_002_0	14	3	Preferred Brand	000001	
H0879	002	0	1	04	01	H0879_002_0	14	4	Non-Preferred Brand	100000	
H0901	004	0	1	01	01	H0901_004_0	5	5	Select Care Drugs	010000	
H0901	004	0	1	01	01	H0901_004_0	5	3	Non-Preferred Brand	110000	
H0901	004	0	1	01	01	H0901_004_0	5	2	Preferred Brand	010001	
H0901	004	0	1	01	01	H0901_004_0	5	1	Generic	010000	
H0901	004	0	1	01	01	H0901_004_0	5	4	Specialty Tier	010010	
H0901	004	0	1	01	01	H0901_004_0	5	5	Select Care Drugs	010000	1
H0908	001	0	1	01	01	H0908_001_0	8	4	Injectable Drugs	000001	
H0908	001	0	1	01	01	H0908_001_0	8	3	Non-Preferred Brand	100000	
H0908	001	0	1	01	01	H0908_001_0	8	2	Preferred Brand	000001	
H0908	001	0	1	01	01	H0908_001_0	8	1	Generic	010000	
H0913	002	0	1	01	01	H0913_002_0	6	4	Non-Preferred Brand	100000	
H0913	002	0	1	01	01	H0913_002_0	6	3	Preferred Brand	000001	
H0913	002	0	1	01	01	H0913_002_0	6	2	Non-Preferred Generic	000100	
H0913	002	0	1	01	01	H0913_002_0	6	1	Preferred Generic	001000	
H0913	002	0	1	01	01	H0913_002_0	6	5	Specialty Tier	010010	
H0927	001	0	1	48	05	H0927_001_0	8	2	Brand Drugs	100000	
H0927	001	0	1	48	05	H0927_001_0	8	1	Generic Drugs	001101	
H0927	001	0	1	48	05	H0927_001_0	8	3	Non-Medicare OTC Drugs	010010	
H0979	022	0	1	09	04	H0979_022_0	4	4	Specialty Tier	100100	
H0979	022	0	1	09	04	H0979_022_0	4	1	Preferred Generic	001010	
H0979	022	0	1	09	04	H0979_022_0	4	2	Preferred Brand	000101	
H0979	022	0	1	09	04	H0979_022_0	4	3	Non-Preferred Brand	100100	
H1013	011	0	1	01	01	H1013_011_0	15	1	Preferred Generic	001010	
H1013	011	0	1	01	01	H1013_011_0	15	2	Preferred Brand	000001	
H1013	011	0	1	01	01	H1013_011_0	15	3	Non-Preferred Brand	100100	
H1013	011	0	1	01	01	H1013_011_0	15	4	Specialty Tier	010010	
H1013	011	0	1	01	01	H1013_011_0	15	1	Preferred Generic	001010	1
H1013	021	0	1	01	01	H1013_021_0	8	1	Preferred Generic	001010	
H1013	021	0	1	01	01	H1013_021_0	8	2	Preferred Brand	000001	
H1013	021	0	1	01	01	H1013_021_0	8	4	Specialty Tier	010010	
H1013	021	0	1	01	01	H1013_021_0	8	3	Non-Preferred Brand	100100	
H1013	024	0	1	01	01	H1013_024_0	8	1	Preferred Generic	001010	
H1013	024	0	1	01	01	H1013_024_0	8	3	Non-Preferred Brand	100100	
H1013	024	0	1	01	01	H1013_024_0	8	2	Preferred Brand	000001	
H1013	024	0	1	01	01	H1013_024_0	8	4	Specialty Tier	010010	
H1016	001	0	1	01	01	H1016_001_0	8	2	Non-Preferred Generic	000100	
H1016	001	0	1	01	01	H1016_001_0	8	1	Preferred Generic	001000	
H1016	001	0	1	01	01	H1016_001_0	8	3	Preferred Brand	000001	
H1016	001	0	1	01	01	H1016_001_0	8	4	Non-Preferred Brand	100000	
H1016	001	0	1	01	01	H1016_001_0	8	5	Specialty Tier	010010	
H1016	001	0	1	01	01	H1016_001_0	8	1	Preferred Generic	001000	1
H1016	001	0	1	01	01	H1016_001_0	8	2	Non-Preferred Generic	000100	1
H1016	021	0	1	01	01	H1016_021_0	6	2	Non-Preferred Generic	000100	
H1016	021	0	1	01	01	H1016_021_0	6	1	Preferred Generic	001000	
H1016	021	0	1	01	01	H1016_021_0	6	3	Preferred Brand	000001	
H1016	021	0	1	01	01	H1016_021_0	6	2	Non-Preferred Generic	000100	1
H1016	021	0	1	01	01	H1016_021_0	6	5	Specialty Tier	010010	
H1016	021	0	1	01	01	H1016_021_0	6	4	Non-Preferred Brand	100000	
H1016	022	0	1	01	01	H1016_022_0	6	1	Preferred Generic	001000	
H1016	022	0	1	01	01	H1016_022_0	6	2	Non-Preferred Generic	000100	
H1016	022	0	1	01	01	H1016_022_0	6	5	Specialty Tier	010010	
H1016	022	0	1	01	01	H1016_022_0	6	4	Non-Preferred Brand	100000	
H1016	022	0	1	01	01	H1016_022_0	6	3	Preferred Brand	000001	
H1016	022	0	1	01	01	H1016_022_0	6	2	Non-Preferred Generic	000100	1
H1019	001	0	1	01	01	H1019_001_0	5	4	Non-Preferred Brand	110000	
H1019	001	0	1	01	01	H1019_001_0	5	3	Preferred Brand	000101	
H1019	001	0	1	01	01	H1019_001_0	5	5	Specialty Tier	010010	2
H1019	001	0	1	01	01	H1019_001_0	5	4	Non-Preferred Brand	110000	2
H1019	001	0	1	01	01	H1019_001_0	5	3	Preferred Brand	000101	2
H1019	001	0	1	01	01	H1019_001_0	5	2	Non-Preferred Generic	000101	1
H1019	001	0	1	01	01	H1019_001_0	5	1	Preferred Generic	001010	1
H1019	001	0	1	01	01	H1019_001_0	5	5	Specialty Tier	010010	
H1019	001	0	1	01	01	H1019_001_0	5	1	Preferred Generic	001010	
H1019	001	0	1	01	01	H1019_001_0	5	2	Non-Preferred Generic	000101	
H1019	006	0	1	01	01	H1019_006_0	5	1	Preferred Generic	001010	
H1019	006	0	1	01	01	H1019_006_0	5	4	Non-Preferred Brand	110000	2
H1019	006	0	1	01	01	H1019_006_0	5	3	Preferred Brand	000101	2
H1019	006	0	1	01	01	H1019_006_0	5	2	Non-Preferred Generic	000101	1
H1019	006	0	1	01	01	H1019_006_0	5	5	Specialty Tier	010010	2
H1019	006	0	1	01	01	H1019_006_0	5	5	Specialty Tier	010010	
H1019	006	0	1	01	01	H1019_006_0	5	4	Non-Preferred Brand	110000	
H1019	006	0	1	01	01	H1019_006_0	5	3	Preferred Brand	000101	
H1019	006	0	1	01	01	H1019_006_0	5	2	Non-Preferred Generic	000101	
H1019	006	0	1	01	01	H1019_006_0	5	1	Preferred Generic	001010	1
H1019	010	0	1	01	01	H1019_010_0	5	4	Non-Preferred Brand	110000	
H1019	010	0	1	01	01	H1019_010_0	5	3	Preferred Brand	000101	
H1019	010	0	1	01	01	H1019_010_0	5	2	Non-Preferred Generic	000101	
H1019	010	0	1	01	01	H1019_010_0	5	1	Preferred Generic	001010	
H1019	010	0	1	01	01	H1019_010_0	5	5	Specialty Tier	010010	
H1019	010	0	1	01	01	H1019_010_0	5	5	Specialty Tier	010010	2
H1019	010	0	1	01	01	H1019_010_0	5	4	Non-Preferred Brand	110000	2
H1019	010	0	1	01	01	H1019_010_0	5	3	Preferred Brand	000101	2
H1019	010	0	1	01	01	H1019_010_0	5	2	Non-Preferred Generic	000101	1
H1019	010	0	1	01	01	H1019_010_0	5	1	Preferred Generic	001010	1
H1019	014	0	1	01	01	H1019_014_0	6	1	Preferred Generic	001010	
H1019	014	0	1	01	01	H1019_014_0	6	2	Non-Preferred Generic	000101	
H1019	014	0	1	01	01	H1019_014_0	6	5	Specialty Tier	010010	2
H1019	014	0	1	01	01	H1019_014_0	6	4	Non-Preferred Brand	110000	2
H1019	014	0	1	01	01	H1019_014_0	6	3	Preferred Brand	000101	2
H1019	014	0	1	01	01	H1019_014_0	6	2	Non-Preferred Generic	000101	2
H1019	014	0	1	01	01	H1019_014_0	6	1	Preferred Generic	001010	2
H1019	014	0	1	01	01	H1019_014_0	6	5	Specialty Tier	010010	
H1019	014	0	1	01	01	H1019_014_0	6	4	Non-Preferred Brand	110000	
H1019	014	0	1	01	01	H1019_014_0	6	3	Preferred Brand	000101	
H1019	023	0	1	01	01	H1019_023_0	6	2	Non-Preferred Generic	000101	
H1019	023	0	1	01	01	H1019_023_0	6	3	Preferred Brand	000101	
H1019	023	0	1	01	01	H1019_023_0	6	4	Non-Preferred Brand	110000	
H1019	023	0	1	01	01	H1019_023_0	6	5	Specialty Tier	010010	
H1019	023	0	1	01	01	H1019_023_0	6	1	Preferred Generic	001010	
H1019	024	0	1	01	01	H1019_024_0	6	4	Non-Preferred Brand	110000	
H1019	024	0	1	01	01	H1019_024_0	6	5	Specialty Tier	010010	
H1019	024	0	1	01	01	H1019_024_0	6	2	Non-Preferred Generic	000101	
H1019	024	0	1	01	01	H1019_024_0	6	1	Preferred Generic	001010	
H1019	024	0	1	01	01	H1019_024_0	6	3	Preferred Brand	000101	
H1019	025	0	1	01	01	H1019_025_0	5	3	Preferred Brand	000101	
H1019	025	0	1	01	01	H1019_025_0	5	4	Non-Preferred Brand	110000	
H1019	025	0	1	01	01	H1019_025_0	5	5	Specialty Tier	010010	
H1019	025	0	1	01	01	H1019_025_0	5	1	Preferred Generic	001010	
H1019	025	0	1	01	01	H1019_025_0	5	2	Non-Preferred Generic	000101	
H1019	026	0	1	01	01	H1019_026_0	5	1	Preferred Generic	001010	
H1019	026	0	1	01	01	H1019_026_0	5	2	Non-Preferred Generic	000101	
H1019	026	0	1	01	01	H1019_026_0	5	3	Preferred Brand	000101	
H1019	026	0	1	01	01	H1019_026_0	5	4	Non-Preferred Brand	110000	
H1019	026	0	1	01	01	H1019_026_0	5	5	Specialty Tier	010010	
H1019	027	0	1	01	01	H1019_027_0	5	5	Specialty Tier	010010	2
H1019	027	0	1	01	01	H1019_027_0	5	4	Non-Preferred Brand	110000	2
H1019	027	0	1	01	01	H1019_027_0	5	3	Preferred Brand	000101	2
H1019	027	0	1	01	01	H1019_027_0	5	2	Non-Preferred Generic	000101	2
H1019	027	0	1	01	01	H1019_027_0	5	4	Non-Preferred Brand	110000	
H1019	027	0	1	01	01	H1019_027_0	5	5	Specialty Tier	010010	
H1019	027	0	1	01	01	H1019_027_0	5	1	Preferred Generic	001010	2
H1019	027	0	1	01	01	H1019_027_0	5	3	Preferred Brand	000101	
H1019	027	0	1	01	01	H1019_027_0	5	2	Non-Preferred Generic	000101	
H1019	027	0	1	01	01	H1019_027_0	5	1	Preferred Generic	001010	
H1019	028	0	1	01	01	H1019_028_0	4	3	Preferred Brand	000101	
H1019	028	0	1	01	01	H1019_028_0	4	4	Non-Preferred Brand	110000	
H1019	028	0	1	01	01	H1019_028_0	4	5	Specialty Tier	010010	
H1019	028	0	1	01	01	H1019_028_0	4	1	Preferred Generic	001010	
H1019	028	0	1	01	01	H1019_028_0	4	2	Non-Preferred Generic	000101	
H1019	032	0	1	01	01	H1019_032_0	4	5	Specialty Tier	010010	2
H1019	032	0	1	01	01	H1019_032_0	4	4	Non-Preferred Brand	110000	
H1019	032	0	1	01	01	H1019_032_0	4	3	Preferred Brand	000101	
H1019	032	0	1	01	01	H1019_032_0	4	2	Non-Preferred Generic	000101	
H1019	032	0	1	01	01	H1019_032_0	4	4	Non-Preferred Brand	110000	2
H1019	032	0	1	01	01	H1019_032_0	4	3	Preferred Brand	000101	2
H1019	032	0	1	01	01	H1019_032_0	4	2	Non-Preferred Generic	000101	1
H1019	032	0	1	01	01	H1019_032_0	4	1	Preferred Generic	001010	
H1019	032	0	1	01	01	H1019_032_0	4	5	Specialty Tier	010010	
H1019	032	0	1	01	01	H1019_032_0	4	1	Preferred Generic	001010	1
H1019	043	0	1	01	01	H1019_043_0	7	1	Preferred Generic	001010	
H1019	043	0	1	01	01	H1019_043_0	7	2	Non-Preferred Generic	000101	
H1019	043	0	1	01	01	H1019_043_0	7	3	Preferred Brand	000101	
H1019	043	0	1	01	01	H1019_043_0	7	4	Non-Preferred Brand	110000	
H1019	043	0	1	01	01	H1019_043_0	7	5	Specialty Tier	010010	
H1019	043	0	1	01	01	H1019_043_0	7	1	Preferred Generic	001010	2
H1019	043	0	1	01	01	H1019_043_0	7	2	Non-Preferred Generic	000101	2
H1019	043	0	1	01	01	H1019_043_0	7	3	Preferred Brand	000101	2
H1019	043	0	1	01	01	H1019_043_0	7	4	Non-Preferred Brand	110000	2
H1019	043	0	1	01	01	H1019_043_0	7	5	Specialty Tier	010010	2
H1019	045	0	1	01	01	H1019_045_0	5	5	Specialty Tier	010010	
H1019	045	0	1	01	01	H1019_045_0	5	4	Non-Preferred Brand	110000	
H1019	045	0	1	01	01	H1019_045_0	5	3	Preferred Brand	000101	
H1019	045	0	1	01	01	H1019_045_0	5	2	Non-Preferred Generic	000101	
H1019	045	0	1	01	01	H1019_045_0	5	1	Preferred Generic	001010	
H1019	046	0	1	01	01	H1019_046_0	5	5	Specialty Tier	010010	
H1019	046	0	1	01	01	H1019_046_0	5	4	Non-Preferred Brand	110000	
H1019	046	0	1	01	01	H1019_046_0	5	3	Preferred Brand	000101	
H1019	046	0	1	01	01	H1019_046_0	5	2	Non-Preferred Generic	000101	
H1019	046	0	1	01	01	H1019_046_0	5	1	Preferred Generic	001010	
H1019	047	0	1	01	01	H1019_047_0	6	1	Preferred Generic	001010	
H1019	047	0	1	01	01	H1019_047_0	6	5	Specialty Tier	010010	
H1019	047	0	1	01	01	H1019_047_0	6	4	Non-Preferred Brand	110000	
H1019	047	0	1	01	01	H1019_047_0	6	3	Preferred Brand	000101	
H1019	047	0	1	01	01	H1019_047_0	6	2	Non-Preferred Generic	000101	
H1019	048	0	1	01	01	H1019_048_0	7	5	Specialty Tier	010010	
H1019	048	0	1	01	01	H1019_048_0	7	4	Non-Preferred Brand	110000	
H1019	048	0	1	01	01	H1019_048_0	7	3	Preferred Brand	000101	
H1019	048	0	1	01	01	H1019_048_0	7	2	Non-Preferred Generic	000101	
H1019	048	0	1	01	01	H1019_048_0	7	1	Preferred Generic	001010	
H1019	049	0	1	01	01	H1019_049_0	4	1	Preferred Generic	001010	
H1019	049	0	1	01	01	H1019_049_0	4	2	Non-Preferred Generic	000101	
H1019	049	0	1	01	01	H1019_049_0	4	3	Preferred Brand	000101	
H1019	049	0	1	01	01	H1019_049_0	4	4	Non-Preferred Brand	110000	
H1019	049	0	1	01	01	H1019_049_0	4	5	Specialty Tier	010010	
H1019	050	0	1	01	01	H1019_050_0	4	4	Non-Preferred Brand	110000	
H1019	050	0	1	01	01	H1019_050_0	4	3	Preferred Brand	000101	
H1019	050	0	1	01	01	H1019_050_0	4	1	Preferred Generic	001010	
H1019	050	0	1	01	01	H1019_050_0	4	2	Non-Preferred Generic	000101	
H1019	050	0	1	01	01	H1019_050_0	4	5	Specialty Tier	010010	
H1019	054	0	1	01	01	H1019_054_0	5	1	Preferred Generic	001010	1
H1019	054	0	1	01	01	H1019_054_0	5	2	Non-Preferred Generic	000101	1
H1019	054	0	1	01	01	H1019_054_0	5	3	Preferred Brand	000101	2
H1019	054	0	1	01	01	H1019_054_0	5	4	Non-Preferred Brand	110000	2
H1019	054	0	1	01	01	H1019_054_0	5	5	Specialty Tier	010010	
H1019	054	0	1	01	01	H1019_054_0	5	4	Non-Preferred Brand	110000	
H1019	054	0	1	01	01	H1019_054_0	5	5	Specialty Tier	010010	2
H1019	054	0	1	01	01	H1019_054_0	5	2	Non-Preferred Generic	000101	
H1019	054	0	1	01	01	H1019_054_0	5	1	Preferred Generic	001010	
H1019	054	0	1	01	01	H1019_054_0	5	3	Preferred Brand	000101	
H1019	057	0	1	01	01	H1019_057_0	5	2	Non-Preferred Generic	000101	
H1019	057	0	1	01	01	H1019_057_0	5	1	Preferred Generic	001010	
H1019	057	0	1	01	01	H1019_057_0	5	3	Preferred Brand	000101	
H1019	057	0	1	01	01	H1019_057_0	5	5	Specialty Tier	010010	2
H1019	057	0	1	01	01	H1019_057_0	5	4	Non-Preferred Brand	110000	2
H1019	057	0	1	01	01	H1019_057_0	5	3	Preferred Brand	000101	2
H1019	057	0	1	01	01	H1019_057_0	5	2	Non-Preferred Generic	000101	1
H1019	057	0	1	01	01	H1019_057_0	5	1	Preferred Generic	001010	1
H1019	057	0	1	01	01	H1019_057_0	5	5	Specialty Tier	010010	
H1019	057	0	1	01	01	H1019_057_0	5	4	Non-Preferred Brand	110000	
H1019	059	0	1	01	01	H1019_059_0	3	1	Preferred Generic	001010	
H1019	059	0	1	01	01	H1019_059_0	3	2	Non-Preferred Generic	000101	
H1019	059	0	1	01	01	H1019_059_0	3	4	Non-Preferred Brand	110000	2
H1019	059	0	1	01	01	H1019_059_0	3	3	Preferred Brand	000101	2
H1019	059	0	1	01	01	H1019_059_0	3	5	Specialty Tier	010010	2
H1019	059	0	1	01	01	H1019_059_0	3	1	Preferred Generic	001010	2
H1019	059	0	1	01	01	H1019_059_0	3	5	Specialty Tier	010010	
H1019	059	0	1	01	01	H1019_059_0	3	4	Non-Preferred Brand	110000	
H1019	059	0	1	01	01	H1019_059_0	3	3	Preferred Brand	000101	
H1019	059	0	1	01	01	H1019_059_0	3	2	Non-Preferred Generic	000101	2
H1019	060	0	1	01	01	H1019_060_0	6	1	Preferred Generic	001010	
H1019	060	0	1	01	01	H1019_060_0	6	2	Non-Preferred Generic	000101	
H1019	060	0	1	01	01	H1019_060_0	6	3	Preferred Brand	000101	2
H1019	060	0	1	01	01	H1019_060_0	6	2	Non-Preferred Generic	000101	2
H1019	060	0	1	01	01	H1019_060_0	6	3	Preferred Brand	000101	
H1019	060	0	1	01	01	H1019_060_0	6	5	Specialty Tier	010010	
H1019	060	0	1	01	01	H1019_060_0	6	4	Non-Preferred Brand	110000	
H1019	060	0	1	01	01	H1019_060_0	6	5	Specialty Tier	010010	2
H1019	060	0	1	01	01	H1019_060_0	6	4	Non-Preferred Brand	110000	2
H1019	060	0	1	01	01	H1019_060_0	6	1	Preferred Generic	001010	2
H1019	061	0	1	01	01	H1019_061_0	4	4	Non-Preferred Brand	110000	
H1019	061	0	1	01	01	H1019_061_0	4	5	Specialty Tier	010010	
H1019	061	0	1	01	01	H1019_061_0	4	2	Non-Preferred Generic	000101	
H1019	061	0	1	01	01	H1019_061_0	4	3	Preferred Brand	000101	
H1019	061	0	1	01	01	H1019_061_0	4	1	Preferred Generic	001010	
H1019	062	0	1	01	01	H1019_062_0	3	1	Preferred Generic	001010	
H1019	062	0	1	01	01	H1019_062_0	3	2	Non-Preferred Generic	000101	
H1019	062	0	1	01	01	H1019_062_0	3	3	Preferred Brand	000101	
H1019	062	0	1	01	01	H1019_062_0	3	4	Non-Preferred Brand	110000	
H1019	062	0	1	01	01	H1019_062_0	3	3	Preferred Brand	000101	2
H1019	062	0	1	01	01	H1019_062_0	3	1	Preferred Generic	001010	1
H1019	062	0	1	01	01	H1019_062_0	3	2	Non-Preferred Generic	000101	1
H1019	062	0	1	01	01	H1019_062_0	3	5	Specialty Tier	010010	2
H1019	062	0	1	01	01	H1019_062_0	3	4	Non-Preferred Brand	110000	2
H1019	062	0	1	01	01	H1019_062_0	3	5	Specialty Tier	010010	
H1019	063	0	1	01	01	H1019_063_0	5	5	Specialty Tier	010010	2
H1019	063	0	1	01	01	H1019_063_0	5	4	Non-Preferred Brand	110000	2
H1019	063	0	1	01	01	H1019_063_0	5	3	Preferred Brand	000101	2
H1019	063	0	1	01	01	H1019_063_0	5	2	Non-Preferred Generic	000101	1
H1019	063	0	1	01	01	H1019_063_0	5	1	Preferred Generic	001010	1
H1019	063	0	1	01	01	H1019_063_0	5	5	Specialty Tier	010010	
H1019	063	0	1	01	01	H1019_063_0	5	4	Non-Preferred Brand	110000	
H1019	063	0	1	01	01	H1019_063_0	5	3	Preferred Brand	000101	
H1019	063	0	1	01	01	H1019_063_0	5	1	Preferred Generic	001010	
H1019	063	0	1	01	01	H1019_063_0	5	2	Non-Preferred Generic	000101	
H1019	064	0	1	01	01	H1019_064_0	3	4	Non-Preferred Brand	110000	2
H1019	064	0	1	01	01	H1019_064_0	3	3	Preferred Brand	000101	2
H1019	064	0	1	01	01	H1019_064_0	3	2	Non-Preferred Generic	000101	1
H1019	064	0	1	01	01	H1019_064_0	3	1	Preferred Generic	001010	1
H1019	064	0	1	01	01	H1019_064_0	3	5	Specialty Tier	010010	2
H1019	064	0	1	01	01	H1019_064_0	3	4	Non-Preferred Brand	110000	
H1019	064	0	1	01	01	H1019_064_0	3	3	Preferred Brand	000101	
H1019	064	0	1	01	01	H1019_064_0	3	2	Non-Preferred Generic	000101	
H1019	064	0	1	01	01	H1019_064_0	3	1	Preferred Generic	001010	
H1019	064	0	1	01	01	H1019_064_0	3	5	Specialty Tier	010010	
H1019	065	0	1	01	01	H1019_065_0	6	4	Non-Preferred Brand	110000	2
H1019	065	0	1	01	01	H1019_065_0	6	3	Preferred Brand	000101	2
H1019	065	0	1	01	01	H1019_065_0	6	2	Non-Preferred Generic	000101	2
H1019	065	0	1	01	01	H1019_065_0	6	1	Preferred Generic	001010	2
H1019	065	0	1	01	01	H1019_065_0	6	5	Specialty Tier	010010	
H1019	065	0	1	01	01	H1019_065_0	6	4	Non-Preferred Brand	110000	
H1019	065	0	1	01	01	H1019_065_0	6	3	Preferred Brand	000101	
H1019	065	0	1	01	01	H1019_065_0	6	2	Non-Preferred Generic	000101	
H1019	065	0	1	01	01	H1019_065_0	6	1	Preferred Generic	001010	
H1019	065	0	1	01	01	H1019_065_0	6	5	Specialty Tier	010010	2
H1019	066	0	1	01	01	H1019_066_0	3	4	Non-Preferred Brand	110000	
H1019	066	0	1	01	01	H1019_066_0	3	5	Specialty Tier	010010	
H1019	066	0	1	01	01	H1019_066_0	3	1	Preferred Generic	001010	2
H1019	066	0	1	01	01	H1019_066_0	3	2	Non-Preferred Generic	000101	2
H1019	066	0	1	01	01	H1019_066_0	3	3	Preferred Brand	000101	2
H1019	066	0	1	01	01	H1019_066_0	3	4	Non-Preferred Brand	110000	2
H1019	066	0	1	01	01	H1019_066_0	3	5	Specialty Tier	010010	2
H1019	066	0	1	01	01	H1019_066_0	3	1	Preferred Generic	001010	
H1019	066	0	1	01	01	H1019_066_0	3	2	Non-Preferred Generic	000101	
H1019	066	0	1	01	01	H1019_066_0	3	3	Preferred Brand	000101	
H1019	067	0	1	01	01	H1019_067_0	3	4	Non-Preferred Brand	110000	
H1019	067	0	1	01	01	H1019_067_0	3	3	Preferred Brand	000101	
H1019	067	0	1	01	01	H1019_067_0	3	2	Non-Preferred Generic	000101	
H1019	067	0	1	01	01	H1019_067_0	3	1	Preferred Generic	001010	
H1019	067	0	1	01	01	H1019_067_0	3	5	Specialty Tier	010010	2
H1019	067	0	1	01	01	H1019_067_0	3	1	Preferred Generic	001010	2
H1019	067	0	1	01	01	H1019_067_0	3	2	Non-Preferred Generic	000101	2
H1019	067	0	1	01	01	H1019_067_0	3	3	Preferred Brand	000101	2
H1019	067	0	1	01	01	H1019_067_0	3	4	Non-Preferred Brand	110000	2
H1019	067	0	1	01	01	H1019_067_0	3	5	Specialty Tier	010010	
H1019	068	0	1	01	01	H1019_068_0	4	4	Non-Preferred Brand	110000	
H1019	068	0	1	01	01	H1019_068_0	4	3	Preferred Brand	000101	
H1019	068	0	1	01	01	H1019_068_0	4	2	Non-Preferred Generic	000101	
H1019	068	0	1	01	01	H1019_068_0	4	1	Preferred Generic	001010	
H1019	068	0	1	01	01	H1019_068_0	4	5	Specialty Tier	010010	
H1019	068	0	1	01	01	H1019_068_0	4	5	Specialty Tier	010010	2
H1019	068	0	1	01	01	H1019_068_0	4	4	Non-Preferred Brand	110000	2
H1019	068	0	1	01	01	H1019_068_0	4	3	Preferred Brand	000101	2
H1019	068	0	1	01	01	H1019_068_0	4	2	Non-Preferred Generic	000101	2
H1019	068	0	1	01	01	H1019_068_0	4	1	Preferred Generic	001010	2
H1019	069	0	1	01	01	H1019_069_0	3	1	Preferred Generic	001010	
H1019	069	0	1	01	01	H1019_069_0	3	2	Non-Preferred Generic	000101	
H1019	069	0	1	01	01	H1019_069_0	3	3	Preferred Brand	000101	
H1019	069	0	1	01	01	H1019_069_0	3	4	Non-Preferred Brand	110000	
H1019	069	0	1	01	01	H1019_069_0	3	5	Specialty Tier	010010	2
H1019	069	0	1	01	01	H1019_069_0	3	3	Preferred Brand	000101	2
H1019	069	0	1	01	01	H1019_069_0	3	2	Non-Preferred Generic	000101	2
H1019	069	0	1	01	01	H1019_069_0	3	1	Preferred Generic	001010	2
H1019	069	0	1	01	01	H1019_069_0	3	5	Specialty Tier	010010	
H1019	069	0	1	01	01	H1019_069_0	3	4	Non-Preferred Brand	110000	2
H1019	070	0	1	01	01	H1019_070_0	3	1	Preferred Generic	001010	
H1019	070	0	1	01	01	H1019_070_0	3	2	Non-Preferred Generic	000101	
H1019	070	0	1	01	01	H1019_070_0	3	3	Preferred Brand	000101	
H1019	070	0	1	01	01	H1019_070_0	3	4	Non-Preferred Brand	110000	
H1019	070	0	1	01	01	H1019_070_0	3	2	Non-Preferred Generic	000101	1
H1019	070	0	1	01	01	H1019_070_0	3	1	Preferred Generic	001010	1
H1019	070	0	1	01	01	H1019_070_0	3	5	Specialty Tier	010010	2
H1019	070	0	1	01	01	H1019_070_0	3	4	Non-Preferred Brand	110000	2
H1019	070	0	1	01	01	H1019_070_0	3	3	Preferred Brand	000101	2
H1019	070	0	1	01	01	H1019_070_0	3	5	Specialty Tier	010010	
H1019	071	0	1	01	01	H1019_071_0	3	3	Preferred Brand	000101	
H1019	071	0	1	01	01	H1019_071_0	3	5	Specialty Tier	010010	
H1019	071	0	1	01	01	H1019_071_0	3	4	Non-Preferred Brand	110000	
H1019	071	0	1	01	01	H1019_071_0	3	2	Non-Preferred Generic	000101	
H1019	071	0	1	01	01	H1019_071_0	3	1	Preferred Generic	001010	
H1019	072	0	1	01	01	H1019_072_0	3	2	Non-Preferred Generic	000101	
H1019	072	0	1	01	01	H1019_072_0	3	1	Preferred Generic	001010	
H1019	072	0	1	01	01	H1019_072_0	3	4	Non-Preferred Brand	110000	
H1019	072	0	1	01	01	H1019_072_0	3	5	Specialty Tier	010010	
H1019	072	0	1	01	01	H1019_072_0	3	3	Preferred Brand	000101	
H1019	073	0	1	01	01	H1019_073_0	3	4	Non-Preferred Brand	110000	
H1019	073	0	1	01	01	H1019_073_0	3	5	Specialty Tier	010010	
H1019	073	0	1	01	01	H1019_073_0	3	2	Non-Preferred Generic	000101	
H1019	073	0	1	01	01	H1019_073_0	3	3	Preferred Brand	000101	
H1019	073	0	1	01	01	H1019_073_0	3	1	Preferred Generic	001010	
H1019	074	0	1	01	01	H1019_074_0	3	4	Non-Preferred Brand	110000	
H1019	074	0	1	01	01	H1019_074_0	3	5	Specialty Tier	010010	
H1019	074	0	1	01	01	H1019_074_0	3	2	Non-Preferred Generic	000101	
H1019	074	0	1	01	01	H1019_074_0	3	3	Preferred Brand	000101	
H1019	074	0	1	01	01	H1019_074_0	3	1	Preferred Generic	001010	
H1019	075	0	1	01	01	H1019_075_0	3	1	Preferred Generic	001010	
H1019	075	0	1	01	01	H1019_075_0	3	2	Non-Preferred Generic	000101	
H1019	075	0	1	01	01	H1019_075_0	3	3	Preferred Brand	000101	
H1019	075	0	1	01	01	H1019_075_0	3	5	Specialty Tier	010010	2
H1019	075	0	1	01	01	H1019_075_0	3	2	Non-Preferred Generic	000101	1
H1019	075	0	1	01	01	H1019_075_0	3	4	Non-Preferred Brand	110000	
H1019	075	0	1	01	01	H1019_075_0	3	5	Specialty Tier	010010	
H1019	075	0	1	01	01	H1019_075_0	3	3	Preferred Brand	000101	2
H1019	075	0	1	01	01	H1019_075_0	3	1	Preferred Generic	001010	1
H1019	075	0	1	01	01	H1019_075_0	3	4	Non-Preferred Brand	110000	2
H1019	076	0	1	01	01	H1019_076_0	3	4	Non-Preferred Brand	110000	
H1019	076	0	1	01	01	H1019_076_0	3	5	Specialty Tier	010010	
H1019	076	0	1	01	01	H1019_076_0	3	1	Preferred Generic	001010	2
H1019	076	0	1	01	01	H1019_076_0	3	2	Non-Preferred Generic	000101	2
H1019	076	0	1	01	01	H1019_076_0	3	1	Preferred Generic	001010	
H1019	076	0	1	01	01	H1019_076_0	3	2	Non-Preferred Generic	000101	
H1019	076	0	1	01	01	H1019_076_0	3	5	Specialty Tier	010010	2
H1019	076	0	1	01	01	H1019_076_0	3	3	Preferred Brand	000101	
H1019	076	0	1	01	01	H1019_076_0	3	3	Preferred Brand	000101	2
H1019	076	0	1	01	01	H1019_076_0	3	4	Non-Preferred Brand	110000	2
H1026	001	0	1	01	01	H1026_001_0	13	3	Preferred Brand	000001	
H1026	001	0	1	01	01	H1026_001_0	13	2	Non-Preferred Generic	000100	
H1026	001	0	1	01	01	H1026_001_0	13	5	Specialty Tier	101101	2
H1026	001	0	1	01	01	H1026_001_0	13	2	Non-Preferred Generic	000100	1
H1026	001	0	1	01	01	H1026_001_0	13	1	Preferred Generic	001000	1
H1026	001	0	1	01	01	H1026_001_0	13	5	Specialty Tier	101101	
H1026	001	0	1	01	01	H1026_001_0	13	4	Non-Preferred Brand	110000	
H1026	001	0	1	01	01	H1026_001_0	13	1	Preferred Generic	001000	
H1026	038	0	1	01	01	H1026_038_0	9	1	Preferred Generic	001000	
H1026	038	0	1	01	01	H1026_038_0	9	2	Non-Preferred Generic	000100	1
H1026	038	0	1	01	01	H1026_038_0	9	1	Preferred Generic	001000	1
H1026	038	0	1	01	01	H1026_038_0	9	5	Specialty Tier	101101	
H1026	038	0	1	01	01	H1026_038_0	9	4	Non-Preferred Brand	110000	
H1026	038	0	1	01	01	H1026_038_0	9	3	Preferred Brand	000001	
H1026	038	0	1	01	01	H1026_038_0	9	2	Non-Preferred Generic	000100	
H1026	038	0	1	01	01	H1026_038_0	9	5	Specialty Tier	101101	2
H1026	040	0	1	01	01	H1026_040_0	10	3	Preferred Brand	000001	
H1026	040	0	1	01	01	H1026_040_0	10	2	Non-Preferred Generic	000100	
H1026	040	0	1	01	01	H1026_040_0	10	1	Preferred Generic	001000	
H1026	040	0	1	01	01	H1026_040_0	10	4	Non-Preferred Brand	110000	
H1026	040	0	1	01	01	H1026_040_0	10	5	Specialty Tier	101101	2
H1026	040	0	1	01	01	H1026_040_0	10	2	Non-Preferred Generic	000100	1
H1026	040	0	1	01	01	H1026_040_0	10	1	Preferred Generic	001000	1
H1026	040	0	1	01	01	H1026_040_0	10	5	Specialty Tier	101101	
H1026	048	0	1	01	01	H1026_048_0	8	2	Non-Preferred Generic	000100	
H1026	048	0	1	01	01	H1026_048_0	8	1	Preferred Generic	001000	
H1026	048	0	1	01	01	H1026_048_0	8	3	Preferred Brand	000001	
H1026	048	0	1	01	01	H1026_048_0	8	4	Non-Preferred Brand	110000	
H1026	048	0	1	01	01	H1026_048_0	8	5	Specialty Tier	101101	
H1026	051	0	1	01	01	H1026_051_0	8	2	Non-Preferred Generic	000100	
H1026	051	0	1	01	01	H1026_051_0	8	1	Preferred Generic	001000	
H1026	051	0	1	01	01	H1026_051_0	8	3	Preferred Brand	000001	
H1026	051	0	1	01	01	H1026_051_0	8	5	Specialty Tier	101101	
H1026	051	0	1	01	01	H1026_051_0	8	4	Non-Preferred Brand	110000	
H1026	054	0	1	01	01	H1026_054_0	9	4	Non-Preferred Brand	110000	
H1026	054	0	1	01	01	H1026_054_0	9	3	Preferred Brand	000001	
H1026	054	0	1	01	01	H1026_054_0	9	1	Preferred Generic	001000	
H1026	054	0	1	01	01	H1026_054_0	9	2	Non-Preferred Generic	000100	
H1026	054	0	1	01	01	H1026_054_0	9	5	Specialty Tier	101101	
H1032	002	0	1	02	01	H1032_002_0	6	4	Non-Preferred Brand	100000	
H1032	002	0	1	02	01	H1032_002_0	6	3	Preferred Brand	000001	
H1032	002	0	1	02	01	H1032_002_0	6	2	Non-Preferred Generic	000100	
H1032	002	0	1	02	01	H1032_002_0	6	1	Preferred Generic	001000	
H1032	002	0	1	02	01	H1032_002_0	6	5	Specialty Tier	010010	
H1032	025	0	1	02	01	H1032_025_0	5	4	Non-Preferred Brand	100000	
H1032	025	0	1	02	01	H1032_025_0	5	3	Preferred Brand	000001	
H1032	025	0	1	02	01	H1032_025_0	5	2	Non-Preferred Generic	000100	
H1032	025	0	1	02	01	H1032_025_0	5	1	Preferred Generic	001000	
H1032	025	0	1	02	01	H1032_025_0	5	5	Specialty Tier	010010	
H1032	032	0	1	01	01	H1032_032_0	6	1	Preferred Generic	001000	
H1032	032	0	1	01	01	H1032_032_0	6	2	Non-Preferred Generic	000100	
H1032	032	0	1	01	01	H1032_032_0	6	3	Preferred Brand	000001	
H1032	032	0	1	01	01	H1032_032_0	6	4	Non-Preferred Brand	100000	
H1032	032	0	1	01	01	H1032_032_0	6	5	Specialty Tier	010010	
H1032	035	0	1	02	01	H1032_035_0	7	1	Preferred Generic	001000	
H1032	035	0	1	02	01	H1032_035_0	7	2	Non-Preferred Generic	000100	
H1032	035	0	1	02	01	H1032_035_0	7	3	Preferred Brand	000001	
H1032	035	0	1	02	01	H1032_035_0	7	4	Non-Preferred Brand	100000	
H1032	035	0	1	02	01	H1032_035_0	7	5	Specialty Tier	010010	
H1032	040	0	1	02	01	H1032_040_0	5	3	Preferred Brand	000001	
H1032	040	0	1	02	01	H1032_040_0	5	4	Non-Preferred Brand	100000	
H1032	040	0	1	02	01	H1032_040_0	5	5	Specialty Tier	010010	
H1032	040	0	1	02	01	H1032_040_0	5	1	Preferred Generic	001000	
H1032	040	0	1	02	01	H1032_040_0	5	2	Non-Preferred Generic	000100	
H1032	061	0	1	01	01	H1032_061_0	5	4	Non-Preferred Brand	110000	
H1032	061	0	1	01	01	H1032_061_0	5	3	Preferred Brand	010001	
H1032	061	0	1	01	01	H1032_061_0	5	2	Non-Preferred Generic	000100	
H1032	061	0	1	01	01	H1032_061_0	5	1	Preferred Generic	001000	
H1032	061	0	1	01	01	H1032_061_0	5	5	Specialty Tier	010010	
H1032	073	0	1	01	01	H1032_073_0	5	4	Non-Preferred Brand	100000	
H1032	073	0	1	01	01	H1032_073_0	5	3	Preferred Brand	000001	
H1032	073	0	1	01	01	H1032_073_0	5	2	Non-Preferred Generic	000100	
H1032	073	0	1	01	01	H1032_073_0	5	1	Preferred Generic	001000	
H1032	073	0	1	01	01	H1032_073_0	5	5	Specialty Tier	010010	
H1032	079	0	1	01	01	H1032_079_0	5	1	Preferred Generic	001000	
H1032	079	0	1	01	01	H1032_079_0	5	2	Non-Preferred Generic	000100	
H1032	079	0	1	01	01	H1032_079_0	5	3	Preferred Brand	000001	
H1032	079	0	1	01	01	H1032_079_0	5	4	Non-Preferred Brand	100000	
H1032	079	0	1	01	01	H1032_079_0	5	5	Specialty Tier	010010	
H1032	091	0	1	02	01	H1032_091_0	6	1	Preferred Generic	001000	
H1032	091	0	1	02	01	H1032_091_0	6	2	Non-Preferred Generic	000100	
H1032	091	0	1	02	01	H1032_091_0	6	3	Preferred Brand	000001	
H1032	091	0	1	02	01	H1032_091_0	6	4	Non-Preferred Brand	100000	
H1032	091	0	1	02	01	H1032_091_0	6	5	Specialty Tier	010010	
H1032	124	0	1	01	01	H1032_124_0	5	4	Non-Preferred Brand	110000	
H1032	124	0	1	01	01	H1032_124_0	5	3	Preferred Brand	010001	
H1032	124	0	1	01	01	H1032_124_0	5	1	Preferred Generic	001000	
H1032	124	0	1	01	01	H1032_124_0	5	2	Non-Preferred Generic	000100	
H1032	124	0	1	01	01	H1032_124_0	5	5	Specialty Tier	010010	
H1032	133	0	1	02	01	H1032_133_0	5	4	Non-Preferred Brand	100000	
H1032	133	0	1	02	01	H1032_133_0	5	3	Preferred Brand	000001	
H1032	133	0	1	02	01	H1032_133_0	5	2	Non-Preferred Generic	000100	
H1032	133	0	1	02	01	H1032_133_0	5	1	Preferred Generic	001000	
H1032	133	0	1	02	01	H1032_133_0	5	5	Specialty Tier	010010	
H1032	170	0	1	01	01	H1032_170_0	5	1	Preferred Generic	001000	
H1032	170	0	1	01	01	H1032_170_0	5	2	Non-Preferred Generic	000100	
H1032	170	0	1	01	01	H1032_170_0	5	3	Preferred Brand	010001	
H1032	170	0	1	01	01	H1032_170_0	5	4	Non-Preferred Brand	110000	
H1032	170	0	1	01	01	H1032_170_0	5	5	Specialty Tier	010010	
H1032	173	0	1	01	01	H1032_173_0	6	1	Preferred Generic	001000	
H1032	173	0	1	01	01	H1032_173_0	6	2	Non-Preferred Generic	000100	
H1032	173	0	1	01	01	H1032_173_0	6	3	Preferred Brand	000001	
H1032	173	0	1	01	01	H1032_173_0	6	4	Non-Preferred Brand	100000	
H1032	173	0	1	01	01	H1032_173_0	6	5	Specialty Tier	010010	
H1032	174	0	1	01	01	H1032_174_0	6	2	Non-Preferred Generic	000100	
H1032	174	0	1	01	01	H1032_174_0	6	1	Preferred Generic	001000	
H1032	174	0	1	01	01	H1032_174_0	6	3	Preferred Brand	000001	
H1032	174	0	1	01	01	H1032_174_0	6	5	Specialty Tier	010010	
H1032	174	0	1	01	01	H1032_174_0	6	4	Non-Preferred Brand	100000	
H1032	175	0	1	01	01	H1032_175_0	5	4	Non-Preferred Brand	110000	
H1032	175	0	1	01	01	H1032_175_0	5	3	Preferred Brand	010001	
H1032	175	0	1	01	01	H1032_175_0	5	2	Non-Preferred Generic	000100	
H1032	175	0	1	01	01	H1032_175_0	5	1	Preferred Generic	001000	
H1032	175	0	1	01	01	H1032_175_0	5	5	Specialty Tier	010010	
H1032	176	0	1	01	01	H1032_176_0	6	4	Non-Preferred Brand	110000	
H1032	176	0	1	01	01	H1032_176_0	6	3	Preferred Brand	010001	
H1032	176	0	1	01	01	H1032_176_0	6	2	Non-Preferred Generic	000100	
H1032	176	0	1	01	01	H1032_176_0	6	1	Preferred Generic	001000	
H1032	176	0	1	01	01	H1032_176_0	6	5	Specialty Tier	010010	
H1032	177	0	1	01	01	H1032_177_0	5	1	Preferred Generic	001000	
H1032	177	0	1	01	01	H1032_177_0	5	2	Non-Preferred Generic	000100	
H1032	177	0	1	01	01	H1032_177_0	5	3	Preferred Brand	000001	
H1032	177	0	1	01	01	H1032_177_0	5	4	Non-Preferred Brand	100000	
H1032	177	0	1	01	01	H1032_177_0	5	5	Specialty Tier	010010	
H1032	179	0	1	01	01	H1032_179_0	6	1	Preferred Generic	001000	
H1032	179	0	1	01	01	H1032_179_0	6	2	Non-Preferred Generic	000100	
H1032	179	0	1	01	01	H1032_179_0	6	4	Non-Preferred Brand	100000	
H1032	179	0	1	01	01	H1032_179_0	6	3	Preferred Brand	000001	
H1032	179	0	1	01	01	H1032_179_0	6	5	Specialty Tier	010010	
H1035	002	0	1	02	01	H1035_002_0	7	4	Non-Preferred Brand	100000	
H1035	002	0	1	02	01	H1035_002_0	7	2	Non-Preferred Generic	000100	1
H1035	002	0	1	02	01	H1035_002_0	7	1	Preferred Generic	001000	1
H1035	002	0	1	02	01	H1035_002_0	7	6	Injectable Drugs	010010	
H1035	002	0	1	02	01	H1035_002_0	7	5	Specialty Tier	010010	
H1035	002	0	1	02	01	H1035_002_0	7	3	Preferred Brand	000001	
H1035	002	0	1	02	01	H1035_002_0	7	1	Preferred Generic	001000	
H1035	002	0	1	02	01	H1035_002_0	7	2	Non-Preferred Generic	000100	
H1035	006	0	1	01	01	H1035_006_0	5	2	Non-Preferred Generic	000100	
H1035	006	0	1	01	01	H1035_006_0	5	1	Preferred Generic	001000	
H1035	006	0	1	01	01	H1035_006_0	5	3	Preferred Brand	000001	
H1035	006	0	1	01	01	H1035_006_0	5	6	Injectable Drugs	010010	
H1035	006	0	1	01	01	H1035_006_0	5	5	Specialty Tier	010010	
H1035	006	0	1	01	01	H1035_006_0	5	4	Non-Preferred Brand	100000	
H1036	025	0	1	01	01	H1036_025_0	4	1	Preferred Generic	001010	
H1036	025	0	1	01	01	H1036_025_0	4	2	Non-Preferred Generic	000101	
H1036	025	0	1	01	01	H1036_025_0	4	3	Preferred Brand	000101	
H1036	025	0	1	01	01	H1036_025_0	4	4	Non-Preferred Brand	110000	
H1036	025	0	1	01	01	H1036_025_0	4	5	Specialty Tier	010010	2
H1036	025	0	1	01	01	H1036_025_0	4	1	Preferred Generic	001010	1
H1036	025	0	1	01	01	H1036_025_0	4	2	Non-Preferred Generic	000101	1
H1036	025	0	1	01	01	H1036_025_0	4	3	Preferred Brand	000101	2
H1036	025	0	1	01	01	H1036_025_0	4	4	Non-Preferred Brand	110000	2
H1036	025	0	1	01	01	H1036_025_0	4	5	Specialty Tier	010010	
H1036	040	0	1	01	01	H1036_040_0	4	1	Preferred Generic	001010	
H1036	040	0	1	01	01	H1036_040_0	4	2	Non-Preferred Generic	000101	
H1036	040	0	1	01	01	H1036_040_0	4	5	Specialty Tier	010010	2
H1036	040	0	1	01	01	H1036_040_0	4	4	Non-Preferred Brand	110000	2
H1036	040	0	1	01	01	H1036_040_0	4	3	Preferred Brand	000101	2
H1036	040	0	1	01	01	H1036_040_0	4	2	Non-Preferred Generic	000101	1
H1036	040	0	1	01	01	H1036_040_0	4	1	Preferred Generic	001010	1
H1036	040	0	1	01	01	H1036_040_0	4	5	Specialty Tier	010010	
H1036	040	0	1	01	01	H1036_040_0	4	4	Non-Preferred Brand	110000	
H1036	040	0	1	01	01	H1036_040_0	4	3	Preferred Brand	000101	
H1036	044	0	1	01	01	H1036_044_0	3	1	Preferred Generic	001010	
H1036	044	0	1	01	01	H1036_044_0	3	4	Non-Preferred Brand	110000	2
H1036	044	0	1	01	01	H1036_044_0	3	3	Preferred Brand	000101	2
H1036	044	0	1	01	01	H1036_044_0	3	2	Non-Preferred Generic	000101	2
H1036	044	0	1	01	01	H1036_044_0	3	5	Specialty Tier	010010	2
H1036	044	0	1	01	01	H1036_044_0	3	5	Specialty Tier	010010	
H1036	044	0	1	01	01	H1036_044_0	3	4	Non-Preferred Brand	110000	
H1036	044	0	1	01	01	H1036_044_0	3	3	Preferred Brand	000101	
H1036	044	0	1	01	01	H1036_044_0	3	2	Non-Preferred Generic	000101	
H1036	044	0	1	01	01	H1036_044_0	3	1	Preferred Generic	001010	2
H1036	052	0	1	01	01	H1036_052_0	4	1	Preferred Generic	001010	
H1036	052	0	1	01	01	H1036_052_0	4	2	Non-Preferred Generic	000101	
H1036	052	0	1	01	01	H1036_052_0	4	5	Specialty Tier	010010	2
H1036	052	0	1	01	01	H1036_052_0	4	4	Non-Preferred Brand	110000	2
H1036	052	0	1	01	01	H1036_052_0	4	3	Preferred Brand	000101	2
H1036	052	0	1	01	01	H1036_052_0	4	2	Non-Preferred Generic	000101	1
H1036	052	0	1	01	01	H1036_052_0	4	1	Preferred Generic	001010	1
H1036	052	0	1	01	01	H1036_052_0	4	5	Specialty Tier	010010	
H1036	052	0	1	01	01	H1036_052_0	4	4	Non-Preferred Brand	110000	
H1036	052	0	1	01	01	H1036_052_0	4	3	Preferred Brand	000101	
H1036	054	0	1	01	01	H1036_054_0	5	1	Preferred Generic	001010	
H1036	054	0	1	01	01	H1036_054_0	5	4	Non-Preferred Brand	110000	2
H1036	054	0	1	01	01	H1036_054_0	5	3	Preferred Brand	000101	2
H1036	054	0	1	01	01	H1036_054_0	5	2	Non-Preferred Generic	000101	1
H1036	054	0	1	01	01	H1036_054_0	5	5	Specialty Tier	010010	2
H1036	054	0	1	01	01	H1036_054_0	5	5	Specialty Tier	010010	
H1036	054	0	1	01	01	H1036_054_0	5	4	Non-Preferred Brand	110000	
H1036	054	0	1	01	01	H1036_054_0	5	3	Preferred Brand	000101	
H1036	054	0	1	01	01	H1036_054_0	5	2	Non-Preferred Generic	000101	
H1036	054	0	1	01	01	H1036_054_0	5	1	Preferred Generic	001010	1
H1036	062	0	1	01	01	H1036_062_0	4	1	Preferred Generic	001010	
H1036	062	0	1	01	01	H1036_062_0	4	2	Non-Preferred Generic	000101	
H1036	062	0	1	01	01	H1036_062_0	4	3	Preferred Brand	000101	
H1036	062	0	1	01	01	H1036_062_0	4	4	Non-Preferred Brand	110000	
H1036	062	0	1	01	01	H1036_062_0	4	2	Non-Preferred Generic	000101	1
H1036	062	0	1	01	01	H1036_062_0	4	1	Preferred Generic	001010	1
H1036	062	0	1	01	01	H1036_062_0	4	5	Specialty Tier	010010	2
H1036	062	0	1	01	01	H1036_062_0	4	4	Non-Preferred Brand	110000	2
H1036	062	0	1	01	01	H1036_062_0	4	3	Preferred Brand	000101	2
H1036	062	0	1	01	01	H1036_062_0	4	5	Specialty Tier	010010	
H1036	065	0	1	01	01	H1036_065_0	5	5	Specialty Tier	010010	2
H1036	065	0	1	01	01	H1036_065_0	5	4	Non-Preferred Brand	110000	2
H1036	065	0	1	01	01	H1036_065_0	5	3	Preferred Brand	000101	2
H1036	065	0	1	01	01	H1036_065_0	5	2	Non-Preferred Generic	000101	1
H1036	065	0	1	01	01	H1036_065_0	5	4	Non-Preferred Brand	110000	
H1036	065	0	1	01	01	H1036_065_0	5	5	Specialty Tier	010010	
H1036	065	0	1	01	01	H1036_065_0	5	1	Preferred Generic	001010	1
H1036	065	0	1	01	01	H1036_065_0	5	3	Preferred Brand	000101	
H1036	065	0	1	01	01	H1036_065_0	5	2	Non-Preferred Generic	000101	
H1036	065	0	1	01	01	H1036_065_0	5	1	Preferred Generic	001010	
H1036	067	0	1	01	01	H1036_067_0	4	3	Preferred Brand	000101	2
H1036	067	0	1	01	01	H1036_067_0	4	4	Non-Preferred Brand	110000	2
H1036	067	0	1	01	01	H1036_067_0	4	5	Specialty Tier	010010	2
H1036	067	0	1	01	01	H1036_067_0	4	1	Preferred Generic	001010	
H1036	067	0	1	01	01	H1036_067_0	4	2	Non-Preferred Generic	000101	1
H1036	067	0	1	01	01	H1036_067_0	4	3	Preferred Brand	000101	
H1036	067	0	1	01	01	H1036_067_0	4	4	Non-Preferred Brand	110000	
H1036	067	0	1	01	01	H1036_067_0	4	5	Specialty Tier	010010	
H1036	067	0	1	01	01	H1036_067_0	4	1	Preferred Generic	001010	1
H1036	067	0	1	01	01	H1036_067_0	4	2	Non-Preferred Generic	000101	
H1036	068	0	1	01	01	H1036_068_0	3	2	Non-Preferred Generic	000101	
H1036	068	0	1	01	01	H1036_068_0	3	3	Preferred Brand	000101	
H1036	068	0	1	01	01	H1036_068_0	3	4	Non-Preferred Brand	110000	
H1036	068	0	1	01	01	H1036_068_0	3	5	Specialty Tier	010010	2
H1036	068	0	1	01	01	H1036_068_0	3	4	Non-Preferred Brand	110000	2
H1036	068	0	1	01	01	H1036_068_0	3	3	Preferred Brand	000101	2
H1036	068	0	1	01	01	H1036_068_0	3	2	Non-Preferred Generic	000101	2
H1036	068	0	1	01	01	H1036_068_0	3	1	Preferred Generic	001010	
H1036	068	0	1	01	01	H1036_068_0	3	5	Specialty Tier	010010	
H1036	068	0	1	01	01	H1036_068_0	3	1	Preferred Generic	001010	2
H1036	074	0	1	01	01	H1036_074_0	4	1	Preferred Generic	001010	
H1036	074	0	1	01	01	H1036_074_0	4	2	Non-Preferred Generic	000101	
H1036	074	0	1	01	01	H1036_074_0	4	3	Preferred Brand	000101	
H1036	074	0	1	01	01	H1036_074_0	4	4	Non-Preferred Brand	110000	
H1036	074	0	1	01	01	H1036_074_0	4	5	Specialty Tier	010010	2
H1036	074	0	1	01	01	H1036_074_0	4	1	Preferred Generic	001010	1
H1036	074	0	1	01	01	H1036_074_0	4	2	Non-Preferred Generic	000101	1
H1036	074	0	1	01	01	H1036_074_0	4	3	Preferred Brand	000101	2
H1036	074	0	1	01	01	H1036_074_0	4	4	Non-Preferred Brand	110000	2
H1036	074	0	1	01	01	H1036_074_0	4	5	Specialty Tier	010010	
H1036	077	0	1	01	01	H1036_077_0	6	1	Preferred Generic	001010	
H1036	077	0	1	01	01	H1036_077_0	6	2	Non-Preferred Generic	000101	
H1036	077	0	1	01	01	H1036_077_0	6	3	Preferred Brand	000101	
H1036	077	0	1	01	01	H1036_077_0	6	4	Non-Preferred Brand	110000	
H1036	077	0	1	01	01	H1036_077_0	6	5	Specialty Tier	010010	
H1036	081	0	1	01	01	H1036_081_0	3	1	Preferred Generic	001010	
H1036	081	0	1	01	01	H1036_081_0	3	2	Non-Preferred Generic	000101	
H1036	081	0	1	01	01	H1036_081_0	3	3	Preferred Brand	000101	
H1036	081	0	1	01	01	H1036_081_0	3	4	Non-Preferred Brand	110000	
H1036	081	0	1	01	01	H1036_081_0	3	5	Specialty Tier	010010	2
H1036	081	0	1	01	01	H1036_081_0	3	1	Preferred Generic	001010	2
H1036	081	0	1	01	01	H1036_081_0	3	2	Non-Preferred Generic	000101	2
H1036	081	0	1	01	01	H1036_081_0	3	3	Preferred Brand	000101	2
H1036	081	0	1	01	01	H1036_081_0	3	4	Non-Preferred Brand	110000	2
H1036	081	0	1	01	01	H1036_081_0	3	5	Specialty Tier	010010	
H1036	102	0	1	01	01	H1036_102_0	4	1	Preferred Generic	001010	
H1036	102	0	1	01	01	H1036_102_0	4	2	Non-Preferred Generic	000101	
H1036	102	0	1	01	01	H1036_102_0	4	3	Preferred Brand	000101	
H1036	102	0	1	01	01	H1036_102_0	4	4	Non-Preferred Brand	110000	
H1036	102	0	1	01	01	H1036_102_0	4	5	Specialty Tier	010010	
H1036	103	0	1	01	01	H1036_103_0	7	1	Preferred Generic	001010	
H1036	103	0	1	01	01	H1036_103_0	7	2	Non-Preferred Generic	000101	
H1036	103	0	1	01	01	H1036_103_0	7	3	Preferred Brand	000101	
H1036	103	0	1	01	01	H1036_103_0	7	4	Non-Preferred Brand	110000	
H1036	103	0	1	01	01	H1036_103_0	7	5	Specialty Tier	010010	
H1036	104	0	1	01	01	H1036_104_0	5	3	Preferred Brand	000101	
H1036	104	0	1	01	01	H1036_104_0	5	4	Non-Preferred Brand	110000	
H1036	104	0	1	01	01	H1036_104_0	5	5	Specialty Tier	010010	
H1036	104	0	1	01	01	H1036_104_0	5	1	Preferred Generic	001010	
H1036	104	0	1	01	01	H1036_104_0	5	2	Non-Preferred Generic	000101	
H1036	121	0	1	01	01	H1036_121_0	5	4	Non-Preferred Brand	110000	
H1036	121	0	1	01	01	H1036_121_0	5	3	Preferred Brand	000101	
H1036	121	0	1	01	01	H1036_121_0	5	5	Specialty Tier	010010	2
H1036	121	0	1	01	01	H1036_121_0	5	4	Non-Preferred Brand	110000	2
H1036	121	0	1	01	01	H1036_121_0	5	3	Preferred Brand	000101	2
H1036	121	0	1	01	01	H1036_121_0	5	2	Non-Preferred Generic	000101	1
H1036	121	0	1	01	01	H1036_121_0	5	1	Preferred Generic	001010	1
H1036	121	0	1	01	01	H1036_121_0	5	5	Specialty Tier	010010	
H1036	121	0	1	01	01	H1036_121_0	5	1	Preferred Generic	001010	
H1036	121	0	1	01	01	H1036_121_0	5	2	Non-Preferred Generic	000101	
H1036	130	0	1	01	01	H1036_130_0	4	1	Preferred Generic	001010	
H1036	130	0	1	01	01	H1036_130_0	4	4	Non-Preferred Brand	110000	2
H1036	130	0	1	01	01	H1036_130_0	4	3	Preferred Brand	000101	2
H1036	130	0	1	01	01	H1036_130_0	4	2	Non-Preferred Generic	000101	1
H1036	130	0	1	01	01	H1036_130_0	4	5	Specialty Tier	010010	2
H1036	130	0	1	01	01	H1036_130_0	4	5	Specialty Tier	010010	
H1036	130	0	1	01	01	H1036_130_0	4	4	Non-Preferred Brand	110000	
H1036	130	0	1	01	01	H1036_130_0	4	3	Preferred Brand	000101	
H1036	130	0	1	01	01	H1036_130_0	4	2	Non-Preferred Generic	000101	
H1036	130	0	1	01	01	H1036_130_0	4	1	Preferred Generic	001010	1
H1036	137	0	1	01	01	H1036_137_0	12	4	Non-Preferred Brand	110000	
H1036	137	0	1	01	01	H1036_137_0	12	3	Preferred Brand	000101	
H1036	137	0	1	01	01	H1036_137_0	12	2	Non-Preferred Generic	000101	
H1036	137	0	1	01	01	H1036_137_0	12	1	Preferred Generic	001010	
H1036	137	0	1	01	01	H1036_137_0	12	5	Specialty Tier	010010	
H1036	137	0	1	01	01	H1036_137_0	12	5	Specialty Tier	010010	2
H1036	137	0	1	01	01	H1036_137_0	12	4	Non-Preferred Brand	110000	2
H1036	137	0	1	01	01	H1036_137_0	12	3	Preferred Brand	000101	2
H1036	137	0	1	01	01	H1036_137_0	12	2	Non-Preferred Generic	000101	2
H1036	137	0	1	01	01	H1036_137_0	12	1	Preferred Generic	001010	2
H1036	138	0	1	01	01	H1036_138_0	11	1	Preferred Generic	001010	
H1036	138	0	1	01	01	H1036_138_0	11	2	Non-Preferred Generic	000101	
H1036	138	0	1	01	01	H1036_138_0	11	5	Specialty Tier	010010	2
H1036	138	0	1	01	01	H1036_138_0	11	4	Non-Preferred Brand	110000	2
H1036	138	0	1	01	01	H1036_138_0	11	3	Preferred Brand	000101	2
H1036	138	0	1	01	01	H1036_138_0	11	2	Non-Preferred Generic	000101	2
H1036	138	0	1	01	01	H1036_138_0	11	1	Preferred Generic	001010	2
H1036	138	0	1	01	01	H1036_138_0	11	5	Specialty Tier	010010	
H1036	138	0	1	01	01	H1036_138_0	11	4	Non-Preferred Brand	110000	
H1036	138	0	1	01	01	H1036_138_0	11	3	Preferred Brand	000101	
H1036	140	0	1	01	01	H1036_140_0	3	1	Preferred Generic	001010	
H1036	140	0	1	01	01	H1036_140_0	3	5	Specialty Tier	010010	
H1036	140	0	1	01	01	H1036_140_0	3	1	Preferred Generic	001010	2
H1036	140	0	1	01	01	H1036_140_0	3	2	Non-Preferred Generic	000101	2
H1036	140	0	1	01	01	H1036_140_0	3	5	Specialty Tier	010010	2
H1036	140	0	1	01	01	H1036_140_0	3	4	Non-Preferred Brand	110000	2
H1036	140	0	1	01	01	H1036_140_0	3	4	Non-Preferred Brand	110000	
H1036	140	0	1	01	01	H1036_140_0	3	3	Preferred Brand	000101	
H1036	140	0	1	01	01	H1036_140_0	3	2	Non-Preferred Generic	000101	
H1036	140	0	1	01	01	H1036_140_0	3	3	Preferred Brand	000101	2
H1036	141	0	1	01	01	H1036_141_0	3	1	Preferred Generic	001010	
H1036	141	0	1	01	01	H1036_141_0	3	2	Non-Preferred Generic	000101	
H1036	141	0	1	01	01	H1036_141_0	3	3	Preferred Brand	000101	
H1036	141	0	1	01	01	H1036_141_0	3	4	Non-Preferred Brand	110000	
H1036	141	0	1	01	01	H1036_141_0	3	5	Specialty Tier	010010	
H1036	141	0	1	01	01	H1036_141_0	3	1	Preferred Generic	001010	2
H1036	141	0	1	01	01	H1036_141_0	3	2	Non-Preferred Generic	000101	2
H1036	141	0	1	01	01	H1036_141_0	3	3	Preferred Brand	000101	2
H1036	141	0	1	01	01	H1036_141_0	3	4	Non-Preferred Brand	110000	2
H1036	141	0	1	01	01	H1036_141_0	3	5	Specialty Tier	010010	2
H1036	143	0	1	01	01	H1036_143_0	3	1	Preferred Generic	001010	
H1036	143	0	1	01	01	H1036_143_0	3	2	Non-Preferred Generic	000101	
H1036	143	0	1	01	01	H1036_143_0	3	5	Specialty Tier	010010	2
H1036	143	0	1	01	01	H1036_143_0	3	4	Non-Preferred Brand	110000	2
H1036	143	0	1	01	01	H1036_143_0	3	3	Preferred Brand	000101	2
H1036	143	0	1	01	01	H1036_143_0	3	2	Non-Preferred Generic	000101	2
H1036	143	0	1	01	01	H1036_143_0	3	1	Preferred Generic	001010	2
H1036	143	0	1	01	01	H1036_143_0	3	5	Specialty Tier	010010	
H1036	143	0	1	01	01	H1036_143_0	3	4	Non-Preferred Brand	110000	
H1036	143	0	1	01	01	H1036_143_0	3	3	Preferred Brand	000101	
H1036	146	0	1	01	01	H1036_146_0	4	1	Preferred Generic	001010	
H1036	146	0	1	01	01	H1036_146_0	4	4	Non-Preferred Brand	110000	2
H1036	146	0	1	01	01	H1036_146_0	4	3	Preferred Brand	000101	2
H1036	146	0	1	01	01	H1036_146_0	4	2	Non-Preferred Generic	000101	1
H1036	146	0	1	01	01	H1036_146_0	4	5	Specialty Tier	010010	2
H1036	146	0	1	01	01	H1036_146_0	4	5	Specialty Tier	010010	
H1036	146	0	1	01	01	H1036_146_0	4	4	Non-Preferred Brand	110000	
H1036	146	0	1	01	01	H1036_146_0	4	3	Preferred Brand	000101	
H1036	146	0	1	01	01	H1036_146_0	4	2	Non-Preferred Generic	000101	
H1036	146	0	1	01	01	H1036_146_0	4	1	Preferred Generic	001010	1
H1036	151	0	1	01	01	H1036_151_0	5	1	Preferred Generic	001010	
H1036	151	0	1	01	01	H1036_151_0	5	5	Specialty Tier	010010	2
H1036	151	0	1	01	01	H1036_151_0	5	4	Non-Preferred Brand	110000	2
H1036	151	0	1	01	01	H1036_151_0	5	3	Preferred Brand	000101	2
H1036	151	0	1	01	01	H1036_151_0	5	2	Non-Preferred Generic	000101	
H1036	151	0	1	01	01	H1036_151_0	5	1	Preferred Generic	001010	2
H1036	151	0	1	01	01	H1036_151_0	5	5	Specialty Tier	010010	
H1036	151	0	1	01	01	H1036_151_0	5	4	Non-Preferred Brand	110000	
H1036	151	0	1	01	01	H1036_151_0	5	3	Preferred Brand	000101	
H1036	151	0	1	01	01	H1036_151_0	5	2	Non-Preferred Generic	000101	2
H1036	152	0	1	01	01	H1036_152_0	5	5	Specialty Tier	010010	
H1036	152	0	1	01	01	H1036_152_0	5	3	Preferred Brand	000101	
H1036	152	0	1	01	01	H1036_152_0	5	4	Non-Preferred Brand	110000	
H1036	152	0	1	01	01	H1036_152_0	5	2	Non-Preferred Generic	000101	
H1036	152	0	1	01	01	H1036_152_0	5	1	Preferred Generic	001010	
H1036	153	0	1	01	01	H1036_153_0	5	5	Specialty Tier	010010	
H1036	153	0	1	01	01	H1036_153_0	5	5	Specialty Tier	010010	2
H1036	153	0	1	01	01	H1036_153_0	5	1	Preferred Generic	001010	2
H1036	153	0	1	01	01	H1036_153_0	5	2	Non-Preferred Generic	000101	2
H1036	153	0	1	01	01	H1036_153_0	5	1	Preferred Generic	001010	
H1036	153	0	1	01	01	H1036_153_0	5	4	Non-Preferred Brand	110000	2
H1036	153	0	1	01	01	H1036_153_0	5	4	Non-Preferred Brand	110000	
H1036	153	0	1	01	01	H1036_153_0	5	3	Preferred Brand	000101	
H1036	153	0	1	01	01	H1036_153_0	5	2	Non-Preferred Generic	000101	
H1036	153	0	1	01	01	H1036_153_0	5	3	Preferred Brand	000101	2
H1036	154	0	1	01	01	H1036_154_0	3	5	Specialty Tier	010010	
H1036	154	0	1	01	01	H1036_154_0	3	3	Preferred Brand	000101	
H1036	154	0	1	01	01	H1036_154_0	3	4	Non-Preferred Brand	110000	
H1036	154	0	1	01	01	H1036_154_0	3	2	Non-Preferred Generic	000101	
H1036	154	0	1	01	01	H1036_154_0	3	1	Preferred Generic	001010	
H1036	156	0	1	01	01	H1036_156_0	5	5	Specialty Tier	010010	2
H1036	156	0	1	01	01	H1036_156_0	5	1	Preferred Generic	001010	
H1036	156	0	1	01	01	H1036_156_0	5	2	Non-Preferred Generic	000101	
H1036	156	0	1	01	01	H1036_156_0	5	3	Preferred Brand	000101	
H1036	156	0	1	01	01	H1036_156_0	5	1	Preferred Generic	001010	2
H1036	156	0	1	01	01	H1036_156_0	5	5	Specialty Tier	010010	
H1036	156	0	1	01	01	H1036_156_0	5	4	Non-Preferred Brand	110000	2
H1036	156	0	1	01	01	H1036_156_0	5	3	Preferred Brand	000101	2
H1036	156	0	1	01	01	H1036_156_0	5	2	Non-Preferred Generic	000101	2
H1036	156	0	1	01	01	H1036_156_0	5	4	Non-Preferred Brand	110000	
H1036	157	0	1	01	01	H1036_157_0	4	5	Specialty Tier	010010	2
H1036	157	0	1	01	01	H1036_157_0	4	4	Non-Preferred Brand	110000	2
H1036	157	0	1	01	01	H1036_157_0	4	3	Preferred Brand	000101	2
H1036	157	0	1	01	01	H1036_157_0	4	2	Non-Preferred Generic	000101	2
H1036	157	0	1	01	01	H1036_157_0	4	4	Non-Preferred Brand	110000	
H1036	157	0	1	01	01	H1036_157_0	4	5	Specialty Tier	010010	
H1036	157	0	1	01	01	H1036_157_0	4	1	Preferred Generic	001010	2
H1036	157	0	1	01	01	H1036_157_0	4	3	Preferred Brand	000101	
H1036	157	0	1	01	01	H1036_157_0	4	2	Non-Preferred Generic	000101	
H1036	157	0	1	01	01	H1036_157_0	4	1	Preferred Generic	001010	
H1036	159	0	1	01	01	H1036_159_0	3	1	Preferred Generic	001010	
H1036	159	0	1	01	01	H1036_159_0	3	2	Non-Preferred Generic	000101	
H1036	159	0	1	01	01	H1036_159_0	3	3	Preferred Brand	000101	
H1036	159	0	1	01	01	H1036_159_0	3	4	Non-Preferred Brand	110000	
H1036	159	0	1	01	01	H1036_159_0	3	5	Specialty Tier	010010	
H1036	160	0	1	01	01	H1036_160_0	4	4	Non-Preferred Brand	110000	
H1036	160	0	1	01	01	H1036_160_0	4	3	Preferred Brand	000101	
H1036	160	0	1	01	01	H1036_160_0	4	5	Specialty Tier	010010	2
H1036	160	0	1	01	01	H1036_160_0	4	4	Non-Preferred Brand	110000	2
H1036	160	0	1	01	01	H1036_160_0	4	3	Preferred Brand	000101	2
H1036	160	0	1	01	01	H1036_160_0	4	2	Non-Preferred Generic	000101	2
H1036	160	0	1	01	01	H1036_160_0	4	1	Preferred Generic	001010	2
H1036	160	0	1	01	01	H1036_160_0	4	5	Specialty Tier	010010	
H1036	160	0	1	01	01	H1036_160_0	4	1	Preferred Generic	001010	
H1036	160	0	1	01	01	H1036_160_0	4	2	Non-Preferred Generic	000101	
H1036	161	0	1	01	01	H1036_161_0	5	2	Non-Preferred Generic	000101	
H1036	161	0	1	01	01	H1036_161_0	5	3	Preferred Brand	000101	
H1036	161	0	1	01	01	H1036_161_0	5	4	Non-Preferred Brand	110000	
H1036	161	0	1	01	01	H1036_161_0	5	5	Specialty Tier	010010	
H1036	161	0	1	01	01	H1036_161_0	5	1	Preferred Generic	001010	
H1036	162	0	1	01	01	H1036_162_0	5	5	Specialty Tier	010010	
H1036	162	0	1	01	01	H1036_162_0	5	2	Non-Preferred Generic	000101	
H1036	162	0	1	01	01	H1036_162_0	5	3	Preferred Brand	000101	
H1036	162	0	1	01	01	H1036_162_0	5	4	Non-Preferred Brand	110000	
H1036	162	0	1	01	01	H1036_162_0	5	1	Preferred Generic	001010	
H1036	163	0	1	01	01	H1036_163_0	6	4	Non-Preferred Brand	110000	
H1036	163	0	1	01	01	H1036_163_0	6	3	Preferred Brand	000101	
H1036	163	0	1	01	01	H1036_163_0	6	2	Non-Preferred Generic	000101	
H1036	163	0	1	01	01	H1036_163_0	6	1	Preferred Generic	001010	
H1036	163	0	1	01	01	H1036_163_0	6	5	Specialty Tier	010010	
H1036	164	0	1	01	01	H1036_164_0	4	2	Non-Preferred Generic	000101	
H1036	164	0	1	01	01	H1036_164_0	4	1	Preferred Generic	001010	
H1036	164	0	1	01	01	H1036_164_0	4	3	Preferred Brand	000101	
H1036	164	0	1	01	01	H1036_164_0	4	4	Non-Preferred Brand	110000	
H1036	164	0	1	01	01	H1036_164_0	4	5	Specialty Tier	010010	2
H1036	164	0	1	01	01	H1036_164_0	4	1	Preferred Generic	001010	2
H1036	164	0	1	01	01	H1036_164_0	4	2	Non-Preferred Generic	000101	2
H1036	164	0	1	01	01	H1036_164_0	4	3	Preferred Brand	000101	2
H1036	164	0	1	01	01	H1036_164_0	4	4	Non-Preferred Brand	110000	2
H1036	164	0	1	01	01	H1036_164_0	4	5	Specialty Tier	010010	
H1036	167	0	1	01	01	H1036_167_0	6	2	Non-Preferred Generic	000101	
H1036	167	0	1	01	01	H1036_167_0	6	1	Preferred Generic	001010	
H1036	167	0	1	01	01	H1036_167_0	6	3	Preferred Brand	000101	
H1036	167	0	1	01	01	H1036_167_0	6	5	Specialty Tier	010010	
H1036	167	0	1	01	01	H1036_167_0	6	4	Non-Preferred Brand	110000	
H1036	168	0	1	01	01	H1036_168_0	5	1	Preferred Generic	001010	
H1036	168	0	1	01	01	H1036_168_0	5	2	Non-Preferred Generic	000101	
H1036	168	0	1	01	01	H1036_168_0	5	3	Preferred Brand	000101	
H1036	168	0	1	01	01	H1036_168_0	5	4	Non-Preferred Brand	110000	
H1036	168	0	1	01	01	H1036_168_0	5	5	Specialty Tier	010010	
H1036	169	0	1	01	01	H1036_169_0	5	1	Preferred Generic	001010	
H1036	169	0	1	01	01	H1036_169_0	5	2	Non-Preferred Generic	000101	
H1036	169	0	1	01	01	H1036_169_0	5	4	Non-Preferred Brand	110000	
H1036	169	0	1	01	01	H1036_169_0	5	3	Preferred Brand	000101	
H1036	169	0	1	01	01	H1036_169_0	5	5	Specialty Tier	010010	
H1036	170	0	1	01	01	H1036_170_0	5	4	Non-Preferred Brand	110000	
H1036	170	0	1	01	01	H1036_170_0	5	5	Specialty Tier	010010	
H1036	170	0	1	01	01	H1036_170_0	5	3	Preferred Brand	000101	
H1036	170	0	1	01	01	H1036_170_0	5	2	Non-Preferred Generic	000101	
H1036	170	0	1	01	01	H1036_170_0	5	1	Preferred Generic	001010	
H1036	171	0	1	01	01	H1036_171_0	4	1	Preferred Generic	001010	
H1036	171	0	1	01	01	H1036_171_0	4	2	Non-Preferred Generic	000101	
H1036	171	0	1	01	01	H1036_171_0	4	3	Preferred Brand	000101	
H1036	171	0	1	01	01	H1036_171_0	4	4	Non-Preferred Brand	110000	
H1036	171	0	1	01	01	H1036_171_0	4	5	Specialty Tier	010010	
H1036	171	0	1	01	01	H1036_171_0	4	1	Preferred Generic	001010	2
H1036	171	0	1	01	01	H1036_171_0	4	2	Non-Preferred Generic	000101	2
H1036	171	0	1	01	01	H1036_171_0	4	3	Preferred Brand	000101	2
H1036	171	0	1	01	01	H1036_171_0	4	4	Non-Preferred Brand	110000	2
H1036	171	0	1	01	01	H1036_171_0	4	5	Specialty Tier	010010	2
H1036	175	0	1	01	01	H1036_175_0	3	4	Non-Preferred Brand	110000	
H1036	175	0	1	01	01	H1036_175_0	3	3	Preferred Brand	000101	
H1036	175	0	1	01	01	H1036_175_0	3	2	Non-Preferred Generic	000101	
H1036	175	0	1	01	01	H1036_175_0	3	1	Preferred Generic	001010	
H1036	175	0	1	01	01	H1036_175_0	3	5	Specialty Tier	010010	2
H1036	175	0	1	01	01	H1036_175_0	3	1	Preferred Generic	001010	2
H1036	175	0	1	01	01	H1036_175_0	3	2	Non-Preferred Generic	000101	2
H1036	175	0	1	01	01	H1036_175_0	3	3	Preferred Brand	000101	2
H1036	175	0	1	01	01	H1036_175_0	3	4	Non-Preferred Brand	110000	2
H1036	175	0	1	01	01	H1036_175_0	3	5	Specialty Tier	010010	
H1036	178	0	1	01	01	H1036_178_0	4	4	Non-Preferred Brand	110000	
H1036	178	0	1	01	01	H1036_178_0	4	3	Preferred Brand	000101	
H1036	178	0	1	01	01	H1036_178_0	4	2	Non-Preferred Generic	000101	
H1036	178	0	1	01	01	H1036_178_0	4	1	Preferred Generic	001010	
H1036	178	0	1	01	01	H1036_178_0	4	5	Specialty Tier	010010	
H1036	178	0	1	01	01	H1036_178_0	4	5	Specialty Tier	010010	2
H1036	178	0	1	01	01	H1036_178_0	4	4	Non-Preferred Brand	110000	2
H1036	178	0	1	01	01	H1036_178_0	4	3	Preferred Brand	000101	2
H1036	178	0	1	01	01	H1036_178_0	4	2	Non-Preferred Generic	000101	2
H1036	178	0	1	01	01	H1036_178_0	4	1	Preferred Generic	001010	2
H1036	179	0	1	01	01	H1036_179_0	4	1	Preferred Generic	001010	
H1036	179	0	1	01	01	H1036_179_0	4	2	Non-Preferred Generic	000101	
H1036	179	0	1	01	01	H1036_179_0	4	3	Preferred Brand	000101	
H1036	179	0	1	01	01	H1036_179_0	4	4	Non-Preferred Brand	110000	
H1036	179	0	1	01	01	H1036_179_0	4	5	Specialty Tier	010010	2
H1036	179	0	1	01	01	H1036_179_0	4	3	Preferred Brand	000101	2
H1036	179	0	1	01	01	H1036_179_0	4	2	Non-Preferred Generic	000101	2
H1036	179	0	1	01	01	H1036_179_0	4	1	Preferred Generic	001010	2
H1036	179	0	1	01	01	H1036_179_0	4	5	Specialty Tier	010010	
H1036	179	0	1	01	01	H1036_179_0	4	4	Non-Preferred Brand	110000	2
H1036	184	0	1	01	01	H1036_184_0	5	1	Preferred Generic	001010	
H1036	184	0	1	01	01	H1036_184_0	5	4	Non-Preferred Brand	110000	
H1036	184	0	1	01	01	H1036_184_0	5	3	Preferred Brand	000101	
H1036	184	0	1	01	01	H1036_184_0	5	2	Non-Preferred Generic	000101	
H1036	184	0	1	01	01	H1036_184_0	5	5	Specialty Tier	010010	
H1036	184	0	1	01	01	H1036_184_0	5	1	Preferred Generic	001010	2
H1036	184	0	1	01	01	H1036_184_0	5	2	Non-Preferred Generic	000101	2
H1036	184	0	1	01	01	H1036_184_0	5	3	Preferred Brand	000101	2
H1036	184	0	1	01	01	H1036_184_0	5	5	Specialty Tier	010010	2
H1036	184	0	1	01	01	H1036_184_0	5	4	Non-Preferred Brand	110000	2
H1036	185	0	1	01	01	H1036_185_0	4	1	Preferred Generic	001010	
H1036	185	0	1	01	01	H1036_185_0	4	2	Non-Preferred Generic	000101	
H1036	185	0	1	01	01	H1036_185_0	4	3	Preferred Brand	000101	
H1036	185	0	1	01	01	H1036_185_0	4	4	Non-Preferred Brand	110000	
H1036	185	0	1	01	01	H1036_185_0	4	5	Specialty Tier	010010	
H1036	186	0	1	01	01	H1036_186_0	4	5	Specialty Tier	010010	2
H1036	186	0	1	01	01	H1036_186_0	4	2	Non-Preferred Generic	000101	1
H1036	186	0	1	01	01	H1036_186_0	4	3	Preferred Brand	000101	2
H1036	186	0	1	01	01	H1036_186_0	4	4	Non-Preferred Brand	110000	2
H1036	186	0	1	01	01	H1036_186_0	4	1	Preferred Generic	001010	1
H1036	186	0	1	01	01	H1036_186_0	4	5	Specialty Tier	010010	
H1036	186	0	1	01	01	H1036_186_0	4	4	Non-Preferred Brand	110000	
H1036	186	0	1	01	01	H1036_186_0	4	3	Preferred Brand	000101	
H1036	186	0	1	01	01	H1036_186_0	4	2	Non-Preferred Generic	000101	
H1036	186	0	1	01	01	H1036_186_0	4	1	Preferred Generic	001010	
H1036	187	0	1	01	01	H1036_187_0	4	2	Non-Preferred Generic	000101	
H1036	187	0	1	01	01	H1036_187_0	4	5	Specialty Tier	010010	
H1036	187	0	1	01	01	H1036_187_0	4	3	Preferred Brand	000101	
H1036	187	0	1	01	01	H1036_187_0	4	4	Non-Preferred Brand	110000	
H1036	187	0	1	01	01	H1036_187_0	4	1	Preferred Generic	001010	
H1036	188	0	1	01	01	H1036_188_0	4	5	Specialty Tier	010010	2
H1036	188	0	1	01	01	H1036_188_0	4	3	Preferred Brand	000101	
H1036	188	0	1	01	01	H1036_188_0	4	2	Non-Preferred Generic	000101	
H1036	188	0	1	01	01	H1036_188_0	4	1	Preferred Generic	001010	
H1036	188	0	1	01	01	H1036_188_0	4	5	Specialty Tier	010010	
H1036	188	0	1	01	01	H1036_188_0	4	4	Non-Preferred Brand	110000	2
H1036	188	0	1	01	01	H1036_188_0	4	3	Preferred Brand	000101	2
H1036	188	0	1	01	01	H1036_188_0	4	2	Non-Preferred Generic	000101	1
H1036	188	0	1	01	01	H1036_188_0	4	1	Preferred Generic	001010	1
H1036	188	0	1	01	01	H1036_188_0	4	4	Non-Preferred Brand	110000	
H1036	189	0	1	01	01	H1036_189_0	4	2	Non-Preferred Generic	000101	
H1036	189	0	1	01	01	H1036_189_0	4	3	Preferred Brand	000101	
H1036	189	0	1	01	01	H1036_189_0	4	4	Non-Preferred Brand	110000	
H1036	189	0	1	01	01	H1036_189_0	4	5	Specialty Tier	010010	
H1036	189	0	1	01	01	H1036_189_0	4	1	Preferred Generic	001010	1
H1036	189	0	1	01	01	H1036_189_0	4	2	Non-Preferred Generic	000101	1
H1036	189	0	1	01	01	H1036_189_0	4	5	Specialty Tier	010010	2
H1036	189	0	1	01	01	H1036_189_0	4	1	Preferred Generic	001010	
H1036	189	0	1	01	01	H1036_189_0	4	3	Preferred Brand	000101	2
H1036	189	0	1	01	01	H1036_189_0	4	4	Non-Preferred Brand	110000	2
H1036	190	0	1	01	01	H1036_190_0	4	3	Preferred Brand	000101	
H1036	190	0	1	01	01	H1036_190_0	4	2	Non-Preferred Generic	000101	
H1036	190	0	1	01	01	H1036_190_0	4	4	Non-Preferred Brand	110000	
H1036	190	0	1	01	01	H1036_190_0	4	5	Specialty Tier	010010	
H1036	190	0	1	01	01	H1036_190_0	4	1	Preferred Generic	001010	
H1036	190	0	1	01	01	H1036_190_0	4	2	Non-Preferred Generic	000101	1
H1036	190	0	1	01	01	H1036_190_0	4	3	Preferred Brand	000101	2
H1036	190	0	1	01	01	H1036_190_0	4	4	Non-Preferred Brand	110000	2
H1036	190	0	1	01	01	H1036_190_0	4	5	Specialty Tier	010010	2
H1036	190	0	1	01	01	H1036_190_0	4	1	Preferred Generic	001010	1
H1036	192	0	1	01	01	H1036_192_0	3	4	Non-Preferred Brand	110000	
H1036	192	0	1	01	01	H1036_192_0	3	5	Specialty Tier	010010	
H1036	192	0	1	01	01	H1036_192_0	3	3	Preferred Brand	000101	
H1036	192	0	1	01	01	H1036_192_0	3	1	Preferred Generic	001010	
H1036	192	0	1	01	01	H1036_192_0	3	2	Non-Preferred Generic	000101	
H1036	193	0	1	01	01	H1036_193_0	3	2	Non-Preferred Generic	000101	
H1036	193	0	1	01	01	H1036_193_0	3	3	Preferred Brand	000101	
H1036	193	0	1	01	01	H1036_193_0	3	4	Non-Preferred Brand	110000	
H1036	193	0	1	01	01	H1036_193_0	3	5	Specialty Tier	010010	
H1036	193	0	1	01	01	H1036_193_0	3	1	Preferred Generic	001010	
H1036	193	0	1	01	01	H1036_193_0	3	2	Non-Preferred Generic	000101	2
H1036	193	0	1	01	01	H1036_193_0	3	3	Preferred Brand	000101	2
H1036	193	0	1	01	01	H1036_193_0	3	5	Specialty Tier	010010	2
H1036	193	0	1	01	01	H1036_193_0	3	4	Non-Preferred Brand	110000	2
H1036	193	0	1	01	01	H1036_193_0	3	1	Preferred Generic	001010	2
H1036	194	0	1	01	01	H1036_194_0	4	5	Specialty Tier	010010	2
H1036	194	0	1	01	01	H1036_194_0	4	4	Non-Preferred Brand	110000	2
H1036	194	0	1	01	01	H1036_194_0	4	3	Preferred Brand	000101	2
H1036	194	0	1	01	01	H1036_194_0	4	2	Non-Preferred Generic	000101	2
H1036	194	0	1	01	01	H1036_194_0	4	1	Preferred Generic	001010	2
H1036	194	0	1	01	01	H1036_194_0	4	5	Specialty Tier	010010	
H1036	194	0	1	01	01	H1036_194_0	4	4	Non-Preferred Brand	110000	
H1036	194	0	1	01	01	H1036_194_0	4	3	Preferred Brand	000101	
H1036	194	0	1	01	01	H1036_194_0	4	2	Non-Preferred Generic	000101	
H1036	194	0	1	01	01	H1036_194_0	4	1	Preferred Generic	001010	
H1036	195	0	1	01	01	H1036_195_0	3	2	Non-Preferred Generic	000101	
H1036	195	0	1	01	01	H1036_195_0	3	3	Preferred Brand	000101	
H1036	195	0	1	01	01	H1036_195_0	3	4	Non-Preferred Brand	110000	
H1036	195	0	1	01	01	H1036_195_0	3	5	Specialty Tier	010010	
H1036	195	0	1	01	01	H1036_195_0	3	1	Preferred Generic	001010	
H1036	196	0	1	01	01	H1036_196_0	3	4	Non-Preferred Brand	110000	
H1036	196	0	1	01	01	H1036_196_0	3	3	Preferred Brand	000101	
H1036	196	0	1	01	01	H1036_196_0	3	2	Non-Preferred Generic	000101	
H1036	196	0	1	01	01	H1036_196_0	3	1	Preferred Generic	001010	
H1036	196	0	1	01	01	H1036_196_0	3	5	Specialty Tier	010010	
H1036	196	0	1	01	01	H1036_196_0	3	1	Preferred Generic	001010	2
H1036	196	0	1	01	01	H1036_196_0	3	2	Non-Preferred Generic	000101	2
H1036	196	0	1	01	01	H1036_196_0	3	3	Preferred Brand	000101	2
H1036	196	0	1	01	01	H1036_196_0	3	5	Specialty Tier	010010	2
H1036	196	0	1	01	01	H1036_196_0	3	4	Non-Preferred Brand	110000	2
H1036	199	0	1	01	01	H1036_199_0	4	1	Preferred Generic	001010	
H1036	199	0	1	01	01	H1036_199_0	4	2	Non-Preferred Generic	000101	
H1036	199	0	1	01	01	H1036_199_0	4	3	Preferred Brand	000101	
H1036	199	0	1	01	01	H1036_199_0	4	4	Non-Preferred Brand	110000	
H1036	199	0	1	01	01	H1036_199_0	4	5	Specialty Tier	010010	2
H1036	199	0	1	01	01	H1036_199_0	4	1	Preferred Generic	001010	2
H1036	199	0	1	01	01	H1036_199_0	4	2	Non-Preferred Generic	000101	2
H1036	199	0	1	01	01	H1036_199_0	4	3	Preferred Brand	000101	2
H1036	199	0	1	01	01	H1036_199_0	4	4	Non-Preferred Brand	110000	2
H1036	199	0	1	01	01	H1036_199_0	4	5	Specialty Tier	010010	
H1036	209	0	1	01	01	H1036_209_0	3	3	Preferred Brand	000101	
H1036	209	0	1	01	01	H1036_209_0	3	4	Non-Preferred Brand	110000	
H1036	209	0	1	01	01	H1036_209_0	3	2	Non-Preferred Generic	000101	
H1036	209	0	1	01	01	H1036_209_0	3	1	Preferred Generic	001010	
H1036	209	0	1	01	01	H1036_209_0	3	5	Specialty Tier	010010	
H1036	210	0	1	01	01	H1036_210_0	3	2	Non-Preferred Generic	000101	
H1036	210	0	1	01	01	H1036_210_0	3	1	Preferred Generic	001010	
H1036	210	0	1	01	01	H1036_210_0	3	3	Preferred Brand	000101	
H1036	210	0	1	01	01	H1036_210_0	3	5	Specialty Tier	010010	
H1036	210	0	1	01	01	H1036_210_0	3	4	Non-Preferred Brand	110000	
H1036	211	0	1	01	01	H1036_211_0	3	1	Preferred Generic	001010	
H1036	211	0	1	01	01	H1036_211_0	3	2	Non-Preferred Generic	000101	
H1036	211	0	1	01	01	H1036_211_0	3	4	Non-Preferred Brand	110000	
H1036	211	0	1	01	01	H1036_211_0	3	3	Preferred Brand	000101	
H1036	211	0	1	01	01	H1036_211_0	3	5	Specialty Tier	010010	
H1036	212	0	1	01	01	H1036_212_0	3	4	Non-Preferred Brand	110000	
H1036	212	0	1	01	01	H1036_212_0	3	3	Preferred Brand	000101	
H1036	212	0	1	01	01	H1036_212_0	3	2	Non-Preferred Generic	000101	
H1036	212	0	1	01	01	H1036_212_0	3	1	Preferred Generic	001010	
H1036	212	0	1	01	01	H1036_212_0	3	5	Specialty Tier	010010	
H1036	213	0	1	01	01	H1036_213_0	3	4	Non-Preferred Brand	110000	
H1036	213	0	1	01	01	H1036_213_0	3	3	Preferred Brand	000101	
H1036	213	0	1	01	01	H1036_213_0	3	2	Non-Preferred Generic	000101	
H1036	213	0	1	01	01	H1036_213_0	3	1	Preferred Generic	001010	
H1036	213	0	1	01	01	H1036_213_0	3	5	Specialty Tier	010010	
H1036	214	0	1	01	01	H1036_214_0	3	4	Non-Preferred Brand	110000	
H1036	214	0	1	01	01	H1036_214_0	3	3	Preferred Brand	000101	
H1036	214	0	1	01	01	H1036_214_0	3	2	Non-Preferred Generic	000101	
H1036	214	0	1	01	01	H1036_214_0	3	1	Preferred Generic	001010	
H1036	214	0	1	01	01	H1036_214_0	3	5	Specialty Tier	010010	
H1036	215	0	1	01	01	H1036_215_0	3	1	Preferred Generic	001010	
H1036	215	0	1	01	01	H1036_215_0	3	2	Non-Preferred Generic	000101	
H1036	215	0	1	01	01	H1036_215_0	3	3	Preferred Brand	000101	
H1036	215	0	1	01	01	H1036_215_0	3	4	Non-Preferred Brand	110000	
H1036	215	0	1	01	01	H1036_215_0	3	5	Specialty Tier	010010	2
H1036	215	0	1	01	01	H1036_215_0	3	1	Preferred Generic	001010	2
H1036	215	0	1	01	01	H1036_215_0	3	2	Non-Preferred Generic	000101	2
H1036	215	0	1	01	01	H1036_215_0	3	3	Preferred Brand	000101	2
H1036	215	0	1	01	01	H1036_215_0	3	4	Non-Preferred Brand	110000	2
H1036	215	0	1	01	01	H1036_215_0	3	5	Specialty Tier	010010	
H1036	217	0	1	01	01	H1036_217_0	3	1	Preferred Generic	001010	
H1036	217	0	1	01	01	H1036_217_0	3	2	Non-Preferred Generic	000101	
H1036	217	0	1	01	01	H1036_217_0	3	3	Preferred Brand	000101	
H1036	217	0	1	01	01	H1036_217_0	3	4	Non-Preferred Brand	110000	
H1036	217	0	1	01	01	H1036_217_0	3	5	Specialty Tier	010010	
H1036	217	0	1	01	01	H1036_217_0	3	1	Preferred Generic	001010	2
H1036	217	0	1	01	01	H1036_217_0	3	2	Non-Preferred Generic	000101	2
H1036	217	0	1	01	01	H1036_217_0	3	3	Preferred Brand	000101	2
H1036	217	0	1	01	01	H1036_217_0	3	4	Non-Preferred Brand	110000	2
H1036	217	0	1	01	01	H1036_217_0	3	5	Specialty Tier	010010	2
H1036	218	0	1	01	01	H1036_218_0	3	2	Non-Preferred Generic	000101	2
H1036	218	0	1	01	01	H1036_218_0	3	1	Preferred Generic	001010	2
H1036	218	0	1	01	01	H1036_218_0	3	5	Specialty Tier	010010	2
H1036	218	0	1	01	01	H1036_218_0	3	4	Non-Preferred Brand	110000	2
H1036	218	0	1	01	01	H1036_218_0	3	3	Preferred Brand	000101	2
H1036	218	0	1	01	01	H1036_218_0	3	1	Preferred Generic	001010	
H1036	218	0	1	01	01	H1036_218_0	3	2	Non-Preferred Generic	000101	
H1036	218	0	1	01	01	H1036_218_0	3	3	Preferred Brand	000101	
H1036	218	0	1	01	01	H1036_218_0	3	4	Non-Preferred Brand	110000	
H1036	218	0	1	01	01	H1036_218_0	3	5	Specialty Tier	010010	
H1036	219	0	1	01	01	H1036_219_0	4	1	Preferred Generic	001010	
H1036	219	0	1	01	01	H1036_219_0	4	4	Non-Preferred Brand	110000	2
H1036	219	0	1	01	01	H1036_219_0	4	3	Preferred Brand	000101	2
H1036	219	0	1	01	01	H1036_219_0	4	2	Non-Preferred Generic	000101	2
H1036	219	0	1	01	01	H1036_219_0	4	5	Specialty Tier	010010	2
H1036	219	0	1	01	01	H1036_219_0	4	5	Specialty Tier	010010	
H1036	219	0	1	01	01	H1036_219_0	4	4	Non-Preferred Brand	110000	
H1036	219	0	1	01	01	H1036_219_0	4	3	Preferred Brand	000101	
H1036	219	0	1	01	01	H1036_219_0	4	2	Non-Preferred Generic	000101	
H1036	219	0	1	01	01	H1036_219_0	4	1	Preferred Generic	001010	2
H1036	220	0	1	02	01	H1036_220_0	5	2	Non-Preferred Generic	000101	2
H1036	220	0	1	02	01	H1036_220_0	5	1	Preferred Generic	001010	2
H1036	220	0	1	02	01	H1036_220_0	5	5	Specialty Tier	010010	
H1036	220	0	1	02	01	H1036_220_0	5	4	Non-Preferred Brand	110000	
H1036	220	0	1	02	01	H1036_220_0	5	3	Preferred Brand	000101	
H1036	220	0	1	02	01	H1036_220_0	5	2	Non-Preferred Generic	000101	
H1036	220	0	1	02	01	H1036_220_0	5	1	Preferred Generic	001010	
H1036	220	0	1	02	01	H1036_220_0	5	3	Preferred Brand	000101	2
H1036	220	0	1	02	01	H1036_220_0	5	5	Specialty Tier	010010	2
H1036	220	0	1	02	01	H1036_220_0	5	4	Non-Preferred Brand	110000	2
H1036	222	0	1	01	01	H1036_222_0	5	2	Non-Preferred Generic	000101	
H1036	222	0	1	01	01	H1036_222_0	5	1	Preferred Generic	001010	
H1036	222	0	1	01	01	H1036_222_0	5	5	Specialty Tier	010010	
H1036	222	0	1	01	01	H1036_222_0	5	4	Non-Preferred Brand	110000	
H1036	222	0	1	01	01	H1036_222_0	5	3	Preferred Brand	000101	
H1036	223	0	1	01	01	H1036_223_0	4	1	Preferred Generic	001010	2
H1036	223	0	1	01	01	H1036_223_0	4	2	Non-Preferred Generic	000101	2
H1036	223	0	1	01	01	H1036_223_0	4	5	Specialty Tier	010010	
H1036	223	0	1	01	01	H1036_223_0	4	4	Non-Preferred Brand	110000	
H1036	223	0	1	01	01	H1036_223_0	4	3	Preferred Brand	000101	
H1036	223	0	1	01	01	H1036_223_0	4	2	Non-Preferred Generic	000101	
H1036	223	0	1	01	01	H1036_223_0	4	1	Preferred Generic	001010	
H1036	223	0	1	01	01	H1036_223_0	4	3	Preferred Brand	000101	2
H1036	223	0	1	01	01	H1036_223_0	4	5	Specialty Tier	010010	2
H1036	223	0	1	01	01	H1036_223_0	4	4	Non-Preferred Brand	110000	2
H1036	224	0	1	01	01	H1036_224_0	3	1	Preferred Generic	001010	
H1036	224	0	1	01	01	H1036_224_0	3	2	Non-Preferred Generic	000101	
H1036	224	0	1	01	01	H1036_224_0	3	3	Preferred Brand	000101	
H1036	224	0	1	01	01	H1036_224_0	3	4	Non-Preferred Brand	110000	
H1036	224	0	1	01	01	H1036_224_0	3	5	Specialty Tier	010010	2
H1036	224	0	1	01	01	H1036_224_0	3	1	Preferred Generic	001010	2
H1036	224	0	1	01	01	H1036_224_0	3	2	Non-Preferred Generic	000101	2
H1036	224	0	1	01	01	H1036_224_0	3	3	Preferred Brand	000101	2
H1036	224	0	1	01	01	H1036_224_0	3	4	Non-Preferred Brand	110000	2
H1036	224	0	1	01	01	H1036_224_0	3	5	Specialty Tier	010010	
H1036	225	0	1	01	01	H1036_225_0	3	2	Non-Preferred Generic	000101	
H1036	225	0	1	01	01	H1036_225_0	3	3	Preferred Brand	000101	
H1036	225	0	1	01	01	H1036_225_0	3	4	Non-Preferred Brand	110000	
H1036	225	0	1	01	01	H1036_225_0	3	5	Specialty Tier	010010	
H1036	225	0	1	01	01	H1036_225_0	3	1	Preferred Generic	001010	2
H1036	225	0	1	01	01	H1036_225_0	3	2	Non-Preferred Generic	000101	2
H1036	225	0	1	01	01	H1036_225_0	3	3	Preferred Brand	000101	2
H1036	225	0	1	01	01	H1036_225_0	3	4	Non-Preferred Brand	110000	2
H1036	225	0	1	01	01	H1036_225_0	3	5	Specialty Tier	010010	2
H1036	225	0	1	01	01	H1036_225_0	3	1	Preferred Generic	001010	
H1036	226	0	1	01	01	H1036_226_0	3	4	Non-Preferred Brand	110000	
H1036	226	0	1	01	01	H1036_226_0	3	3	Preferred Brand	000101	
H1036	226	0	1	01	01	H1036_226_0	3	2	Non-Preferred Generic	000101	
H1036	226	0	1	01	01	H1036_226_0	3	1	Preferred Generic	001010	
H1036	226	0	1	01	01	H1036_226_0	3	5	Specialty Tier	010010	
H1036	227	0	1	01	01	H1036_227_0	3	1	Preferred Generic	001010	2
H1036	227	0	1	01	01	H1036_227_0	3	2	Non-Preferred Generic	000101	2
H1036	227	0	1	01	01	H1036_227_0	3	3	Preferred Brand	000101	2
H1036	227	0	1	01	01	H1036_227_0	3	4	Non-Preferred Brand	110000	2
H1036	227	0	1	01	01	H1036_227_0	3	5	Specialty Tier	010010	
H1036	227	0	1	01	01	H1036_227_0	3	4	Non-Preferred Brand	110000	
H1036	227	0	1	01	01	H1036_227_0	3	3	Preferred Brand	000101	
H1036	227	0	1	01	01	H1036_227_0	3	2	Non-Preferred Generic	000101	
H1036	227	0	1	01	01	H1036_227_0	3	1	Preferred Generic	001010	
H1036	227	0	1	01	01	H1036_227_0	3	5	Specialty Tier	010010	2
H1036	228	0	1	01	01	H1036_228_0	3	4	Non-Preferred Brand	110000	
H1036	228	0	1	01	01	H1036_228_0	3	3	Preferred Brand	000101	
H1036	228	0	1	01	01	H1036_228_0	3	2	Non-Preferred Generic	000101	
H1036	228	0	1	01	01	H1036_228_0	3	1	Preferred Generic	001010	
H1036	228	0	1	01	01	H1036_228_0	3	5	Specialty Tier	010010	
H1036	229	0	1	01	01	H1036_229_0	3	1	Preferred Generic	001010	2
H1036	229	0	1	01	01	H1036_229_0	3	2	Non-Preferred Generic	000101	2
H1036	229	0	1	01	01	H1036_229_0	3	3	Preferred Brand	000101	2
H1036	229	0	1	01	01	H1036_229_0	3	4	Non-Preferred Brand	110000	2
H1036	229	0	1	01	01	H1036_229_0	3	5	Specialty Tier	010010	
H1036	229	0	1	01	01	H1036_229_0	3	4	Non-Preferred Brand	110000	
H1036	229	0	1	01	01	H1036_229_0	3	5	Specialty Tier	010010	2
H1036	229	0	1	01	01	H1036_229_0	3	2	Non-Preferred Generic	000101	
H1036	229	0	1	01	01	H1036_229_0	3	1	Preferred Generic	001010	
H1036	229	0	1	01	01	H1036_229_0	3	3	Preferred Brand	000101	
H1045	001	0	1	02	01	H1045_001_0	6	1	Preferred Generic	001000	
H1045	001	0	1	02	01	H1045_001_0	6	2	Preferred Brand	010001	
H1045	001	0	1	02	01	H1045_001_0	6	3	Non-Preferred Brand	100100	
H1045	001	0	1	02	01	H1045_001_0	6	4	Specialty Tier	010010	
H1045	001	0	1	02	01	H1045_001_0	6	1	Preferred Generic	001000	1
H1045	005	0	1	01	01	H1045_005_0	5	1	Preferred Generic	001000	
H1045	005	0	1	01	01	H1045_005_0	5	2	Preferred Brand	010001	
H1045	005	0	1	01	01	H1045_005_0	5	3	Non-Preferred Brand	100100	
H1045	005	0	1	01	01	H1045_005_0	5	4	Specialty Tier	010010	
H1045	005	0	1	01	01	H1045_005_0	5	1	Preferred Generic	001000	1
H1045	012	0	1	02	01	H1045_012_0	5	1	Preferred Generic	001000	
H1045	012	0	1	02	01	H1045_012_0	5	2	Preferred Brand	010001	
H1045	012	0	1	02	01	H1045_012_0	5	3	Non-Preferred Brand	100100	
H1045	012	0	1	02	01	H1045_012_0	5	4	Specialty Tier	010010	
H1045	012	0	1	02	01	H1045_012_0	5	1	Preferred Generic	001000	1
H1045	016	0	1	01	01	H1045_016_0	6	3	Non-Preferred Brand	100100	
H1045	016	0	1	01	01	H1045_016_0	6	2	Preferred Brand	010001	
H1045	016	0	1	01	01	H1045_016_0	6	1	Preferred Generic	001000	
H1045	016	0	1	01	01	H1045_016_0	6	4	Specialty Tier	010010	
H1045	016	0	1	01	01	H1045_016_0	6	1	Preferred Generic	001000	1
H1045	016	0	1	01	01	H1045_016_0	6	2	Preferred Brand	010001	1
H1045	018	0	1	01	01	H1045_018_0	5	3	Non-Preferred Brand	100100	
H1045	018	0	1	01	01	H1045_018_0	5	2	Preferred Brand	010001	
H1045	018	0	1	01	01	H1045_018_0	5	1	Preferred Generic	001000	
H1045	018	0	1	01	01	H1045_018_0	5	4	Specialty Tier	010010	
H1045	018	0	1	01	01	H1045_018_0	5	1	Preferred Generic	001000	1
H1045	023	0	1	01	01	H1045_023_0	4	4	Specialty Tier	010010	
H1045	023	0	1	01	01	H1045_023_0	4	3	Non-Preferred Brand	100100	
H1045	023	0	1	01	01	H1045_023_0	4	2	Preferred Brand	010001	
H1045	023	0	1	01	01	H1045_023_0	4	1	Preferred Generic	001000	
H1045	025	0	1	01	01	H1045_025_0	4	4	Non-Preferred Brand	100100	
H1045	025	0	1	01	01	H1045_025_0	4	3	Preferred Brand	010001	
H1045	025	0	1	01	01	H1045_025_0	4	2	Non-Preferred Generic	000100	
H1045	025	0	1	01	01	H1045_025_0	4	5	Specialty Tier	010010	
H1045	025	0	1	01	01	H1045_025_0	4	1	Preferred Generic	001000	
H1076	011	0	1	01	01	H1076_011_0	13	1	Preferred Generic	001010	
H1076	011	0	1	01	01	H1076_011_0	13	4	Specialty Tier	010010	
H1076	011	0	1	01	01	H1076_011_0	13	3	Non-Preferred Brand	100100	
H1076	011	0	1	01	01	H1076_011_0	13	2	Preferred Brand	000001	
H1080	004	0	1	01	01	H1080_004_0	4	2	Non-Preferred Generic	000100	
H1080	004	0	1	01	01	H1080_004_0	4	1	Preferred Generic	001000	
H1080	004	0	1	01	01	H1080_004_0	4	3	Preferred Brand	010001	
H1080	004	0	1	01	01	H1080_004_0	4	4	Non-Preferred Brand	100100	
H1080	004	0	1	01	01	H1080_004_0	4	5	Specialty Tier	010010	
H1080	042	0	1	01	01	H1080_042_0	4	2	Non-Preferred Generic	000100	
H1080	042	0	1	01	01	H1080_042_0	4	1	Preferred Generic	001000	
H1080	042	0	1	01	01	H1080_042_0	4	3	Preferred Brand	010001	
H1080	042	0	1	01	01	H1080_042_0	4	5	Specialty Tier	010010	
H1080	042	0	1	01	01	H1080_042_0	4	4	Non-Preferred Brand	100100	
H1080	043	0	1	01	01	H1080_043_0	4	1	Preferred Generic	001000	
H1080	043	0	1	01	01	H1080_043_0	4	2	Non-Preferred Generic	000100	
H1080	043	0	1	01	01	H1080_043_0	4	4	Non-Preferred Brand	100100	
H1080	043	0	1	01	01	H1080_043_0	4	3	Preferred Brand	010001	
H1080	043	0	1	01	01	H1080_043_0	4	5	Specialty Tier	010010	
H1099	001	0	1	02	01	H1099_001_0	7	2	Non-Preferred Generic	000100	
H1099	001	0	1	02	01	H1099_001_0	7	1	Preferred Generic	001000	
H1099	001	0	1	02	01	H1099_001_0	7	3	Preferred Brand	000001	
H1099	001	0	1	02	01	H1099_001_0	7	4	Non-Preferred Brand	100000	
H1099	001	0	1	02	01	H1099_001_0	7	5	Specialty Tier	010010	
H1099	001	0	1	02	01	H1099_001_0	7	1	Preferred Generic	001000	1
H1099	001	0	1	02	01	H1099_001_0	7	2	Non-Preferred Generic	000100	1
H1099	006	0	1	01	01	H1099_006_0	7	1	Preferred Generic	001000	
H1099	006	0	1	01	01	H1099_006_0	7	2	Non-Preferred Generic	000100	
H1099	006	0	1	01	01	H1099_006_0	7	3	Preferred Brand	000001	
H1099	006	0	1	01	01	H1099_006_0	7	4	Non-Preferred Brand	100000	
H1099	006	0	1	01	01	H1099_006_0	7	5	Specialty Tier	010010	
H1099	006	0	1	01	01	H1099_006_0	7	1	Preferred Generic	001000	1
H1099	014	0	1	01	01	H1099_014_0	7	2	Non-Preferred Generic	000100	
H1099	014	0	1	01	01	H1099_014_0	7	1	Preferred Generic	001000	
H1099	014	0	1	01	01	H1099_014_0	7	3	Preferred Brand	000001	
H1099	014	0	1	01	01	H1099_014_0	7	5	Specialty Tier	010010	
H1099	014	0	1	01	01	H1099_014_0	7	4	Non-Preferred Brand	100000	
H1099	016	0	1	01	01	H1099_016_0	6	1	Preferred Generic	001000	1
H1099	016	0	1	01	01	H1099_016_0	6	5	Specialty Tier	010010	
H1099	016	0	1	01	01	H1099_016_0	6	4	Non-Preferred Brand	100000	
H1099	016	0	1	01	01	H1099_016_0	6	3	Preferred Brand	000001	
H1099	016	0	1	01	01	H1099_016_0	6	2	Non-Preferred Generic	000100	
H1099	016	0	1	01	01	H1099_016_0	6	1	Preferred Generic	001000	
H1099	017	0	1	02	01	H1099_017_0	7	5	Specialty Tier	010010	
H1099	017	0	1	02	01	H1099_017_0	7	1	Preferred Generic	001000	1
H1099	017	0	1	02	01	H1099_017_0	7	4	Non-Preferred Brand	100000	
H1099	017	0	1	02	01	H1099_017_0	7	3	Preferred Brand	000001	
H1099	017	0	1	02	01	H1099_017_0	7	2	Non-Preferred Generic	000100	
H1099	017	0	1	02	01	H1099_017_0	7	2	Non-Preferred Generic	000100	1
H1099	017	0	1	02	01	H1099_017_0	7	1	Preferred Generic	001000	
H1109	001	0	1	01	01	H1109_001_0	7	3	Non-Preferred Brand	110000	
H1109	001	0	1	01	01	H1109_001_0	7	2	Preferred Brand	010001	
H1109	001	0	1	01	01	H1109_001_0	7	4	Specialty Tier	010010	
H1109	001	0	1	01	01	H1109_001_0	7	5	Select Care Drugs	010000	
H1109	001	0	1	01	01	H1109_001_0	7	5	Select Care Drugs	010000	1
H1109	001	0	1	01	01	H1109_001_0	7	1	Generic	010000	
H1109	005	0	1	01	01	H1109_005_0	5	5	Select Care Drugs	010000	
H1109	005	0	1	01	01	H1109_005_0	5	5	Select Care Drugs	010000	1
H1109	005	0	1	01	01	H1109_005_0	5	4	Specialty Tier	010010	
H1109	005	0	1	01	01	H1109_005_0	5	1	Generic	010000	
H1109	005	0	1	01	01	H1109_005_0	5	2	Preferred Brand	010001	
H1109	005	0	1	01	01	H1109_005_0	5	3	Non-Preferred Brand	110000	
H1110	001	0	1	04	01	H1110_001_0	5	2	Preferred Brand	010001	
H1110	001	0	1	04	01	H1110_001_0	5	3	Non-Preferred Brand	110000	
H1110	001	0	1	04	01	H1110_001_0	5	5	Select Care Drugs	010000	1
H1110	001	0	1	04	01	H1110_001_0	5	5	Select Care Drugs	010000	
H1110	001	0	1	04	01	H1110_001_0	5	4	Specialty Tier	010010	
H1110	001	0	1	04	01	H1110_001_0	5	1	Generic	010000	
H1111	002	0	1	01	01	H1111_002_0	7	4	Non-Preferred Brand	100100	
H1111	002	0	1	01	01	H1111_002_0	7	5	Specialty Tier	010010	
H1111	002	0	1	01	01	H1111_002_0	7	3	Preferred Brand	010001	
H1111	002	0	1	01	01	H1111_002_0	7	2	Non-Preferred Generic	000100	
H1111	002	0	1	01	01	H1111_002_0	7	1	Preferred Generic	001000	
H1111	006	0	1	01	01	H1111_006_0	7	2	Non-Preferred Generic	000100	
H1111	006	0	1	01	01	H1111_006_0	7	3	Preferred Brand	010001	
H1111	006	0	1	01	01	H1111_006_0	7	4	Non-Preferred Brand	100100	
H1111	006	0	1	01	01	H1111_006_0	7	1	Preferred Generic	001000	
H1111	006	0	1	01	01	H1111_006_0	7	5	Specialty Tier	010010	
H1112	006	0	1	01	01	H1112_006_0	5	3	Preferred Brand	010001	
H1112	006	0	1	01	01	H1112_006_0	5	2	Non-Preferred Generic	000100	
H1112	006	0	1	01	01	H1112_006_0	5	5	Specialty Tier	010010	
H1112	006	0	1	01	01	H1112_006_0	5	4	Non-Preferred Brand	110000	
H1112	006	0	1	01	01	H1112_006_0	5	1	Preferred Generic	001000	
H1112	027	0	1	02	01	H1112_027_0	5	3	Preferred Brand	000001	
H1112	027	0	1	02	01	H1112_027_0	5	5	Specialty Tier	010010	
H1112	027	0	1	02	01	H1112_027_0	5	4	Non-Preferred Brand	100000	
H1112	027	0	1	02	01	H1112_027_0	5	1	Preferred Generic	001000	
H1112	027	0	1	02	01	H1112_027_0	5	2	Non-Preferred Generic	000100	
H1170	002	0	1	01	01	H1170_002_0	6	1	Preferred Generic	001000	1
H1170	002	0	1	01	01	H1170_002_0	6	2	Non-Preferred Generic	000100	1
H1170	002	0	1	01	01	H1170_002_0	6	6	Vaccines	000001	1
H1170	002	0	1	01	01	H1170_002_0	6	1	Preferred Generic	001000	
H1170	002	0	1	01	01	H1170_002_0	6	2	Non-Preferred Generic	000100	
H1170	002	0	1	01	01	H1170_002_0	6	3	Preferred Brand	000001	
H1170	002	0	1	01	01	H1170_002_0	6	4	Non-Preferred Brand	100000	
H1170	002	0	1	01	01	H1170_002_0	6	5	Specialty Tier	100001	
H1170	002	0	1	01	01	H1170_002_0	6	6	Vaccines	000001	
H1170	008	0	1	01	01	H1170_008_0	6	3	Preferred Brand	000001	
H1170	008	0	1	01	01	H1170_008_0	6	4	Non-Preferred Brand	100000	
H1170	008	0	1	01	01	H1170_008_0	6	5	Specialty Tier	100001	
H1170	008	0	1	01	01	H1170_008_0	6	6	Vaccines	000001	
H1170	008	0	1	01	01	H1170_008_0	6	2	Non-Preferred Generic	000100	
H1170	008	0	1	01	01	H1170_008_0	6	1	Preferred Generic	001000	
H1170	009	0	1	01	01	H1170_009_0	4	5	Specialty Tier	100001	
H1170	009	0	1	01	01	H1170_009_0	4	6	Vaccines	000001	
H1170	009	0	1	01	01	H1170_009_0	4	1	Preferred Generic	001000	1
H1170	009	0	1	01	01	H1170_009_0	4	2	Non-Preferred Generic	000100	1
H1170	009	0	1	01	01	H1170_009_0	4	1	Preferred Generic	001000	
H1170	009	0	1	01	01	H1170_009_0	4	2	Non-Preferred Generic	000100	
H1170	009	0	1	01	01	H1170_009_0	4	4	Non-Preferred Brand	100000	
H1170	009	0	1	01	01	H1170_009_0	4	6	Vaccines	000001	1
H1170	009	0	1	01	01	H1170_009_0	4	3	Preferred Brand	000001	
H1216	001	0	1	02	01	H1216_001_0	4	1	Preferred Generic	001000	
H1216	001	0	1	02	01	H1216_001_0	4	2	Non-Preferred Generic	000100	
H1216	001	0	1	02	01	H1216_001_0	4	3	Preferred Brand	000001	
H1216	001	0	1	02	01	H1216_001_0	4	4	Non-Preferred Brand	100000	
H1216	001	0	1	02	01	H1216_001_0	4	5	Specialty Tier	010010	
H1216	003	0	1	01	01	H1216_003_0	4	1	Preferred Generic	001000	
H1216	003	0	1	01	01	H1216_003_0	4	2	Non-Preferred Generic	000100	
H1216	003	0	1	01	01	H1216_003_0	4	3	Preferred Brand	010001	
H1216	003	0	1	01	01	H1216_003_0	4	4	Non-Preferred Brand	110000	
H1216	003	0	1	01	01	H1216_003_0	4	5	Specialty Tier	010010	
H1230	001	0	1	01	01	H1230_001_0	6	1	Preferred Generic	001000	
H1230	001	0	1	01	01	H1230_001_0	6	2	Non-Preferred Generic	000100	
H1230	001	0	1	01	01	H1230_001_0	6	6	Vaccines	000001	1
H1230	001	0	1	01	01	H1230_001_0	6	2	Non-Preferred Generic	000100	1
H1230	001	0	1	01	01	H1230_001_0	6	3	Preferred Brand	000001	
H1230	001	0	1	01	01	H1230_001_0	6	6	Vaccines	000001	
H1230	001	0	1	01	01	H1230_001_0	6	5	Specialty Tier	100001	
H1230	001	0	1	01	01	H1230_001_0	6	4	Non-Preferred Brand	100000	
H1230	001	0	1	01	01	H1230_001_0	6	1	Preferred Generic	001000	1
H1230	003	0	1	01	01	H1230_003_0	4	1	Preferred Generic	001000	1
H1230	003	0	1	01	01	H1230_003_0	4	2	Non-Preferred Generic	000100	1
H1230	003	0	1	01	01	H1230_003_0	4	6	Vaccines	000001	1
H1230	003	0	1	01	01	H1230_003_0	4	6	Vaccines	000001	
H1230	003	0	1	01	01	H1230_003_0	4	5	Specialty Tier	100001	
H1230	003	0	1	01	01	H1230_003_0	4	4	Non-Preferred Brand	100000	
H1230	003	0	1	01	01	H1230_003_0	4	3	Preferred Brand	000001	
H1230	003	0	1	01	01	H1230_003_0	4	2	Non-Preferred Generic	000100	
H1230	003	0	1	01	01	H1230_003_0	4	1	Preferred Generic	001000	
H1230	005	0	1	01	01	H1230_005_0	5	1	Preferred Generic	001000	
H1230	005	0	1	01	01	H1230_005_0	5	2	Non-Preferred Generic	000100	
H1230	005	0	1	01	01	H1230_005_0	5	3	Preferred Brand	000001	
H1230	005	0	1	01	01	H1230_005_0	5	4	Non-Preferred Brand	100000	
H1230	005	0	1	01	01	H1230_005_0	5	5	Specialty Tier	100001	
H1230	005	0	1	01	01	H1230_005_0	5	6	Vaccines	000001	
H1230	006	0	1	01	01	H1230_006_0	4	6	Vaccines	000001	
H1230	006	0	1	01	01	H1230_006_0	4	5	Specialty Tier	100001	
H1230	006	0	1	01	01	H1230_006_0	4	1	Preferred Generic	001000	1
H1230	006	0	1	01	01	H1230_006_0	4	2	Non-Preferred Generic	000100	1
H1230	006	0	1	01	01	H1230_006_0	4	6	Vaccines	000001	1
H1230	006	0	1	01	01	H1230_006_0	4	3	Preferred Brand	000001	
H1230	006	0	1	01	01	H1230_006_0	4	4	Non-Preferred Brand	100000	
H1230	006	0	1	01	01	H1230_006_0	4	2	Non-Preferred Generic	000100	
H1230	006	0	1	01	01	H1230_006_0	4	1	Preferred Generic	001000	
H1264	004	0	1	02	01	H1264_004_0	5	4	Non-Preferred Brand	100000	
H1264	004	0	1	02	01	H1264_004_0	5	3	Preferred Brand	000001	
H1264	004	0	1	02	01	H1264_004_0	5	2	Non-Preferred Generic	000100	
H1264	004	0	1	02	01	H1264_004_0	5	1	Preferred Generic	001000	
H1264	004	0	1	02	01	H1264_004_0	5	5	Specialty Tier	010010	
H1264	007	0	1	01	01	H1264_007_0	5	4	Non-Preferred Brand	110000	
H1264	007	0	1	01	01	H1264_007_0	5	3	Preferred Brand	010001	
H1264	007	0	1	01	01	H1264_007_0	5	2	Non-Preferred Generic	000100	
H1264	007	0	1	01	01	H1264_007_0	5	1	Preferred Generic	001000	
H1264	007	0	1	01	01	H1264_007_0	5	5	Specialty Tier	010010	
H1264	008	0	1	01	01	H1264_008_0	6	1	Preferred Generic	001000	
H1264	008	0	1	01	01	H1264_008_0	6	2	Non-Preferred Generic	000100	
H1264	008	0	1	01	01	H1264_008_0	6	3	Preferred Brand	000001	
H1264	008	0	1	01	01	H1264_008_0	6	4	Non-Preferred Brand	100000	
H1264	008	0	1	01	01	H1264_008_0	6	5	Specialty Tier	010010	
H1264	018	0	1	01	01	H1264_018_0	6	1	Preferred Generic	001000	
H1264	018	0	1	01	01	H1264_018_0	6	2	Non-Preferred Generic	000100	
H1264	018	0	1	01	01	H1264_018_0	6	3	Preferred Brand	010001	
H1264	018	0	1	01	01	H1264_018_0	6	4	Non-Preferred Brand	110000	
H1264	018	0	1	01	01	H1264_018_0	6	5	Specialty Tier	010010	
H1286	002	0	1	01	01	H1286_002_0	5	1	Preferred Generic	001000	
H1286	002	0	1	01	01	H1286_002_0	5	2	Non-Preferred Generic	000100	
H1286	002	0	1	01	01	H1286_002_0	5	3	Preferred Brand	010001	
H1286	002	0	1	01	01	H1286_002_0	5	4	Non-Preferred Brand	100100	
H1286	002	0	1	01	01	H1286_002_0	5	5	Specialty Tier	010010	
H1286	009	0	1	01	01	H1286_009_0	5	1	Preferred Generic	001000	
H1286	009	0	1	01	01	H1286_009_0	5	2	Non-Preferred Generic	000100	
H1286	009	0	1	01	01	H1286_009_0	5	3	Preferred Brand	010001	
H1286	009	0	1	01	01	H1286_009_0	5	4	Non-Preferred Brand	100100	
H1286	009	0	1	01	01	H1286_009_0	5	5	Specialty Tier	010010	
H1291	001	0	1	09	04	H1291_001_0	4	2	Non-Preferred Generic	000101	
H1291	001	0	1	09	04	H1291_001_0	4	3	Preferred Brand	000101	
H1291	001	0	1	09	04	H1291_001_0	4	4	Non-Preferred Brand	110000	
H1291	001	0	1	09	04	H1291_001_0	4	5	Specialty Tier	010010	
H1291	001	0	1	09	04	H1291_001_0	4	1	Preferred Generic	001010	2
H1291	001	0	1	09	04	H1291_001_0	4	2	Non-Preferred Generic	000101	2
H1291	001	0	1	09	04	H1291_001_0	4	3	Preferred Brand	000101	2
H1291	001	0	1	09	04	H1291_001_0	4	4	Non-Preferred Brand	110000	2
H1291	001	0	1	09	04	H1291_001_0	4	5	Specialty Tier	010010	2
H1291	001	0	1	09	04	H1291_001_0	4	1	Preferred Generic	001010	
H1302	001	0	1	04	01	H1302_001_0	5	4	Non-Preferred Brand	100000	
H1302	001	0	1	04	01	H1302_001_0	5	3	Preferred Brand	000001	
H1302	001	0	1	04	01	H1302_001_0	5	2	Non-Preferred Generic	000100	
H1302	001	0	1	04	01	H1302_001_0	5	1	Preferred Generic	001000	
H1302	001	0	1	04	01	H1302_001_0	5	5	Specialty Tier	101101	
H1302	006	0	1	04	01	H1302_006_0	5	1	Preferred Generic	001000	
H1302	006	0	1	04	01	H1302_006_0	5	2	Non-Preferred Generic	000100	
H1302	006	0	1	04	01	H1302_006_0	5	3	Preferred Brand	000001	
H1302	006	0	1	04	01	H1302_006_0	5	4	Non-Preferred Brand	100000	
H1302	006	0	1	04	01	H1302_006_0	5	5	Specialty Tier	101101	
H1303	001	0	1	04	01	H1303_001_0	6	5	Specialty Tier	010010	
H1303	001	0	1	04	01	H1303_001_0	6	4	Non-Preferred Brand	100100	
H1303	001	0	1	04	01	H1303_001_0	6	3	Preferred Brand	010001	
H1303	001	0	1	04	01	H1303_001_0	6	1	Preferred Generic	001000	
H1303	001	0	1	04	01	H1303_001_0	6	2	Non-Preferred Generic	000100	
H1303	007	0	1	04	01	H1303_007_0	6	1	Preferred Generic	001000	
H1303	007	0	1	04	01	H1303_007_0	6	2	Non-Preferred Generic	000100	
H1303	007	0	1	04	01	H1303_007_0	6	3	Preferred Brand	010001	
H1303	007	0	1	04	01	H1303_007_0	6	4	Non-Preferred Brand	100100	
H1303	007	0	1	04	01	H1303_007_0	6	5	Specialty Tier	010010	
H1304	002	0	1	04	01	H1304_002_0	15	4	Non-Preferred Brand	100000	
H1304	002	0	1	04	01	H1304_002_0	15	5	Specialty Tier	010010	
H1304	002	0	1	04	01	H1304_002_0	15	3	Preferred Brand	000001	
H1304	002	0	1	04	01	H1304_002_0	15	2	Non-Preferred Generic	000100	
H1304	002	0	1	04	01	H1304_002_0	15	1	Preferred Generic	001000	
H1304	004	0	1	04	01	H1304_004_0	12	5	Specialty Tier	010010	
H1304	004	0	1	04	01	H1304_004_0	12	3	Preferred Brand	000001	
H1304	004	0	1	04	01	H1304_004_0	12	2	Non-Preferred Generic	000100	
H1304	004	0	1	04	01	H1304_004_0	12	1	Preferred Generic	001000	
H1304	004	0	1	04	01	H1304_004_0	12	1	Preferred Generic	001000	1
H1304	004	0	1	04	01	H1304_004_0	12	4	Non-Preferred Brand	100000	
H1304	009	0	1	04	01	H1304_009_0	12	1	Preferred Generic	001000	
H1304	009	0	1	04	01	H1304_009_0	12	5	Specialty Tier	010010	
H1304	009	0	1	04	01	H1304_009_0	12	2	Non-Preferred Generic	000100	
H1304	009	0	1	04	01	H1304_009_0	12	3	Preferred Brand	000001	
H1304	009	0	1	04	01	H1304_009_0	12	4	Non-Preferred Brand	100000	
H1304	010	0	1	04	01	H1304_010_0	12	5	Specialty Tier	010010	
H1304	010	0	1	04	01	H1304_010_0	12	1	Preferred Generic	001000	
H1304	010	0	1	04	01	H1304_010_0	12	2	Non-Preferred Generic	000100	
H1304	010	0	1	04	01	H1304_010_0	12	1	Preferred Generic	001000	1
H1304	010	0	1	04	01	H1304_010_0	12	4	Non-Preferred Brand	100000	
H1304	010	0	1	04	01	H1304_010_0	12	3	Preferred Brand	000001	
H1350	001	0	1	01	01	H1350_001_0	3	3	Preferred Brand	000001	
H1350	001	0	1	01	01	H1350_001_0	3	2	Non-Preferred Generic	000100	
H1350	001	0	1	01	01	H1350_001_0	3	1	Preferred Generic	001000	
H1350	001	0	1	01	01	H1350_001_0	3	5	Specialty Tier	101101	
H1350	001	0	1	01	01	H1350_001_0	3	1	Preferred Generic	001000	1
H1350	001	0	1	01	01	H1350_001_0	3	2	Non-Preferred Generic	000100	1
H1350	001	0	1	01	01	H1350_001_0	3	4	Non-Preferred Brand	100000	
H1350	010	0	1	01	01	H1350_010_0	4	3	Preferred Brand	000001	
H1350	010	0	1	01	01	H1350_010_0	4	4	Non-Preferred Brand	100000	
H1350	010	0	1	01	01	H1350_010_0	4	5	Specialty Tier	101101	
H1350	010	0	1	01	01	H1350_010_0	4	1	Preferred Generic	001000	
H1350	010	0	1	01	01	H1350_010_0	4	2	Non-Preferred Generic	000100	
H1350	012	0	1	02	01	H1350_012_0	4	1	Preferred Generic	001000	
H1350	012	0	1	02	01	H1350_012_0	4	3	Preferred Brand	000001	
H1350	012	0	1	02	01	H1350_012_0	4	4	Non-Preferred Brand	100000	
H1350	012	0	1	02	01	H1350_012_0	4	5	Specialty Tier	101101	
H1350	012	0	1	02	01	H1350_012_0	4	2	Non-Preferred Generic	000100	
H1365	001	0	1	04	01	H1365_001_0	11	1	Preferred Generic	001001	
H1365	001	0	1	04	01	H1365_001_0	11	2	Non-Preferred Generic	000101	
H1365	001	0	1	04	01	H1365_001_0	11	3	Preferred Brand	000101	
H1365	001	0	1	04	01	H1365_001_0	11	4	Non-Preferred Brand	100100	
H1365	001	0	1	04	01	H1365_001_0	11	5	Specialty Tier	010010	
H1365	002	0	1	04	01	H1365_002_0	8	1	Preferred Generic	001001	
H1365	002	0	1	04	01	H1365_002_0	8	5	Specialty Tier	010010	
H1365	002	0	1	04	01	H1365_002_0	8	3	Preferred Brand	000101	
H1365	002	0	1	04	01	H1365_002_0	8	2	Non-Preferred Generic	000101	
H1365	002	0	1	04	01	H1365_002_0	8	4	Non-Preferred Brand	100100	
H1365	003	0	1	04	01	H1365_003_0	10	1	Preferred Generic	001001	
H1365	003	0	1	04	01	H1365_003_0	10	5	Specialty Tier	010010	
H1365	003	0	1	04	01	H1365_003_0	10	2	Non-Preferred Generic	000101	
H1365	003	0	1	04	01	H1365_003_0	10	3	Preferred Brand	000101	
H1365	003	0	1	04	01	H1365_003_0	10	4	Non-Preferred Brand	100100	
H1367	002	0	1	01	01	H1367_002_0	10	4	Specialty Tier	010010	
H1367	002	0	1	01	01	H1367_002_0	10	2	Preferred Brand	000001	
H1367	002	0	1	01	01	H1367_002_0	10	1	Generic	010000	
H1367	002	0	1	01	01	H1367_002_0	10	3	Non-Preferred Brand	100000	
H1406	013	0	1	01	01	H1406_013_0	8	5	Specialty Tier	010010	
H1406	013	0	1	01	01	H1406_013_0	8	4	Non-Preferred Brand	110000	
H1406	013	0	1	01	01	H1406_013_0	8	2	Non-Preferred Generic	000101	2
H1406	013	0	1	01	01	H1406_013_0	8	3	Preferred Brand	000101	2
H1406	013	0	1	01	01	H1406_013_0	8	4	Non-Preferred Brand	110000	2
H1406	013	0	1	01	01	H1406_013_0	8	5	Specialty Tier	010010	2
H1406	013	0	1	01	01	H1406_013_0	8	1	Preferred Generic	001010	2
H1406	013	0	1	01	01	H1406_013_0	8	3	Preferred Brand	000101	
H1406	013	0	1	01	01	H1406_013_0	8	2	Non-Preferred Generic	000101	
H1406	013	0	1	01	01	H1406_013_0	8	1	Preferred Generic	001010	
H1406	022	0	1	01	01	H1406_022_0	8	5	Specialty Tier	010010	
H1406	022	0	1	01	01	H1406_022_0	8	1	Preferred Generic	001010	
H1406	022	0	1	01	01	H1406_022_0	8	2	Non-Preferred Generic	000101	2
H1406	022	0	1	01	01	H1406_022_0	8	3	Preferred Brand	000101	2
H1406	022	0	1	01	01	H1406_022_0	8	4	Non-Preferred Brand	110000	2
H1406	022	0	1	01	01	H1406_022_0	8	5	Specialty Tier	010010	2
H1406	022	0	1	01	01	H1406_022_0	8	1	Preferred Generic	001010	2
H1406	022	0	1	01	01	H1406_022_0	8	2	Non-Preferred Generic	000101	
H1406	022	0	1	01	01	H1406_022_0	8	3	Preferred Brand	000101	
H1406	022	0	1	01	01	H1406_022_0	8	4	Non-Preferred Brand	110000	
H1406	026	0	1	01	01	H1406_026_0	8	5	Specialty Tier	010010	
H1406	026	0	1	01	01	H1406_026_0	8	1	Preferred Generic	001010	
H1406	026	0	1	01	01	H1406_026_0	8	2	Non-Preferred Generic	000101	2
H1406	026	0	1	01	01	H1406_026_0	8	3	Preferred Brand	000101	2
H1406	026	0	1	01	01	H1406_026_0	8	4	Non-Preferred Brand	110000	2
H1406	026	0	1	01	01	H1406_026_0	8	5	Specialty Tier	010010	2
H1406	026	0	1	01	01	H1406_026_0	8	1	Preferred Generic	001010	2
H1406	026	0	1	01	01	H1406_026_0	8	2	Non-Preferred Generic	000101	
H1406	026	0	1	01	01	H1406_026_0	8	3	Preferred Brand	000101	
H1406	026	0	1	01	01	H1406_026_0	8	4	Non-Preferred Brand	110000	
H1406	027	0	1	01	01	H1406_027_0	5	5	Specialty Tier	010010	
H1406	027	0	1	01	01	H1406_027_0	5	1	Preferred Generic	001010	2
H1406	027	0	1	01	01	H1406_027_0	5	2	Non-Preferred Generic	000101	2
H1406	027	0	1	01	01	H1406_027_0	5	3	Preferred Brand	000101	2
H1406	027	0	1	01	01	H1406_027_0	5	1	Preferred Generic	001010	
H1406	027	0	1	01	01	H1406_027_0	5	5	Specialty Tier	010010	2
H1406	027	0	1	01	01	H1406_027_0	5	4	Non-Preferred Brand	110000	
H1406	027	0	1	01	01	H1406_027_0	5	3	Preferred Brand	000101	
H1406	027	0	1	01	01	H1406_027_0	5	2	Non-Preferred Generic	000101	
H1406	027	0	1	01	01	H1406_027_0	5	4	Non-Preferred Brand	110000	2
H1406	028	0	1	01	01	H1406_028_0	9	1	Preferred Generic	001010	
H1406	028	0	1	01	01	H1406_028_0	9	2	Non-Preferred Generic	000101	
H1406	028	0	1	01	01	H1406_028_0	9	3	Preferred Brand	000101	
H1406	028	0	1	01	01	H1406_028_0	9	4	Non-Preferred Brand	110000	
H1406	028	0	1	01	01	H1406_028_0	9	1	Preferred Generic	001010	2
H1406	028	0	1	01	01	H1406_028_0	9	2	Non-Preferred Generic	000101	2
H1406	028	0	1	01	01	H1406_028_0	9	3	Preferred Brand	000101	2
H1406	028	0	1	01	01	H1406_028_0	9	4	Non-Preferred Brand	110000	2
H1406	028	0	1	01	01	H1406_028_0	9	5	Specialty Tier	010010	2
H1406	028	0	1	01	01	H1406_028_0	9	5	Specialty Tier	010010	
H1406	029	0	1	01	01	H1406_029_0	10	2	Non-Preferred Generic	000101	
H1406	029	0	1	01	01	H1406_029_0	10	1	Preferred Generic	001010	
H1406	029	0	1	01	01	H1406_029_0	10	3	Preferred Brand	000101	
H1406	029	0	1	01	01	H1406_029_0	10	4	Non-Preferred Brand	110000	
H1406	029	0	1	01	01	H1406_029_0	10	5	Specialty Tier	010010	2
H1406	029	0	1	01	01	H1406_029_0	10	1	Preferred Generic	001010	2
H1406	029	0	1	01	01	H1406_029_0	10	2	Non-Preferred Generic	000101	2
H1406	029	0	1	01	01	H1406_029_0	10	3	Preferred Brand	000101	2
H1406	029	0	1	01	01	H1406_029_0	10	4	Non-Preferred Brand	110000	2
H1406	029	0	1	01	01	H1406_029_0	10	5	Specialty Tier	010010	
H1406	030	0	1	01	01	H1406_030_0	8	2	Non-Preferred Generic	000101	
H1406	030	0	1	01	01	H1406_030_0	8	1	Preferred Generic	001010	
H1406	030	0	1	01	01	H1406_030_0	8	3	Preferred Brand	000101	
H1406	030	0	1	01	01	H1406_030_0	8	5	Specialty Tier	010010	2
H1406	030	0	1	01	01	H1406_030_0	8	4	Non-Preferred Brand	110000	2
H1406	030	0	1	01	01	H1406_030_0	8	3	Preferred Brand	000101	2
H1406	030	0	1	01	01	H1406_030_0	8	2	Non-Preferred Generic	000101	2
H1406	030	0	1	01	01	H1406_030_0	8	4	Non-Preferred Brand	110000	
H1406	030	0	1	01	01	H1406_030_0	8	5	Specialty Tier	010010	
H1406	030	0	1	01	01	H1406_030_0	8	1	Preferred Generic	001010	2
H1406	031	0	1	01	01	H1406_031_0	4	1	Preferred Generic	001010	
H1406	031	0	1	01	01	H1406_031_0	4	4	Non-Preferred Brand	110000	
H1406	031	0	1	01	01	H1406_031_0	4	3	Preferred Brand	000101	
H1406	031	0	1	01	01	H1406_031_0	4	2	Non-Preferred Generic	000101	
H1406	031	0	1	01	01	H1406_031_0	4	5	Specialty Tier	010010	
H1415	021	0	1	02	01	H1415_021_0	3	4	Non-Preferred Brand	100100	
H1415	021	0	1	02	01	H1415_021_0	3	5	Specialty Tier	010010	
H1415	021	0	1	02	01	H1415_021_0	3	1	Preferred Generic	001000	
H1415	021	0	1	02	01	H1415_021_0	3	2	Non-Preferred Generic	000100	
H1415	021	0	1	02	01	H1415_021_0	3	3	Preferred Brand	000001	
H1416	007	0	1	01	01	H1416_007_0	5	1	Preferred Generic	001000	
H1416	007	0	1	01	01	H1416_007_0	5	5	Specialty Tier	010010	
H1416	007	0	1	01	01	H1416_007_0	5	4	Non-Preferred Brand	110000	
H1416	007	0	1	01	01	H1416_007_0	5	3	Preferred Brand	010001	
H1416	007	0	1	01	01	H1416_007_0	5	2	Non-Preferred Generic	000100	
H1416	009	0	1	02	01	H1416_009_0	5	5	Specialty Tier	010010	
H1416	009	0	1	02	01	H1416_009_0	5	4	Non-Preferred Brand	100000	
H1416	009	0	1	02	01	H1416_009_0	5	3	Preferred Brand	000001	
H1416	009	0	1	02	01	H1416_009_0	5	2	Non-Preferred Generic	000100	
H1416	009	0	1	02	01	H1416_009_0	5	1	Preferred Generic	001000	
H1416	019	0	1	01	01	H1416_019_0	5	5	Specialty Tier	010010	
H1416	019	0	1	01	01	H1416_019_0	5	4	Non-Preferred Brand	100000	
H1416	019	0	1	01	01	H1416_019_0	5	3	Preferred Brand	000001	
H1416	019	0	1	01	01	H1416_019_0	5	1	Preferred Generic	001000	
H1416	019	0	1	01	01	H1416_019_0	5	2	Non-Preferred Generic	000100	
H1417	002	0	1	04	01	H1417_002_0	11	5	Specialty Tier	100000	
H1417	002	0	1	04	01	H1417_002_0	11	1	Preferred Generic	001000	
H1417	002	0	1	04	01	H1417_002_0	11	2	Non-Preferred Generic	000100	
H1417	002	0	1	04	01	H1417_002_0	11	3	Preferred Brand	000001	
H1417	002	0	1	04	01	H1417_002_0	11	4	Non-Preferred Brand	100000	
H1417	004	0	1	04	01	H1417_004_0	11	1	Preferred Generic	001000	
H1417	004	0	1	04	01	H1417_004_0	11	2	Non-Preferred Generic	000100	
H1417	004	0	1	04	01	H1417_004_0	11	3	Preferred Brand	000001	
H1417	004	0	1	04	01	H1417_004_0	11	4	Non-Preferred Brand	100000	
H1417	004	0	1	04	01	H1417_004_0	11	5	Specialty Tier	100000	
H1418	002	0	1	04	01	H1418_002_0	7	5	Specialty Tier	010010	2
H1418	002	0	1	04	01	H1418_002_0	7	4	Non-Preferred Brand	110000	2
H1418	002	0	1	04	01	H1418_002_0	7	3	Preferred Brand	000101	2
H1418	002	0	1	04	01	H1418_002_0	7	2	Non-Preferred Generic	000101	2
H1418	002	0	1	04	01	H1418_002_0	7	1	Preferred Generic	001010	2
H1418	002	0	1	04	01	H1418_002_0	7	5	Specialty Tier	010010	
H1418	002	0	1	04	01	H1418_002_0	7	4	Non-Preferred Brand	110000	
H1418	002	0	1	04	01	H1418_002_0	7	3	Preferred Brand	000101	
H1418	002	0	1	04	01	H1418_002_0	7	1	Preferred Generic	001010	
H1418	002	0	1	04	01	H1418_002_0	7	2	Non-Preferred Generic	000101	
H1418	007	0	1	04	01	H1418_007_0	7	2	Non-Preferred Generic	000101	2
H1418	007	0	1	04	01	H1418_007_0	7	3	Preferred Brand	000101	2
H1418	007	0	1	04	01	H1418_007_0	7	4	Non-Preferred Brand	110000	2
H1418	007	0	1	04	01	H1418_007_0	7	5	Specialty Tier	010010	2
H1418	007	0	1	04	01	H1418_007_0	7	5	Specialty Tier	010010	
H1418	007	0	1	04	01	H1418_007_0	7	3	Preferred Brand	000101	
H1418	007	0	1	04	01	H1418_007_0	7	1	Preferred Generic	001010	2
H1418	007	0	1	04	01	H1418_007_0	7	2	Non-Preferred Generic	000101	
H1418	007	0	1	04	01	H1418_007_0	7	1	Preferred Generic	001010	
H1418	007	0	1	04	01	H1418_007_0	7	4	Non-Preferred Brand	110000	
H1418	008	0	1	04	01	H1418_008_0	4	1	Preferred Generic	001010	
H1418	008	0	1	04	01	H1418_008_0	4	2	Non-Preferred Generic	000101	
H1418	008	0	1	04	01	H1418_008_0	4	4	Non-Preferred Brand	110000	
H1418	008	0	1	04	01	H1418_008_0	4	5	Specialty Tier	010010	
H1418	008	0	1	04	01	H1418_008_0	4	1	Preferred Generic	001010	2
H1418	008	0	1	04	01	H1418_008_0	4	2	Non-Preferred Generic	000101	2
H1418	008	0	1	04	01	H1418_008_0	4	3	Preferred Brand	000101	2
H1418	008	0	1	04	01	H1418_008_0	4	4	Non-Preferred Brand	110000	2
H1418	008	0	1	04	01	H1418_008_0	4	5	Specialty Tier	010010	2
H1418	008	0	1	04	01	H1418_008_0	4	3	Preferred Brand	000101	
H1419	001	0	1	01	01	H1419_001_0	5	5	Select Care Drugs	010000	
H1419	001	0	1	01	01	H1419_001_0	5	5	Select Care Drugs	010000	1
H1419	001	0	1	01	01	H1419_001_0	5	1	Generic	010000	
H1419	001	0	1	01	01	H1419_001_0	5	2	Preferred Brand	010001	
H1419	001	0	1	01	01	H1419_001_0	5	4	Specialty Tier	010010	
H1419	001	0	1	01	01	H1419_001_0	5	3	Non-Preferred Brand	110000	
H1444	001	0	1	01	01	H1444_001_0	5	1	Preferred Generic	001000	
H1444	001	0	1	01	01	H1444_001_0	5	2	Non-Preferred Generic	000100	
H1444	001	0	1	01	01	H1444_001_0	5	3	Preferred Brand	000001	
H1444	001	0	1	01	01	H1444_001_0	5	2	Non-Preferred Generic	000100	1
H1444	001	0	1	01	01	H1444_001_0	5	5	Specialty Tier	000010	
H1444	001	0	1	01	01	H1444_001_0	5	1	Preferred Generic	001000	1
H1444	001	0	1	01	01	H1444_001_0	5	4	Non-Preferred Brand	100000	
H1463	003	0	1	01	01	H1463_003_0	11	4	Non-Preferred Brand	100000	
H1463	003	0	1	01	01	H1463_003_0	11	3	Preferred Brand	000001	
H1463	003	0	1	01	01	H1463_003_0	11	2	Non-Preferred Generic	000100	
H1463	003	0	1	01	01	H1463_003_0	11	1	Preferred Generic	001000	
H1463	003	0	1	01	01	H1463_003_0	11	5	Specialty Tier	100000	
H1463	009	0	1	01	01	H1463_009_0	10	4	Non-Preferred Brand	100000	
H1463	009	0	1	01	01	H1463_009_0	10	3	Preferred Brand	000001	
H1463	009	0	1	01	01	H1463_009_0	10	2	Non-Preferred Generic	000100	
H1463	009	0	1	01	01	H1463_009_0	10	1	Preferred Generic	001000	
H1463	009	0	1	01	01	H1463_009_0	10	5	Specialty Tier	100000	
H1468	007	0	1	01	01	H1468_007_0	7	1	Preferred Generic	001010	
H1468	007	0	1	01	01	H1468_007_0	7	2	Non-Preferred Generic	000101	
H1468	007	0	1	01	01	H1468_007_0	7	3	Preferred Brand	000101	
H1468	007	0	1	01	01	H1468_007_0	7	4	Non-Preferred Brand	110000	
H1468	007	0	1	01	01	H1468_007_0	7	5	Specialty Tier	010010	2
H1468	007	0	1	01	01	H1468_007_0	7	1	Preferred Generic	001010	2
H1468	007	0	1	01	01	H1468_007_0	7	2	Non-Preferred Generic	000101	2
H1468	007	0	1	01	01	H1468_007_0	7	3	Preferred Brand	000101	2
H1468	007	0	1	01	01	H1468_007_0	7	4	Non-Preferred Brand	110000	2
H1468	007	0	1	01	01	H1468_007_0	7	5	Specialty Tier	010010	
H1509	001	0	1	04	01	H1509_001_0	4	5	Specialty Tier	010010	
H1509	001	0	1	04	01	H1509_001_0	4	1	Preferred Generic	001000	
H1509	001	0	1	04	01	H1509_001_0	4	2	Non-Preferred Generic	000100	
H1509	001	0	1	04	01	H1509_001_0	4	3	Preferred Brand	010001	
H1509	001	0	1	04	01	H1509_001_0	4	4	Non-Preferred Brand	100100	
H1509	007	0	1	04	01	H1509_007_0	4	2	Non-Preferred Generic	000100	
H1509	007	0	1	04	01	H1509_007_0	4	1	Preferred Generic	001000	
H1509	007	0	1	04	01	H1509_007_0	4	3	Preferred Brand	010001	
H1509	007	0	1	04	01	H1509_007_0	4	4	Non-Preferred Brand	100100	
H1509	007	0	1	04	01	H1509_007_0	4	5	Specialty Tier	010010	
H1509	009	0	1	04	01	H1509_009_0	4	2	Non-Preferred Generic	000100	
H1509	009	0	1	04	01	H1509_009_0	4	1	Preferred Generic	001000	
H1509	009	0	1	04	01	H1509_009_0	4	3	Preferred Brand	010001	
H1509	009	0	1	04	01	H1509_009_0	4	5	Specialty Tier	010010	
H1509	009	0	1	04	01	H1509_009_0	4	4	Non-Preferred Brand	100100	
H1509	010	0	1	04	01	H1509_010_0	4	1	Preferred Generic	001000	
H1509	010	0	1	04	01	H1509_010_0	4	2	Non-Preferred Generic	000100	
H1509	010	0	1	04	01	H1509_010_0	4	4	Non-Preferred Brand	100100	
H1509	010	0	1	04	01	H1509_010_0	4	3	Preferred Brand	010001	
H1509	010	0	1	04	01	H1509_010_0	4	5	Specialty Tier	010010	
H1510	001	0	1	04	01	H1510_001_0	4	2	Non-Preferred Generic	000101	
H1510	001	0	1	04	01	H1510_001_0	4	1	Preferred Generic	001010	
H1510	001	0	1	04	01	H1510_001_0	4	3	Preferred Brand	000101	
H1510	001	0	1	04	01	H1510_001_0	4	5	Specialty Tier	010010	2
H1510	001	0	1	04	01	H1510_001_0	4	4	Non-Preferred Brand	110000	
H1510	001	0	1	04	01	H1510_001_0	4	3	Preferred Brand	000101	2
H1510	001	0	1	04	01	H1510_001_0	4	2	Non-Preferred Generic	000101	2
H1510	001	0	1	04	01	H1510_001_0	4	1	Preferred Generic	001010	2
H1510	001	0	1	04	01	H1510_001_0	4	5	Specialty Tier	010010	
H1510	001	0	1	04	01	H1510_001_0	4	4	Non-Preferred Brand	110000	2
H1510	004	0	1	04	01	H1510_004_0	4	2	Non-Preferred Generic	000101	2
H1510	004	0	1	04	01	H1510_004_0	4	5	Specialty Tier	010010	2
H1510	004	0	1	04	01	H1510_004_0	4	4	Non-Preferred Brand	110000	2
H1510	004	0	1	04	01	H1510_004_0	4	3	Preferred Brand	000101	2
H1510	004	0	1	04	01	H1510_004_0	4	1	Preferred Generic	001010	2
H1510	004	0	1	04	01	H1510_004_0	4	5	Specialty Tier	010010	
H1510	004	0	1	04	01	H1510_004_0	4	4	Non-Preferred Brand	110000	
H1510	004	0	1	04	01	H1510_004_0	4	3	Preferred Brand	000101	
H1510	004	0	1	04	01	H1510_004_0	4	2	Non-Preferred Generic	000101	
H1510	004	0	1	04	01	H1510_004_0	4	1	Preferred Generic	001010	
H1510	005	0	1	04	01	H1510_005_0	4	1	Preferred Generic	001010	2
H1510	005	0	1	04	01	H1510_005_0	4	5	Specialty Tier	010010	
H1510	005	0	1	04	01	H1510_005_0	4	4	Non-Preferred Brand	110000	
H1510	005	0	1	04	01	H1510_005_0	4	3	Preferred Brand	000101	
H1510	005	0	1	04	01	H1510_005_0	4	1	Preferred Generic	001010	
H1510	005	0	1	04	01	H1510_005_0	4	4	Non-Preferred Brand	110000	2
H1510	005	0	1	04	01	H1510_005_0	4	5	Specialty Tier	010010	2
H1510	005	0	1	04	01	H1510_005_0	4	3	Preferred Brand	000101	2
H1510	005	0	1	04	01	H1510_005_0	4	2	Non-Preferred Generic	000101	2
H1510	005	0	1	04	01	H1510_005_0	4	2	Non-Preferred Generic	000101	
H1510	008	0	1	04	01	H1510_008_0	4	5	Specialty Tier	010010	2
H1510	008	0	1	04	01	H1510_008_0	4	4	Non-Preferred Brand	110000	2
H1510	008	0	1	04	01	H1510_008_0	4	3	Preferred Brand	000101	2
H1510	008	0	1	04	01	H1510_008_0	4	2	Non-Preferred Generic	000101	2
H1510	008	0	1	04	01	H1510_008_0	4	5	Specialty Tier	010010	
H1510	008	0	1	04	01	H1510_008_0	4	1	Preferred Generic	001010	2
H1510	008	0	1	04	01	H1510_008_0	4	4	Non-Preferred Brand	110000	
H1510	008	0	1	04	01	H1510_008_0	4	3	Preferred Brand	000101	
H1510	008	0	1	04	01	H1510_008_0	4	2	Non-Preferred Generic	000101	
H1510	008	0	1	04	01	H1510_008_0	4	1	Preferred Generic	001010	
H1517	004	0	1	04	01	H1517_004_0	6	6	Specialty Tier	010010	
H1517	004	0	1	04	01	H1517_004_0	6	2	Non-Preferred Generic	000100	
H1517	004	0	1	04	01	H1517_004_0	6	3	Preferred Brand	000101	
H1517	004	0	1	04	01	H1517_004_0	6	1	Preferred Generic	001000	
H1517	004	0	1	04	01	H1517_004_0	6	5	Injectable Drugs	010010	
H1517	004	0	1	04	01	H1517_004_0	6	4	Non-Preferred Brand	100100	
H1517	005	0	1	04	01	H1517_005_0	6	5	Injectable Drugs	010010	
H1517	005	0	1	04	01	H1517_005_0	6	2	Non-Preferred Generic	000100	
H1517	005	0	1	04	01	H1517_005_0	6	1	Preferred Generic	001000	
H1517	005	0	1	04	01	H1517_005_0	6	6	Specialty Tier	010010	
H1517	005	0	1	04	01	H1517_005_0	6	4	Non-Preferred Brand	100100	
H1517	005	0	1	04	01	H1517_005_0	6	3	Preferred Brand	000101	
H1537	001	0	1	04	01	H1537_001_0	6	1	Preferred Generic	001000	
H1537	001	0	1	04	01	H1537_001_0	6	2	Non-Preferred Generic	000100	
H1537	001	0	1	04	01	H1537_001_0	6	5	Specialty Tier	010010	
H1537	001	0	1	04	01	H1537_001_0	6	4	Non-Preferred Brand	100100	
H1537	001	0	1	04	01	H1537_001_0	6	3	Preferred Brand	010001	
H1595	002	0	1	04	01	H1595_002_0	7	1	Generic	010000	
H1595	002	0	1	04	01	H1595_002_0	7	2	Preferred Brand	000001	
H1595	002	0	1	04	01	H1595_002_0	7	3	Non-Preferred Brand	100000	
H1595	002	0	1	04	01	H1595_002_0	7	4	Specialty Tier	110001	
H1595	003	0	1	04	01	H1595_003_0	7	1	Generic	010000	
H1595	003	0	1	04	01	H1595_003_0	7	2	Preferred Brand	000001	
H1595	003	0	1	04	01	H1595_003_0	7	3	Non-Preferred Brand	100000	
H1595	003	0	1	04	01	H1595_003_0	7	4	Specialty Tier	110001	
H1607	001	0	1	04	01	H1607_001_0	7	1	Preferred Generic	001000	
H1607	001	0	1	04	01	H1607_001_0	7	2	Non-Preferred Generic	000100	
H1607	001	0	1	04	01	H1607_001_0	7	3	Preferred Brand	000101	
H1607	001	0	1	04	01	H1607_001_0	7	4	Non-Preferred Brand	100100	
H1607	001	0	1	04	01	H1607_001_0	7	6	Specialty Tier	010010	
H1607	001	0	1	04	01	H1607_001_0	7	5	Injectable Drugs	010010	
H1608	001	0	1	04	01	H1608_001_0	10	5	Specialty Tier	010010	
H1608	001	0	1	04	01	H1608_001_0	10	4	Non-Preferred Brand	100100	
H1608	001	0	1	04	01	H1608_001_0	10	3	Preferred Brand	000001	
H1608	001	0	1	04	01	H1608_001_0	10	1	Preferred Generic	001000	
H1608	001	0	1	04	01	H1608_001_0	10	2	Non-Preferred Generic	000100	
H1608	004	0	1	04	01	H1608_004_0	8	5	Specialty Tier	010010	
H1608	004	0	1	04	01	H1608_004_0	8	4	Non-Preferred Brand	100100	
H1608	004	0	1	04	01	H1608_004_0	8	3	Preferred Brand	000001	
H1608	004	0	1	04	01	H1608_004_0	8	2	Non-Preferred Generic	000100	
H1608	004	0	1	04	01	H1608_004_0	8	1	Preferred Generic	001000	
H1608	007	0	1	04	01	H1608_007_0	8	5	Specialty Tier	010010	
H1608	007	0	1	04	01	H1608_007_0	8	4	Non-Preferred Brand	100100	
H1608	007	0	1	04	01	H1608_007_0	8	1	Preferred Generic	001000	
H1608	007	0	1	04	01	H1608_007_0	8	2	Non-Preferred Generic	000100	
H1608	007	0	1	04	01	H1608_007_0	8	3	Preferred Brand	000001	
H1608	008	0	1	04	01	H1608_008_0	8	5	Specialty Tier	010010	
H1608	008	0	1	04	01	H1608_008_0	8	4	Non-Preferred Brand	100100	
H1608	008	0	1	04	01	H1608_008_0	8	3	Preferred Brand	000001	
H1608	008	0	1	04	01	H1608_008_0	8	2	Non-Preferred Generic	000100	
H1608	008	0	1	04	01	H1608_008_0	8	1	Preferred Generic	001000	
H1609	001	0	1	01	01	H1609_001_0	9	5	Specialty Tier	010010	
H1609	001	0	1	01	01	H1609_001_0	9	4	Non-Preferred Brand	100100	
H1609	001	0	1	01	01	H1609_001_0	9	1	Preferred Generic	001000	
H1609	001	0	1	01	01	H1609_001_0	9	2	Non-Preferred Generic	000100	
H1609	001	0	1	01	01	H1609_001_0	9	3	Preferred Brand	000001	
H1609	009	0	1	01	01	H1609_009_0	7	5	Specialty Tier	010010	
H1609	009	0	1	01	01	H1609_009_0	7	1	Preferred Generic	001000	
H1609	009	0	1	01	01	H1609_009_0	7	2	Non-Preferred Generic	000100	
H1609	009	0	1	01	01	H1609_009_0	7	3	Preferred Brand	000001	
H1609	009	0	1	01	01	H1609_009_0	7	4	Non-Preferred Brand	100100	
H1609	010	0	1	01	01	H1609_010_0	7	1	Preferred Generic	001000	
H1609	010	0	1	01	01	H1609_010_0	7	5	Specialty Tier	010010	
H1609	010	0	1	01	01	H1609_010_0	7	4	Non-Preferred Brand	100100	
H1609	010	0	1	01	01	H1609_010_0	7	3	Preferred Brand	000001	
H1609	010	0	1	01	01	H1609_010_0	7	2	Non-Preferred Generic	000100	
H1659	001	0	1	04	01	H1659_001_0	7	1	Generic	010000	
H1659	001	0	1	04	01	H1659_001_0	7	2	Preferred Brand	000001	
H1659	001	0	1	04	01	H1659_001_0	7	3	Non-Preferred Brand	100000	
H1659	001	0	1	04	01	H1659_001_0	7	4	Specialty Tier	100001	
H1659	002	0	1	04	01	H1659_002_0	8	1	Generic	010000	
H1659	002	0	1	04	01	H1659_002_0	8	2	Preferred Brand	000001	
H1659	002	0	1	04	01	H1659_002_0	8	4	Specialty Tier	100001	
H1659	002	0	1	04	01	H1659_002_0	8	3	Non-Preferred Brand	100000	
H1659	003	0	1	04	01	H1659_003_0	9	1	Generic	010000	
H1659	003	0	1	04	01	H1659_003_0	9	3	Non-Preferred Brand	100000	
H1659	003	0	1	04	01	H1659_003_0	9	2	Preferred Brand	000001	
H1659	003	0	1	04	01	H1659_003_0	9	4	Specialty Tier	100001	
H1660	001	0	1	01	01	H1660_001_0	7	1	Preferred Generic	001000	1
H1660	001	0	1	01	01	H1660_001_0	7	4	Non-Preferred Brand	100000	
H1660	001	0	1	01	01	H1660_001_0	7	3	Preferred Brand	000001	
H1660	001	0	1	01	01	H1660_001_0	7	2	Non-Preferred Generic	000100	
H1660	001	0	1	01	01	H1660_001_0	7	1	Preferred Generic	001000	
H1660	001	0	1	01	01	H1660_001_0	7	2	Non-Preferred Generic	000100	1
H1660	004	0	1	01	01	H1660_004_0	7	1	Preferred Generic	001000	1
H1660	004	0	1	01	01	H1660_004_0	7	4	Non-Preferred Brand	100000	
H1660	004	0	1	01	01	H1660_004_0	7	3	Preferred Brand	000001	
H1660	004	0	1	01	01	H1660_004_0	7	2	Non-Preferred Generic	000100	
H1660	004	0	1	01	01	H1660_004_0	7	1	Preferred Generic	001000	
H1660	004	0	1	01	01	H1660_004_0	7	2	Non-Preferred Generic	000100	1
H1660	005	0	1	01	01	H1660_005_0	9	1	Preferred Generic	001000	
H1660	005	0	1	01	01	H1660_005_0	9	2	Non-Preferred Generic	000100	
H1660	005	0	1	01	01	H1660_005_0	9	3	Preferred Brand	000001	
H1660	005	0	1	01	01	H1660_005_0	9	4	Non-Preferred Brand	100000	
H1660	005	0	1	01	01	H1660_005_0	9	1	Preferred Generic	001000	1
H1660	005	0	1	01	01	H1660_005_0	9	2	Non-Preferred Generic	000100	1
H1666	001	0	1	04	01	H1666_001_0	9	1	Preferred Generic	001000	
H1666	001	0	1	04	01	H1666_001_0	9	2	Non-Preferred Generic	000100	
H1666	001	0	1	04	01	H1666_001_0	9	3	Preferred Brand	000001	
H1666	001	0	1	04	01	H1666_001_0	9	4	Non-Preferred Brand	110000	
H1666	001	0	1	04	01	H1666_001_0	9	5	Specialty Tier	010010	
H1666	002	0	1	04	01	H1666_002_0	9	1	Preferred Generic	001000	
H1666	002	0	1	04	01	H1666_002_0	9	5	Specialty Tier	010010	
H1666	002	0	1	04	01	H1666_002_0	9	4	Non-Preferred Brand	110000	
H1666	002	0	1	04	01	H1666_002_0	9	3	Preferred Brand	000001	
H1666	002	0	1	04	01	H1666_002_0	9	2	Non-Preferred Generic	000100	
H1666	003	0	1	04	01	H1666_003_0	9	4	Non-Preferred Brand	110000	
H1666	003	0	1	04	01	H1666_003_0	9	3	Preferred Brand	000001	
H1666	003	0	1	04	01	H1666_003_0	9	2	Non-Preferred Generic	000100	
H1666	003	0	1	04	01	H1666_003_0	9	1	Preferred Generic	001000	
H1666	003	0	1	04	01	H1666_003_0	9	5	Specialty Tier	010010	
H1666	004	0	1	04	01	H1666_004_0	9	4	Non-Preferred Brand	110000	
H1666	004	0	1	04	01	H1666_004_0	9	3	Preferred Brand	000001	
H1666	004	0	1	04	01	H1666_004_0	9	2	Non-Preferred Generic	000100	
H1666	004	0	1	04	01	H1666_004_0	9	1	Preferred Generic	001000	
H1666	004	0	1	04	01	H1666_004_0	9	5	Specialty Tier	010010	
H1666	005	0	1	04	01	H1666_005_0	9	1	Preferred Generic	001000	
H1666	005	0	1	04	01	H1666_005_0	9	2	Non-Preferred Generic	000100	
H1666	005	0	1	04	01	H1666_005_0	9	3	Preferred Brand	000001	
H1666	005	0	1	04	01	H1666_005_0	9	4	Non-Preferred Brand	110000	
H1666	005	0	1	04	01	H1666_005_0	9	5	Specialty Tier	010010	
H1666	006	0	1	04	01	H1666_006_0	9	4	Non-Preferred Brand	110000	
H1666	006	0	1	04	01	H1666_006_0	9	3	Preferred Brand	000001	
H1666	006	0	1	04	01	H1666_006_0	9	2	Non-Preferred Generic	000100	
H1666	006	0	1	04	01	H1666_006_0	9	1	Preferred Generic	001000	
H1666	006	0	1	04	01	H1666_006_0	9	5	Specialty Tier	010010	
H1681	001	0	1	04	01	H1681_001_0	4	1	Preferred Generic	001010	
H1681	001	0	1	04	01	H1681_001_0	4	2	Non-Preferred Generic	000101	
H1681	001	0	1	04	01	H1681_001_0	4	5	Specialty Tier	010010	2
H1681	001	0	1	04	01	H1681_001_0	4	4	Non-Preferred Brand	110000	2
H1681	001	0	1	04	01	H1681_001_0	4	3	Preferred Brand	000101	2
H1681	001	0	1	04	01	H1681_001_0	4	2	Non-Preferred Generic	000101	2
H1681	001	0	1	04	01	H1681_001_0	4	3	Preferred Brand	000101	
H1681	001	0	1	04	01	H1681_001_0	4	4	Non-Preferred Brand	110000	
H1681	001	0	1	04	01	H1681_001_0	4	5	Specialty Tier	010010	
H1681	001	0	1	04	01	H1681_001_0	4	1	Preferred Generic	001010	2
H1681	002	0	1	04	01	H1681_002_0	4	4	Non-Preferred Brand	110000	
H1681	002	0	1	04	01	H1681_002_0	4	3	Preferred Brand	000101	
H1681	002	0	1	04	01	H1681_002_0	4	2	Non-Preferred Generic	000101	
H1681	002	0	1	04	01	H1681_002_0	4	1	Preferred Generic	001010	
H1681	002	0	1	04	01	H1681_002_0	4	5	Specialty Tier	010010	
H1681	005	0	1	04	01	H1681_005_0	4	2	Non-Preferred Generic	000101	
H1681	005	0	1	04	01	H1681_005_0	4	3	Preferred Brand	000101	
H1681	005	0	1	04	01	H1681_005_0	4	4	Non-Preferred Brand	110000	
H1681	005	0	1	04	01	H1681_005_0	4	5	Specialty Tier	010010	
H1681	005	0	1	04	01	H1681_005_0	4	1	Preferred Generic	001010	2
H1681	005	0	1	04	01	H1681_005_0	4	2	Non-Preferred Generic	000101	2
H1681	005	0	1	04	01	H1681_005_0	4	3	Preferred Brand	000101	2
H1681	005	0	1	04	01	H1681_005_0	4	4	Non-Preferred Brand	110000	2
H1681	005	0	1	04	01	H1681_005_0	4	5	Specialty Tier	010010	2
H1681	005	0	1	04	01	H1681_005_0	4	1	Preferred Generic	001010	
H1681	006	0	1	04	01	H1681_006_0	4	5	Specialty Tier	010010	2
H1681	006	0	1	04	01	H1681_006_0	4	4	Non-Preferred Brand	110000	2
H1681	006	0	1	04	01	H1681_006_0	4	3	Preferred Brand	000101	2
H1681	006	0	1	04	01	H1681_006_0	4	2	Non-Preferred Generic	000101	2
H1681	006	0	1	04	01	H1681_006_0	4	1	Preferred Generic	001010	2
H1681	006	0	1	04	01	H1681_006_0	4	2	Non-Preferred Generic	000101	
H1681	006	0	1	04	01	H1681_006_0	4	3	Preferred Brand	000101	
H1681	006	0	1	04	01	H1681_006_0	4	4	Non-Preferred Brand	110000	
H1681	006	0	1	04	01	H1681_006_0	4	5	Specialty Tier	010010	
H1681	006	0	1	04	01	H1681_006_0	4	1	Preferred Generic	001010	
H1692	001	0	1	01	01	H1692_001_0	7	5	Specialty Tier	010010	
H1692	001	0	1	01	01	H1692_001_0	7	4	Non-Preferred Brand	100100	
H1692	001	0	1	01	01	H1692_001_0	7	3	Preferred Brand	000001	
H1692	001	0	1	01	01	H1692_001_0	7	2	Non-Preferred Generic	000100	
H1692	001	0	1	01	01	H1692_001_0	7	1	Preferred Generic	001000	
H1692	002	0	1	01	01	H1692_002_0	6	1	Preferred Generic	001000	
H1692	002	0	1	01	01	H1692_002_0	6	2	Non-Preferred Generic	000100	
H1692	002	0	1	01	01	H1692_002_0	6	3	Preferred Brand	000001	
H1692	002	0	1	01	01	H1692_002_0	6	4	Non-Preferred Brand	100100	
H1692	002	0	1	01	01	H1692_002_0	6	5	Specialty Tier	010010	
H1716	001	0	1	04	01	H1716_001_0	4	1	Preferred Generic	001010	
H1716	001	0	1	04	01	H1716_001_0	4	2	Non-Preferred Generic	000101	
H1716	001	0	1	04	01	H1716_001_0	4	3	Preferred Brand	000101	
H1716	001	0	1	04	01	H1716_001_0	4	4	Non-Preferred Brand	110000	
H1716	001	0	1	04	01	H1716_001_0	4	2	Non-Preferred Generic	000101	2
H1716	001	0	1	04	01	H1716_001_0	4	1	Preferred Generic	001010	2
H1716	001	0	1	04	01	H1716_001_0	4	5	Specialty Tier	010010	2
H1716	001	0	1	04	01	H1716_001_0	4	4	Non-Preferred Brand	110000	2
H1716	001	0	1	04	01	H1716_001_0	4	3	Preferred Brand	000101	2
H1716	001	0	1	04	01	H1716_001_0	4	5	Specialty Tier	010010	
H1716	006	0	1	04	01	H1716_006_0	4	5	Specialty Tier	010010	2
H1716	006	0	1	04	01	H1716_006_0	4	4	Non-Preferred Brand	110000	2
H1716	006	0	1	04	01	H1716_006_0	4	3	Preferred Brand	000101	2
H1716	006	0	1	04	01	H1716_006_0	4	2	Non-Preferred Generic	000101	2
H1716	006	0	1	04	01	H1716_006_0	4	1	Preferred Generic	001010	2
H1716	006	0	1	04	01	H1716_006_0	4	4	Non-Preferred Brand	110000	
H1716	006	0	1	04	01	H1716_006_0	4	5	Specialty Tier	010010	
H1716	006	0	1	04	01	H1716_006_0	4	3	Preferred Brand	000101	
H1716	006	0	1	04	01	H1716_006_0	4	2	Non-Preferred Generic	000101	
H1716	006	0	1	04	01	H1716_006_0	4	1	Preferred Generic	001010	
H1716	020	0	1	04	01	H1716_020_0	4	4	Non-Preferred Brand	110000	2
H1716	020	0	1	04	01	H1716_020_0	4	3	Preferred Brand	000101	2
H1716	020	0	1	04	01	H1716_020_0	4	2	Non-Preferred Generic	000101	2
H1716	020	0	1	04	01	H1716_020_0	4	2	Non-Preferred Generic	000101	
H1716	020	0	1	04	01	H1716_020_0	4	3	Preferred Brand	000101	
H1716	020	0	1	04	01	H1716_020_0	4	5	Specialty Tier	010010	
H1716	020	0	1	04	01	H1716_020_0	4	5	Specialty Tier	010010	2
H1716	020	0	1	04	01	H1716_020_0	4	4	Non-Preferred Brand	110000	
H1716	020	0	1	04	01	H1716_020_0	4	1	Preferred Generic	001010	
H1737	001	0	1	01	01	H1737_001_0	7	4	Non-Preferred Brand	100000	
H1737	001	0	1	01	01	H1737_001_0	7	2	Non-Preferred Generic	000100	
H1737	001	0	1	01	01	H1737_001_0	7	1	Preferred Generic	001000	
H1737	001	0	1	01	01	H1737_001_0	7	3	Preferred Brand	000001	
H1737	001	0	1	01	01	H1737_001_0	7	5	Specialty Tier	100000	
H1846	001	0	1	04	01	H1846_001_0	4	5	Specialty Tier	010010	
H1846	001	0	1	04	01	H1846_001_0	4	4	Non-Preferred Brand	100100	
H1846	001	0	1	04	01	H1846_001_0	4	3	Preferred Brand	000101	
H1846	001	0	1	04	01	H1846_001_0	4	2	Non-Preferred Generic	000101	
H1846	001	0	1	04	01	H1846_001_0	4	1	Preferred Generic	001001	
H1846	001	0	1	04	01	H1846_001_0	4	2	Non-Preferred Generic	000101	1
H1846	001	0	1	04	01	H1846_001_0	4	1	Preferred Generic	001001	1
H1846	003	0	1	04	01	H1846_003_0	4	4	Non-Preferred Brand	100100	
H1846	003	0	1	04	01	H1846_003_0	4	3	Preferred Brand	000101	
H1846	003	0	1	04	01	H1846_003_0	4	2	Non-Preferred Generic	000101	
H1846	003	0	1	04	01	H1846_003_0	4	1	Preferred Generic	001001	
H1846	003	0	1	04	01	H1846_003_0	4	5	Specialty Tier	010010	
H1849	015	0	1	01	01	H1849_015_0	5	4	Non-Preferred Brand	100100	
H1849	015	0	1	01	01	H1849_015_0	5	3	Preferred Brand	000101	
H1849	015	0	1	01	01	H1849_015_0	5	2	Non-Preferred Generic	000100	
H1849	015	0	1	01	01	H1849_015_0	5	1	Preferred Generic	001000	
H1849	015	0	1	01	01	H1849_015_0	5	6	Specialty Tier	010010	
H1849	015	0	1	01	01	H1849_015_0	5	5	Injectable Drugs	010010	
H1894	001	0	1	01	01	H1894_001_0	7	5	Specialty Tier	010010	
H1894	001	0	1	01	01	H1894_001_0	7	4	Non-Preferred Brand	100000	
H1894	001	0	1	01	01	H1894_001_0	7	3	Preferred Brand	000001	
H1894	001	0	1	01	01	H1894_001_0	7	2	Non-Preferred Generic	000100	
H1894	001	0	1	01	01	H1894_001_0	7	1	Preferred Generic	001000	
H1894	001	0	1	01	01	H1894_001_0	7	1	Preferred Generic	001000	1
H1903	011	0	1	01	01	H1903_011_0	4	5	Specialty Tier	010010	
H1903	011	0	1	01	01	H1903_011_0	4	1	Preferred Generic	001000	
H1903	011	0	1	01	01	H1903_011_0	4	2	Non-Preferred Generic	000100	
H1903	011	0	1	01	01	H1903_011_0	4	3	Preferred Brand	010001	
H1903	011	0	1	01	01	H1903_011_0	4	4	Non-Preferred Brand	110000	
H1903	022	0	1	01	01	H1903_022_0	4	5	Specialty Tier	010010	
H1903	022	0	1	01	01	H1903_022_0	4	1	Preferred Generic	001000	
H1903	022	0	1	01	01	H1903_022_0	4	2	Non-Preferred Generic	000100	
H1903	022	0	1	01	01	H1903_022_0	4	3	Preferred Brand	000001	
H1903	022	0	1	01	01	H1903_022_0	4	4	Non-Preferred Brand	100000	
H1906	001	0	1	09	04	H1906_001_0	3	5	Specialty Tier	010010	2
H1906	001	0	1	09	04	H1906_001_0	3	4	Non-Preferred Brand	110000	2
H1906	001	0	1	09	04	H1906_001_0	3	3	Preferred Brand	000101	2
H1906	001	0	1	09	04	H1906_001_0	3	2	Non-Preferred Generic	000101	2
H1906	001	0	1	09	04	H1906_001_0	3	1	Preferred Generic	001010	2
H1906	001	0	1	09	04	H1906_001_0	3	5	Specialty Tier	010010	
H1906	001	0	1	09	04	H1906_001_0	3	4	Non-Preferred Brand	110000	
H1906	001	0	1	09	04	H1906_001_0	3	3	Preferred Brand	000101	
H1906	001	0	1	09	04	H1906_001_0	3	1	Preferred Generic	001010	
H1906	001	0	1	09	04	H1906_001_0	3	2	Non-Preferred Generic	000101	
H1944	001	0	1	01	01	H1944_001_0	5	1	Preferred Generic	001000	
H1944	001	0	1	01	01	H1944_001_0	5	2	Non-Preferred Generic	000100	
H1944	001	0	1	01	01	H1944_001_0	5	3	Preferred Brand	010001	
H1944	001	0	1	01	01	H1944_001_0	5	4	Non-Preferred Brand	100100	
H1944	001	0	1	01	01	H1944_001_0	5	5	Specialty Tier	010010	
H1944	004	0	1	01	01	H1944_004_0	5	1	Preferred Generic	001000	
H1944	004	0	1	01	01	H1944_004_0	5	2	Non-Preferred Generic	000100	
H1944	004	0	1	01	01	H1944_004_0	5	3	Preferred Brand	010001	
H1944	004	0	1	01	01	H1944_004_0	5	4	Non-Preferred Brand	100100	
H1944	004	0	1	01	01	H1944_004_0	5	5	Specialty Tier	010010	
H1951	001	0	1	01	01	H1951_001_0	3	1	Preferred Generic	001010	
H1951	001	0	1	01	01	H1951_001_0	3	2	Non-Preferred Generic	000101	
H1951	001	0	1	01	01	H1951_001_0	3	5	Specialty Tier	010010	2
H1951	001	0	1	01	01	H1951_001_0	3	4	Non-Preferred Brand	110000	2
H1951	001	0	1	01	01	H1951_001_0	3	3	Preferred Brand	000101	2
H1951	001	0	1	01	01	H1951_001_0	3	2	Non-Preferred Generic	000101	2
H1951	001	0	1	01	01	H1951_001_0	3	1	Preferred Generic	001010	2
H1951	001	0	1	01	01	H1951_001_0	3	5	Specialty Tier	010010	
H1951	001	0	1	01	01	H1951_001_0	3	4	Non-Preferred Brand	110000	
H1951	001	0	1	01	01	H1951_001_0	3	3	Preferred Brand	000101	
H1951	005	0	1	01	01	H1951_005_0	3	1	Preferred Generic	001010	
H1951	005	0	1	01	01	H1951_005_0	3	4	Non-Preferred Brand	110000	2
H1951	005	0	1	01	01	H1951_005_0	3	3	Preferred Brand	000101	2
H1951	005	0	1	01	01	H1951_005_0	3	2	Non-Preferred Generic	000101	2
H1951	005	0	1	01	01	H1951_005_0	3	5	Specialty Tier	010010	2
H1951	005	0	1	01	01	H1951_005_0	3	5	Specialty Tier	010010	
H1951	005	0	1	01	01	H1951_005_0	3	4	Non-Preferred Brand	110000	
H1951	005	0	1	01	01	H1951_005_0	3	3	Preferred Brand	000101	
H1951	005	0	1	01	01	H1951_005_0	3	2	Non-Preferred Generic	000101	
H1951	005	0	1	01	01	H1951_005_0	3	1	Preferred Generic	001010	2
H1951	013	0	1	01	01	H1951_013_0	3	1	Preferred Generic	001010	
H1951	013	0	1	01	01	H1951_013_0	3	2	Non-Preferred Generic	000101	
H1951	013	0	1	01	01	H1951_013_0	3	3	Preferred Brand	000101	
H1951	013	0	1	01	01	H1951_013_0	3	4	Non-Preferred Brand	110000	
H1951	013	0	1	01	01	H1951_013_0	3	5	Specialty Tier	010010	2
H1951	013	0	1	01	01	H1951_013_0	3	1	Preferred Generic	001010	2
H1951	013	0	1	01	01	H1951_013_0	3	2	Non-Preferred Generic	000101	2
H1951	013	0	1	01	01	H1951_013_0	3	3	Preferred Brand	000101	2
H1951	013	0	1	01	01	H1951_013_0	3	4	Non-Preferred Brand	110000	2
H1951	013	0	1	01	01	H1951_013_0	3	5	Specialty Tier	010010	
H1951	024	0	1	01	01	H1951_024_0	3	5	Specialty Tier	010010	2
H1951	024	0	1	01	01	H1951_024_0	3	1	Preferred Generic	001010	
H1951	024	0	1	01	01	H1951_024_0	3	2	Non-Preferred Generic	000101	
H1951	024	0	1	01	01	H1951_024_0	3	3	Preferred Brand	000101	
H1951	024	0	1	01	01	H1951_024_0	3	4	Non-Preferred Brand	110000	2
H1951	024	0	1	01	01	H1951_024_0	3	5	Specialty Tier	010010	
H1951	024	0	1	01	01	H1951_024_0	3	1	Preferred Generic	001010	2
H1951	024	0	1	01	01	H1951_024_0	3	2	Non-Preferred Generic	000101	2
H1951	024	0	1	01	01	H1951_024_0	3	3	Preferred Brand	000101	2
H1951	024	0	1	01	01	H1951_024_0	3	4	Non-Preferred Brand	110000	
H1951	025	0	1	01	01	H1951_025_0	3	4	Non-Preferred Brand	110000	
H1951	025	0	1	01	01	H1951_025_0	3	5	Specialty Tier	010010	2
H1951	025	0	1	01	01	H1951_025_0	3	4	Non-Preferred Brand	110000	2
H1951	025	0	1	01	01	H1951_025_0	3	3	Preferred Brand	000101	2
H1951	025	0	1	01	01	H1951_025_0	3	2	Non-Preferred Generic	000101	2
H1951	025	0	1	01	01	H1951_025_0	3	1	Preferred Generic	001010	2
H1951	025	0	1	01	01	H1951_025_0	3	5	Specialty Tier	010010	
H1951	025	0	1	01	01	H1951_025_0	3	3	Preferred Brand	000101	
H1951	025	0	1	01	01	H1951_025_0	3	2	Non-Preferred Generic	000101	
H1951	025	0	1	01	01	H1951_025_0	3	1	Preferred Generic	001010	
H1951	028	0	1	01	01	H1951_028_0	3	2	Non-Preferred Generic	000101	2
H1951	028	0	1	01	01	H1951_028_0	3	1	Preferred Generic	001010	2
H1951	028	0	1	01	01	H1951_028_0	3	5	Specialty Tier	010010	
H1951	028	0	1	01	01	H1951_028_0	3	4	Non-Preferred Brand	110000	
H1951	028	0	1	01	01	H1951_028_0	3	5	Specialty Tier	010010	2
H1951	028	0	1	01	01	H1951_028_0	3	4	Non-Preferred Brand	110000	2
H1951	028	0	1	01	01	H1951_028_0	3	2	Non-Preferred Generic	000101	
H1951	028	0	1	01	01	H1951_028_0	3	1	Preferred Generic	001010	
H1951	028	0	1	01	01	H1951_028_0	3	3	Preferred Brand	000101	2
H1951	028	0	1	01	01	H1951_028_0	3	3	Preferred Brand	000101	
H1951	032	0	1	01	01	H1951_032_0	5	4	Non-Preferred Brand	110000	
H1951	032	0	1	01	01	H1951_032_0	5	3	Preferred Brand	000101	
H1951	032	0	1	01	01	H1951_032_0	5	2	Non-Preferred Generic	000101	
H1951	032	0	1	01	01	H1951_032_0	5	1	Preferred Generic	001010	
H1951	032	0	1	01	01	H1951_032_0	5	5	Specialty Tier	010010	
H1951	033	0	1	01	01	H1951_033_0	4	4	Non-Preferred Brand	110000	
H1951	033	0	1	01	01	H1951_033_0	4	3	Preferred Brand	000101	
H1951	033	0	1	01	01	H1951_033_0	4	2	Non-Preferred Generic	000101	
H1951	033	0	1	01	01	H1951_033_0	4	1	Preferred Generic	001010	
H1951	033	0	1	01	01	H1951_033_0	4	5	Specialty Tier	010010	
H1951	034	0	1	01	01	H1951_034_0	4	1	Preferred Generic	001010	
H1951	034	0	1	01	01	H1951_034_0	4	2	Non-Preferred Generic	000101	
H1951	034	0	1	01	01	H1951_034_0	4	3	Preferred Brand	000101	
H1951	034	0	1	01	01	H1951_034_0	4	4	Non-Preferred Brand	110000	
H1951	034	0	1	01	01	H1951_034_0	4	5	Specialty Tier	010010	
H1951	035	0	1	01	01	H1951_035_0	3	1	Preferred Generic	001010	
H1951	035	0	1	01	01	H1951_035_0	3	2	Non-Preferred Generic	000101	
H1951	035	0	1	01	01	H1951_035_0	3	3	Preferred Brand	000101	
H1951	035	0	1	01	01	H1951_035_0	3	4	Non-Preferred Brand	110000	
H1951	035	0	1	01	01	H1951_035_0	3	5	Specialty Tier	010010	
H1951	036	0	1	01	01	H1951_036_0	3	1	Preferred Generic	001010	
H1951	036	0	1	01	01	H1951_036_0	3	2	Non-Preferred Generic	000101	
H1951	036	0	1	01	01	H1951_036_0	3	3	Preferred Brand	000101	
H1951	036	0	1	01	01	H1951_036_0	3	4	Non-Preferred Brand	110000	
H1951	036	0	1	01	01	H1951_036_0	3	5	Specialty Tier	010010	
H1951	036	0	1	01	01	H1951_036_0	3	1	Preferred Generic	001010	2
H1951	036	0	1	01	01	H1951_036_0	3	2	Non-Preferred Generic	000101	2
H1951	036	0	1	01	01	H1951_036_0	3	3	Preferred Brand	000101	2
H1951	036	0	1	01	01	H1951_036_0	3	4	Non-Preferred Brand	110000	2
H1951	036	0	1	01	01	H1951_036_0	3	5	Specialty Tier	010010	2
H1951	037	0	1	01	01	H1951_037_0	3	2	Non-Preferred Generic	000101	
H1951	037	0	1	01	01	H1951_037_0	3	1	Preferred Generic	001010	
H1951	037	0	1	01	01	H1951_037_0	3	5	Specialty Tier	010010	2
H1951	037	0	1	01	01	H1951_037_0	3	4	Non-Preferred Brand	110000	2
H1951	037	0	1	01	01	H1951_037_0	3	3	Preferred Brand	000101	
H1951	037	0	1	01	01	H1951_037_0	3	2	Non-Preferred Generic	000101	2
H1951	037	0	1	01	01	H1951_037_0	3	1	Preferred Generic	001010	2
H1951	037	0	1	01	01	H1951_037_0	3	5	Specialty Tier	010010	
H1951	037	0	1	01	01	H1951_037_0	3	4	Non-Preferred Brand	110000	
H1951	037	0	1	01	01	H1951_037_0	3	3	Preferred Brand	000101	2
H1951	038	0	1	01	01	H1951_038_0	3	2	Non-Preferred Generic	000101	
H1951	038	0	1	01	01	H1951_038_0	3	1	Preferred Generic	001010	
H1951	038	0	1	01	01	H1951_038_0	3	4	Non-Preferred Brand	110000	
H1951	038	0	1	01	01	H1951_038_0	3	5	Specialty Tier	010010	
H1951	038	0	1	01	01	H1951_038_0	3	1	Preferred Generic	001010	1
H1951	038	0	1	01	01	H1951_038_0	3	2	Non-Preferred Generic	000101	1
H1951	038	0	1	01	01	H1951_038_0	3	3	Preferred Brand	000101	2
H1951	038	0	1	01	01	H1951_038_0	3	3	Preferred Brand	000101	
H1951	038	0	1	01	01	H1951_038_0	3	5	Specialty Tier	010010	2
H1951	038	0	1	01	01	H1951_038_0	3	4	Non-Preferred Brand	110000	2
H1951	039	0	1	01	01	H1951_039_0	3	1	Preferred Generic	001010	
H1951	039	0	1	01	01	H1951_039_0	3	2	Non-Preferred Generic	000101	
H1951	039	0	1	01	01	H1951_039_0	3	5	Specialty Tier	010010	2
H1951	039	0	1	01	01	H1951_039_0	3	4	Non-Preferred Brand	110000	2
H1951	039	0	1	01	01	H1951_039_0	3	3	Preferred Brand	000101	2
H1951	039	0	1	01	01	H1951_039_0	3	2	Non-Preferred Generic	000101	1
H1951	039	0	1	01	01	H1951_039_0	3	1	Preferred Generic	001010	1
H1951	039	0	1	01	01	H1951_039_0	3	5	Specialty Tier	010010	
H1951	039	0	1	01	01	H1951_039_0	3	4	Non-Preferred Brand	110000	
H1951	039	0	1	01	01	H1951_039_0	3	3	Preferred Brand	000101	
H1951	041	0	1	01	01	H1951_041_0	4	1	Preferred Generic	001010	
H1951	041	0	1	01	01	H1951_041_0	4	3	Preferred Brand	000101	
H1951	041	0	1	01	01	H1951_041_0	4	2	Non-Preferred Generic	000101	
H1951	041	0	1	01	01	H1951_041_0	4	4	Non-Preferred Brand	110000	
H1951	041	0	1	01	01	H1951_041_0	4	5	Specialty Tier	010010	
H1951	042	0	1	01	01	H1951_042_0	3	1	Preferred Generic	001010	
H1951	042	0	1	01	01	H1951_042_0	3	2	Non-Preferred Generic	000101	2
H1951	042	0	1	01	01	H1951_042_0	3	3	Preferred Brand	000101	2
H1951	042	0	1	01	01	H1951_042_0	3	4	Non-Preferred Brand	110000	2
H1951	042	0	1	01	01	H1951_042_0	3	2	Non-Preferred Generic	000101	
H1951	042	0	1	01	01	H1951_042_0	3	3	Preferred Brand	000101	
H1951	042	0	1	01	01	H1951_042_0	3	1	Preferred Generic	001010	2
H1951	042	0	1	01	01	H1951_042_0	3	5	Specialty Tier	010010	2
H1951	042	0	1	01	01	H1951_042_0	3	5	Specialty Tier	010010	
H1951	042	0	1	01	01	H1951_042_0	3	4	Non-Preferred Brand	110000	
H1951	043	0	1	01	01	H1951_043_0	3	1	Preferred Generic	001010	2
H1951	043	0	1	01	01	H1951_043_0	3	2	Non-Preferred Generic	000101	2
H1951	043	0	1	01	01	H1951_043_0	3	3	Preferred Brand	000101	2
H1951	043	0	1	01	01	H1951_043_0	3	4	Non-Preferred Brand	110000	2
H1951	043	0	1	01	01	H1951_043_0	3	5	Specialty Tier	010010	2
H1951	043	0	1	01	01	H1951_043_0	3	1	Preferred Generic	001010	
H1951	043	0	1	01	01	H1951_043_0	3	2	Non-Preferred Generic	000101	
H1951	043	0	1	01	01	H1951_043_0	3	3	Preferred Brand	000101	
H1951	043	0	1	01	01	H1951_043_0	3	4	Non-Preferred Brand	110000	
H1951	043	0	1	01	01	H1951_043_0	3	5	Specialty Tier	010010	
H1961	001	0	1	01	01	H1961_001_0	7	1	Preferred Generic	001000	
H1961	001	0	1	01	01	H1961_001_0	7	2	Non-Preferred Generic	000110	
H1961	001	0	1	01	01	H1961_001_0	7	3	Preferred Brand	000001	
H1961	001	0	1	01	01	H1961_001_0	7	2	Non-Preferred Generic	000110	1
H1961	001	0	1	01	01	H1961_001_0	7	1	Preferred Generic	001000	1
H1961	001	0	1	01	01	H1961_001_0	7	5	Specialty Tier	000010	
H1961	001	0	1	01	01	H1961_001_0	7	4	Non-Preferred Brand	100000	
H1961	002	0	1	01	01	H1961_002_0	7	5	Specialty Tier	000010	
H1961	002	0	1	01	01	H1961_002_0	7	1	Preferred Generic	001000	1
H1961	002	0	1	01	01	H1961_002_0	7	4	Non-Preferred Brand	100000	
H1961	002	0	1	01	01	H1961_002_0	7	2	Non-Preferred Generic	000100	1
H1961	002	0	1	01	01	H1961_002_0	7	3	Preferred Brand	000001	
H1961	002	0	1	01	01	H1961_002_0	7	2	Non-Preferred Generic	000100	
H1961	002	0	1	01	01	H1961_002_0	7	1	Preferred Generic	001000	
H1961	007	0	1	01	01	H1961_007_0	4	2	Non-Preferred Generic	000100	
H1961	007	0	1	01	01	H1961_007_0	4	1	Preferred Generic	001000	1
H1961	007	0	1	01	01	H1961_007_0	4	5	Specialty Tier	000010	
H1961	007	0	1	01	01	H1961_007_0	4	4	Non-Preferred Brand	100000	
H1961	007	0	1	01	01	H1961_007_0	4	3	Preferred Brand	000001	
H1961	007	0	1	01	01	H1961_007_0	4	2	Non-Preferred Generic	000100	1
H1961	007	0	1	01	01	H1961_007_0	4	1	Preferred Generic	001000	
H1994	001	0	1	02	01	H1994_001_0	9	1	Preferred Generic	001000	
H1994	001	0	1	02	01	H1994_001_0	9	3	Preferred Brand	000001	
H1994	001	0	1	02	01	H1994_001_0	9	2	Non-Preferred Generic	000100	
H1994	001	0	1	02	01	H1994_001_0	9	4	Non-Preferred Brand	100000	
H1994	001	0	1	02	01	H1994_001_0	9	5	Specialty Tier	010010	
H1994	002	0	1	02	01	H1994_002_0	8	1	Preferred Generic	001000	
H1994	002	0	1	02	01	H1994_002_0	8	2	Non-Preferred Generic	000100	
H1994	002	0	1	02	01	H1994_002_0	8	3	Preferred Brand	000001	
H1994	002	0	1	02	01	H1994_002_0	8	4	Non-Preferred Brand	100000	
H1994	002	0	1	02	01	H1994_002_0	8	5	Specialty Tier	010010	
H1994	003	0	1	02	01	H1994_003_0	9	1	Preferred Generic	001000	
H1994	003	0	1	02	01	H1994_003_0	9	5	Specialty Tier	010010	
H1994	003	0	1	02	01	H1994_003_0	9	4	Non-Preferred Brand	100000	
H1994	003	0	1	02	01	H1994_003_0	9	2	Non-Preferred Generic	000100	
H1994	003	0	1	02	01	H1994_003_0	9	3	Preferred Brand	000001	
H1994	004	0	1	02	01	H1994_004_0	7	1	Preferred Generic	001000	
H1994	004	0	1	02	01	H1994_004_0	7	2	Non-Preferred Generic	000100	
H1994	004	0	1	02	01	H1994_004_0	7	3	Preferred Brand	000001	
H1994	004	0	1	02	01	H1994_004_0	7	4	Non-Preferred Brand	100000	
H1994	004	0	1	02	01	H1994_004_0	7	5	Specialty Tier	010010	
H1997	002	0	1	01	01	H1997_002_0	8	4	Non-Preferred Brand	100000	
H1997	002	0	1	01	01	H1997_002_0	8	3	Preferred Brand	000001	
H1997	002	0	1	01	01	H1997_002_0	8	2	Non-Preferred Generic	000100	
H1997	002	0	1	01	01	H1997_002_0	8	1	Preferred Generic	001000	
H1997	002	0	1	01	01	H1997_002_0	8	5	Specialty Tier	010010	
H2001	001	0	1	04	01	H2001_001_0	6	3	Preferred Brand	010001	
H2001	001	0	1	04	01	H2001_001_0	6	5	Specialty Tier	010010	
H2001	001	0	1	04	01	H2001_001_0	6	4	Non-Preferred Brand	100100	
H2001	001	0	1	04	01	H2001_001_0	6	1	Preferred Generic	001000	
H2001	001	0	1	04	01	H2001_001_0	6	2	Non-Preferred Generic	000100	
H2005	001	0	1	48	05	H2005_001_0	3	1	Generic Drugs	010000	
H2005	001	0	1	48	05	H2005_001_0	3	2	Brand Drugs	000010	
H2005	001	0	1	48	05	H2005_001_0	3	3	Non-Medicare Rx/OTC Drugs	010010	
H2012	001	0	1	01	01	H2012_001_0	4	4	Non-Preferred Brand	110000	2
H2012	001	0	1	01	01	H2012_001_0	4	3	Preferred Brand	000101	2
H2012	001	0	1	01	01	H2012_001_0	4	2	Non-Preferred Generic	000101	2
H2012	001	0	1	01	01	H2012_001_0	4	1	Preferred Generic	001010	2
H2012	001	0	1	01	01	H2012_001_0	4	5	Specialty Tier	010010	2
H2012	001	0	1	01	01	H2012_001_0	4	4	Non-Preferred Brand	110000	
H2012	001	0	1	01	01	H2012_001_0	4	3	Preferred Brand	000101	
H2012	001	0	1	01	01	H2012_001_0	4	2	Non-Preferred Generic	000101	
H2012	001	0	1	01	01	H2012_001_0	4	1	Preferred Generic	001010	
H2012	001	0	1	01	01	H2012_001_0	4	5	Specialty Tier	010010	
H2012	002	0	1	01	01	H2012_002_0	4	4	Non-Preferred Brand	110000	2
H2012	002	0	1	01	01	H2012_002_0	4	3	Preferred Brand	000101	2
H2012	002	0	1	01	01	H2012_002_0	4	2	Non-Preferred Generic	000101	2
H2012	002	0	1	01	01	H2012_002_0	4	1	Preferred Generic	001010	2
H2012	002	0	1	01	01	H2012_002_0	4	5	Specialty Tier	010010	
H2012	002	0	1	01	01	H2012_002_0	4	4	Non-Preferred Brand	110000	
H2012	002	0	1	01	01	H2012_002_0	4	3	Preferred Brand	000101	
H2012	002	0	1	01	01	H2012_002_0	4	2	Non-Preferred Generic	000101	
H2012	002	0	1	01	01	H2012_002_0	4	1	Preferred Generic	001010	
H2012	002	0	1	01	01	H2012_002_0	4	5	Specialty Tier	010010	2
H2012	003	0	1	01	01	H2012_003_0	4	1	Preferred Generic	001010	
H2012	003	0	1	01	01	H2012_003_0	4	2	Non-Preferred Generic	000101	
H2012	003	0	1	01	01	H2012_003_0	4	5	Specialty Tier	010010	2
H2012	003	0	1	01	01	H2012_003_0	4	4	Non-Preferred Brand	110000	2
H2012	003	0	1	01	01	H2012_003_0	4	3	Preferred Brand	000101	2
H2012	003	0	1	01	01	H2012_003_0	4	2	Non-Preferred Generic	000101	2
H2012	003	0	1	01	01	H2012_003_0	4	1	Preferred Generic	001010	2
H2012	003	0	1	01	01	H2012_003_0	4	5	Specialty Tier	010010	
H2012	003	0	1	01	01	H2012_003_0	4	4	Non-Preferred Brand	110000	
H2012	003	0	1	01	01	H2012_003_0	4	3	Preferred Brand	000101	
H2012	006	0	1	02	01	H2012_006_0	9	1	Preferred Generic	001010	
H2012	006	0	1	02	01	H2012_006_0	9	4	Non-Preferred Brand	110000	2
H2012	006	0	1	02	01	H2012_006_0	9	3	Preferred Brand	000101	2
H2012	006	0	1	02	01	H2012_006_0	9	2	Non-Preferred Generic	000101	2
H2012	006	0	1	02	01	H2012_006_0	9	5	Specialty Tier	010010	2
H2012	006	0	1	02	01	H2012_006_0	9	5	Specialty Tier	010010	
H2012	006	0	1	02	01	H2012_006_0	9	4	Non-Preferred Brand	110000	
H2012	006	0	1	02	01	H2012_006_0	9	3	Preferred Brand	000101	
H2012	006	0	1	02	01	H2012_006_0	9	2	Non-Preferred Generic	000101	
H2012	006	0	1	02	01	H2012_006_0	9	1	Preferred Generic	001010	2
H2012	007	0	1	01	01	H2012_007_0	11	2	Non-Preferred Generic	000101	2
H2012	007	0	1	01	01	H2012_007_0	11	3	Preferred Brand	000101	2
H2012	007	0	1	01	01	H2012_007_0	11	4	Non-Preferred Brand	110000	2
H2012	007	0	1	01	01	H2012_007_0	11	5	Specialty Tier	010010	2
H2012	007	0	1	01	01	H2012_007_0	11	1	Preferred Generic	001010	
H2012	007	0	1	01	01	H2012_007_0	11	2	Non-Preferred Generic	000101	
H2012	007	0	1	01	01	H2012_007_0	11	3	Preferred Brand	000101	
H2012	007	0	1	01	01	H2012_007_0	11	4	Non-Preferred Brand	110000	
H2012	007	0	1	01	01	H2012_007_0	11	5	Specialty Tier	010010	
H2012	007	0	1	01	01	H2012_007_0	11	1	Preferred Generic	001010	2
H2012	008	0	1	01	01	H2012_008_0	6	1	Preferred Generic	001010	
H2012	008	0	1	01	01	H2012_008_0	6	2	Non-Preferred Generic	000101	
H2012	008	0	1	01	01	H2012_008_0	6	5	Specialty Tier	010010	2
H2012	008	0	1	01	01	H2012_008_0	6	4	Non-Preferred Brand	110000	2
H2012	008	0	1	01	01	H2012_008_0	6	3	Preferred Brand	000101	2
H2012	008	0	1	01	01	H2012_008_0	6	2	Non-Preferred Generic	000101	2
H2012	008	0	1	01	01	H2012_008_0	6	1	Preferred Generic	001010	2
H2012	008	0	1	01	01	H2012_008_0	6	5	Specialty Tier	010010	
H2012	008	0	1	01	01	H2012_008_0	6	4	Non-Preferred Brand	110000	
H2012	008	0	1	01	01	H2012_008_0	6	3	Preferred Brand	000101	
H2012	009	0	1	01	01	H2012_009_0	4	1	Preferred Generic	001010	
H2012	009	0	1	01	01	H2012_009_0	4	4	Non-Preferred Brand	110000	2
H2012	009	0	1	01	01	H2012_009_0	4	3	Preferred Brand	000101	2
H2012	009	0	1	01	01	H2012_009_0	4	2	Non-Preferred Generic	000101	2
H2012	009	0	1	01	01	H2012_009_0	4	5	Specialty Tier	010010	2
H2012	009	0	1	01	01	H2012_009_0	4	5	Specialty Tier	010010	
H2012	009	0	1	01	01	H2012_009_0	4	4	Non-Preferred Brand	110000	
H2012	009	0	1	01	01	H2012_009_0	4	3	Preferred Brand	000101	
H2012	009	0	1	01	01	H2012_009_0	4	2	Non-Preferred Generic	000101	
H2012	009	0	1	01	01	H2012_009_0	4	1	Preferred Generic	001010	2
H2012	011	0	1	01	01	H2012_011_0	4	4	Non-Preferred Brand	110000	
H2012	011	0	1	01	01	H2012_011_0	4	5	Specialty Tier	010010	
H2012	011	0	1	01	01	H2012_011_0	4	1	Preferred Generic	001010	2
H2012	011	0	1	01	01	H2012_011_0	4	2	Non-Preferred Generic	000101	2
H2012	011	0	1	01	01	H2012_011_0	4	3	Preferred Brand	000101	
H2012	011	0	1	01	01	H2012_011_0	4	4	Non-Preferred Brand	110000	2
H2012	011	0	1	01	01	H2012_011_0	4	5	Specialty Tier	010010	2
H2012	011	0	1	01	01	H2012_011_0	4	1	Preferred Generic	001010	
H2012	011	0	1	01	01	H2012_011_0	4	2	Non-Preferred Generic	000101	
H2012	011	0	1	01	01	H2012_011_0	4	3	Preferred Brand	000101	2
H2012	012	0	1	02	01	H2012_012_0	6	1	Preferred Generic	001010	
H2012	012	0	1	02	01	H2012_012_0	6	2	Non-Preferred Generic	000101	
H2012	012	0	1	02	01	H2012_012_0	6	3	Preferred Brand	000101	
H2012	012	0	1	02	01	H2012_012_0	6	4	Non-Preferred Brand	110000	
H2012	012	0	1	02	01	H2012_012_0	6	5	Specialty Tier	010010	
H2012	012	0	1	02	01	H2012_012_0	6	1	Preferred Generic	001010	2
H2012	012	0	1	02	01	H2012_012_0	6	2	Non-Preferred Generic	000101	2
H2012	012	0	1	02	01	H2012_012_0	6	3	Preferred Brand	000101	2
H2012	012	0	1	02	01	H2012_012_0	6	4	Non-Preferred Brand	110000	2
H2012	012	0	1	02	01	H2012_012_0	6	5	Specialty Tier	010010	2
H2012	013	0	1	01	01	H2012_013_0	7	1	Preferred Generic	001010	
H2012	013	0	1	01	01	H2012_013_0	7	2	Non-Preferred Generic	000101	
H2012	013	0	1	01	01	H2012_013_0	7	3	Preferred Brand	000101	2
H2012	013	0	1	01	01	H2012_013_0	7	2	Non-Preferred Generic	000101	2
H2012	013	0	1	01	01	H2012_013_0	7	3	Preferred Brand	000101	
H2012	013	0	1	01	01	H2012_013_0	7	5	Specialty Tier	010010	2
H2012	013	0	1	01	01	H2012_013_0	7	4	Non-Preferred Brand	110000	2
H2012	013	0	1	01	01	H2012_013_0	7	5	Specialty Tier	010010	
H2012	013	0	1	01	01	H2012_013_0	7	4	Non-Preferred Brand	110000	
H2012	013	0	1	01	01	H2012_013_0	7	1	Preferred Generic	001010	2
H2012	015	0	1	01	01	H2012_015_0	4	4	Non-Preferred Brand	110000	2
H2012	015	0	1	01	01	H2012_015_0	4	5	Specialty Tier	010010	2
H2012	015	0	1	01	01	H2012_015_0	4	2	Non-Preferred Generic	000101	2
H2012	015	0	1	01	01	H2012_015_0	4	3	Preferred Brand	000101	2
H2012	015	0	1	01	01	H2012_015_0	4	1	Preferred Generic	001010	2
H2012	015	0	1	01	01	H2012_015_0	4	5	Specialty Tier	010010	
H2012	015	0	1	01	01	H2012_015_0	4	4	Non-Preferred Brand	110000	
H2012	015	0	1	01	01	H2012_015_0	4	3	Preferred Brand	000101	
H2012	015	0	1	01	01	H2012_015_0	4	2	Non-Preferred Generic	000101	
H2012	015	0	1	01	01	H2012_015_0	4	1	Preferred Generic	001010	
H2012	016	0	1	01	01	H2012_016_0	4	4	Non-Preferred Brand	110000	
H2012	016	0	1	01	01	H2012_016_0	4	5	Specialty Tier	010010	
H2012	016	0	1	01	01	H2012_016_0	4	3	Preferred Brand	000101	
H2012	016	0	1	01	01	H2012_016_0	4	2	Non-Preferred Generic	000101	
H2012	016	0	1	01	01	H2012_016_0	4	1	Preferred Generic	001010	2
H2012	016	0	1	01	01	H2012_016_0	4	5	Specialty Tier	010010	2
H2012	016	0	1	01	01	H2012_016_0	4	4	Non-Preferred Brand	110000	2
H2012	016	0	1	01	01	H2012_016_0	4	3	Preferred Brand	000101	2
H2012	016	0	1	01	01	H2012_016_0	4	2	Non-Preferred Generic	000101	2
H2012	016	0	1	01	01	H2012_016_0	4	1	Preferred Generic	001010	
H2012	021	0	1	01	01	H2012_021_0	6	5	Specialty Tier	010010	2
H2012	021	0	1	01	01	H2012_021_0	6	4	Non-Preferred Brand	110000	2
H2012	021	0	1	01	01	H2012_021_0	6	3	Preferred Brand	000101	2
H2012	021	0	1	01	01	H2012_021_0	6	2	Non-Preferred Generic	000101	2
H2012	021	0	1	01	01	H2012_021_0	6	1	Preferred Generic	001010	2
H2012	021	0	1	01	01	H2012_021_0	6	5	Specialty Tier	010010	
H2012	021	0	1	01	01	H2012_021_0	6	3	Preferred Brand	000101	
H2012	021	0	1	01	01	H2012_021_0	6	4	Non-Preferred Brand	110000	
H2012	021	0	1	01	01	H2012_021_0	6	2	Non-Preferred Generic	000101	
H2012	021	0	1	01	01	H2012_021_0	6	1	Preferred Generic	001010	
H2012	022	0	1	01	01	H2012_022_0	4	1	Preferred Generic	001010	
H2012	022	0	1	01	01	H2012_022_0	4	2	Non-Preferred Generic	000101	2
H2012	022	0	1	01	01	H2012_022_0	4	5	Specialty Tier	010010	
H2012	022	0	1	01	01	H2012_022_0	4	1	Preferred Generic	001010	2
H2012	022	0	1	01	01	H2012_022_0	4	5	Specialty Tier	010010	2
H2012	022	0	1	01	01	H2012_022_0	4	3	Preferred Brand	000101	
H2012	022	0	1	01	01	H2012_022_0	4	4	Non-Preferred Brand	110000	
H2012	022	0	1	01	01	H2012_022_0	4	3	Preferred Brand	000101	2
H2012	022	0	1	01	01	H2012_022_0	4	4	Non-Preferred Brand	110000	2
H2012	022	0	1	01	01	H2012_022_0	4	2	Non-Preferred Generic	000101	
H2012	027	0	1	01	01	H2012_027_0	4	1	Preferred Generic	001010	
H2012	027	0	1	01	01	H2012_027_0	4	2	Non-Preferred Generic	000101	
H2012	027	0	1	01	01	H2012_027_0	4	3	Preferred Brand	000101	
H2012	027	0	1	01	01	H2012_027_0	4	4	Non-Preferred Brand	110000	
H2012	027	0	1	01	01	H2012_027_0	4	5	Specialty Tier	010010	
H2012	027	0	1	01	01	H2012_027_0	4	1	Preferred Generic	001010	2
H2012	027	0	1	01	01	H2012_027_0	4	2	Non-Preferred Generic	000101	2
H2012	027	0	1	01	01	H2012_027_0	4	3	Preferred Brand	000101	2
H2012	027	0	1	01	01	H2012_027_0	4	4	Non-Preferred Brand	110000	2
H2012	027	0	1	01	01	H2012_027_0	4	5	Specialty Tier	010010	2
H2012	028	0	1	01	01	H2012_028_0	4	1	Preferred Generic	001010	
H2012	028	0	1	01	01	H2012_028_0	4	2	Non-Preferred Generic	000101	
H2012	028	0	1	01	01	H2012_028_0	4	5	Specialty Tier	010010	2
H2012	028	0	1	01	01	H2012_028_0	4	4	Non-Preferred Brand	110000	2
H2012	028	0	1	01	01	H2012_028_0	4	3	Preferred Brand	000101	2
H2012	028	0	1	01	01	H2012_028_0	4	2	Non-Preferred Generic	000101	2
H2012	028	0	1	01	01	H2012_028_0	4	1	Preferred Generic	001010	2
H2012	028	0	1	01	01	H2012_028_0	4	5	Specialty Tier	010010	
H2012	028	0	1	01	01	H2012_028_0	4	4	Non-Preferred Brand	110000	
H2012	028	0	1	01	01	H2012_028_0	4	3	Preferred Brand	000101	
H2012	029	0	1	01	01	H2012_029_0	6	1	Preferred Generic	001010	
H2012	029	0	1	01	01	H2012_029_0	6	4	Non-Preferred Brand	110000	2
H2012	029	0	1	01	01	H2012_029_0	6	3	Preferred Brand	000101	2
H2012	029	0	1	01	01	H2012_029_0	6	2	Non-Preferred Generic	000101	2
H2012	029	0	1	01	01	H2012_029_0	6	5	Specialty Tier	010010	2
H2012	029	0	1	01	01	H2012_029_0	6	5	Specialty Tier	010010	
H2012	029	0	1	01	01	H2012_029_0	6	4	Non-Preferred Brand	110000	
H2012	029	0	1	01	01	H2012_029_0	6	3	Preferred Brand	000101	
H2012	029	0	1	01	01	H2012_029_0	6	2	Non-Preferred Generic	000101	
H2012	029	0	1	01	01	H2012_029_0	6	1	Preferred Generic	001010	2
H2012	030	0	1	02	01	H2012_030_0	5	2	Non-Preferred Generic	000101	
H2012	030	0	1	02	01	H2012_030_0	5	3	Preferred Brand	000101	
H2012	030	0	1	02	01	H2012_030_0	5	4	Non-Preferred Brand	110000	
H2012	030	0	1	02	01	H2012_030_0	5	5	Specialty Tier	010010	
H2012	030	0	1	02	01	H2012_030_0	5	1	Preferred Generic	001010	
H2012	030	0	1	02	01	H2012_030_0	5	2	Non-Preferred Generic	000101	2
H2012	030	0	1	02	01	H2012_030_0	5	3	Preferred Brand	000101	2
H2012	030	0	1	02	01	H2012_030_0	5	4	Non-Preferred Brand	110000	2
H2012	030	0	1	02	01	H2012_030_0	5	5	Specialty Tier	010010	2
H2012	030	0	1	02	01	H2012_030_0	5	1	Preferred Generic	001010	2
H2012	031	0	1	01	01	H2012_031_0	4	1	Preferred Generic	001010	
H2012	031	0	1	01	01	H2012_031_0	4	2	Non-Preferred Generic	000101	
H2012	031	0	1	01	01	H2012_031_0	4	3	Preferred Brand	000101	
H2012	031	0	1	01	01	H2012_031_0	4	4	Non-Preferred Brand	110000	
H2012	031	0	1	01	01	H2012_031_0	4	5	Specialty Tier	010010	
H2012	031	0	1	01	01	H2012_031_0	4	1	Preferred Generic	001010	2
H2012	031	0	1	01	01	H2012_031_0	4	2	Non-Preferred Generic	000101	2
H2012	031	0	1	01	01	H2012_031_0	4	3	Preferred Brand	000101	2
H2012	031	0	1	01	01	H2012_031_0	4	5	Specialty Tier	010010	2
H2012	031	0	1	01	01	H2012_031_0	4	4	Non-Preferred Brand	110000	2
H2012	033	0	1	01	01	H2012_033_0	5	2	Non-Preferred Generic	000101	2
H2012	033	0	1	01	01	H2012_033_0	5	5	Specialty Tier	010010	
H2012	033	0	1	01	01	H2012_033_0	5	4	Non-Preferred Brand	110000	
H2012	033	0	1	01	01	H2012_033_0	5	3	Preferred Brand	000101	
H2012	033	0	1	01	01	H2012_033_0	5	2	Non-Preferred Generic	000101	
H2012	033	0	1	01	01	H2012_033_0	5	1	Preferred Generic	001010	
H2012	033	0	1	01	01	H2012_033_0	5	5	Specialty Tier	010010	2
H2012	033	0	1	01	01	H2012_033_0	5	4	Non-Preferred Brand	110000	2
H2012	033	0	1	01	01	H2012_033_0	5	3	Preferred Brand	000101	2
H2012	033	0	1	01	01	H2012_033_0	5	1	Preferred Generic	001010	2
H2012	035	0	1	01	01	H2012_035_0	4	3	Preferred Brand	000101	2
H2012	035	0	1	01	01	H2012_035_0	4	4	Non-Preferred Brand	110000	2
H2012	035	0	1	01	01	H2012_035_0	4	5	Specialty Tier	010010	2
H2012	035	0	1	01	01	H2012_035_0	4	3	Preferred Brand	000101	
H2012	035	0	1	01	01	H2012_035_0	4	1	Preferred Generic	001010	
H2012	035	0	1	01	01	H2012_035_0	4	4	Non-Preferred Brand	110000	
H2012	035	0	1	01	01	H2012_035_0	4	5	Specialty Tier	010010	
H2012	035	0	1	01	01	H2012_035_0	4	2	Non-Preferred Generic	000101	
H2012	035	0	1	01	01	H2012_035_0	4	1	Preferred Generic	001010	2
H2012	035	0	1	01	01	H2012_035_0	4	2	Non-Preferred Generic	000101	2
H2012	037	0	1	01	01	H2012_037_0	4	1	Preferred Generic	001010	
H2012	037	0	1	01	01	H2012_037_0	4	3	Preferred Brand	000101	
H2012	037	0	1	01	01	H2012_037_0	4	4	Non-Preferred Brand	110000	
H2012	037	0	1	01	01	H2012_037_0	4	5	Specialty Tier	010010	
H2012	037	0	1	01	01	H2012_037_0	4	1	Preferred Generic	001010	2
H2012	037	0	1	01	01	H2012_037_0	4	2	Non-Preferred Generic	000101	2
H2012	037	0	1	01	01	H2012_037_0	4	3	Preferred Brand	000101	2
H2012	037	0	1	01	01	H2012_037_0	4	4	Non-Preferred Brand	110000	2
H2012	037	0	1	01	01	H2012_037_0	4	5	Specialty Tier	010010	2
H2012	037	0	1	01	01	H2012_037_0	4	2	Non-Preferred Generic	000101	
H2012	039	0	1	01	01	H2012_039_0	5	1	Preferred Generic	001010	
H2012	039	0	1	01	01	H2012_039_0	5	2	Non-Preferred Generic	000101	
H2012	039	0	1	01	01	H2012_039_0	5	5	Specialty Tier	010010	2
H2012	039	0	1	01	01	H2012_039_0	5	4	Non-Preferred Brand	110000	2
H2012	039	0	1	01	01	H2012_039_0	5	3	Preferred Brand	000101	
H2012	039	0	1	01	01	H2012_039_0	5	2	Non-Preferred Generic	000101	2
H2012	039	0	1	01	01	H2012_039_0	5	1	Preferred Generic	001010	2
H2012	039	0	1	01	01	H2012_039_0	5	5	Specialty Tier	010010	
H2012	039	0	1	01	01	H2012_039_0	5	4	Non-Preferred Brand	110000	
H2012	039	0	1	01	01	H2012_039_0	5	3	Preferred Brand	000101	2
H2012	042	0	1	01	01	H2012_042_0	4	1	Preferred Generic	001010	
H2012	042	0	1	01	01	H2012_042_0	4	2	Non-Preferred Generic	000101	
H2012	042	0	1	01	01	H2012_042_0	4	5	Specialty Tier	010010	
H2012	042	0	1	01	01	H2012_042_0	4	4	Non-Preferred Brand	110000	
H2012	042	0	1	01	01	H2012_042_0	4	3	Preferred Brand	000101	
H2012	051	0	1	01	01	H2012_051_0	4	2	Non-Preferred Generic	000101	2
H2012	051	0	1	01	01	H2012_051_0	4	3	Preferred Brand	000101	2
H2012	051	0	1	01	01	H2012_051_0	4	4	Non-Preferred Brand	110000	2
H2012	051	0	1	01	01	H2012_051_0	4	5	Specialty Tier	010010	2
H2012	051	0	1	01	01	H2012_051_0	4	1	Preferred Generic	001010	
H2012	051	0	1	01	01	H2012_051_0	4	2	Non-Preferred Generic	000101	
H2012	051	0	1	01	01	H2012_051_0	4	3	Preferred Brand	000101	
H2012	051	0	1	01	01	H2012_051_0	4	4	Non-Preferred Brand	110000	
H2012	051	0	1	01	01	H2012_051_0	4	5	Specialty Tier	010010	
H2012	051	0	1	01	01	H2012_051_0	4	1	Preferred Generic	001010	2
H2012	053	0	1	01	01	H2012_053_0	4	2	Non-Preferred Generic	000101	
H2012	053	0	1	01	01	H2012_053_0	4	3	Preferred Brand	000101	
H2012	053	0	1	01	01	H2012_053_0	4	4	Non-Preferred Brand	110000	
H2012	053	0	1	01	01	H2012_053_0	4	5	Specialty Tier	010010	
H2012	053	0	1	01	01	H2012_053_0	4	1	Preferred Generic	001010	
H2012	054	0	1	01	01	H2012_054_0	5	2	Non-Preferred Generic	000101	
H2012	054	0	1	01	01	H2012_054_0	5	3	Preferred Brand	000101	
H2012	054	0	1	01	01	H2012_054_0	5	4	Non-Preferred Brand	110000	
H2012	054	0	1	01	01	H2012_054_0	5	5	Specialty Tier	010010	
H2012	054	0	1	01	01	H2012_054_0	5	1	Preferred Generic	001010	
H2012	055	0	1	01	01	H2012_055_0	7	4	Non-Preferred Brand	110000	2
H2012	055	0	1	01	01	H2012_055_0	7	5	Specialty Tier	010010	2
H2012	055	0	1	01	01	H2012_055_0	7	3	Preferred Brand	000101	2
H2012	055	0	1	01	01	H2012_055_0	7	2	Non-Preferred Generic	000101	2
H2012	055	0	1	01	01	H2012_055_0	7	1	Preferred Generic	001010	2
H2012	055	0	1	01	01	H2012_055_0	7	5	Specialty Tier	010010	
H2012	055	0	1	01	01	H2012_055_0	7	4	Non-Preferred Brand	110000	
H2012	055	0	1	01	01	H2012_055_0	7	3	Preferred Brand	000101	
H2012	055	0	1	01	01	H2012_055_0	7	2	Non-Preferred Generic	000101	
H2012	055	0	1	01	01	H2012_055_0	7	1	Preferred Generic	001010	
H2012	056	0	1	01	01	H2012_056_0	4	5	Specialty Tier	010010	2
H2012	056	0	1	01	01	H2012_056_0	4	4	Non-Preferred Brand	110000	2
H2012	056	0	1	01	01	H2012_056_0	4	1	Preferred Generic	001010	
H2012	056	0	1	01	01	H2012_056_0	4	2	Non-Preferred Generic	000101	
H2012	056	0	1	01	01	H2012_056_0	4	3	Preferred Brand	000101	
H2012	056	0	1	01	01	H2012_056_0	4	4	Non-Preferred Brand	110000	
H2012	056	0	1	01	01	H2012_056_0	4	5	Specialty Tier	010010	
H2012	056	0	1	01	01	H2012_056_0	4	1	Preferred Generic	001010	2
H2012	056	0	1	01	01	H2012_056_0	4	2	Non-Preferred Generic	000101	2
H2012	056	0	1	01	01	H2012_056_0	4	3	Preferred Brand	000101	2
H2012	059	0	1	01	01	H2012_059_0	5	1	Preferred Generic	001010	
H2012	059	0	1	01	01	H2012_059_0	5	4	Non-Preferred Brand	110000	2
H2012	059	0	1	01	01	H2012_059_0	5	3	Preferred Brand	000101	2
H2012	059	0	1	01	01	H2012_059_0	5	2	Non-Preferred Generic	000101	2
H2012	059	0	1	01	01	H2012_059_0	5	5	Specialty Tier	010010	2
H2012	059	0	1	01	01	H2012_059_0	5	5	Specialty Tier	010010	
H2012	059	0	1	01	01	H2012_059_0	5	4	Non-Preferred Brand	110000	
H2012	059	0	1	01	01	H2012_059_0	5	3	Preferred Brand	000101	
H2012	059	0	1	01	01	H2012_059_0	5	2	Non-Preferred Generic	000101	
H2012	059	0	1	01	01	H2012_059_0	5	1	Preferred Generic	001010	2
H2012	060	0	1	01	01	H2012_060_0	3	1	Preferred Generic	001010	
H2012	060	0	1	01	01	H2012_060_0	3	2	Non-Preferred Generic	000101	
H2012	060	0	1	01	01	H2012_060_0	3	3	Preferred Brand	000101	
H2012	060	0	1	01	01	H2012_060_0	3	4	Non-Preferred Brand	110000	
H2012	060	0	1	01	01	H2012_060_0	3	5	Specialty Tier	010010	2
H2012	060	0	1	01	01	H2012_060_0	3	1	Preferred Generic	001010	2
H2012	060	0	1	01	01	H2012_060_0	3	2	Non-Preferred Generic	000101	2
H2012	060	0	1	01	01	H2012_060_0	3	3	Preferred Brand	000101	2
H2012	060	0	1	01	01	H2012_060_0	3	4	Non-Preferred Brand	110000	2
H2012	060	0	1	01	01	H2012_060_0	3	5	Specialty Tier	010010	
H2012	061	0	1	01	01	H2012_061_0	3	1	Preferred Generic	001010	
H2012	061	0	1	01	01	H2012_061_0	3	2	Non-Preferred Generic	000101	
H2012	061	0	1	01	01	H2012_061_0	3	3	Preferred Brand	000101	
H2012	061	0	1	01	01	H2012_061_0	3	4	Non-Preferred Brand	110000	
H2012	061	0	1	01	01	H2012_061_0	3	5	Specialty Tier	010010	
H2012	061	0	1	01	01	H2012_061_0	3	1	Preferred Generic	001010	2
H2012	061	0	1	01	01	H2012_061_0	3	2	Non-Preferred Generic	000101	2
H2012	061	0	1	01	01	H2012_061_0	3	3	Preferred Brand	000101	2
H2012	061	0	1	01	01	H2012_061_0	3	4	Non-Preferred Brand	110000	2
H2012	061	0	1	01	01	H2012_061_0	3	5	Specialty Tier	010010	2
H2012	062	0	1	01	01	H2012_062_0	5	2	Non-Preferred Generic	000101	
H2012	062	0	1	01	01	H2012_062_0	5	1	Preferred Generic	001010	
H2012	062	0	1	01	01	H2012_062_0	5	3	Preferred Brand	000101	
H2012	062	0	1	01	01	H2012_062_0	5	4	Non-Preferred Brand	110000	
H2012	062	0	1	01	01	H2012_062_0	5	5	Specialty Tier	010010	
H2012	063	0	1	01	01	H2012_063_0	4	2	Non-Preferred Generic	000101	
H2012	063	0	1	01	01	H2012_063_0	4	1	Preferred Generic	001010	
H2012	063	0	1	01	01	H2012_063_0	4	3	Preferred Brand	000101	
H2012	063	0	1	01	01	H2012_063_0	4	5	Specialty Tier	010010	
H2012	063	0	1	01	01	H2012_063_0	4	4	Non-Preferred Brand	110000	
H2012	064	0	1	01	01	H2012_064_0	5	1	Preferred Generic	001010	
H2012	064	0	1	01	01	H2012_064_0	5	2	Non-Preferred Generic	000101	
H2012	064	0	1	01	01	H2012_064_0	5	4	Non-Preferred Brand	110000	
H2012	064	0	1	01	01	H2012_064_0	5	3	Preferred Brand	000101	
H2012	064	0	1	01	01	H2012_064_0	5	5	Specialty Tier	010010	
H2012	070	0	1	01	01	H2012_070_0	4	1	Preferred Generic	001010	
H2012	070	0	1	01	01	H2012_070_0	4	2	Non-Preferred Generic	000101	
H2012	070	0	1	01	01	H2012_070_0	4	5	Specialty Tier	010010	
H2012	070	0	1	01	01	H2012_070_0	4	4	Non-Preferred Brand	110000	
H2012	070	0	1	01	01	H2012_070_0	4	3	Preferred Brand	000101	
H2012	080	0	1	01	01	H2012_080_0	4	4	Non-Preferred Brand	110000	
H2012	080	0	1	01	01	H2012_080_0	4	1	Preferred Generic	001010	2
H2012	080	0	1	01	01	H2012_080_0	4	2	Non-Preferred Generic	000101	2
H2012	080	0	1	01	01	H2012_080_0	4	3	Preferred Brand	000101	2
H2012	080	0	1	01	01	H2012_080_0	4	4	Non-Preferred Brand	110000	2
H2012	080	0	1	01	01	H2012_080_0	4	5	Specialty Tier	010010	2
H2012	080	0	1	01	01	H2012_080_0	4	5	Specialty Tier	010010	
H2012	080	0	1	01	01	H2012_080_0	4	1	Preferred Generic	001010	
H2012	080	0	1	01	01	H2012_080_0	4	2	Non-Preferred Generic	000101	
H2012	080	0	1	01	01	H2012_080_0	4	3	Preferred Brand	000101	
H2012	082	0	1	01	01	H2012_082_0	4	2	Non-Preferred Generic	000101	2
H2012	082	0	1	01	01	H2012_082_0	4	1	Preferred Generic	001010	2
H2012	082	0	1	01	01	H2012_082_0	4	5	Specialty Tier	010010	2
H2012	082	0	1	01	01	H2012_082_0	4	4	Non-Preferred Brand	110000	2
H2012	082	0	1	01	01	H2012_082_0	4	3	Preferred Brand	000101	2
H2012	082	0	1	01	01	H2012_082_0	4	1	Preferred Generic	001010	
H2012	082	0	1	01	01	H2012_082_0	4	2	Non-Preferred Generic	000101	
H2012	082	0	1	01	01	H2012_082_0	4	3	Preferred Brand	000101	
H2012	082	0	1	01	01	H2012_082_0	4	4	Non-Preferred Brand	110000	
H2012	082	0	1	01	01	H2012_082_0	4	5	Specialty Tier	010010	
H2012	084	0	1	01	01	H2012_084_0	4	1	Preferred Generic	001010	
H2012	084	0	1	01	01	H2012_084_0	4	4	Non-Preferred Brand	110000	2
H2012	084	0	1	01	01	H2012_084_0	4	3	Preferred Brand	000101	2
H2012	084	0	1	01	01	H2012_084_0	4	2	Non-Preferred Generic	000101	2
H2012	084	0	1	01	01	H2012_084_0	4	5	Specialty Tier	010010	2
H2012	084	0	1	01	01	H2012_084_0	4	5	Specialty Tier	010010	
H2012	084	0	1	01	01	H2012_084_0	4	4	Non-Preferred Brand	110000	
H2012	084	0	1	01	01	H2012_084_0	4	3	Preferred Brand	000101	
H2012	084	0	1	01	01	H2012_084_0	4	2	Non-Preferred Generic	000101	
H2012	084	0	1	01	01	H2012_084_0	4	1	Preferred Generic	001010	2
H2012	085	0	1	01	01	H2012_085_0	5	2	Non-Preferred Generic	000101	2
H2012	085	0	1	01	01	H2012_085_0	5	1	Preferred Generic	001010	2
H2012	085	0	1	01	01	H2012_085_0	5	5	Specialty Tier	010010	
H2012	085	0	1	01	01	H2012_085_0	5	4	Non-Preferred Brand	110000	
H2012	085	0	1	01	01	H2012_085_0	5	3	Preferred Brand	000101	
H2012	085	0	1	01	01	H2012_085_0	5	2	Non-Preferred Generic	000101	
H2012	085	0	1	01	01	H2012_085_0	5	1	Preferred Generic	001010	
H2012	085	0	1	01	01	H2012_085_0	5	3	Preferred Brand	000101	2
H2012	085	0	1	01	01	H2012_085_0	5	5	Specialty Tier	010010	2
H2012	085	0	1	01	01	H2012_085_0	5	4	Non-Preferred Brand	110000	2
H2012	087	0	1	01	01	H2012_087_0	6	2	Non-Preferred Generic	000101	
H2012	087	0	1	01	01	H2012_087_0	6	1	Preferred Generic	001010	
H2012	087	0	1	01	01	H2012_087_0	6	5	Specialty Tier	010010	
H2012	087	0	1	01	01	H2012_087_0	6	4	Non-Preferred Brand	110000	
H2012	087	0	1	01	01	H2012_087_0	6	3	Preferred Brand	000101	
H2012	088	0	1	01	01	H2012_088_0	4	1	Preferred Generic	001010	2
H2012	088	0	1	01	01	H2012_088_0	4	2	Non-Preferred Generic	000101	2
H2012	088	0	1	01	01	H2012_088_0	4	5	Specialty Tier	010010	
H2012	088	0	1	01	01	H2012_088_0	4	4	Non-Preferred Brand	110000	
H2012	088	0	1	01	01	H2012_088_0	4	3	Preferred Brand	000101	
H2012	088	0	1	01	01	H2012_088_0	4	2	Non-Preferred Generic	000101	
H2012	088	0	1	01	01	H2012_088_0	4	1	Preferred Generic	001010	
H2012	088	0	1	01	01	H2012_088_0	4	3	Preferred Brand	000101	2
H2012	088	0	1	01	01	H2012_088_0	4	5	Specialty Tier	010010	2
H2012	088	0	1	01	01	H2012_088_0	4	4	Non-Preferred Brand	110000	2
H2012	089	0	1	01	01	H2012_089_0	4	1	Preferred Generic	001010	
H2012	089	0	1	01	01	H2012_089_0	4	2	Non-Preferred Generic	000101	
H2012	089	0	1	01	01	H2012_089_0	4	3	Preferred Brand	000101	
H2012	089	0	1	01	01	H2012_089_0	4	4	Non-Preferred Brand	110000	
H2012	089	0	1	01	01	H2012_089_0	4	5	Specialty Tier	010010	2
H2012	089	0	1	01	01	H2012_089_0	4	1	Preferred Generic	001010	2
H2012	089	0	1	01	01	H2012_089_0	4	2	Non-Preferred Generic	000101	2
H2012	089	0	1	01	01	H2012_089_0	4	3	Preferred Brand	000101	2
H2012	089	0	1	01	01	H2012_089_0	4	4	Non-Preferred Brand	110000	2
H2012	089	0	1	01	01	H2012_089_0	4	5	Specialty Tier	010010	
H2012	090	0	1	01	01	H2012_090_0	4	3	Preferred Brand	000101	
H2012	090	0	1	01	01	H2012_090_0	4	4	Non-Preferred Brand	110000	
H2012	090	0	1	01	01	H2012_090_0	4	5	Specialty Tier	010010	
H2012	090	0	1	01	01	H2012_090_0	4	1	Preferred Generic	001010	2
H2012	090	0	1	01	01	H2012_090_0	4	2	Non-Preferred Generic	000101	2
H2012	090	0	1	01	01	H2012_090_0	4	3	Preferred Brand	000101	2
H2012	090	0	1	01	01	H2012_090_0	4	4	Non-Preferred Brand	110000	2
H2012	090	0	1	01	01	H2012_090_0	4	5	Specialty Tier	010010	2
H2012	090	0	1	01	01	H2012_090_0	4	1	Preferred Generic	001010	
H2012	090	0	1	01	01	H2012_090_0	4	2	Non-Preferred Generic	000101	
H2012	091	0	1	01	01	H2012_091_0	4	1	Preferred Generic	001010	
H2012	091	0	1	01	01	H2012_091_0	4	2	Non-Preferred Generic	000101	
H2012	091	0	1	01	01	H2012_091_0	4	3	Preferred Brand	000101	
H2012	091	0	1	01	01	H2012_091_0	4	4	Non-Preferred Brand	110000	
H2012	091	0	1	01	01	H2012_091_0	4	5	Specialty Tier	010010	2
H2012	091	0	1	01	01	H2012_091_0	4	1	Preferred Generic	001010	2
H2012	091	0	1	01	01	H2012_091_0	4	2	Non-Preferred Generic	000101	2
H2012	091	0	1	01	01	H2012_091_0	4	3	Preferred Brand	000101	2
H2012	091	0	1	01	01	H2012_091_0	4	4	Non-Preferred Brand	110000	2
H2012	091	0	1	01	01	H2012_091_0	4	5	Specialty Tier	010010	
H2012	092	0	1	01	01	H2012_092_0	6	2	Non-Preferred Generic	000101	
H2012	092	0	1	01	01	H2012_092_0	6	1	Preferred Generic	001010	
H2012	092	0	1	01	01	H2012_092_0	6	3	Preferred Brand	000101	
H2012	092	0	1	01	01	H2012_092_0	6	5	Specialty Tier	010010	
H2012	092	0	1	01	01	H2012_092_0	6	4	Non-Preferred Brand	110000	
H2012	093	0	1	01	01	H2012_093_0	4	1	Preferred Generic	001010	
H2012	093	0	1	01	01	H2012_093_0	4	2	Non-Preferred Generic	000101	
H2012	093	0	1	01	01	H2012_093_0	4	3	Preferred Brand	000101	
H2012	093	0	1	01	01	H2012_093_0	4	4	Non-Preferred Brand	110000	
H2012	093	0	1	01	01	H2012_093_0	4	5	Specialty Tier	010010	
H2012	094	0	1	01	01	H2012_094_0	4	1	Preferred Generic	001010	
H2012	094	0	1	01	01	H2012_094_0	4	2	Non-Preferred Generic	000101	
H2012	094	0	1	01	01	H2012_094_0	4	4	Non-Preferred Brand	110000	
H2012	094	0	1	01	01	H2012_094_0	4	3	Preferred Brand	000101	
H2012	094	0	1	01	01	H2012_094_0	4	5	Specialty Tier	010010	
H2012	096	0	1	01	01	H2012_096_0	8	2	Non-Preferred Generic	000101	
H2012	096	0	1	01	01	H2012_096_0	8	1	Preferred Generic	001010	
H2012	096	0	1	01	01	H2012_096_0	8	3	Preferred Brand	000101	
H2012	096	0	1	01	01	H2012_096_0	8	5	Specialty Tier	010010	2
H2012	096	0	1	01	01	H2012_096_0	8	4	Non-Preferred Brand	110000	2
H2012	096	0	1	01	01	H2012_096_0	8	3	Preferred Brand	000101	2
H2012	096	0	1	01	01	H2012_096_0	8	2	Non-Preferred Generic	000101	2
H2012	096	0	1	01	01	H2012_096_0	8	1	Preferred Generic	001010	2
H2012	096	0	1	01	01	H2012_096_0	8	5	Specialty Tier	010010	
H2012	096	0	1	01	01	H2012_096_0	8	4	Non-Preferred Brand	110000	
H2012	097	0	1	01	01	H2012_097_0	4	1	Preferred Generic	001010	
H2012	097	0	1	01	01	H2012_097_0	4	2	Non-Preferred Generic	000101	
H2012	097	0	1	01	01	H2012_097_0	4	5	Specialty Tier	010010	2
H2012	097	0	1	01	01	H2012_097_0	4	4	Non-Preferred Brand	110000	2
H2012	097	0	1	01	01	H2012_097_0	4	3	Preferred Brand	000101	2
H2012	097	0	1	01	01	H2012_097_0	4	2	Non-Preferred Generic	000101	2
H2012	097	0	1	01	01	H2012_097_0	4	1	Preferred Generic	001010	2
H2012	097	0	1	01	01	H2012_097_0	4	5	Specialty Tier	010010	
H2012	097	0	1	01	01	H2012_097_0	4	4	Non-Preferred Brand	110000	
H2012	097	0	1	01	01	H2012_097_0	4	3	Preferred Brand	000101	
H2012	098	0	1	01	01	H2012_098_0	4	1	Preferred Generic	001010	
H2012	098	0	1	01	01	H2012_098_0	4	3	Preferred Brand	000101	
H2012	098	0	1	01	01	H2012_098_0	4	4	Non-Preferred Brand	110000	
H2012	098	0	1	01	01	H2012_098_0	4	5	Specialty Tier	010010	
H2012	098	0	1	01	01	H2012_098_0	4	5	Specialty Tier	010010	2
H2012	098	0	1	01	01	H2012_098_0	4	2	Non-Preferred Generic	000101	2
H2012	098	0	1	01	01	H2012_098_0	4	3	Preferred Brand	000101	2
H2012	098	0	1	01	01	H2012_098_0	4	4	Non-Preferred Brand	110000	2
H2012	098	0	1	01	01	H2012_098_0	4	2	Non-Preferred Generic	000101	
H2012	098	0	1	01	01	H2012_098_0	4	1	Preferred Generic	001010	2
H2029	001	0	1	04	01	H2029_001_0	3	1	Preferred Generic	001010	
H2029	001	0	1	04	01	H2029_001_0	3	2	Non-Preferred Generic	000101	
H2029	001	0	1	04	01	H2029_001_0	3	5	Specialty Tier	010010	2
H2029	001	0	1	04	01	H2029_001_0	3	4	Non-Preferred Brand	110000	2
H2029	001	0	1	04	01	H2029_001_0	3	3	Preferred Brand	000101	2
H2029	001	0	1	04	01	H2029_001_0	3	2	Non-Preferred Generic	000101	2
H2029	001	0	1	04	01	H2029_001_0	3	1	Preferred Generic	001010	2
H2029	001	0	1	04	01	H2029_001_0	3	5	Specialty Tier	010010	
H2029	001	0	1	04	01	H2029_001_0	3	4	Non-Preferred Brand	110000	
H2029	001	0	1	04	01	H2029_001_0	3	3	Preferred Brand	000101	
H2029	002	0	1	04	01	H2029_002_0	4	1	Preferred Generic	001010	
H2029	002	0	1	04	01	H2029_002_0	4	4	Non-Preferred Brand	110000	2
H2029	002	0	1	04	01	H2029_002_0	4	3	Preferred Brand	000101	2
H2029	002	0	1	04	01	H2029_002_0	4	2	Non-Preferred Generic	000101	2
H2029	002	0	1	04	01	H2029_002_0	4	5	Specialty Tier	010010	2
H2029	002	0	1	04	01	H2029_002_0	4	5	Specialty Tier	010010	
H2029	002	0	1	04	01	H2029_002_0	4	4	Non-Preferred Brand	110000	
H2029	002	0	1	04	01	H2029_002_0	4	3	Preferred Brand	000101	
H2029	002	0	1	04	01	H2029_002_0	4	2	Non-Preferred Generic	000101	
H2029	002	0	1	04	01	H2029_002_0	4	1	Preferred Generic	001010	2
H2108	022	0	1	01	01	H2108_022_0	4	2	Non-Preferred Generic	000100	
H2108	022	0	1	01	01	H2108_022_0	4	1	Preferred Generic	001000	
H2108	022	0	1	01	01	H2108_022_0	4	5	Specialty Tier	010010	
H2108	022	0	1	01	01	H2108_022_0	4	4	Non-Preferred Brand	100100	
H2108	022	0	1	01	01	H2108_022_0	4	3	Preferred Brand	000001	
H2108	028	0	1	01	01	H2108_028_0	3	2	Non-Preferred Generic	000100	
H2108	028	0	1	01	01	H2108_028_0	3	1	Preferred Generic	001000	
H2108	028	0	1	01	01	H2108_028_0	3	4	Non-Preferred Brand	100100	
H2108	028	0	1	01	01	H2108_028_0	3	3	Preferred Brand	000001	
H2108	028	0	1	01	01	H2108_028_0	3	5	Specialty Tier	010010	
H2108	029	0	1	01	01	H2108_029_0	3	1	Preferred Generic	001000	
H2108	029	0	1	01	01	H2108_029_0	3	6	Select Diabetic Drugs	010010	
H2108	029	0	1	01	01	H2108_029_0	3	5	Specialty Tier	010010	
H2108	029	0	1	01	01	H2108_029_0	3	4	Non-Preferred Brand	100100	
H2108	029	0	1	01	01	H2108_029_0	3	3	Preferred Brand	000001	
H2108	029	0	1	01	01	H2108_029_0	3	2	Non-Preferred Generic	000100	
H2108	030	0	1	01	01	H2108_030_0	3	4	Non-Preferred Brand	100100	
H2108	030	0	1	01	01	H2108_030_0	3	5	Specialty Tier	010010	
H2108	030	0	1	01	01	H2108_030_0	3	6	Select Diabetic Drugs	010010	
H2108	030	0	1	01	01	H2108_030_0	3	1	Preferred Generic	001000	
H2108	030	0	1	01	01	H2108_030_0	3	3	Preferred Brand	000001	
H2108	030	0	1	01	01	H2108_030_0	3	2	Non-Preferred Generic	000100	
H2112	007	0	1	01	01	H2112_007_0	5	5	Select Care Drugs	010000	
H2112	007	0	1	01	01	H2112_007_0	5	4	Specialty Tier	010010	
H2112	007	0	1	01	01	H2112_007_0	5	3	Non-Preferred Brand	110000	
H2112	007	0	1	01	01	H2112_007_0	5	2	Preferred Brand	010001	
H2112	007	0	1	01	01	H2112_007_0	5	1	Generic	010000	
H2112	007	0	1	01	01	H2112_007_0	5	5	Select Care Drugs	010000	1
H2150	002	0	1	18	06	H2150_002_0	4	6	Vaccines	000001	1
H2150	002	0	1	18	06	H2150_002_0	4	2	Non-Preferred Generic	000100	1
H2150	002	0	1	18	06	H2150_002_0	4	1	Preferred Generic	001000	1
H2150	002	0	1	18	06	H2150_002_0	4	6	Vaccines	000001	
H2150	002	0	1	18	06	H2150_002_0	4	5	Specialty Tier	100001	
H2150	002	0	1	18	06	H2150_002_0	4	4	Non-Preferred Brand	100000	
H2150	002	0	1	18	06	H2150_002_0	4	3	Preferred Brand	000001	
H2150	002	0	1	18	06	H2150_002_0	4	1	Preferred Generic	001000	
H2150	002	0	1	18	06	H2150_002_0	4	2	Non-Preferred Generic	000100	
H2150	009	0	1	18	06	H2150_009_0	4	3	Preferred Brand	000001	
H2150	009	0	1	18	06	H2150_009_0	4	2	Non-Preferred Generic	000100	
H2150	009	0	1	18	06	H2150_009_0	4	1	Preferred Generic	001000	
H2150	009	0	1	18	06	H2150_009_0	4	6	Vaccines	000001	
H2150	009	0	1	18	06	H2150_009_0	4	5	Specialty Tier	100001	
H2150	009	0	1	18	06	H2150_009_0	4	4	Non-Preferred Brand	100000	
H2150	029	0	2	18	06	H2150_029_0	4	6	Vaccines	000001	
H2150	029	0	2	18	06	H2150_029_0	4	1	Preferred Generic	001000	
H2150	029	0	2	18	06	H2150_029_0	4	2	Non-Preferred Generic	000100	
H2150	029	0	2	18	06	H2150_029_0	4	3	Preferred Brand	000001	
H2150	029	0	2	18	06	H2150_029_0	4	4	Non-Preferred Brand	100000	
H2150	029	0	2	18	06	H2150_029_0	4	5	Specialty Tier	100001	
H2161	002	0	1	01	01	H2161_002_0	9	1	Preferred Generic	001000	
H2161	002	0	1	01	01	H2161_002_0	9	5	Specialty Tier	101101	
H2161	002	0	1	01	01	H2161_002_0	9	4	Non-Preferred Brand	100000	
H2161	002	0	1	01	01	H2161_002_0	9	3	Preferred Brand	000001	
H2161	002	0	1	01	01	H2161_002_0	9	2	Non-Preferred Generic	000100	
H2165	005	0	1	01	01	H2165_005_0	4	1	Preferred Generic	001000	
H2165	005	0	1	01	01	H2165_005_0	4	2	Non-Preferred Generic	000100	
H2165	005	0	1	01	01	H2165_005_0	4	4	Non-Preferred Brand	100100	
H2165	005	0	1	01	01	H2165_005_0	4	5	Specialty Tier	010010	
H2165	005	0	1	01	01	H2165_005_0	4	1	Preferred Generic	001000	1
H2165	005	0	1	01	01	H2165_005_0	4	2	Non-Preferred Generic	000100	1
H2165	005	0	1	01	01	H2165_005_0	4	3	Preferred Brand	000001	
H2165	011	0	1	02	01	H2165_011_0	5	1	Preferred Generic	001000	
H2165	011	0	1	02	01	H2165_011_0	5	3	Preferred Brand	000001	
H2165	011	0	1	02	01	H2165_011_0	5	4	Non-Preferred Brand	100100	
H2165	011	0	1	02	01	H2165_011_0	5	5	Specialty Tier	010010	
H2165	011	0	1	02	01	H2165_011_0	5	2	Non-Preferred Generic	000100	
H2165	011	0	1	02	01	H2165_011_0	5	2	Non-Preferred Generic	000100	1
H2165	011	0	1	02	01	H2165_011_0	5	1	Preferred Generic	001000	1
H2165	018	0	1	01	01	H2165_018_0	3	4	Non-Preferred Brand	100100	
H2165	018	0	1	01	01	H2165_018_0	3	5	Specialty Tier	010010	
H2165	018	0	1	01	01	H2165_018_0	3	3	Preferred Brand	000001	
H2165	018	0	1	01	01	H2165_018_0	3	2	Non-Preferred Generic	000100	
H2165	018	0	1	01	01	H2165_018_0	3	1	Preferred Generic	001000	
H2174	008	0	1	01	01	H2174_008_0	5	1	Preferred Generic	001000	
H2174	008	0	1	01	01	H2174_008_0	5	2	Non-Preferred Generic	000100	
H2174	008	0	1	01	01	H2174_008_0	5	3	Preferred Brand	000001	
H2174	008	0	1	01	01	H2174_008_0	5	4	Non-Preferred Brand	100000	
H2174	008	0	1	01	01	H2174_008_0	5	5	Specialty Tier	010010	
H2224	001	0	1	01	01	H2224_001_0	8	1	Preferred Generic	001000	
H2224	001	0	1	01	01	H2224_001_0	8	2	Preferred Brand	000001	
H2224	001	0	1	01	01	H2224_001_0	8	3	Specialty Tier	001001	
H2224	001	0	1	01	01	H2224_001_0	8	1	Preferred Generic	001000	2
H2224	003	0	1	01	01	H2224_003_0	10	1	Preferred Generic	001000	
H2224	003	0	1	01	01	H2224_003_0	10	2	Preferred Brand	000001	
H2224	003	0	1	01	01	H2224_003_0	10	3	Specialty Tier	001001	
H2224	003	0	1	01	01	H2224_003_0	10	1	Preferred Generic	001000	2
H2230	002	0	1	04	01	H2230_002_0	9	1	Preferred Generic	001000	
H2230	002	0	1	04	01	H2230_002_0	9	2	Non-Preferred Generic	000100	
H2230	002	0	1	04	01	H2230_002_0	9	3	Preferred Brand	000001	
H2230	002	0	1	04	01	H2230_002_0	9	4	Non-Preferred Brand	100000	
H2230	002	0	1	04	01	H2230_002_0	9	5	Specialty Tier	101101	
H2230	016	0	1	04	01	H2230_016_0	8	1	Preferred Generic	001000	
H2230	016	0	1	04	01	H2230_016_0	8	2	Non-Preferred Generic	000100	
H2230	016	0	1	04	01	H2230_016_0	8	3	Preferred Brand	000001	
H2230	016	0	1	04	01	H2230_016_0	8	4	Non-Preferred Brand	100000	
H2230	016	0	1	04	01	H2230_016_0	8	5	Specialty Tier	101101	
H2230	017	0	1	04	01	H2230_017_0	10	1	Preferred Generic	001000	
H2230	017	0	1	04	01	H2230_017_0	10	5	Specialty Tier	101101	
H2230	017	0	1	04	01	H2230_017_0	10	4	Non-Preferred Brand	100000	
H2230	017	0	1	04	01	H2230_017_0	10	3	Preferred Brand	000001	
H2230	017	0	1	04	01	H2230_017_0	10	2	Non-Preferred Generic	000100	
H2237	001	0	1	01	01	H2237_001_0	10	1	Generic	010000	
H2237	001	0	1	01	01	H2237_001_0	10	3	Specialty Tier	010010	
H2237	001	0	1	01	01	H2237_001_0	10	2	Brand	000010	
H2237	007	0	1	01	01	H2237_007_0	9	2	Brand	000010	
H2237	007	0	1	01	01	H2237_007_0	9	1	Generic	010000	
H2237	007	0	1	01	01	H2237_007_0	9	3	Specialty Tier	010010	
H2241	001	0	1	01	01	H2241_001_0	8	1	Preferred Generic	001000	
H2241	001	0	1	01	01	H2241_001_0	8	2	Preferred Brand	010001	
H2241	001	0	1	01	01	H2241_001_0	8	1	Preferred Generic	001000	1
H2241	001	0	1	01	01	H2241_001_0	8	4	Specialty Tier	010010	
H2241	001	0	1	01	01	H2241_001_0	8	3	Non-Preferred Brand	100100	
H2256	001	1	1	01	01	H2256_001_1	5	5	Specialty Tier	010010	
H2256	001	1	1	01	01	H2256_001_1	5	1	Preferred Generic	001000	
H2256	001	1	1	01	01	H2256_001_1	5	2	Non-Preferred Generic	000100	
H2256	001	1	1	01	01	H2256_001_1	5	3	Preferred Brand	000101	
H2256	001	1	1	01	01	H2256_001_1	5	4	Non-Preferred Brand	100000	
H2256	001	1	1	01	01	H2256_001_1	5	1	Preferred Generic	001000	1
H2256	001	1	1	01	01	H2256_001_1	5	2	Non-Preferred Generic	000100	1
H2256	001	2	1	01	01	H2256_001_2	5	5	Specialty Tier	010010	
H2256	001	2	1	01	01	H2256_001_2	5	4	Non-Preferred Brand	100000	
H2256	001	2	1	01	01	H2256_001_2	5	3	Preferred Brand	000101	
H2256	001	2	1	01	01	H2256_001_2	5	2	Non-Preferred Generic	000100	
H2256	001	2	1	01	01	H2256_001_2	5	1	Preferred Generic	001000	
H2256	001	2	1	01	01	H2256_001_2	5	1	Preferred Generic	001000	1
H2256	001	2	1	01	01	H2256_001_2	5	2	Non-Preferred Generic	000100	1
H2256	001	6	1	01	01	H2256_001_6	5	1	Preferred Generic	001000	
H2256	001	6	1	01	01	H2256_001_6	5	2	Non-Preferred Generic	000100	
H2256	001	6	1	01	01	H2256_001_6	5	3	Preferred Brand	000101	
H2256	001	6	1	01	01	H2256_001_6	5	4	Non-Preferred Brand	100000	
H2256	001	6	1	01	01	H2256_001_6	5	5	Specialty Tier	010010	
H2256	001	6	1	01	01	H2256_001_6	5	1	Preferred Generic	001000	1
H2256	001	6	1	01	01	H2256_001_6	5	2	Non-Preferred Generic	000100	1
H2256	015	1	1	01	01	H2256_015_1	5	1	Preferred Generic	001000	
H2256	015	1	1	01	01	H2256_015_1	5	2	Non-Preferred Generic	000100	
H2256	015	1	1	01	01	H2256_015_1	5	3	Preferred Brand	000101	
H2256	015	1	1	01	01	H2256_015_1	5	4	Non-Preferred Brand	100000	
H2256	015	1	1	01	01	H2256_015_1	5	5	Specialty Tier	010010	
H2256	015	2	1	01	01	H2256_015_2	5	4	Non-Preferred Brand	100000	
H2256	015	2	1	01	01	H2256_015_2	5	3	Preferred Brand	000101	
H2256	015	2	1	01	01	H2256_015_2	5	2	Non-Preferred Generic	000100	
H2256	015	2	1	01	01	H2256_015_2	5	1	Preferred Generic	001000	
H2256	015	2	1	01	01	H2256_015_2	5	5	Specialty Tier	010010	
H2256	015	6	1	01	01	H2256_015_6	5	4	Non-Preferred Brand	100000	
H2256	015	6	1	01	01	H2256_015_6	5	3	Preferred Brand	000101	
H2256	015	6	1	01	01	H2256_015_6	5	2	Non-Preferred Generic	000100	
H2256	015	6	1	01	01	H2256_015_6	5	1	Preferred Generic	001000	
H2256	015	6	1	01	01	H2256_015_6	5	5	Specialty Tier	010010	
H2256	018	1	1	01	01	H2256_018_1	5	1	Preferred Generic	001000	
H2256	018	1	1	01	01	H2256_018_1	5	2	Non-Preferred Generic	000100	
H2256	018	1	1	01	01	H2256_018_1	5	3	Preferred Brand	000101	
H2256	018	1	1	01	01	H2256_018_1	5	4	Non-Preferred Brand	100000	
H2256	018	1	1	01	01	H2256_018_1	5	5	Specialty Tier	010010	
H2256	018	7	1	01	01	H2256_018_7	5	4	Non-Preferred Brand	100000	
H2256	018	7	1	01	01	H2256_018_7	5	3	Preferred Brand	000101	
H2256	018	7	1	01	01	H2256_018_7	5	2	Non-Preferred Generic	000100	
H2256	018	7	1	01	01	H2256_018_7	5	1	Preferred Generic	001000	
H2256	018	7	1	01	01	H2256_018_7	5	5	Specialty Tier	010010	
H2256	018	8	1	01	01	H2256_018_8	5	2	Non-Preferred Generic	000100	
H2256	018	8	1	01	01	H2256_018_8	5	1	Preferred Generic	001000	
H2256	018	8	1	01	01	H2256_018_8	5	3	Preferred Brand	000101	
H2256	018	8	1	01	01	H2256_018_8	5	4	Non-Preferred Brand	100000	
H2256	018	8	1	01	01	H2256_018_8	5	5	Specialty Tier	010010	
H2256	026	1	1	01	01	H2256_026_1	5	2	Non-Preferred Generic	000100	
H2256	026	1	1	01	01	H2256_026_1	5	1	Preferred Generic	001000	
H2256	026	1	1	01	01	H2256_026_1	5	3	Preferred Brand	000101	
H2256	026	1	1	01	01	H2256_026_1	5	5	Specialty Tier	010010	
H2256	026	1	1	01	01	H2256_026_1	5	4	Non-Preferred Brand	100000	
H2256	026	2	1	01	01	H2256_026_2	5	1	Preferred Generic	001000	
H2256	026	2	1	01	01	H2256_026_2	5	2	Non-Preferred Generic	000100	
H2256	026	2	1	01	01	H2256_026_2	5	4	Non-Preferred Brand	100000	
H2256	026	2	1	01	01	H2256_026_2	5	3	Preferred Brand	000101	
H2256	026	2	1	01	01	H2256_026_2	5	5	Specialty Tier	010010	
H2256	026	3	1	01	01	H2256_026_3	5	4	Non-Preferred Brand	100000	
H2256	026	3	1	01	01	H2256_026_3	5	5	Specialty Tier	010010	
H2256	026	3	1	01	01	H2256_026_3	5	1	Preferred Generic	001000	
H2256	026	3	1	01	01	H2256_026_3	5	2	Non-Preferred Generic	000100	
H2256	026	3	1	01	01	H2256_026_3	5	3	Preferred Brand	000101	
H2256	028	0	1	01	01	H2256_028_0	4	2	Non-Preferred Generic	000100	
H2256	028	0	1	01	01	H2256_028_0	4	1	Preferred Generic	001000	
H2256	028	0	1	01	01	H2256_028_0	4	3	Preferred Brand	000101	
H2256	028	0	1	01	01	H2256_028_0	4	4	Non-Preferred Brand	100000	
H2256	028	0	1	01	01	H2256_028_0	4	5	Specialty Tier	010010	
H2256	033	0	1	01	01	H2256_033_0	4	2	Non-Preferred Generic	000100	
H2256	033	0	1	01	01	H2256_033_0	4	1	Preferred Generic	001000	
H2256	033	0	1	01	01	H2256_033_0	4	3	Preferred Brand	000101	
H2256	033	0	1	01	01	H2256_033_0	4	5	Specialty Tier	010010	
H2256	033	0	1	01	01	H2256_033_0	4	4	Non-Preferred Brand	100000	
H2256	034	0	1	01	01	H2256_034_0	4	1	Preferred Generic	001000	
H2256	034	0	1	01	01	H2256_034_0	4	2	Non-Preferred Generic	000100	
H2256	034	0	1	01	01	H2256_034_0	4	4	Non-Preferred Brand	100000	
H2256	034	0	1	01	01	H2256_034_0	4	3	Preferred Brand	000101	
H2256	034	0	1	01	01	H2256_034_0	4	5	Specialty Tier	010010	
H2256	036	0	1	01	01	H2256_036_0	4	1	Preferred Generic	001000	
H2256	036	0	1	01	01	H2256_036_0	4	2	Non-Preferred Generic	000100	
H2256	036	0	1	01	01	H2256_036_0	4	3	Preferred Brand	000101	
H2256	036	0	1	01	01	H2256_036_0	4	4	Non-Preferred Brand	100000	
H2256	036	0	1	01	01	H2256_036_0	4	5	Specialty Tier	010010	
H2261	005	0	1	01	01	H2261_005_0	9	3	Preferred Brand	000001	
H2261	005	0	1	01	01	H2261_005_0	9	5	Specialty Tier	101101	
H2261	005	0	1	01	01	H2261_005_0	9	4	Non-Preferred Brand	100000	
H2261	005	0	1	01	01	H2261_005_0	9	2	Non-Preferred Generic	000100	
H2261	005	0	1	01	01	H2261_005_0	9	1	Preferred Generic	001000	
H2261	019	0	1	01	01	H2261_019_0	10	3	Preferred Brand	000001	
H2261	019	0	1	01	01	H2261_019_0	10	2	Non-Preferred Generic	000100	
H2261	019	0	1	01	01	H2261_019_0	10	1	Preferred Generic	001000	
H2261	019	0	1	01	01	H2261_019_0	10	5	Specialty Tier	101101	
H2261	019	0	1	01	01	H2261_019_0	10	4	Non-Preferred Brand	100000	
H2312	004	0	1	01	01	H2312_004_0	7	1	Preferred Generic	001000	
H2312	004	0	1	01	01	H2312_004_0	7	2	Non-Preferred Generic	000100	
H2312	004	0	1	01	01	H2312_004_0	7	5	Specialty Tier	000010	
H2312	004	0	1	01	01	H2312_004_0	7	4	Non-Preferred Brand	100000	
H2312	004	0	1	01	01	H2312_004_0	7	3	Preferred Brand	000001	
H2312	007	0	1	02	01	H2312_007_0	9	4	Non-Preferred Brand	100000	
H2312	007	0	1	02	01	H2312_007_0	9	3	Preferred Brand	000001	
H2312	007	0	1	02	01	H2312_007_0	9	5	Specialty Tier	000010	
H2312	007	0	1	02	01	H2312_007_0	9	2	Non-Preferred Generic	000100	
H2312	007	0	1	02	01	H2312_007_0	9	1	Preferred Generic	001000	
H2312	010	0	1	02	01	H2312_010_0	10	2	Non-Preferred Generic	000100	1
H2312	010	0	1	02	01	H2312_010_0	10	1	Preferred Generic	001000	1
H2312	010	0	1	02	01	H2312_010_0	10	1	Preferred Generic	001000	
H2312	010	0	1	02	01	H2312_010_0	10	2	Non-Preferred Generic	000100	
H2312	010	0	1	02	01	H2312_010_0	10	5	Specialty Tier	000010	
H2312	010	0	1	02	01	H2312_010_0	10	4	Non-Preferred Brand	100000	
H2312	010	0	1	02	01	H2312_010_0	10	3	Preferred Brand	000001	
H2312	012	0	1	02	01	H2312_012_0	7	5	Specialty Tier	000010	
H2312	012	0	1	02	01	H2312_012_0	7	4	Non-Preferred Brand	100000	
H2312	012	0	1	02	01	H2312_012_0	7	1	Preferred Generic	001000	
H2312	012	0	1	02	01	H2312_012_0	7	2	Non-Preferred Generic	000100	
H2312	012	0	1	02	01	H2312_012_0	7	3	Preferred Brand	000001	
H2320	007	0	1	02	01	H2320_007_0	10	4	Specialty Tier	010010	
H2320	007	0	1	02	01	H2320_007_0	10	3	Non-Preferred Brand	110000	
H2320	007	0	1	02	01	H2320_007_0	10	1	Generic	010010	
H2320	007	0	1	02	01	H2320_007_0	10	2	Preferred Brand	000001	
H2320	008	0	1	02	01	H2320_008_0	8	3	Non-Preferred Brand	110000	
H2320	008	0	1	02	01	H2320_008_0	8	4	Specialty Tier	010010	
H2320	008	0	1	02	01	H2320_008_0	8	1	Generic	010010	
H2320	008	0	1	02	01	H2320_008_0	8	2	Preferred Brand	000001	
H2320	011	0	1	02	01	H2320_011_0	10	1	Generic	010010	
H2320	011	0	1	02	01	H2320_011_0	10	2	Preferred Brand	000001	
H2320	011	0	1	02	01	H2320_011_0	10	3	Non-Preferred Brand	110000	
H2320	011	0	1	02	01	H2320_011_0	10	4	Specialty Tier	010010	
H2320	012	0	1	02	01	H2320_012_0	9	1	Generic	010010	
H2320	012	0	1	02	01	H2320_012_0	9	3	Non-Preferred Brand	110000	
H2320	012	0	1	02	01	H2320_012_0	9	4	Specialty Tier	010010	
H2320	012	0	1	02	01	H2320_012_0	9	2	Preferred Brand	000001	
H2320	013	0	1	02	01	H2320_013_0	8	4	Specialty Tier	010010	
H2320	013	0	1	02	01	H2320_013_0	8	1	Generic	010010	
H2320	013	0	1	02	01	H2320_013_0	8	2	Preferred Brand	000001	
H2320	013	0	1	02	01	H2320_013_0	8	3	Non-Preferred Brand	110000	
H2320	015	0	1	02	01	H2320_015_0	8	3	Non-Preferred Brand	110000	
H2320	015	0	1	02	01	H2320_015_0	8	4	Specialty Tier	010010	
H2320	015	0	1	02	01	H2320_015_0	8	1	Generic	010010	
H2320	015	0	1	02	01	H2320_015_0	8	2	Preferred Brand	000001	
H2320	016	0	1	02	01	H2320_016_0	8	3	Non-Preferred Brand	110000	
H2320	016	0	1	02	01	H2320_016_0	8	2	Preferred Brand	000001	
H2320	016	0	1	02	01	H2320_016_0	8	1	Generic	010010	
H2320	016	0	1	02	01	H2320_016_0	8	4	Specialty Tier	010010	
H2320	018	0	1	02	01	H2320_018_0	8	3	Non-Preferred Brand	110000	
H2320	018	0	1	02	01	H2320_018_0	8	2	Preferred Brand	000001	
H2320	018	0	1	02	01	H2320_018_0	8	1	Generic	010010	
H2320	018	0	1	02	01	H2320_018_0	8	4	Specialty Tier	010010	
H2320	019	0	1	02	01	H2320_019_0	8	1	Generic	010010	
H2320	019	0	1	02	01	H2320_019_0	8	2	Preferred Brand	000001	
H2320	019	0	1	02	01	H2320_019_0	8	3	Non-Preferred Brand	110000	
H2320	019	0	1	02	01	H2320_019_0	8	4	Specialty Tier	010010	
H2320	021	0	1	02	01	H2320_021_0	8	1	Generic	010010	
H2320	021	0	1	02	01	H2320_021_0	8	2	Preferred Brand	000001	
H2320	021	0	1	02	01	H2320_021_0	8	3	Non-Preferred Brand	110000	
H2320	021	0	1	02	01	H2320_021_0	8	4	Specialty Tier	010010	
H2322	004	0	1	04	01	H2322_004_0	7	1	Preferred Generic	001000	1
H2322	004	0	1	04	01	H2322_004_0	7	2	Non-Preferred Generic	000100	1
H2322	004	0	1	04	01	H2322_004_0	7	5	Specialty Tier	000010	
H2322	004	0	1	04	01	H2322_004_0	7	4	Non-Preferred Brand	100000	
H2322	004	0	1	04	01	H2322_004_0	7	3	Preferred Brand	000001	
H2322	004	0	1	04	01	H2322_004_0	7	2	Non-Preferred Generic	000100	
H2322	004	0	1	04	01	H2322_004_0	7	1	Preferred Generic	001000	
H2322	008	0	1	04	01	H2322_008_0	8	4	Non-Preferred Brand	100000	
H2322	008	0	1	04	01	H2322_008_0	8	5	Specialty Tier	000010	
H2322	008	0	1	04	01	H2322_008_0	8	3	Preferred Brand	000001	
H2322	008	0	1	04	01	H2322_008_0	8	1	Preferred Generic	001000	
H2322	008	0	1	04	01	H2322_008_0	8	2	Non-Preferred Generic	000100	
H2323	015	0	1	01	01	H2323_015_0	3	4	Specialty Tier	010010	
H2323	015	0	1	01	01	H2323_015_0	3	3	Non-Preferred Brand	100000	
H2323	015	0	1	01	01	H2323_015_0	3	2	Preferred Brand	000001	
H2323	015	0	1	01	01	H2323_015_0	3	1	Generic	010000	
H2323	016	0	1	01	01	H2323_016_0	4	2	Preferred Brand	000001	
H2323	016	0	1	01	01	H2323_016_0	4	1	Generic	010000	1
H2323	016	0	1	01	01	H2323_016_0	4	4	Specialty Tier	010010	
H2323	016	0	1	01	01	H2323_016_0	4	3	Non-Preferred Brand	100000	
H2323	016	0	1	01	01	H2323_016_0	4	1	Generic	010000	
H2354	001	0	1	02	01	H2354_001_0	7	2	Preferred Brand	000001	
H2354	001	0	1	02	01	H2354_001_0	7	3	Non-Preferred Brand	100000	
H2354	001	0	1	02	01	H2354_001_0	7	4	Specialty Tier	110001	
H2354	001	0	1	02	01	H2354_001_0	7	1	Generic	010000	
H2354	013	0	1	02	01	H2354_013_0	6	4	Specialty Tier	110001	
H2354	013	0	1	02	01	H2354_013_0	6	3	Non-Preferred Brand	100000	
H2354	013	0	1	02	01	H2354_013_0	6	1	Generic	010000	
H2354	013	0	1	02	01	H2354_013_0	6	1	Generic	010000	1
H2354	013	0	1	02	01	H2354_013_0	6	2	Preferred Brand	000001	
H2354	015	0	1	02	01	H2354_015_0	6	2	Preferred Brand	000001	
H2354	015	0	1	02	01	H2354_015_0	6	3	Non-Preferred Brand	100000	
H2354	015	0	1	02	01	H2354_015_0	6	4	Specialty Tier	110001	
H2354	015	0	1	02	01	H2354_015_0	6	1	Generic	010000	
H2425	002	0	1	02	01	H2425_002_0	6	1	Preferred Generic	001000	
H2425	002	0	1	02	01	H2425_002_0	6	2	Non-Preferred Generic	000100	
H2425	002	0	1	02	01	H2425_002_0	6	3	Preferred Brand	000001	
H2425	002	0	1	02	01	H2425_002_0	6	4	Non-Preferred Brand	110000	
H2450	001	0	1	18	06	H2450_001_0	6	4	Specialty Tier	010010	
H2450	001	0	1	18	06	H2450_001_0	6	3	Non-Preferred Brand	100000	
H2450	001	0	1	18	06	H2450_001_0	6	1	Generic	010000	
H2450	001	0	1	18	06	H2450_001_0	6	2	Preferred Brand	000001	
H2450	002	0	1	18	06	H2450_002_0	8	3	Non-Preferred Brand	100000	
H2450	002	0	1	18	06	H2450_002_0	8	2	Preferred Brand	000001	
H2450	002	0	1	18	06	H2450_002_0	8	1	Generic	010000	
H2450	002	0	1	18	06	H2450_002_0	8	4	Specialty Tier	010010	
H2450	023	0	1	18	06	H2450_023_0	4	1	Generic	010000	
H2450	023	0	1	18	06	H2450_023_0	4	2	Preferred Brand	000001	
H2450	023	0	1	18	06	H2450_023_0	4	3	Non-Preferred Brand	100000	
H2450	023	0	1	18	06	H2450_023_0	4	4	Specialty Tier	010010	
H2459	002	0	1	02	01	H2459_002_0	6	1	Preferred Generic	001000	
H2459	002	0	1	02	01	H2459_002_0	6	2	Non-Preferred Generic	000100	
H2459	002	0	1	02	01	H2459_002_0	6	3	Preferred Brand	000001	
H2459	002	0	1	02	01	H2459_002_0	6	4	Non-Preferred Brand	100000	
H2459	002	0	1	02	01	H2459_002_0	6	5	Specialty Tier	010010	
H2459	002	0	1	02	01	H2459_002_0	6	1	Preferred Generic	001000	1
H2459	002	0	1	02	01	H2459_002_0	6	2	Non-Preferred Generic	000100	1
H2459	013	0	1	02	01	H2459_013_0	9	3	Preferred Brand	000001	
H2459	013	0	1	02	01	H2459_013_0	9	1	Preferred Generic	001000	
H2459	013	0	1	02	01	H2459_013_0	9	2	Non-Preferred Generic	000100	
H2459	013	0	1	02	01	H2459_013_0	9	4	Non-Preferred Brand	100000	
H2459	013	0	1	02	01	H2459_013_0	9	5	Specialty Tier	010010	
H2459	019	0	1	02	01	H2459_019_0	9	3	Preferred Brand	000001	
H2459	019	0	1	02	01	H2459_019_0	9	5	Specialty Tier	010010	
H2459	019	0	1	02	01	H2459_019_0	9	4	Non-Preferred Brand	100000	
H2459	019	0	1	02	01	H2459_019_0	9	1	Preferred Generic	001000	
H2459	019	0	1	02	01	H2459_019_0	9	2	Non-Preferred Generic	000100	
H2462	008	0	1	18	06	H2462_008_0	7	5	Specialty Tier	010010	
H2462	008	0	1	18	06	H2462_008_0	7	1	Preferred Generic	001000	
H2462	008	0	1	18	06	H2462_008_0	7	2	Non-Preferred Generic	000100	
H2462	008	0	1	18	06	H2462_008_0	7	3	Preferred Brand	000001	
H2462	008	0	1	18	06	H2462_008_0	7	4	Non-Preferred Brand	100000	
H2462	011	0	1	18	06	H2462_011_0	6	2	Non-Preferred Generic	000100	
H2462	011	0	1	18	06	H2462_011_0	6	1	Preferred Generic	001000	
H2462	011	0	1	18	06	H2462_011_0	6	4	Non-Preferred Brand	100000	
H2462	011	0	1	18	06	H2462_011_0	6	3	Preferred Brand	000001	
H2462	011	0	1	18	06	H2462_011_0	6	5	Specialty Tier	010010	
H2462	012	0	1	18	06	H2462_012_0	6	4	Non-Preferred Brand	100000	
H2462	012	0	1	18	06	H2462_012_0	6	5	Specialty Tier	010010	
H2462	012	0	1	18	06	H2462_012_0	6	2	Non-Preferred Generic	000100	
H2462	012	0	1	18	06	H2462_012_0	6	1	Preferred Generic	001000	
H2462	012	0	1	18	06	H2462_012_0	6	3	Preferred Brand	000001	1
H2462	012	0	1	18	06	H2462_012_0	6	2	Non-Preferred Generic	000100	1
H2462	012	0	1	18	06	H2462_012_0	6	1	Preferred Generic	001000	1
H2462	012	0	1	18	06	H2462_012_0	6	3	Preferred Brand	000001	
H2462	019	0	1	18	06	H2462_019_0	5	4	Non-Preferred Brand	100000	
H2462	019	0	1	18	06	H2462_019_0	5	5	Specialty Tier	010010	
H2462	019	0	1	18	06	H2462_019_0	5	3	Preferred Brand	000001	
H2462	019	0	1	18	06	H2462_019_0	5	2	Non-Preferred Generic	000100	
H2462	019	0	1	18	06	H2462_019_0	5	1	Preferred Generic	001000	
H2486	003	0	1	01	01	H2486_003_0	4	5	Specialty Tier	010010	
H2486	003	0	1	01	01	H2486_003_0	4	5	Specialty Tier	010010	2
H2486	003	0	1	01	01	H2486_003_0	4	3	Preferred Brand	000101	
H2486	003	0	1	01	01	H2486_003_0	4	2	Non-Preferred Generic	000101	
H2486	003	0	1	01	01	H2486_003_0	4	1	Preferred Generic	001010	
H2486	003	0	1	01	01	H2486_003_0	4	4	Non-Preferred Brand	110000	
H2486	003	0	1	01	01	H2486_003_0	4	4	Non-Preferred Brand	110000	2
H2486	003	0	1	01	01	H2486_003_0	4	3	Preferred Brand	000101	2
H2486	003	0	1	01	01	H2486_003_0	4	2	Non-Preferred Generic	000101	2
H2486	003	0	1	01	01	H2486_003_0	4	1	Preferred Generic	001010	2
H2491	002	0	1	02	01	H2491_002_0	3	5	Specialty Tier	010010	
H2491	002	0	1	02	01	H2491_002_0	3	4	Non-Preferred Brand	100000	
H2491	002	0	1	02	01	H2491_002_0	3	3	Preferred Brand	000001	
H2491	002	0	1	02	01	H2491_002_0	3	2	Non-Preferred Generic	000100	
H2491	002	0	1	02	01	H2491_002_0	3	1	Preferred Generic	001000	
H2491	004	0	1	02	01	H2491_004_0	4	1	Preferred Generic	001000	
H2491	004	0	1	02	01	H2491_004_0	4	2	Non-Preferred Generic	000100	
H2491	004	0	1	02	01	H2491_004_0	4	3	Preferred Brand	010001	
H2491	004	0	1	02	01	H2491_004_0	4	4	Non-Preferred Brand	110000	
H2491	004	0	1	02	01	H2491_004_0	4	5	Specialty Tier	010010	
H2506	001	0	1	48	05	H2506_001_0	6	2	Brand Drugs	000010	
H2506	001	0	1	48	05	H2506_001_0	6	3	Non-Medicare Rx Generic Drugs	010000	
H2506	001	0	1	48	05	H2506_001_0	6	4	Non-Medicare Rx Brand Drugs	000010	
H2506	001	0	1	48	05	H2506_001_0	6	5	Non-Medicare OTC Generic Drugs	010010	
H2506	001	0	1	48	05	H2506_001_0	6	1	Generic Drugs	010000	
H2531	001	0	1	48	05	H2531_001_0	4	3	Non-Medicare Rx/OTC Drugs	010010	
H2531	001	0	1	48	05	H2531_001_0	4	2	Brand Drugs	000010	
H2531	001	0	1	48	05	H2531_001_0	4	1	Generic Drugs	010000	
H2542	001	0	1	04	01	H2542_001_0	6	5	Specialty Tier	010010	
H2542	001	0	1	04	01	H2542_001_0	6	2	Non-Preferred Generic	000101	
H2542	001	0	1	04	01	H2542_001_0	6	1	Preferred Generic	001010	
H2542	001	0	1	04	01	H2542_001_0	6	4	Non-Preferred Brand	110000	
H2542	001	0	1	04	01	H2542_001_0	6	3	Preferred Brand	000101	2
H2542	001	0	1	04	01	H2542_001_0	6	2	Non-Preferred Generic	000101	2
H2542	001	0	1	04	01	H2542_001_0	6	1	Preferred Generic	001010	2
H2542	001	0	1	04	01	H2542_001_0	6	5	Specialty Tier	010010	2
H2542	001	0	1	04	01	H2542_001_0	6	4	Non-Preferred Brand	110000	2
H2542	001	0	1	04	01	H2542_001_0	6	3	Preferred Brand	000101	
H2542	002	0	1	04	01	H2542_002_0	6	5	Specialty Tier	010010	2
H2542	002	0	1	04	01	H2542_002_0	6	4	Non-Preferred Brand	110000	2
H2542	002	0	1	04	01	H2542_002_0	6	3	Preferred Brand	000101	2
H2542	002	0	1	04	01	H2542_002_0	6	2	Non-Preferred Generic	000101	2
H2542	002	0	1	04	01	H2542_002_0	6	1	Preferred Generic	001010	2
H2542	002	0	1	04	01	H2542_002_0	6	5	Specialty Tier	010010	
H2542	002	0	1	04	01	H2542_002_0	6	4	Non-Preferred Brand	110000	
H2542	002	0	1	04	01	H2542_002_0	6	3	Preferred Brand	000101	
H2542	002	0	1	04	01	H2542_002_0	6	2	Non-Preferred Generic	000101	
H2542	002	0	1	04	01	H2542_002_0	6	1	Preferred Generic	001010	
H2542	003	0	1	04	01	H2542_003_0	6	3	Preferred Brand	000101	2
H2542	003	0	1	04	01	H2542_003_0	6	2	Non-Preferred Generic	000101	2
H2542	003	0	1	04	01	H2542_003_0	6	1	Preferred Generic	001010	2
H2542	003	0	1	04	01	H2542_003_0	6	5	Specialty Tier	010010	
H2542	003	0	1	04	01	H2542_003_0	6	5	Specialty Tier	010010	2
H2542	003	0	1	04	01	H2542_003_0	6	3	Preferred Brand	000101	
H2542	003	0	1	04	01	H2542_003_0	6	2	Non-Preferred Generic	000101	
H2542	003	0	1	04	01	H2542_003_0	6	1	Preferred Generic	001010	
H2542	003	0	1	04	01	H2542_003_0	6	4	Non-Preferred Brand	110000	2
H2542	003	0	1	04	01	H2542_003_0	6	4	Non-Preferred Brand	110000	
H2542	004	0	1	04	01	H2542_004_0	6	5	Specialty Tier	010010	2
H2542	004	0	1	04	01	H2542_004_0	6	4	Non-Preferred Brand	110000	2
H2542	004	0	1	04	01	H2542_004_0	6	3	Preferred Brand	000101	2
H2542	004	0	1	04	01	H2542_004_0	6	2	Non-Preferred Generic	000101	2
H2542	004	0	1	04	01	H2542_004_0	6	1	Preferred Generic	001010	2
H2542	004	0	1	04	01	H2542_004_0	6	5	Specialty Tier	010010	
H2542	004	0	1	04	01	H2542_004_0	6	4	Non-Preferred Brand	110000	
H2542	004	0	1	04	01	H2542_004_0	6	3	Preferred Brand	000101	
H2542	004	0	1	04	01	H2542_004_0	6	1	Preferred Generic	001010	
H2542	004	0	1	04	01	H2542_004_0	6	2	Non-Preferred Generic	000101	
H2563	001	0	1	01	01	H2563_001_0	6	1	Preferred Generic	001000	
H2563	001	0	1	01	01	H2563_001_0	6	2	Non-Preferred Generic	000100	
H2563	001	0	1	01	01	H2563_001_0	6	3	Preferred Brand	000001	
H2563	001	0	1	01	01	H2563_001_0	6	4	Non-Preferred Brand	100000	
H2563	001	0	1	01	01	H2563_001_0	6	5	Specialty Tier	010010	
H2563	002	0	1	01	01	H2563_002_0	6	1	Preferred Generic	001000	
H2563	002	0	1	01	01	H2563_002_0	6	2	Non-Preferred Generic	000100	
H2563	002	0	1	01	01	H2563_002_0	6	3	Preferred Brand	000001	
H2563	002	0	1	01	01	H2563_002_0	6	4	Non-Preferred Brand	100000	
H2563	002	0	1	01	01	H2563_002_0	6	5	Specialty Tier	010010	
H2593	001	0	1	01	01	H2593_001_0	10	2	Non-Preferred Generic	000100	
H2593	001	0	1	01	01	H2593_001_0	10	3	Preferred Brand	000001	
H2593	001	0	1	01	01	H2593_001_0	10	4	Non-Preferred Brand	100000	
H2593	001	0	1	01	01	H2593_001_0	10	5	Specialty Tier	010010	
H2593	001	0	1	01	01	H2593_001_0	10	6	Select Care Drugs	000010	
H2593	001	0	1	01	01	H2593_001_0	10	1	Preferred Generic	001000	1
H2593	001	0	1	01	01	H2593_001_0	10	2	Non-Preferred Generic	000100	1
H2593	001	0	1	01	01	H2593_001_0	10	6	Select Care Drugs	000010	2
H2593	001	0	1	01	01	H2593_001_0	10	1	Preferred Generic	001000	
H2593	003	0	1	01	01	H2593_003_0	8	3	Preferred Brand	000001	2
H2593	003	0	1	01	01	H2593_003_0	8	2	Non-Preferred Generic	000100	1
H2593	003	0	1	01	01	H2593_003_0	8	1	Preferred Generic	001000	1
H2593	003	0	1	01	01	H2593_003_0	8	6	Select Care Drugs	000010	
H2593	003	0	1	01	01	H2593_003_0	8	5	Specialty Tier	010010	
H2593	003	0	1	01	01	H2593_003_0	8	6	Select Care Drugs	000010	1
H2593	003	0	1	01	01	H2593_003_0	8	3	Preferred Brand	000001	
H2593	003	0	1	01	01	H2593_003_0	8	2	Non-Preferred Generic	000100	
H2593	003	0	1	01	01	H2593_003_0	8	1	Preferred Generic	001000	
H2593	003	0	1	01	01	H2593_003_0	8	4	Non-Preferred Brand	100000	2
H2593	003	0	1	01	01	H2593_003_0	8	4	Non-Preferred Brand	100000	
H2593	005	0	1	01	01	H2593_005_0	8	3	Preferred Brand	000001	2
H2593	005	0	1	01	01	H2593_005_0	8	2	Non-Preferred Generic	000100	1
H2593	005	0	1	01	01	H2593_005_0	8	1	Preferred Generic	001000	1
H2593	005	0	1	01	01	H2593_005_0	8	6	Select Care Drugs	000010	
H2593	005	0	1	01	01	H2593_005_0	8	5	Specialty Tier	010010	
H2593	005	0	1	01	01	H2593_005_0	8	4	Non-Preferred Brand	100000	
H2593	005	0	1	01	01	H2593_005_0	8	3	Preferred Brand	000001	
H2593	005	0	1	01	01	H2593_005_0	8	2	Non-Preferred Generic	000100	
H2593	005	0	1	01	01	H2593_005_0	8	1	Preferred Generic	001000	
H2593	005	0	1	01	01	H2593_005_0	8	4	Non-Preferred Brand	100000	2
H2593	005	0	1	01	01	H2593_005_0	8	6	Select Care Drugs	000010	1
H2593	006	0	1	01	01	H2593_006_0	12	1	Preferred Generic	001000	
H2593	006	0	1	01	01	H2593_006_0	12	2	Non-Preferred Generic	000100	
H2593	006	0	1	01	01	H2593_006_0	12	6	Select Care Drugs	000010	1
H2593	006	0	1	01	01	H2593_006_0	12	4	Non-Preferred Brand	100000	2
H2593	006	0	1	01	01	H2593_006_0	12	3	Preferred Brand	000001	2
H2593	006	0	1	01	01	H2593_006_0	12	2	Non-Preferred Generic	000100	1
H2593	006	0	1	01	01	H2593_006_0	12	1	Preferred Generic	001000	1
H2593	006	0	1	01	01	H2593_006_0	12	6	Select Care Drugs	000010	
H2593	006	0	1	01	01	H2593_006_0	12	5	Specialty Tier	010010	
H2593	006	0	1	01	01	H2593_006_0	12	4	Non-Preferred Brand	100000	
H2593	006	0	1	01	01	H2593_006_0	12	3	Preferred Brand	000001	
H2593	007	0	1	01	01	H2593_007_0	7	1	Preferred Generic	001000	1
H2593	007	0	1	01	01	H2593_007_0	7	6	Select Care Drugs	000010	
H2593	007	0	1	01	01	H2593_007_0	7	5	Specialty Tier	010010	
H2593	007	0	1	01	01	H2593_007_0	7	4	Non-Preferred Brand	100000	
H2593	007	0	1	01	01	H2593_007_0	7	6	Select Care Drugs	000010	2
H2593	007	0	1	01	01	H2593_007_0	7	2	Non-Preferred Generic	000100	
H2593	007	0	1	01	01	H2593_007_0	7	1	Preferred Generic	001000	
H2593	007	0	1	01	01	H2593_007_0	7	2	Non-Preferred Generic	000100	1
H2593	007	0	1	01	01	H2593_007_0	7	3	Preferred Brand	000001	
H2593	011	0	1	01	01	H2593_011_0	7	5	Specialty Tier	010010	
H2593	011	0	1	01	01	H2593_011_0	7	4	Non-Preferred Brand	100000	
H2593	011	0	1	01	01	H2593_011_0	7	6	Select Care Drugs	000010	1
H2593	011	0	1	01	01	H2593_011_0	7	4	Non-Preferred Brand	100000	2
H2593	011	0	1	01	01	H2593_011_0	7	3	Preferred Brand	000001	2
H2593	011	0	1	01	01	H2593_011_0	7	2	Non-Preferred Generic	000100	1
H2593	011	0	1	01	01	H2593_011_0	7	1	Preferred Generic	001000	1
H2593	011	0	1	01	01	H2593_011_0	7	6	Select Care Drugs	000010	
H2593	011	0	1	01	01	H2593_011_0	7	1	Preferred Generic	001000	
H2593	011	0	1	01	01	H2593_011_0	7	2	Non-Preferred Generic	000100	
H2593	011	0	1	01	01	H2593_011_0	7	3	Preferred Brand	000001	
H2593	013	0	1	01	01	H2593_013_0	5	1	Preferred Generic	001000	
H2593	013	0	1	01	01	H2593_013_0	5	4	Non-Preferred Brand	100000	2
H2593	013	0	1	01	01	H2593_013_0	5	3	Preferred Brand	000001	2
H2593	013	0	1	01	01	H2593_013_0	5	2	Non-Preferred Generic	000100	1
H2593	013	0	1	01	01	H2593_013_0	5	1	Preferred Generic	001000	1
H2593	013	0	1	01	01	H2593_013_0	5	6	Select Care Drugs	000010	1
H2593	013	0	1	01	01	H2593_013_0	5	5	Specialty Tier	010010	
H2593	013	0	1	01	01	H2593_013_0	5	4	Non-Preferred Brand	100000	
H2593	013	0	1	01	01	H2593_013_0	5	3	Preferred Brand	000001	
H2593	013	0	1	01	01	H2593_013_0	5	2	Non-Preferred Generic	000100	
H2593	013	0	1	01	01	H2593_013_0	5	6	Select Care Drugs	000010	
H2593	014	0	1	01	01	H2593_014_0	5	5	Specialty Tier	010010	
H2593	014	0	1	01	01	H2593_014_0	5	4	Non-Preferred Brand	100000	
H2593	014	0	1	01	01	H2593_014_0	5	3	Preferred Brand	000001	
H2593	014	0	1	01	01	H2593_014_0	5	2	Non-Preferred Generic	000100	
H2593	014	0	1	01	01	H2593_014_0	5	1	Preferred Generic	001000	
H2593	014	0	1	01	01	H2593_014_0	5	6	Select Care Drugs	000010	
H2593	014	0	1	01	01	H2593_014_0	5	6	Select Care Drugs	000010	1
H2593	014	0	1	01	01	H2593_014_0	5	4	Non-Preferred Brand	100000	2
H2593	014	0	1	01	01	H2593_014_0	5	3	Preferred Brand	000001	2
H2593	014	0	1	01	01	H2593_014_0	5	2	Non-Preferred Generic	000100	1
H2593	014	0	1	01	01	H2593_014_0	5	1	Preferred Generic	001000	1
H2593	015	0	1	01	01	H2593_015_0	5	1	Preferred Generic	001000	
H2593	015	0	1	01	01	H2593_015_0	5	2	Non-Preferred Generic	000100	
H2593	015	0	1	01	01	H2593_015_0	5	3	Preferred Brand	000001	
H2593	015	0	1	01	01	H2593_015_0	5	4	Non-Preferred Brand	100000	
H2593	015	0	1	01	01	H2593_015_0	5	5	Specialty Tier	010010	
H2593	015	0	1	01	01	H2593_015_0	5	6	Select Care Drugs	000010	1
H2593	015	0	1	01	01	H2593_015_0	5	1	Preferred Generic	001000	1
H2593	015	0	1	01	01	H2593_015_0	5	2	Non-Preferred Generic	000100	1
H2593	015	0	1	01	01	H2593_015_0	5	3	Preferred Brand	000001	2
H2593	015	0	1	01	01	H2593_015_0	5	4	Non-Preferred Brand	100000	2
H2593	015	0	1	01	01	H2593_015_0	5	6	Select Care Drugs	000010	
H2593	016	0	1	01	01	H2593_016_0	7	1	Preferred Generic	001000	
H2593	016	0	1	01	01	H2593_016_0	7	6	Select Care Drugs	000010	
H2593	016	0	1	01	01	H2593_016_0	7	5	Specialty Tier	010010	
H2593	016	0	1	01	01	H2593_016_0	7	4	Non-Preferred Brand	100000	
H2593	016	0	1	01	01	H2593_016_0	7	3	Preferred Brand	000001	
H2593	016	0	1	01	01	H2593_016_0	7	2	Non-Preferred Generic	000100	
H2593	018	0	1	01	01	H2593_018_0	6	1	Preferred Generic	001000	
H2593	018	0	1	01	01	H2593_018_0	6	2	Non-Preferred Generic	000100	
H2593	018	0	1	01	01	H2593_018_0	6	3	Preferred Brand	000001	
H2593	018	0	1	01	01	H2593_018_0	6	4	Non-Preferred Brand	100000	
H2593	018	0	1	01	01	H2593_018_0	6	5	Specialty Tier	010010	
H2593	018	0	1	01	01	H2593_018_0	6	6	Select Care Drugs	000010	
H2610	005	0	1	01	01	H2610_005_0	6	3	Preferred Brand	000001	
H2610	005	0	1	01	01	H2610_005_0	6	2	Non-Preferred Generic	000100	
H2610	005	0	1	01	01	H2610_005_0	6	1	Preferred Generic	001000	
H2610	005	0	1	01	01	H2610_005_0	6	4	Non-Preferred Brand	100000	
H2610	005	0	1	01	01	H2610_005_0	6	5	Specialty Tier	100100	
H2610	006	0	1	01	01	H2610_006_0	5	3	Preferred Brand	000001	
H2610	006	0	1	01	01	H2610_006_0	5	2	Non-Preferred Generic	000100	
H2610	006	0	1	01	01	H2610_006_0	5	1	Preferred Generic	001000	
H2610	006	0	1	01	01	H2610_006_0	5	4	Non-Preferred Brand	100000	
H2610	006	0	1	01	01	H2610_006_0	5	2	Non-Preferred Generic	000100	1
H2610	006	0	1	01	01	H2610_006_0	5	1	Preferred Generic	001000	1
H2610	006	0	1	01	01	H2610_006_0	5	5	Specialty Tier	100100	
H2610	011	0	1	01	01	H2610_011_0	5	1	Preferred Generic	001000	
H2610	011	0	1	01	01	H2610_011_0	5	4	Non-Preferred Brand	100000	
H2610	011	0	1	01	01	H2610_011_0	5	3	Preferred Brand	000001	
H2610	011	0	1	01	01	H2610_011_0	5	2	Non-Preferred Generic	000100	
H2610	011	0	1	01	01	H2610_011_0	5	5	Specialty Tier	100100	
H2610	014	0	1	02	01	H2610_014_0	6	1	Preferred Generic	001000	
H2610	014	0	1	02	01	H2610_014_0	6	2	Non-Preferred Generic	000100	
H2610	014	0	1	02	01	H2610_014_0	6	5	Specialty Tier	100100	
H2610	014	0	1	02	01	H2610_014_0	6	4	Non-Preferred Brand	100000	
H2610	014	0	1	02	01	H2610_014_0	6	3	Preferred Brand	000001	
H2611	001	0	1	04	01	H2611_001_0	7	2	Non-Preferred Generic	000101	
H2611	001	0	1	04	01	H2611_001_0	7	1	Preferred Generic	001000	
H2611	001	0	1	04	01	H2611_001_0	7	3	Preferred Brand	000001	
H2611	001	0	1	04	01	H2611_001_0	7	4	Non-Preferred Brand	100100	
H2611	001	0	1	04	01	H2611_001_0	7	5	Specialty Tier	010010	
H2611	008	0	1	04	01	H2611_008_0	10	2	Non-Preferred Generic	000100	
H2611	008	0	1	04	01	H2611_008_0	10	1	Preferred Generic	001000	
H2611	008	0	1	04	01	H2611_008_0	10	3	Preferred Brand	000001	
H2611	008	0	1	04	01	H2611_008_0	10	5	Specialty Tier	010010	
H2611	008	0	1	04	01	H2611_008_0	10	4	Non-Preferred Brand	100100	
H2611	018	0	1	04	01	H2611_018_0	8	1	Preferred Generic	001000	
H2611	018	0	1	04	01	H2611_018_0	8	4	Non-Preferred Brand	100100	
H2611	018	0	1	04	01	H2611_018_0	8	2	Non-Preferred Generic	000100	
H2611	018	0	1	04	01	H2611_018_0	8	3	Preferred Brand	000001	
H2611	018	0	1	04	01	H2611_018_0	8	5	Specialty Tier	010010	
H2649	004	0	1	01	01	H2649_004_0	5	4	Non-Preferred Brand	110000	2
H2649	004	0	1	01	01	H2649_004_0	5	3	Preferred Brand	000101	2
H2649	004	0	1	01	01	H2649_004_0	5	2	Non-Preferred Generic	000101	2
H2649	004	0	1	01	01	H2649_004_0	5	1	Preferred Generic	001010	2
H2649	004	0	1	01	01	H2649_004_0	5	5	Specialty Tier	010010	2
H2649	004	0	1	01	01	H2649_004_0	5	4	Non-Preferred Brand	110000	
H2649	004	0	1	01	01	H2649_004_0	5	3	Preferred Brand	000101	
H2649	004	0	1	01	01	H2649_004_0	5	2	Non-Preferred Generic	000101	
H2649	004	0	1	01	01	H2649_004_0	5	1	Preferred Generic	001010	
H2649	004	0	1	01	01	H2649_004_0	5	5	Specialty Tier	010010	
H2649	020	0	1	01	01	H2649_020_0	4	4	Non-Preferred Brand	110000	2
H2649	020	0	1	01	01	H2649_020_0	4	3	Preferred Brand	000101	2
H2649	020	0	1	01	01	H2649_020_0	4	2	Non-Preferred Generic	000101	2
H2649	020	0	1	01	01	H2649_020_0	4	1	Preferred Generic	001010	2
H2649	020	0	1	01	01	H2649_020_0	4	5	Specialty Tier	010010	
H2649	020	0	1	01	01	H2649_020_0	4	4	Non-Preferred Brand	110000	
H2649	020	0	1	01	01	H2649_020_0	4	3	Preferred Brand	000101	
H2649	020	0	1	01	01	H2649_020_0	4	2	Non-Preferred Generic	000101	
H2649	020	0	1	01	01	H2649_020_0	4	1	Preferred Generic	001010	
H2649	020	0	1	01	01	H2649_020_0	4	5	Specialty Tier	010010	2
H2649	021	0	1	02	01	H2649_021_0	6	1	Preferred Generic	001010	
H2649	021	0	1	02	01	H2649_021_0	6	2	Non-Preferred Generic	000101	
H2649	021	0	1	02	01	H2649_021_0	6	5	Specialty Tier	010010	2
H2649	021	0	1	02	01	H2649_021_0	6	4	Non-Preferred Brand	110000	2
H2649	021	0	1	02	01	H2649_021_0	6	3	Preferred Brand	000101	2
H2649	021	0	1	02	01	H2649_021_0	6	2	Non-Preferred Generic	000101	2
H2649	021	0	1	02	01	H2649_021_0	6	1	Preferred Generic	001010	2
H2649	021	0	1	02	01	H2649_021_0	6	5	Specialty Tier	010010	
H2649	021	0	1	02	01	H2649_021_0	6	4	Non-Preferred Brand	110000	
H2649	021	0	1	02	01	H2649_021_0	6	3	Preferred Brand	000101	
H2649	022	0	1	01	01	H2649_022_0	4	1	Preferred Generic	001010	
H2649	022	0	1	01	01	H2649_022_0	4	4	Non-Preferred Brand	110000	2
H2649	022	0	1	01	01	H2649_022_0	4	3	Preferred Brand	000101	2
H2649	022	0	1	01	01	H2649_022_0	4	2	Non-Preferred Generic	000101	2
H2649	022	0	1	01	01	H2649_022_0	4	5	Specialty Tier	010010	2
H2649	022	0	1	01	01	H2649_022_0	4	5	Specialty Tier	010010	
H2649	022	0	1	01	01	H2649_022_0	4	4	Non-Preferred Brand	110000	
H2649	022	0	1	01	01	H2649_022_0	4	3	Preferred Brand	000101	
H2649	022	0	1	01	01	H2649_022_0	4	2	Non-Preferred Generic	000101	
H2649	022	0	1	01	01	H2649_022_0	4	1	Preferred Generic	001010	2
H2649	023	0	1	01	01	H2649_023_0	4	2	Non-Preferred Generic	000101	2
H2649	023	0	1	01	01	H2649_023_0	4	3	Preferred Brand	000101	2
H2649	023	0	1	01	01	H2649_023_0	4	4	Non-Preferred Brand	110000	2
H2649	023	0	1	01	01	H2649_023_0	4	5	Specialty Tier	010010	2
H2649	023	0	1	01	01	H2649_023_0	4	1	Preferred Generic	001010	
H2649	023	0	1	01	01	H2649_023_0	4	2	Non-Preferred Generic	000101	
H2649	023	0	1	01	01	H2649_023_0	4	3	Preferred Brand	000101	
H2649	023	0	1	01	01	H2649_023_0	4	4	Non-Preferred Brand	110000	
H2649	023	0	1	01	01	H2649_023_0	4	5	Specialty Tier	010010	
H2649	023	0	1	01	01	H2649_023_0	4	1	Preferred Generic	001010	2
H2649	024	0	1	01	01	H2649_024_0	4	5	Specialty Tier	010010	
H2649	024	0	1	01	01	H2649_024_0	4	4	Non-Preferred Brand	110000	
H2649	024	0	1	01	01	H2649_024_0	4	3	Preferred Brand	000101	
H2649	024	0	1	01	01	H2649_024_0	4	2	Non-Preferred Generic	000101	
H2649	024	0	1	01	01	H2649_024_0	4	5	Specialty Tier	010010	2
H2649	024	0	1	01	01	H2649_024_0	4	2	Non-Preferred Generic	000101	2
H2649	024	0	1	01	01	H2649_024_0	4	3	Preferred Brand	000101	2
H2649	024	0	1	01	01	H2649_024_0	4	4	Non-Preferred Brand	110000	2
H2649	024	0	1	01	01	H2649_024_0	4	1	Preferred Generic	001010	
H2649	025	0	1	01	01	H2649_025_0	8	5	Specialty Tier	010010	
H2649	025	0	1	01	01	H2649_025_0	8	4	Non-Preferred Brand	110000	
H2649	025	0	1	01	01	H2649_025_0	8	3	Preferred Brand	000101	
H2649	025	0	1	01	01	H2649_025_0	8	2	Non-Preferred Generic	000101	
H2649	025	0	1	01	01	H2649_025_0	8	1	Preferred Generic	001010	
H2649	025	0	1	01	01	H2649_025_0	8	1	Preferred Generic	001010	2
H2649	025	0	1	01	01	H2649_025_0	8	5	Specialty Tier	010010	2
H2649	025	0	1	01	01	H2649_025_0	8	4	Non-Preferred Brand	110000	2
H2649	025	0	1	01	01	H2649_025_0	8	3	Preferred Brand	000101	2
H2649	025	0	1	01	01	H2649_025_0	8	2	Non-Preferred Generic	000101	2
H2649	029	0	1	01	01	H2649_029_0	4	1	Preferred Generic	001010	
H2649	029	0	1	01	01	H2649_029_0	4	2	Non-Preferred Generic	000101	
H2649	029	0	1	01	01	H2649_029_0	4	3	Preferred Brand	000101	
H2649	029	0	1	01	01	H2649_029_0	4	4	Non-Preferred Brand	110000	
H2649	029	0	1	01	01	H2649_029_0	4	5	Specialty Tier	010010	2
H2649	029	0	1	01	01	H2649_029_0	4	4	Non-Preferred Brand	110000	2
H2649	029	0	1	01	01	H2649_029_0	4	3	Preferred Brand	000101	2
H2649	029	0	1	01	01	H2649_029_0	4	2	Non-Preferred Generic	000101	2
H2649	029	0	1	01	01	H2649_029_0	4	1	Preferred Generic	001010	2
H2649	029	0	1	01	01	H2649_029_0	4	5	Specialty Tier	010010	
H2649	030	0	1	02	01	H2649_030_0	7	1	Preferred Generic	001010	
H2649	030	0	1	02	01	H2649_030_0	7	2	Non-Preferred Generic	000101	
H2649	030	0	1	02	01	H2649_030_0	7	3	Preferred Brand	000101	
H2649	030	0	1	02	01	H2649_030_0	7	4	Non-Preferred Brand	110000	
H2649	030	0	1	02	01	H2649_030_0	7	5	Specialty Tier	010010	
H2649	030	0	1	02	01	H2649_030_0	7	1	Preferred Generic	001010	2
H2649	030	0	1	02	01	H2649_030_0	7	2	Non-Preferred Generic	000101	2
H2649	030	0	1	02	01	H2649_030_0	7	3	Preferred Brand	000101	2
H2649	030	0	1	02	01	H2649_030_0	7	4	Non-Preferred Brand	110000	2
H2649	030	0	1	02	01	H2649_030_0	7	5	Specialty Tier	010010	2
H2649	031	0	1	01	01	H2649_031_0	5	1	Preferred Generic	001010	
H2649	031	0	1	01	01	H2649_031_0	5	2	Non-Preferred Generic	000101	
H2649	031	0	1	01	01	H2649_031_0	5	3	Preferred Brand	000101	
H2649	031	0	1	01	01	H2649_031_0	5	4	Non-Preferred Brand	110000	
H2649	031	0	1	01	01	H2649_031_0	5	5	Specialty Tier	010010	2
H2649	031	0	1	01	01	H2649_031_0	5	1	Preferred Generic	001010	2
H2649	031	0	1	01	01	H2649_031_0	5	2	Non-Preferred Generic	000101	2
H2649	031	0	1	01	01	H2649_031_0	5	3	Preferred Brand	000101	2
H2649	031	0	1	01	01	H2649_031_0	5	4	Non-Preferred Brand	110000	2
H2649	031	0	1	01	01	H2649_031_0	5	5	Specialty Tier	010010	
H2649	032	0	1	01	01	H2649_032_0	5	1	Preferred Generic	001010	
H2649	032	0	1	01	01	H2649_032_0	5	2	Non-Preferred Generic	000101	
H2649	032	0	1	01	01	H2649_032_0	5	3	Preferred Brand	000101	
H2649	032	0	1	01	01	H2649_032_0	5	4	Non-Preferred Brand	110000	
H2649	032	0	1	01	01	H2649_032_0	5	5	Specialty Tier	010010	2
H2649	032	0	1	01	01	H2649_032_0	5	1	Preferred Generic	001010	2
H2649	032	0	1	01	01	H2649_032_0	5	2	Non-Preferred Generic	000101	2
H2649	032	0	1	01	01	H2649_032_0	5	3	Preferred Brand	000101	2
H2649	032	0	1	01	01	H2649_032_0	5	4	Non-Preferred Brand	110000	2
H2649	032	0	1	01	01	H2649_032_0	5	5	Specialty Tier	010010	
H2649	033	0	1	01	01	H2649_033_0	5	1	Preferred Generic	001010	
H2649	033	0	1	01	01	H2649_033_0	5	2	Non-Preferred Generic	000101	
H2649	033	0	1	01	01	H2649_033_0	5	3	Preferred Brand	000101	
H2649	033	0	1	01	01	H2649_033_0	5	4	Non-Preferred Brand	110000	
H2649	033	0	1	01	01	H2649_033_0	5	5	Specialty Tier	010010	2
H2649	033	0	1	01	01	H2649_033_0	5	1	Preferred Generic	001010	2
H2649	033	0	1	01	01	H2649_033_0	5	2	Non-Preferred Generic	000101	2
H2649	033	0	1	01	01	H2649_033_0	5	3	Preferred Brand	000101	2
H2649	033	0	1	01	01	H2649_033_0	5	4	Non-Preferred Brand	110000	2
H2649	033	0	1	01	01	H2649_033_0	5	5	Specialty Tier	010010	
H2649	034	0	1	01	01	H2649_034_0	5	1	Preferred Generic	001010	
H2649	034	0	1	01	01	H2649_034_0	5	2	Non-Preferred Generic	000101	
H2649	034	0	1	01	01	H2649_034_0	5	3	Preferred Brand	000101	
H2649	034	0	1	01	01	H2649_034_0	5	4	Non-Preferred Brand	110000	
H2649	034	0	1	01	01	H2649_034_0	5	5	Specialty Tier	010010	2
H2649	034	0	1	01	01	H2649_034_0	5	1	Preferred Generic	001010	2
H2649	034	0	1	01	01	H2649_034_0	5	2	Non-Preferred Generic	000101	2
H2649	034	0	1	01	01	H2649_034_0	5	3	Preferred Brand	000101	2
H2649	034	0	1	01	01	H2649_034_0	5	4	Non-Preferred Brand	110000	2
H2649	034	0	1	01	01	H2649_034_0	5	5	Specialty Tier	010010	
H2649	035	0	1	01	01	H2649_035_0	5	4	Non-Preferred Brand	110000	
H2649	035	0	1	01	01	H2649_035_0	5	5	Specialty Tier	010010	
H2649	035	0	1	01	01	H2649_035_0	5	1	Preferred Generic	001010	
H2649	035	0	1	01	01	H2649_035_0	5	2	Non-Preferred Generic	000101	
H2649	035	0	1	01	01	H2649_035_0	5	5	Specialty Tier	010010	2
H2649	035	0	1	01	01	H2649_035_0	5	1	Preferred Generic	001010	2
H2649	035	0	1	01	01	H2649_035_0	5	2	Non-Preferred Generic	000101	2
H2649	035	0	1	01	01	H2649_035_0	5	3	Preferred Brand	000101	2
H2649	035	0	1	01	01	H2649_035_0	5	4	Non-Preferred Brand	110000	2
H2649	035	0	1	01	01	H2649_035_0	5	3	Preferred Brand	000101	
H2649	036	0	1	01	01	H2649_036_0	5	1	Preferred Generic	001010	
H2649	036	0	1	01	01	H2649_036_0	5	2	Non-Preferred Generic	000101	
H2649	036	0	1	01	01	H2649_036_0	5	3	Preferred Brand	000101	
H2649	036	0	1	01	01	H2649_036_0	5	4	Non-Preferred Brand	110000	
H2649	036	0	1	01	01	H2649_036_0	5	5	Specialty Tier	010010	2
H2649	036	0	1	01	01	H2649_036_0	5	1	Preferred Generic	001010	2
H2649	036	0	1	01	01	H2649_036_0	5	2	Non-Preferred Generic	000101	2
H2649	036	0	1	01	01	H2649_036_0	5	3	Preferred Brand	000101	2
H2649	036	0	1	01	01	H2649_036_0	5	4	Non-Preferred Brand	110000	2
H2649	036	0	1	01	01	H2649_036_0	5	5	Specialty Tier	010010	
H2649	037	0	1	01	01	H2649_037_0	5	1	Preferred Generic	001010	
H2649	037	0	1	01	01	H2649_037_0	5	2	Non-Preferred Generic	000101	
H2649	037	0	1	01	01	H2649_037_0	5	3	Preferred Brand	000101	
H2649	037	0	1	01	01	H2649_037_0	5	4	Non-Preferred Brand	110000	
H2649	037	0	1	01	01	H2649_037_0	5	5	Specialty Tier	010010	2
H2649	037	0	1	01	01	H2649_037_0	5	1	Preferred Generic	001010	2
H2649	037	0	1	01	01	H2649_037_0	5	2	Non-Preferred Generic	000101	2
H2649	037	0	1	01	01	H2649_037_0	5	3	Preferred Brand	000101	2
H2649	037	0	1	01	01	H2649_037_0	5	4	Non-Preferred Brand	110000	2
H2649	037	0	1	01	01	H2649_037_0	5	5	Specialty Tier	010010	
H2649	038	0	1	01	01	H2649_038_0	5	5	Specialty Tier	010010	
H2649	038	0	1	01	01	H2649_038_0	5	1	Preferred Generic	001010	
H2649	038	0	1	01	01	H2649_038_0	5	2	Non-Preferred Generic	000101	
H2649	038	0	1	01	01	H2649_038_0	5	3	Preferred Brand	000101	
H2649	038	0	1	01	01	H2649_038_0	5	4	Non-Preferred Brand	110000	
H2649	039	0	1	01	01	H2649_039_0	5	4	Non-Preferred Brand	110000	
H2649	039	0	1	01	01	H2649_039_0	5	3	Preferred Brand	000101	
H2649	039	0	1	01	01	H2649_039_0	5	2	Non-Preferred Generic	000101	
H2649	039	0	1	01	01	H2649_039_0	5	1	Preferred Generic	001010	
H2649	039	0	1	01	01	H2649_039_0	5	5	Specialty Tier	010010	
H2649	040	0	1	01	01	H2649_040_0	4	4	Non-Preferred Brand	110000	
H2649	040	0	1	01	01	H2649_040_0	4	3	Preferred Brand	000101	
H2649	040	0	1	01	01	H2649_040_0	4	2	Non-Preferred Generic	000101	
H2649	040	0	1	01	01	H2649_040_0	4	1	Preferred Generic	001010	
H2649	040	0	1	01	01	H2649_040_0	4	5	Specialty Tier	010010	
H2649	041	0	1	01	01	H2649_041_0	4	1	Preferred Generic	001010	
H2649	041	0	1	01	01	H2649_041_0	4	2	Non-Preferred Generic	000101	
H2649	041	0	1	01	01	H2649_041_0	4	3	Preferred Brand	000101	
H2649	041	0	1	01	01	H2649_041_0	4	4	Non-Preferred Brand	110000	
H2649	041	0	1	01	01	H2649_041_0	4	5	Specialty Tier	010010	2
H2649	041	0	1	01	01	H2649_041_0	4	1	Preferred Generic	001010	2
H2649	041	0	1	01	01	H2649_041_0	4	2	Non-Preferred Generic	000101	2
H2649	041	0	1	01	01	H2649_041_0	4	3	Preferred Brand	000101	2
H2649	041	0	1	01	01	H2649_041_0	4	4	Non-Preferred Brand	110000	2
H2649	041	0	1	01	01	H2649_041_0	4	5	Specialty Tier	010010	
H2654	004	0	1	01	01	H2654_004_0	4	2	Non-Preferred Generic	000100	
H2654	004	0	1	01	01	H2654_004_0	4	1	Preferred Generic	001000	
H2654	004	0	1	01	01	H2654_004_0	4	3	Preferred Brand	010001	
H2654	004	0	1	01	01	H2654_004_0	4	4	Non-Preferred Brand	100100	
H2654	004	0	1	01	01	H2654_004_0	4	5	Specialty Tier	010010	
H2654	010	0	1	01	01	H2654_010_0	5	2	Non-Preferred Generic	000100	
H2654	010	0	1	01	01	H2654_010_0	5	1	Preferred Generic	001000	
H2654	010	0	1	01	01	H2654_010_0	5	3	Preferred Brand	010001	
H2654	010	0	1	01	01	H2654_010_0	5	5	Specialty Tier	010010	
H2654	010	0	1	01	01	H2654_010_0	5	4	Non-Preferred Brand	100100	
H2654	013	0	1	02	01	H2654_013_0	6	1	Preferred Generic	001000	
H2654	013	0	1	02	01	H2654_013_0	6	2	Non-Preferred Generic	000100	
H2654	013	0	1	02	01	H2654_013_0	6	4	Non-Preferred Brand	100100	
H2654	013	0	1	02	01	H2654_013_0	6	3	Preferred Brand	010001	
H2654	013	0	1	02	01	H2654_013_0	6	5	Specialty Tier	010010	
H2663	002	0	1	02	01	H2663_002_0	11	5	Specialty Tier	010010	
H2663	002	0	1	02	01	H2663_002_0	11	3	Preferred Brand	000001	
H2663	002	0	1	02	01	H2663_002_0	11	1	Preferred Generic	001000	
H2663	002	0	1	02	01	H2663_002_0	11	2	Non-Preferred Generic	000101	
H2663	002	0	1	02	01	H2663_002_0	11	4	Non-Preferred Brand	100100	
H2663	005	0	1	01	01	H2663_005_0	8	1	Preferred Generic	001000	
H2663	005	0	1	01	01	H2663_005_0	8	2	Non-Preferred Generic	000101	
H2663	005	0	1	01	01	H2663_005_0	8	3	Preferred Brand	000001	
H2663	005	0	1	01	01	H2663_005_0	8	5	Specialty Tier	010010	
H2663	005	0	1	01	01	H2663_005_0	8	4	Non-Preferred Brand	100100	
H2663	006	0	1	01	01	H2663_006_0	8	5	Specialty Tier	010010	
H2663	006	0	1	01	01	H2663_006_0	8	4	Non-Preferred Brand	100100	
H2663	006	0	1	01	01	H2663_006_0	8	2	Non-Preferred Generic	000101	
H2663	006	0	1	01	01	H2663_006_0	8	3	Preferred Brand	000001	
H2663	006	0	1	01	01	H2663_006_0	8	1	Preferred Generic	001000	
H2663	015	0	1	02	01	H2663_015_0	10	4	Non-Preferred Brand	100100	
H2663	015	0	1	02	01	H2663_015_0	10	1	Preferred Generic	001000	1
H2663	015	0	1	02	01	H2663_015_0	10	2	Non-Preferred Generic	000101	
H2663	015	0	1	02	01	H2663_015_0	10	1	Preferred Generic	001000	
H2663	015	0	1	02	01	H2663_015_0	10	3	Preferred Brand	000001	
H2663	015	0	1	02	01	H2663_015_0	10	5	Specialty Tier	010010	
H2667	001	0	1	01	01	H2667_001_0	6	1	Preferred Generic	001000	
H2667	001	0	1	01	01	H2667_001_0	6	2	Non-Preferred Generic	000100	
H2667	001	0	1	01	01	H2667_001_0	6	3	Preferred Brand	000001	
H2667	001	0	1	01	01	H2667_001_0	6	4	Non-Preferred Brand	100100	
H2667	001	0	1	01	01	H2667_001_0	6	5	Specialty Tier	010010	
H2667	017	0	1	02	01	H2667_017_0	6	1	Preferred Generic	001000	
H2667	017	0	1	02	01	H2667_017_0	6	2	Non-Preferred Generic	000100	
H2667	017	0	1	02	01	H2667_017_0	6	3	Preferred Brand	000001	
H2667	017	0	1	02	01	H2667_017_0	6	4	Non-Preferred Brand	100100	
H2667	017	0	1	02	01	H2667_017_0	6	5	Specialty Tier	010010	
H2672	001	0	1	01	01	H2672_001_0	7	4	Non-Preferred Brand	100100	
H2672	001	0	1	01	01	H2672_001_0	7	3	Preferred Brand	000001	
H2672	001	0	1	01	01	H2672_001_0	7	2	Non-Preferred Generic	000100	
H2672	001	0	1	01	01	H2672_001_0	7	1	Preferred Generic	001000	
H2672	001	0	1	01	01	H2672_001_0	7	5	Specialty Tier	010010	
H2672	008	0	1	01	01	H2672_008_0	6	2	Non-Preferred Generic	000100	
H2672	008	0	1	01	01	H2672_008_0	6	3	Preferred Brand	000001	
H2672	008	0	1	01	01	H2672_008_0	6	4	Non-Preferred Brand	100100	
H2672	008	0	1	01	01	H2672_008_0	6	5	Specialty Tier	010010	
H2672	008	0	1	01	01	H2672_008_0	6	1	Preferred Generic	001000	
H2672	009	0	1	01	01	H2672_009_0	4	4	Non-Preferred Brand	100100	
H2672	009	0	1	01	01	H2672_009_0	4	5	Specialty Tier	010010	
H2672	009	0	1	01	01	H2672_009_0	4	3	Preferred Brand	000001	
H2672	009	0	1	01	01	H2672_009_0	4	2	Non-Preferred Generic	000100	
H2672	009	0	1	01	01	H2672_009_0	4	1	Preferred Generic	001000	
H2672	010	0	1	01	01	H2672_010_0	5	5	Specialty Tier	010010	
H2672	010	0	1	01	01	H2672_010_0	5	4	Non-Preferred Brand	100100	
H2672	010	0	1	01	01	H2672_010_0	5	3	Preferred Brand	000001	
H2672	010	0	1	01	01	H2672_010_0	5	2	Non-Preferred Generic	000100	
H2672	010	0	1	01	01	H2672_010_0	5	1	Preferred Generic	001000	
H2672	012	0	1	01	01	H2672_012_0	4	4	Non-Preferred Brand	100100	
H2672	012	0	1	01	01	H2672_012_0	4	5	Specialty Tier	010010	
H2672	012	0	1	01	01	H2672_012_0	4	3	Preferred Brand	000001	
H2672	012	0	1	01	01	H2672_012_0	4	2	Non-Preferred Generic	000100	
H2672	012	0	1	01	01	H2672_012_0	4	1	Preferred Generic	001000	
H2676	001	0	1	04	01	H2676_001_0	5	1	Preferred Generic	001000	
H2676	001	0	1	04	01	H2676_001_0	5	2	Non-Preferred Generic	000100	
H2676	001	0	1	04	01	H2676_001_0	5	3	Preferred Brand	000001	
H2676	001	0	1	04	01	H2676_001_0	5	4	Non-Preferred Brand	100100	
H2676	001	0	1	04	01	H2676_001_0	5	5	Specialty Tier	010010	
H2701	001	0	1	04	01	H2701_001_0	7	3	Preferred Brand	000001	
H2701	001	0	1	04	01	H2701_001_0	7	4	Non-Preferred Brand	100000	
H2701	001	0	1	04	01	H2701_001_0	7	5	Specialty Tier	101101	
H2701	001	0	1	04	01	H2701_001_0	7	1	Preferred Generic	001000	1
H2701	001	0	1	04	01	H2701_001_0	7	2	Non-Preferred Generic	000100	
H2701	001	0	1	04	01	H2701_001_0	7	1	Preferred Generic	001000	
H2701	001	0	1	04	01	H2701_001_0	7	2	Non-Preferred Generic	000100	1
H2701	003	0	1	04	01	H2701_003_0	10	5	Specialty Tier	101101	
H2701	003	0	1	04	01	H2701_003_0	10	2	Non-Preferred Generic	000100	
H2701	003	0	1	04	01	H2701_003_0	10	3	Preferred Brand	000001	
H2701	003	0	1	04	01	H2701_003_0	10	4	Non-Preferred Brand	100000	
H2701	003	0	1	04	01	H2701_003_0	10	1	Preferred Generic	001000	
H2701	004	0	1	04	01	H2701_004_0	6	5	Specialty Tier	101101	
H2701	004	0	1	04	01	H2701_004_0	6	3	Preferred Brand	000001	
H2701	004	0	1	04	01	H2701_004_0	6	4	Non-Preferred Brand	100000	
H2701	004	0	1	04	01	H2701_004_0	6	2	Non-Preferred Generic	000100	
H2701	004	0	1	04	01	H2701_004_0	6	1	Preferred Generic	001000	
H2701	005	0	1	04	01	H2701_005_0	5	3	Preferred Brand	000001	
H2701	005	0	1	04	01	H2701_005_0	5	4	Non-Preferred Brand	100000	
H2701	005	0	1	04	01	H2701_005_0	5	5	Specialty Tier	101101	
H2701	005	0	1	04	01	H2701_005_0	5	2	Non-Preferred Generic	000100	
H2701	005	0	1	04	01	H2701_005_0	5	1	Preferred Generic	001000	
H2701	006	0	1	04	01	H2701_006_0	5	2	Non-Preferred Generic	000100	
H2701	006	0	1	04	01	H2701_006_0	5	3	Preferred Brand	000001	
H2701	006	0	1	04	01	H2701_006_0	5	1	Preferred Generic	001000	
H2701	006	0	1	04	01	H2701_006_0	5	5	Specialty Tier	101101	
H2701	006	0	1	04	01	H2701_006_0	5	4	Non-Preferred Brand	100000	
H2758	002	0	1	01	01	H2758_002_0	8	1	Preferred Generic	001000	1
H2758	002	0	1	01	01	H2758_002_0	8	5	Specialty Tier	010010	
H2758	002	0	1	01	01	H2758_002_0	8	4	Non-Preferred Brand	100000	
H2758	002	0	1	01	01	H2758_002_0	8	3	Preferred Brand	000001	
H2758	002	0	1	01	01	H2758_002_0	8	1	Preferred Generic	001000	
H2758	002	0	1	01	01	H2758_002_0	8	2	Non-Preferred Generic	000100	
H2773	003	0	1	01	01	H2773_003_0	7	5	Specialty Tier	110000	
H2773	003	0	1	01	01	H2773_003_0	7	1	Preferred Generic	001000	
H2773	003	0	1	01	01	H2773_003_0	7	4	Non-Preferred Brand	100100	
H2773	003	0	1	01	01	H2773_003_0	7	3	Preferred Brand	000101	
H2773	003	0	1	01	01	H2773_003_0	7	2	Non-Preferred Generic	000100	
H2773	013	0	1	01	01	H2773_013_0	7	5	Specialty Tier	110000	
H2773	013	0	1	01	01	H2773_013_0	7	4	Non-Preferred Brand	100100	
H2773	013	0	1	01	01	H2773_013_0	7	3	Preferred Brand	000101	
H2773	013	0	1	01	01	H2773_013_0	7	2	Non-Preferred Generic	000100	
H2773	013	0	1	01	01	H2773_013_0	7	1	Preferred Generic	001000	1
H2773	013	0	1	01	01	H2773_013_0	7	1	Preferred Generic	001000	
H2773	015	0	1	01	01	H2773_015_0	6	3	Preferred Brand	000101	
H2773	015	0	1	01	01	H2773_015_0	6	2	Non-Preferred Generic	000100	
H2773	015	0	1	01	01	H2773_015_0	6	1	Preferred Generic	001000	
H2773	015	0	1	01	01	H2773_015_0	6	4	Non-Preferred Brand	100100	
H2773	015	0	1	01	01	H2773_015_0	6	1	Preferred Generic	001000	1
H2773	015	0	1	01	01	H2773_015_0	6	5	Specialty Tier	110000	
H2773	017	0	1	01	01	H2773_017_0	6	1	Preferred Generic	001000	
H2773	017	0	1	01	01	H2773_017_0	6	2	Non-Preferred Generic	000100	
H2773	017	0	1	01	01	H2773_017_0	6	3	Preferred Brand	000101	
H2773	017	0	1	01	01	H2773_017_0	6	4	Non-Preferred Brand	100100	
H2773	017	0	1	01	01	H2773_017_0	6	5	Specialty Tier	110000	
H2773	017	0	1	01	01	H2773_017_0	6	1	Preferred Generic	001000	1
H2773	018	0	1	01	01	H2773_018_0	5	1	Preferred Generic	001000	
H2773	018	0	1	01	01	H2773_018_0	5	2	Non-Preferred Generic	000100	
H2773	018	0	1	01	01	H2773_018_0	5	3	Preferred Brand	000101	
H2773	018	0	1	01	01	H2773_018_0	5	5	Specialty Tier	110000	
H2773	018	0	1	01	01	H2773_018_0	5	4	Non-Preferred Brand	100100	
H2773	018	0	1	01	01	H2773_018_0	5	1	Preferred Generic	001000	1
H2773	019	0	1	01	01	H2773_019_0	6	1	Preferred Generic	001000	
H2773	019	0	1	01	01	H2773_019_0	6	2	Non-Preferred Generic	000100	
H2773	019	0	1	01	01	H2773_019_0	6	3	Preferred Brand	000101	
H2773	019	0	1	01	01	H2773_019_0	6	4	Non-Preferred Brand	100100	
H2773	019	0	1	01	01	H2773_019_0	6	5	Specialty Tier	110000	
H2775	082	0	1	04	01	H2775_082_0	6	3	Preferred Brand	000101	
H2775	082	0	1	04	01	H2775_082_0	6	2	Non-Preferred Generic	000100	
H2775	082	0	1	04	01	H2775_082_0	6	1	Preferred Generic	001000	
H2775	082	0	1	04	01	H2775_082_0	6	4	Non-Preferred Brand	100100	
H2775	082	0	1	04	01	H2775_082_0	6	5	Specialty Tier	010010	
H2775	083	0	1	04	01	H2775_083_0	7	1	Preferred Generic	001000	
H2775	083	0	1	04	01	H2775_083_0	7	2	Non-Preferred Generic	000100	
H2775	083	0	1	04	01	H2775_083_0	7	3	Preferred Brand	000101	
H2775	083	0	1	04	01	H2775_083_0	7	4	Non-Preferred Brand	100100	
H2775	083	0	1	04	01	H2775_083_0	7	5	Specialty Tier	010010	
H2775	084	0	1	04	01	H2775_084_0	6	1	Preferred Generic	001000	
H2775	084	0	1	04	01	H2775_084_0	6	2	Non-Preferred Generic	000100	
H2775	084	0	1	04	01	H2775_084_0	6	3	Preferred Brand	000101	
H2775	084	0	1	04	01	H2775_084_0	6	5	Specialty Tier	010010	
H2775	084	0	1	04	01	H2775_084_0	6	4	Non-Preferred Brand	100100	
H2775	085	0	1	04	01	H2775_085_0	6	3	Preferred Brand	000101	
H2775	085	0	1	04	01	H2775_085_0	6	2	Non-Preferred Generic	000100	
H2775	085	0	1	04	01	H2775_085_0	6	1	Preferred Generic	001000	
H2775	085	0	1	04	01	H2775_085_0	6	4	Non-Preferred Brand	100100	
H2775	085	0	1	04	01	H2775_085_0	6	5	Specialty Tier	010010	
H2775	088	0	1	04	01	H2775_088_0	7	5	Specialty Tier	010010	
H2775	088	0	1	04	01	H2775_088_0	7	4	Non-Preferred Brand	100100	
H2775	088	0	1	04	01	H2775_088_0	7	3	Preferred Brand	000101	
H2775	088	0	1	04	01	H2775_088_0	7	2	Non-Preferred Generic	000100	
H2775	088	0	1	04	01	H2775_088_0	7	1	Preferred Generic	001000	
H2775	089	0	1	04	01	H2775_089_0	7	4	Non-Preferred Brand	100100	
H2775	089	0	1	04	01	H2775_089_0	7	5	Specialty Tier	010010	
H2775	089	0	1	04	01	H2775_089_0	7	3	Preferred Brand	000101	
H2775	089	0	1	04	01	H2775_089_0	7	2	Non-Preferred Generic	000100	
H2775	089	0	1	04	01	H2775_089_0	7	1	Preferred Generic	001000	
H2775	091	0	1	04	01	H2775_091_0	6	1	Preferred Generic	001000	
H2775	091	0	1	04	01	H2775_091_0	6	3	Preferred Brand	000101	
H2775	091	0	1	04	01	H2775_091_0	6	4	Non-Preferred Brand	100100	
H2775	091	0	1	04	01	H2775_091_0	6	5	Specialty Tier	010010	
H2775	091	0	1	04	01	H2775_091_0	6	2	Non-Preferred Generic	000100	
H2775	098	0	1	04	01	H2775_098_0	5	1	Preferred Generic	001000	
H2775	098	0	1	04	01	H2775_098_0	5	2	Non-Preferred Generic	000100	
H2775	098	0	1	04	01	H2775_098_0	5	3	Preferred Brand	000101	
H2775	098	0	1	04	01	H2775_098_0	5	4	Non-Preferred Brand	100100	
H2775	098	0	1	04	01	H2775_098_0	5	5	Specialty Tier	010010	
H2802	001	0	1	01	01	H2802_001_0	4	1	Preferred Generic	001000	
H2802	001	0	1	01	01	H2802_001_0	4	2	Non-Preferred Generic	000100	
H2802	001	0	1	01	01	H2802_001_0	4	3	Preferred Brand	010001	
H2802	001	0	1	01	01	H2802_001_0	4	5	Specialty Tier	010010	
H2802	001	0	1	01	01	H2802_001_0	4	4	Non-Preferred Brand	100100	
H2810	001	0	1	04	01	H2810_001_0	6	4	Non-Preferred Brand	100000	
H2810	001	0	1	04	01	H2810_001_0	6	3	Preferred Brand	000001	
H2810	001	0	1	04	01	H2810_001_0	6	1	Preferred Generic	001000	
H2810	001	0	1	04	01	H2810_001_0	6	2	Non-Preferred Generic	000100	
H2816	013	0	1	09	04	H2816_013_0	6	5	Specialty Tier	010010	
H2816	013	0	1	09	04	H2816_013_0	6	1	Preferred Generic	001000	
H2816	013	0	1	09	04	H2816_013_0	6	2	Non-Preferred Generic	000100	
H2816	013	0	1	09	04	H2816_013_0	6	3	Preferred Brand	000101	
H2816	013	0	1	09	04	H2816_013_0	6	4	Non-Preferred Brand	100100	
H2816	019	0	1	09	04	H2816_019_0	7	2	Non-Preferred Generic	000100	
H2816	019	0	1	09	04	H2816_019_0	7	5	Specialty Tier	010010	
H2816	019	0	1	09	04	H2816_019_0	7	4	Non-Preferred Brand	100100	
H2816	019	0	1	09	04	H2816_019_0	7	3	Preferred Brand	000101	
H2816	019	0	1	09	04	H2816_019_0	7	1	Preferred Generic	001000	
H2816	021	0	1	09	04	H2816_021_0	6	2	Non-Preferred Generic	000100	
H2816	021	0	1	09	04	H2816_021_0	6	1	Preferred Generic	001000	
H2816	021	0	1	09	04	H2816_021_0	6	4	Non-Preferred Brand	100100	
H2816	021	0	1	09	04	H2816_021_0	6	3	Preferred Brand	000101	
H2816	021	0	1	09	04	H2816_021_0	6	5	Specialty Tier	010010	
H2816	022	0	1	09	04	H2816_022_0	6	2	Non-Preferred Generic	000100	
H2816	022	0	1	09	04	H2816_022_0	6	5	Specialty Tier	010010	
H2816	022	0	1	09	04	H2816_022_0	6	4	Non-Preferred Brand	100100	
H2816	022	0	1	09	04	H2816_022_0	6	3	Preferred Brand	000101	
H2816	022	0	1	09	04	H2816_022_0	6	1	Preferred Generic	001000	
H2816	027	0	1	09	04	H2816_027_0	6	5	Specialty Tier	010010	
H2816	027	0	1	09	04	H2816_027_0	6	1	Preferred Generic	001000	
H2816	027	0	1	09	04	H2816_027_0	6	2	Non-Preferred Generic	000100	
H2816	027	0	1	09	04	H2816_027_0	6	3	Preferred Brand	000101	
H2816	027	0	1	09	04	H2816_027_0	6	4	Non-Preferred Brand	100100	
H2816	028	0	1	09	04	H2816_028_0	6	2	Non-Preferred Generic	000100	
H2816	028	0	1	09	04	H2816_028_0	6	5	Specialty Tier	010010	
H2816	028	0	1	09	04	H2816_028_0	6	4	Non-Preferred Brand	100100	
H2816	028	0	1	09	04	H2816_028_0	6	3	Preferred Brand	000101	
H2816	028	0	1	09	04	H2816_028_0	6	1	Preferred Generic	001000	
H2836	001	0	1	04	01	H2836_001_0	6	4	Non-Preferred Brand	100100	
H2836	001	0	1	04	01	H2836_001_0	6	5	Injectable Drugs	010010	
H2836	001	0	1	04	01	H2836_001_0	6	3	Preferred Brand	000101	
H2836	001	0	1	04	01	H2836_001_0	6	6	Specialty Tier	010010	
H2836	001	0	1	04	01	H2836_001_0	6	2	Non-Preferred Generic	000100	
H2836	001	0	1	04	01	H2836_001_0	6	1	Preferred Generic	001000	
H2905	001	0	1	04	01	H2905_001_0	8	3	Preferred Brand	010001	
H2905	001	0	1	04	01	H2905_001_0	8	1	Preferred Generic	001000	
H2905	001	0	1	04	01	H2905_001_0	8	2	Non-Preferred Generic	000100	
H2905	001	0	1	04	01	H2905_001_0	8	5	Specialty Tier	010010	
H2905	001	0	1	04	01	H2905_001_0	8	4	Non-Preferred Brand	100100	
H2906	003	0	1	04	01	H2906_003_0	8	6	Select Diabetic Drugs	000010	
H2906	003	0	1	04	01	H2906_003_0	8	1	Preferred Generic	001000	1
H2906	003	0	1	04	01	H2906_003_0	8	2	Non-Preferred Generic	000100	1
H2906	003	0	1	04	01	H2906_003_0	8	3	Preferred Brand	000001	1
H2906	003	0	1	04	01	H2906_003_0	8	5	Specialty Tier	010010	
H2906	003	0	1	04	01	H2906_003_0	8	4	Non-Preferred Brand	100000	
H2906	003	0	1	04	01	H2906_003_0	8	6	Select Diabetic Drugs	000010	1
H2906	003	0	1	04	01	H2906_003_0	8	2	Non-Preferred Generic	000100	
H2906	003	0	1	04	01	H2906_003_0	8	1	Preferred Generic	001000	
H2906	003	0	1	04	01	H2906_003_0	8	3	Preferred Brand	000001	
H2906	005	0	1	04	01	H2906_005_0	8	4	Non-Preferred Brand	100000	
H2906	005	0	1	04	01	H2906_005_0	8	3	Preferred Brand	000001	
H2906	005	0	1	04	01	H2906_005_0	8	2	Non-Preferred Generic	000100	
H2906	005	0	1	04	01	H2906_005_0	8	1	Preferred Generic	001000	
H2906	005	0	1	04	01	H2906_005_0	8	5	Specialty Tier	010010	
H2906	005	0	1	04	01	H2906_005_0	8	2	Non-Preferred Generic	000100	1
H2906	005	0	1	04	01	H2906_005_0	8	1	Preferred Generic	001000	1
H2906	005	0	1	04	01	H2906_005_0	8	6	Select Diabetic Drugs	000010	
H2906	006	0	1	04	01	H2906_006_0	8	1	Preferred Generic	001000	
H2906	006	0	1	04	01	H2906_006_0	8	2	Non-Preferred Generic	000100	
H2906	006	0	1	04	01	H2906_006_0	8	2	Non-Preferred Generic	000100	1
H2906	006	0	1	04	01	H2906_006_0	8	1	Preferred Generic	001000	1
H2906	006	0	1	04	01	H2906_006_0	8	6	Select Diabetic Drugs	000010	
H2906	006	0	1	04	01	H2906_006_0	8	5	Specialty Tier	010010	
H2906	006	0	1	04	01	H2906_006_0	8	4	Non-Preferred Brand	100000	
H2906	006	0	1	04	01	H2906_006_0	8	3	Preferred Brand	000001	
H2906	007	0	1	04	01	H2906_007_0	6	1	Preferred Generic	001000	
H2906	007	0	1	04	01	H2906_007_0	6	5	Specialty Tier	010010	
H2906	007	0	1	04	01	H2906_007_0	6	6	Select Diabetic Drugs	000010	
H2906	007	0	1	04	01	H2906_007_0	6	1	Preferred Generic	001000	1
H2906	007	0	1	04	01	H2906_007_0	6	4	Non-Preferred Brand	100000	
H2906	007	0	1	04	01	H2906_007_0	6	3	Preferred Brand	000001	
H2906	007	0	1	04	01	H2906_007_0	6	2	Non-Preferred Generic	000100	
H2906	007	0	1	04	01	H2906_007_0	6	2	Non-Preferred Generic	000100	1
H2911	001	0	1	02	01	H2911_001_0	8	1	Preferred Generic	001000	
H2911	001	0	1	02	01	H2911_001_0	8	2	Non-Preferred Generic	000100	
H2911	001	0	1	02	01	H2911_001_0	8	5	Specialty Tier	100000	
H2911	001	0	1	02	01	H2911_001_0	8	4	Non-Preferred Brand	100000	
H2911	001	0	1	02	01	H2911_001_0	8	3	Preferred Brand	000001	
H2931	002	0	1	01	01	H2931_002_0	8	1	Preferred Generic	001000	
H2931	002	0	1	01	01	H2931_002_0	8	2	Non-Preferred Generic	000100	
H2931	002	0	1	01	01	H2931_002_0	8	3	Preferred Brand	010001	
H2931	002	0	1	01	01	H2931_002_0	8	4	Non-Preferred Brand	100100	
H2931	002	0	1	01	01	H2931_002_0	8	5	Specialty Tier	010010	
H2931	002	0	1	01	01	H2931_002_0	8	1	Preferred Generic	001000	1
H2931	002	0	1	01	01	H2931_002_0	8	2	Non-Preferred Generic	000100	1
H2931	004	0	1	01	01	H2931_004_0	6	1	Preferred Generic	001000	
H2931	004	0	1	01	01	H2931_004_0	6	2	Non-Preferred Generic	000100	
H2931	004	0	1	01	01	H2931_004_0	6	3	Preferred Brand	010001	
H2931	004	0	1	01	01	H2931_004_0	6	4	Non-Preferred Brand	100100	
H2931	004	0	1	01	01	H2931_004_0	6	5	Specialty Tier	010010	
H2944	004	0	1	09	04	H2944_004_0	5	4	Non-Preferred Brand	110000	
H2944	004	0	1	09	04	H2944_004_0	5	3	Preferred Brand	000101	
H2944	004	0	1	09	04	H2944_004_0	5	2	Non-Preferred Generic	000101	
H2944	004	0	1	09	04	H2944_004_0	5	1	Preferred Generic	001010	
H2944	004	0	1	09	04	H2944_004_0	5	5	Specialty Tier	010010	
H2944	013	0	1	09	04	H2944_013_0	9	1	Preferred Generic	001010	
H2944	013	0	1	09	04	H2944_013_0	9	2	Non-Preferred Generic	000101	
H2944	013	0	1	09	04	H2944_013_0	9	3	Preferred Brand	000101	
H2944	013	0	1	09	04	H2944_013_0	9	4	Non-Preferred Brand	110000	
H2944	013	0	1	09	04	H2944_013_0	9	5	Specialty Tier	010010	2
H2944	013	0	1	09	04	H2944_013_0	9	1	Preferred Generic	001010	2
H2944	013	0	1	09	04	H2944_013_0	9	2	Non-Preferred Generic	000101	2
H2944	013	0	1	09	04	H2944_013_0	9	5	Specialty Tier	010010	
H2944	013	0	1	09	04	H2944_013_0	9	4	Non-Preferred Brand	110000	2
H2944	013	0	1	09	04	H2944_013_0	9	3	Preferred Brand	000101	2
H2944	024	0	1	09	04	H2944_024_0	5	2	Non-Preferred Generic	000101	2
H2944	024	0	1	09	04	H2944_024_0	5	1	Preferred Generic	001010	2
H2944	024	0	1	09	04	H2944_024_0	5	5	Specialty Tier	010010	
H2944	024	0	1	09	04	H2944_024_0	5	3	Preferred Brand	000101	
H2944	024	0	1	09	04	H2944_024_0	5	4	Non-Preferred Brand	110000	
H2944	024	0	1	09	04	H2944_024_0	5	5	Specialty Tier	010010	2
H2944	024	0	1	09	04	H2944_024_0	5	4	Non-Preferred Brand	110000	2
H2944	024	0	1	09	04	H2944_024_0	5	3	Preferred Brand	000101	2
H2944	024	0	1	09	04	H2944_024_0	5	2	Non-Preferred Generic	000101	
H2944	024	0	1	09	04	H2944_024_0	5	1	Preferred Generic	001010	
H2944	041	0	1	09	04	H2944_041_0	7	1	Preferred Generic	001010	
H2944	041	0	1	09	04	H2944_041_0	7	2	Non-Preferred Generic	000101	
H2944	041	0	1	09	04	H2944_041_0	7	5	Specialty Tier	010010	2
H2944	041	0	1	09	04	H2944_041_0	7	4	Non-Preferred Brand	110000	2
H2944	041	0	1	09	04	H2944_041_0	7	3	Preferred Brand	000101	2
H2944	041	0	1	09	04	H2944_041_0	7	2	Non-Preferred Generic	000101	2
H2944	041	0	1	09	04	H2944_041_0	7	1	Preferred Generic	001010	2
H2944	041	0	1	09	04	H2944_041_0	7	5	Specialty Tier	010010	
H2944	041	0	1	09	04	H2944_041_0	7	4	Non-Preferred Brand	110000	
H2944	041	0	1	09	04	H2944_041_0	7	3	Preferred Brand	000101	
H2944	078	0	1	09	04	H2944_078_0	8	1	Preferred Generic	001010	
H2944	078	0	1	09	04	H2944_078_0	8	5	Specialty Tier	010010	
H2944	078	0	1	09	04	H2944_078_0	8	1	Preferred Generic	001010	2
H2944	078	0	1	09	04	H2944_078_0	8	2	Non-Preferred Generic	000101	2
H2944	078	0	1	09	04	H2944_078_0	8	5	Specialty Tier	010010	2
H2944	078	0	1	09	04	H2944_078_0	8	4	Non-Preferred Brand	110000	2
H2944	078	0	1	09	04	H2944_078_0	8	4	Non-Preferred Brand	110000	
H2944	078	0	1	09	04	H2944_078_0	8	3	Preferred Brand	000101	
H2944	078	0	1	09	04	H2944_078_0	8	2	Non-Preferred Generic	000101	
H2944	078	0	1	09	04	H2944_078_0	8	3	Preferred Brand	000101	2
H2944	085	0	1	09	04	H2944_085_0	4	1	Preferred Generic	001010	
H2944	085	0	1	09	04	H2944_085_0	4	2	Non-Preferred Generic	000101	
H2944	085	0	1	09	04	H2944_085_0	4	3	Preferred Brand	000101	
H2944	085	0	1	09	04	H2944_085_0	4	4	Non-Preferred Brand	110000	
H2944	085	0	1	09	04	H2944_085_0	4	5	Specialty Tier	010010	
H2944	114	0	1	09	04	H2944_114_0	6	4	Non-Preferred Brand	110000	
H2944	114	0	1	09	04	H2944_114_0	6	3	Preferred Brand	000101	
H2944	114	0	1	09	04	H2944_114_0	6	2	Non-Preferred Generic	000101	
H2944	114	0	1	09	04	H2944_114_0	6	1	Preferred Generic	001010	
H2944	114	0	1	09	04	H2944_114_0	6	5	Specialty Tier	010010	
H2944	124	0	1	09	04	H2944_124_0	3	1	Preferred Generic	001010	2
H2944	124	0	1	09	04	H2944_124_0	3	2	Non-Preferred Generic	000101	2
H2944	124	0	1	09	04	H2944_124_0	3	3	Preferred Brand	000101	2
H2944	124	0	1	09	04	H2944_124_0	3	4	Non-Preferred Brand	110000	2
H2944	124	0	1	09	04	H2944_124_0	3	5	Specialty Tier	010010	
H2944	124	0	1	09	04	H2944_124_0	3	4	Non-Preferred Brand	110000	
H2944	124	0	1	09	04	H2944_124_0	3	5	Specialty Tier	010010	2
H2944	124	0	1	09	04	H2944_124_0	3	2	Non-Preferred Generic	000101	
H2944	124	0	1	09	04	H2944_124_0	3	1	Preferred Generic	001010	
H2944	124	0	1	09	04	H2944_124_0	3	3	Preferred Brand	000101	
H2944	127	0	1	09	04	H2944_127_0	5	1	Preferred Generic	001010	
H2944	127	0	1	09	04	H2944_127_0	5	2	Non-Preferred Generic	000101	
H2944	127	0	1	09	04	H2944_127_0	5	3	Preferred Brand	000101	
H2944	127	0	1	09	04	H2944_127_0	5	4	Non-Preferred Brand	110000	
H2944	127	0	1	09	04	H2944_127_0	5	5	Specialty Tier	010010	
H2944	127	0	1	09	04	H2944_127_0	5	1	Preferred Generic	001010	2
H2944	127	0	1	09	04	H2944_127_0	5	2	Non-Preferred Generic	000101	2
H2944	127	0	1	09	04	H2944_127_0	5	3	Preferred Brand	000101	2
H2944	127	0	1	09	04	H2944_127_0	5	4	Non-Preferred Brand	110000	2
H2944	127	0	1	09	04	H2944_127_0	5	5	Specialty Tier	010010	2
H2944	128	0	1	09	04	H2944_128_0	5	5	Specialty Tier	010010	2
H2944	128	0	1	09	04	H2944_128_0	5	3	Preferred Brand	000101	2
H2944	128	0	1	09	04	H2944_128_0	5	2	Non-Preferred Generic	000101	2
H2944	128	0	1	09	04	H2944_128_0	5	1	Preferred Generic	001010	2
H2944	128	0	1	09	04	H2944_128_0	5	4	Non-Preferred Brand	110000	2
H2944	128	0	1	09	04	H2944_128_0	5	4	Non-Preferred Brand	110000	
H2944	128	0	1	09	04	H2944_128_0	5	3	Preferred Brand	000101	
H2944	128	0	1	09	04	H2944_128_0	5	2	Non-Preferred Generic	000101	
H2944	128	0	1	09	04	H2944_128_0	5	1	Preferred Generic	001010	
H2944	128	0	1	09	04	H2944_128_0	5	5	Specialty Tier	010010	
H2944	133	0	1	09	04	H2944_133_0	8	1	Preferred Generic	001010	
H2944	133	0	1	09	04	H2944_133_0	8	3	Preferred Brand	000101	
H2944	133	0	1	09	04	H2944_133_0	8	2	Non-Preferred Generic	000101	
H2944	133	0	1	09	04	H2944_133_0	8	4	Non-Preferred Brand	110000	
H2944	133	0	1	09	04	H2944_133_0	8	5	Specialty Tier	010010	
H2944	133	0	1	09	04	H2944_133_0	8	1	Preferred Generic	001010	2
H2944	133	0	1	09	04	H2944_133_0	8	5	Specialty Tier	010010	2
H2944	133	0	1	09	04	H2944_133_0	8	2	Non-Preferred Generic	000101	2
H2944	133	0	1	09	04	H2944_133_0	8	3	Preferred Brand	000101	2
H2944	133	0	1	09	04	H2944_133_0	8	4	Non-Preferred Brand	110000	2
H2949	012	0	1	01	01	H2949_012_0	5	5	Specialty Tier	010010	2
H2949	012	0	1	01	01	H2949_012_0	5	4	Non-Preferred Brand	110000	2
H2949	012	0	1	01	01	H2949_012_0	5	3	Preferred Brand	000101	2
H2949	012	0	1	01	01	H2949_012_0	5	2	Non-Preferred Generic	000101	1
H2949	012	0	1	01	01	H2949_012_0	5	1	Preferred Generic	001010	
H2949	012	0	1	01	01	H2949_012_0	5	5	Specialty Tier	010010	
H2949	012	0	1	01	01	H2949_012_0	5	4	Non-Preferred Brand	110000	
H2949	012	0	1	01	01	H2949_012_0	5	3	Preferred Brand	000101	
H2949	012	0	1	01	01	H2949_012_0	5	2	Non-Preferred Generic	000101	
H2949	012	0	1	01	01	H2949_012_0	5	1	Preferred Generic	001010	1
H2949	013	0	1	01	01	H2949_013_0	7	4	Non-Preferred Brand	110000	2
H2949	013	0	1	01	01	H2949_013_0	7	3	Preferred Brand	000101	2
H2949	013	0	1	01	01	H2949_013_0	7	2	Non-Preferred Generic	000101	2
H2949	013	0	1	01	01	H2949_013_0	7	1	Preferred Generic	001010	2
H2949	013	0	1	01	01	H2949_013_0	7	5	Specialty Tier	010010	
H2949	013	0	1	01	01	H2949_013_0	7	3	Preferred Brand	000101	
H2949	013	0	1	01	01	H2949_013_0	7	2	Non-Preferred Generic	000101	
H2949	013	0	1	01	01	H2949_013_0	7	1	Preferred Generic	001010	
H2949	013	0	1	01	01	H2949_013_0	7	5	Specialty Tier	010010	2
H2949	013	0	1	01	01	H2949_013_0	7	4	Non-Preferred Brand	110000	
H2949	014	0	1	01	01	H2949_014_0	6	4	Non-Preferred Brand	110000	2
H2949	014	0	1	01	01	H2949_014_0	6	3	Preferred Brand	000101	2
H2949	014	0	1	01	01	H2949_014_0	6	2	Non-Preferred Generic	000101	2
H2949	014	0	1	01	01	H2949_014_0	6	1	Preferred Generic	001010	2
H2949	014	0	1	01	01	H2949_014_0	6	5	Specialty Tier	010010	2
H2949	014	0	1	01	01	H2949_014_0	6	4	Non-Preferred Brand	110000	
H2949	014	0	1	01	01	H2949_014_0	6	3	Preferred Brand	000101	
H2949	014	0	1	01	01	H2949_014_0	6	2	Non-Preferred Generic	000101	
H2949	014	0	1	01	01	H2949_014_0	6	1	Preferred Generic	001010	
H2949	014	0	1	01	01	H2949_014_0	6	5	Specialty Tier	010010	
H2960	004	0	1	01	01	H2960_004_0	9	2	Non-Preferred Generic	000100	1
H2960	004	0	1	01	01	H2960_004_0	9	1	Preferred Generic	001000	
H2960	004	0	1	01	01	H2960_004_0	9	1	Preferred Generic	001000	1
H2960	004	0	1	01	01	H2960_004_0	9	6	Select Diabetic Drugs	000010	
H2960	004	0	1	01	01	H2960_004_0	9	5	Specialty Tier	010010	
H2960	004	0	1	01	01	H2960_004_0	9	4	Non-Preferred Brand	100000	
H2960	004	0	1	01	01	H2960_004_0	9	3	Preferred Brand	000001	
H2960	004	0	1	01	01	H2960_004_0	9	2	Non-Preferred Generic	000100	
H2960	010	0	1	01	01	H2960_010_0	9	1	Preferred Generic	001000	
H2960	010	0	1	01	01	H2960_010_0	9	2	Non-Preferred Generic	000100	
H2960	010	0	1	01	01	H2960_010_0	9	3	Preferred Brand	000001	
H2960	010	0	1	01	01	H2960_010_0	9	4	Non-Preferred Brand	100000	
H2960	010	0	1	01	01	H2960_010_0	9	5	Specialty Tier	010010	
H2960	010	0	1	01	01	H2960_010_0	9	6	Select Diabetic Drugs	000010	
H2960	010	0	1	01	01	H2960_010_0	9	1	Preferred Generic	001000	1
H2960	010	0	1	01	01	H2960_010_0	9	2	Non-Preferred Generic	000100	1
H2960	010	0	1	01	01	H2960_010_0	9	6	Select Diabetic Drugs	000010	1
H2960	010	0	1	01	01	H2960_010_0	9	3	Preferred Brand	000001	1
H2960	012	0	1	01	01	H2960_012_0	9	2	Non-Preferred Generic	000100	1
H2960	012	0	1	01	01	H2960_012_0	9	1	Preferred Generic	001000	1
H2960	012	0	1	01	01	H2960_012_0	9	6	Select Diabetic Drugs	000010	
H2960	012	0	1	01	01	H2960_012_0	9	5	Specialty Tier	010010	
H2960	012	0	1	01	01	H2960_012_0	9	4	Non-Preferred Brand	100000	
H2960	012	0	1	01	01	H2960_012_0	9	3	Preferred Brand	000001	
H2960	012	0	1	01	01	H2960_012_0	9	1	Preferred Generic	001000	
H2960	012	0	1	01	01	H2960_012_0	9	2	Non-Preferred Generic	000100	
H2960	018	0	1	01	01	H2960_018_0	9	1	Preferred Generic	001000	1
H2960	018	0	1	01	01	H2960_018_0	9	2	Non-Preferred Generic	000100	1
H2960	018	0	1	01	01	H2960_018_0	9	5	Specialty Tier	010010	
H2960	018	0	1	01	01	H2960_018_0	9	4	Non-Preferred Brand	100000	
H2960	018	0	1	01	01	H2960_018_0	9	3	Preferred Brand	000001	
H2960	018	0	1	01	01	H2960_018_0	9	2	Non-Preferred Generic	000100	
H2960	018	0	1	01	01	H2960_018_0	9	1	Preferred Generic	001000	
H2960	018	0	1	01	01	H2960_018_0	9	6	Select Diabetic Drugs	000010	
H2962	001	0	1	01	01	H2962_001_0	10	1	Preferred Generic	001000	
H2962	001	0	1	01	01	H2962_001_0	10	2	Preferred Brand	000101	
H2962	001	0	1	01	01	H2962_001_0	10	3	Non-Preferred Brand	100000	
H2962	001	0	1	01	01	H2962_001_0	10	4	Specialty Tier	010010	
H2962	001	0	1	01	01	H2962_001_0	10	1	Preferred Generic	001000	1
H2962	001	0	1	01	01	H2962_001_0	10	2	Preferred Brand	000101	2
H2962	002	0	1	01	01	H2962_002_0	10	2	Preferred Brand	000101	2
H2962	002	0	1	01	01	H2962_002_0	10	1	Preferred Generic	001000	
H2962	002	0	1	01	01	H2962_002_0	10	2	Preferred Brand	000101	
H2962	002	0	1	01	01	H2962_002_0	10	3	Non-Preferred Brand	100000	
H2962	002	0	1	01	01	H2962_002_0	10	4	Specialty Tier	010010	
H2962	002	0	1	01	01	H2962_002_0	10	1	Preferred Generic	001000	1
H3054	002	0	1	01	01	H3054_002_0	11	4	Non-Preferred Brand	100000	
H3054	002	0	1	01	01	H3054_002_0	11	2	Non-Preferred Generic	000100	1
H3054	002	0	1	01	01	H3054_002_0	11	1	Preferred Generic	001000	1
H3054	002	0	1	01	01	H3054_002_0	11	5	Specialty Tier	100000	
H3054	002	0	1	01	01	H3054_002_0	11	3	Preferred Brand	000001	
H3054	002	0	1	01	01	H3054_002_0	11	1	Preferred Generic	001000	
H3054	002	0	1	01	01	H3054_002_0	11	2	Non-Preferred Generic	000100	
H3067	001	0	1	48	05	H3067_001_0	12	1	Generic Drugs	010000	
H3067	001	0	1	48	05	H3067_001_0	12	2	Brand Drugs	000010	
H3067	001	0	1	48	05	H3067_001_0	12	3	Non-Medicare Rx/OTC Drugs	010010	
H3071	002	0	1	01	01	H3071_002_0	10	2	Brand	000010	
H3071	002	0	1	01	01	H3071_002_0	10	1	Generic	010000	
H3107	004	0	1	01	01	H3107_004_0	5	4	Non-Preferred Brand	100100	
H3107	004	0	1	01	01	H3107_004_0	5	5	Specialty Tier	010010	
H3107	004	0	1	01	01	H3107_004_0	5	3	Preferred Brand	010001	
H3107	004	0	1	01	01	H3107_004_0	5	2	Non-Preferred Generic	000100	
H3107	004	0	1	01	01	H3107_004_0	5	1	Preferred Generic	001000	
H3107	012	0	1	01	01	H3107_012_0	5	3	Preferred Brand	010001	
H3107	012	0	1	01	01	H3107_012_0	5	5	Specialty Tier	010010	
H3107	012	0	1	01	01	H3107_012_0	5	4	Non-Preferred Brand	100100	
H3107	012	0	1	01	01	H3107_012_0	5	2	Non-Preferred Generic	000100	
H3107	012	0	1	01	01	H3107_012_0	5	1	Preferred Generic	001000	
H3132	001	0	1	01	01	H3132_001_0	5	3	Non-Preferred Brand	100000	
H3132	001	0	1	01	01	H3132_001_0	5	2	Preferred Brand	010001	
H3132	001	0	1	01	01	H3132_001_0	5	1	Preferred Generic	001001	
H3144	001	0	1	01	01	H3144_001_0	7	4	Non-Preferred Brand	100100	
H3144	001	0	1	01	01	H3144_001_0	7	5	Specialty Tier	010010	
H3144	001	0	1	01	01	H3144_001_0	7	1	Preferred Generic	001000	
H3144	001	0	1	01	01	H3144_001_0	7	2	Non-Preferred Generic	000100	
H3144	001	0	1	01	01	H3144_001_0	7	3	Preferred Brand	000001	
H3144	002	0	1	01	01	H3144_002_0	8	1	Preferred Generic	001000	
H3144	002	0	1	01	01	H3144_002_0	8	2	Non-Preferred Generic	000100	
H3144	002	0	1	01	01	H3144_002_0	8	3	Preferred Brand	000001	
H3144	002	0	1	01	01	H3144_002_0	8	4	Non-Preferred Brand	100100	
H3144	002	0	1	01	01	H3144_002_0	8	5	Specialty Tier	010010	
H3144	003	0	1	01	01	H3144_003_0	7	1	Preferred Generic	001000	
H3144	003	0	1	01	01	H3144_003_0	7	2	Non-Preferred Generic	000100	
H3144	003	0	1	01	01	H3144_003_0	7	3	Preferred Brand	000001	
H3144	003	0	1	01	01	H3144_003_0	7	4	Non-Preferred Brand	100100	
H3144	003	0	1	01	01	H3144_003_0	7	5	Specialty Tier	010010	
H3152	022	0	1	01	01	H3152_022_0	6	3	Non-Preferred Brand	110000	
H3152	022	0	1	01	01	H3152_022_0	6	5	Select Care Drugs	010000	
H3152	022	0	1	01	01	H3152_022_0	6	4	Specialty Tier	010010	
H3152	022	0	1	01	01	H3152_022_0	6	2	Preferred Brand	010001	
H3152	022	0	1	01	01	H3152_022_0	6	1	Generic	010000	
H3152	046	0	1	01	01	H3152_046_0	6	5	Select Care Drugs	010000	
H3152	046	0	1	01	01	H3152_046_0	6	4	Specialty Tier	010010	
H3152	046	0	1	01	01	H3152_046_0	6	3	Non-Preferred Brand	110000	
H3152	046	0	1	01	01	H3152_046_0	6	2	Preferred Brand	010001	
H3152	046	0	1	01	01	H3152_046_0	6	1	Generic	010000	
H3152	046	0	1	01	01	H3152_046_0	6	5	Select Care Drugs	010000	1
H3152	048	0	1	01	01	H3152_048_0	6	3	Non-Preferred Brand	110000	
H3152	048	0	1	01	01	H3152_048_0	6	4	Specialty Tier	010010	
H3152	048	0	1	01	01	H3152_048_0	6	5	Select Care Drugs	010000	
H3152	048	0	1	01	01	H3152_048_0	6	5	Select Care Drugs	010000	1
H3152	048	0	1	01	01	H3152_048_0	6	1	Generic	010000	
H3152	048	0	1	01	01	H3152_048_0	6	2	Preferred Brand	010001	
H3152	077	0	1	01	01	H3152_077_0	6	2	Preferred Brand	010001	
H3152	077	0	1	01	01	H3152_077_0	6	3	Non-Preferred Brand	110000	
H3152	077	0	1	01	01	H3152_077_0	6	4	Specialty Tier	010010	
H3152	077	0	1	01	01	H3152_077_0	6	5	Select Care Drugs	010000	
H3152	077	0	1	01	01	H3152_077_0	6	1	Generic	010000	
H3152	077	0	1	01	01	H3152_077_0	6	5	Select Care Drugs	010000	1
H3154	004	0	1	01	01	H3154_004_0	10	1	Preferred Generic	001000	
H3154	004	0	1	01	01	H3154_004_0	10	5	Specialty Tier	010010	
H3154	004	0	1	01	01	H3154_004_0	10	4	Non-Preferred Brand	110000	
H3154	004	0	1	01	01	H3154_004_0	10	3	Preferred Brand	000001	
H3154	004	0	1	01	01	H3154_004_0	10	2	Non-Preferred Generic	000100	
H3154	022	0	1	01	01	H3154_022_0	8	4	Non-Preferred Brand	110000	
H3154	022	0	1	01	01	H3154_022_0	8	1	Preferred Generic	001000	
H3154	022	0	1	01	01	H3154_022_0	8	2	Non-Preferred Generic	000100	
H3154	022	0	1	01	01	H3154_022_0	8	5	Specialty Tier	010010	
H3154	022	0	1	01	01	H3154_022_0	8	3	Preferred Brand	000001	
H3156	030	0	1	01	01	H3156_030_0	7	5	Specialty Tier	101101	
H3156	030	0	1	01	01	H3156_030_0	7	1	Preferred Generic	001000	
H3156	030	0	1	01	01	H3156_030_0	7	2	Non-Preferred Generic	000100	
H3156	030	0	1	01	01	H3156_030_0	7	3	Preferred Brand	000001	
H3156	030	0	1	01	01	H3156_030_0	7	4	Non-Preferred Brand	100000	
H3156	032	0	1	01	01	H3156_032_0	7	2	Non-Preferred Generic	000100	
H3156	032	0	1	01	01	H3156_032_0	7	1	Preferred Generic	001000	
H3156	032	0	1	01	01	H3156_032_0	7	3	Preferred Brand	000001	
H3156	032	0	1	01	01	H3156_032_0	7	4	Non-Preferred Brand	100000	
H3156	032	0	1	01	01	H3156_032_0	7	5	Specialty Tier	101101	
H3156	034	0	1	01	01	H3156_034_0	7	5	Specialty Tier	101101	
H3156	034	0	1	01	01	H3156_034_0	7	3	Preferred Brand	000001	
H3156	034	0	1	01	01	H3156_034_0	7	2	Non-Preferred Generic	000100	
H3156	034	0	1	01	01	H3156_034_0	7	4	Non-Preferred Brand	100000	
H3156	034	0	1	01	01	H3156_034_0	7	1	Preferred Generic	001000	
H3204	001	0	1	01	01	H3204_001_0	9	4	Non-Preferred Brand	100100	
H3204	001	0	1	01	01	H3204_001_0	9	2	Non-Preferred Generic	000100	
H3204	001	0	1	01	01	H3204_001_0	9	1	Preferred Generic	001000	
H3204	001	0	1	01	01	H3204_001_0	9	5	Specialty Tier	010010	
H3204	001	0	1	01	01	H3204_001_0	9	3	Preferred Brand	000001	
H3204	007	0	1	01	01	H3204_007_0	9	5	Specialty Tier	010010	
H3204	007	0	1	01	01	H3204_007_0	9	1	Preferred Generic	001000	1
H3204	007	0	1	01	01	H3204_007_0	9	2	Non-Preferred Generic	000100	1
H3204	007	0	1	01	01	H3204_007_0	9	4	Non-Preferred Brand	100100	
H3204	007	0	1	01	01	H3204_007_0	9	3	Preferred Brand	000001	
H3204	007	0	1	01	01	H3204_007_0	9	2	Non-Preferred Generic	000100	
H3204	007	0	1	01	01	H3204_007_0	9	1	Preferred Generic	001000	
H3206	001	0	1	04	01	H3206_001_0	9	1	Preferred Generic	001000	
H3206	001	0	1	04	01	H3206_001_0	9	2	Non-Preferred Generic	000100	
H3206	001	0	1	04	01	H3206_001_0	9	3	Preferred Brand	000001	
H3206	001	0	1	04	01	H3206_001_0	9	4	Non-Preferred Brand	100100	
H3206	001	0	1	04	01	H3206_001_0	9	5	Specialty Tier	010010	
H3206	002	0	1	04	01	H3206_002_0	9	1	Preferred Generic	001000	1
H3206	002	0	1	04	01	H3206_002_0	9	2	Non-Preferred Generic	000100	1
H3206	002	0	1	04	01	H3206_002_0	9	1	Preferred Generic	001000	
H3206	002	0	1	04	01	H3206_002_0	9	2	Non-Preferred Generic	000100	
H3206	002	0	1	04	01	H3206_002_0	9	5	Specialty Tier	010010	
H3206	002	0	1	04	01	H3206_002_0	9	3	Preferred Brand	000001	
H3206	002	0	1	04	01	H3206_002_0	9	4	Non-Preferred Brand	100100	
H3237	001	0	1	48	05	H3237_001_0	5	3	Non-Medicare Rx/OTC Drugs	010010	
H3237	001	0	1	48	05	H3237_001_0	5	1	Generic Drugs	010000	
H3237	001	0	1	48	05	H3237_001_0	5	2	Brand Drugs	000010	
H3237	002	0	1	48	05	H3237_002_0	4	3	Non-Medicare Rx/OTC Drugs	010010	
H3237	002	0	1	48	05	H3237_002_0	4	2	Brand Drugs	000010	
H3237	002	0	1	48	05	H3237_002_0	4	1	Generic Drugs	010000	
H3251	002	0	1	01	01	H3251_002_0	10	4	Non-Preferred Brand	100000	
H3251	002	0	1	01	01	H3251_002_0	10	5	Specialty Tier	000010	
H3251	002	0	1	01	01	H3251_002_0	10	1	Preferred Generic	001000	1
H3251	002	0	1	01	01	H3251_002_0	10	3	Preferred Brand	000001	
H3251	002	0	1	01	01	H3251_002_0	10	2	Non-Preferred Generic	000100	1
H3251	002	0	1	01	01	H3251_002_0	10	1	Preferred Generic	001000	
H3251	002	0	1	01	01	H3251_002_0	10	2	Non-Preferred Generic	000100	
H3251	021	0	1	02	01	H3251_021_0	9	4	Non-Preferred Brand	100000	
H3251	021	0	1	02	01	H3251_021_0	9	1	Preferred Generic	001000	
H3251	021	0	1	02	01	H3251_021_0	9	2	Non-Preferred Generic	000100	
H3251	021	0	1	02	01	H3251_021_0	9	3	Preferred Brand	000001	
H3251	021	0	1	02	01	H3251_021_0	9	5	Specialty Tier	000010	
H3251	021	0	1	02	01	H3251_021_0	9	1	Preferred Generic	001000	1
H3251	021	0	1	02	01	H3251_021_0	9	2	Non-Preferred Generic	000100	1
H3251	024	0	1	01	01	H3251_024_0	12	1	Preferred Generic	001000	1
H3251	024	0	1	01	01	H3251_024_0	12	4	Non-Preferred Brand	100000	
H3251	024	0	1	01	01	H3251_024_0	12	3	Preferred Brand	000001	
H3251	024	0	1	01	01	H3251_024_0	12	2	Non-Preferred Generic	000100	1
H3251	024	0	1	01	01	H3251_024_0	12	5	Specialty Tier	000010	
H3251	024	0	1	01	01	H3251_024_0	12	1	Preferred Generic	001000	
H3251	024	0	1	01	01	H3251_024_0	12	2	Non-Preferred Generic	000100	
H3251	027	0	1	01	01	H3251_027_0	7	5	Specialty Tier	000010	
H3251	027	0	1	01	01	H3251_027_0	7	4	Non-Preferred Brand	100000	
H3251	027	0	1	01	01	H3251_027_0	7	3	Preferred Brand	000001	
H3251	027	0	1	01	01	H3251_027_0	7	1	Preferred Generic	001000	
H3251	027	0	1	01	01	H3251_027_0	7	2	Non-Preferred Generic	000100	
H3305	011	0	1	02	01	H3305_011_0	7	3	Non-Preferred Brand	100100	
H3305	011	0	1	02	01	H3305_011_0	7	4	Specialty Tier	010010	
H3305	011	0	1	02	01	H3305_011_0	7	5	Select Care Drugs	010010	
H3305	011	0	1	02	01	H3305_011_0	7	5	Select Care Drugs	010010	1
H3305	011	0	1	02	01	H3305_011_0	7	1	Preferred Generic	001000	
H3305	011	0	1	02	01	H3305_011_0	7	2	Preferred Brand	000001	
H3305	015	0	1	02	01	H3305_015_0	7	1	Preferred Generic	001000	
H3305	015	0	1	02	01	H3305_015_0	7	3	Non-Preferred Brand	100100	
H3305	015	0	1	02	01	H3305_015_0	7	5	Select Care Drugs	010010	
H3305	015	0	1	02	01	H3305_015_0	7	4	Specialty Tier	010010	
H3305	015	0	1	02	01	H3305_015_0	7	5	Select Care Drugs	010010	1
H3305	015	0	1	02	01	H3305_015_0	7	2	Preferred Brand	000001	
H3307	002	0	1	01	01	H3307_002_0	5	2	Non-Preferred Generic	000100	
H3307	002	0	1	01	01	H3307_002_0	5	1	Preferred Generic	001000	
H3307	002	0	1	01	01	H3307_002_0	5	5	Specialty Tier	010010	
H3307	002	0	1	01	01	H3307_002_0	5	3	Preferred Brand	010001	
H3307	002	0	1	01	01	H3307_002_0	5	4	Non-Preferred Brand	100100	
H3307	012	0	1	01	01	H3307_012_0	5	5	Specialty Tier	010010	
H3307	012	0	1	01	01	H3307_012_0	5	1	Preferred Generic	001000	
H3307	012	0	1	01	01	H3307_012_0	5	2	Non-Preferred Generic	000100	
H3307	012	0	1	01	01	H3307_012_0	5	3	Preferred Brand	010001	
H3307	012	0	1	01	01	H3307_012_0	5	4	Non-Preferred Brand	100100	
H3307	015	0	1	01	01	H3307_015_0	5	5	Specialty Tier	010010	
H3307	015	0	1	01	01	H3307_015_0	5	1	Preferred Generic	001000	
H3307	015	0	1	01	01	H3307_015_0	5	2	Non-Preferred Generic	000100	
H3307	015	0	1	01	01	H3307_015_0	5	3	Preferred Brand	010001	
H3307	015	0	1	01	01	H3307_015_0	5	4	Non-Preferred Brand	100100	
H3312	002	0	1	01	01	H3312_002_0	5	2	Preferred Brand	010001	
H3312	002	0	1	01	01	H3312_002_0	5	1	Generic	010000	
H3312	002	0	1	01	01	H3312_002_0	5	3	Non-Preferred Brand	110000	
H3312	002	0	1	01	01	H3312_002_0	5	4	Specialty Tier	010010	
H3312	002	0	1	01	01	H3312_002_0	5	5	Select Care Drugs	010000	
H3312	002	0	1	01	01	H3312_002_0	5	5	Select Care Drugs	010000	1
H3312	018	0	1	01	01	H3312_018_0	5	1	Generic	010000	
H3312	018	0	1	01	01	H3312_018_0	5	2	Preferred Brand	010001	
H3312	018	0	1	01	01	H3312_018_0	5	3	Non-Preferred Brand	110000	
H3312	018	0	1	01	01	H3312_018_0	5	4	Specialty Tier	010010	
H3312	018	0	1	01	01	H3312_018_0	5	5	Select Care Drugs	010000	
H3312	018	0	1	01	01	H3312_018_0	5	5	Select Care Drugs	010000	1
H3312	048	0	1	01	01	H3312_048_0	5	2	Preferred Brand	010001	
H3312	048	0	1	01	01	H3312_048_0	5	1	Generic	010000	
H3312	048	0	1	01	01	H3312_048_0	5	3	Non-Preferred Brand	110000	
H3312	048	0	1	01	01	H3312_048_0	5	5	Select Care Drugs	010000	1
H3312	048	0	1	01	01	H3312_048_0	5	5	Select Care Drugs	010000	
H3312	048	0	1	01	01	H3312_048_0	5	4	Specialty Tier	010010	
H3312	060	0	1	01	01	H3312_060_0	5	1	Generic	010000	
H3312	060	0	1	01	01	H3312_060_0	5	2	Preferred Brand	010001	
H3312	060	0	1	01	01	H3312_060_0	5	3	Non-Preferred Brand	110000	
H3312	060	0	1	01	01	H3312_060_0	5	4	Specialty Tier	010010	
H3312	060	0	1	01	01	H3312_060_0	5	5	Select Care Drugs	010000	
H3312	060	0	1	01	01	H3312_060_0	5	5	Select Care Drugs	010000	1
H3312	061	0	1	01	01	H3312_061_0	5	1	Generic	010000	
H3312	061	0	1	01	01	H3312_061_0	5	2	Preferred Brand	010001	
H3312	061	0	1	01	01	H3312_061_0	5	5	Select Care Drugs	010000	
H3312	061	0	1	01	01	H3312_061_0	5	4	Specialty Tier	010010	
H3312	061	0	1	01	01	H3312_061_0	5	3	Non-Preferred Brand	110000	
H3312	061	0	1	01	01	H3312_061_0	5	5	Select Care Drugs	010000	1
H3327	001	0	1	01	01	H3327_001_0	7	2	Preferred Brand	000001	
H3327	001	0	1	01	01	H3327_001_0	7	1	Generic	010000	
H3327	001	0	1	01	01	H3327_001_0	7	3	Non-Preferred Brand	100000	
H3327	001	0	1	01	01	H3327_001_0	7	4	Specialty Tier	010010	
H3327	002	0	1	01	01	H3327_002_0	6	1	Generic	010000	
H3327	002	0	1	01	01	H3327_002_0	6	2	Preferred Brand	000001	
H3327	002	0	1	01	01	H3327_002_0	6	3	Non-Preferred Brand	100000	
H3327	002	0	1	01	01	H3327_002_0	6	4	Specialty Tier	010010	
H3327	038	0	1	02	01	H3327_038_0	6	1	Generic	010000	
H3327	038	0	1	02	01	H3327_038_0	6	2	Preferred Brand	000001	
H3327	038	0	1	02	01	H3327_038_0	6	4	Specialty Tier	010010	
H3327	038	0	1	02	01	H3327_038_0	6	3	Non-Preferred Brand	100000	
H3327	040	0	1	01	01	H3327_040_0	6	1	Generic	010000	
H3327	040	0	1	01	01	H3327_040_0	6	2	Preferred Brand	000001	
H3327	040	0	1	01	01	H3327_040_0	6	3	Non-Preferred Brand	100000	
H3327	040	0	1	01	01	H3327_040_0	6	4	Specialty Tier	010010	
H3327	041	0	1	01	01	H3327_041_0	7	1	Generic	010000	
H3327	041	0	1	01	01	H3327_041_0	7	3	Non-Preferred Brand	100000	
H3327	041	0	1	01	01	H3327_041_0	7	2	Preferred Brand	000001	
H3327	041	0	1	01	01	H3327_041_0	7	4	Specialty Tier	010010	
H3328	002	0	1	01	01	H3328_002_0	6	2	Non-Preferred Generic	000100	
H3328	002	0	1	01	01	H3328_002_0	6	1	Preferred Generic	001000	
H3328	002	0	1	01	01	H3328_002_0	6	3	Preferred Brand	000001	
H3328	002	0	1	01	01	H3328_002_0	6	5	Specialty Tier	010010	
H3328	002	0	1	01	01	H3328_002_0	6	4	Non-Preferred Brand	100000	
H3328	003	0	1	02	01	H3328_003_0	10	1	Preferred Generic	001000	
H3328	003	0	1	02	01	H3328_003_0	10	2	Non-Preferred Generic	000100	
H3328	003	0	1	02	01	H3328_003_0	10	3	Preferred Brand	000001	
H3328	003	0	1	02	01	H3328_003_0	10	4	Non-Preferred Brand	100000	
H3328	003	0	1	02	01	H3328_003_0	10	5	Specialty Tier	010010	
H3328	016	0	1	01	01	H3328_016_0	6	1	Preferred Generic	001000	
H3328	016	0	1	01	01	H3328_016_0	6	2	Non-Preferred Generic	000100	
H3328	016	0	1	01	01	H3328_016_0	6	3	Preferred Brand	000001	
H3328	016	0	1	01	01	H3328_016_0	6	4	Non-Preferred Brand	100000	
H3328	016	0	1	01	01	H3328_016_0	6	5	Specialty Tier	010010	
H3328	017	0	1	01	01	H3328_017_0	9	1	Preferred Generic	001000	
H3328	017	0	1	01	01	H3328_017_0	9	1	Preferred Generic	001000	1
H3328	017	0	1	01	01	H3328_017_0	9	5	Specialty Tier	010010	
H3328	017	0	1	01	01	H3328_017_0	9	4	Non-Preferred Brand	100000	
H3328	017	0	1	01	01	H3328_017_0	9	3	Preferred Brand	000001	
H3328	017	0	1	01	01	H3328_017_0	9	2	Non-Preferred Generic	000100	
H3328	019	0	1	01	01	H3328_019_0	10	4	Non-Preferred Brand	100000	
H3328	019	0	1	01	01	H3328_019_0	10	2	Non-Preferred Generic	000100	
H3328	019	0	1	01	01	H3328_019_0	10	1	Preferred Generic	001000	
H3328	019	0	1	01	01	H3328_019_0	10	3	Preferred Brand	000001	
H3328	019	0	1	01	01	H3328_019_0	10	5	Specialty Tier	010010	
H3330	021	1	1	01	01	H3330_021_1	6	1	Preferred Generic	001000	
H3330	021	1	1	01	01	H3330_021_1	6	2	Non-Preferred Generic	000100	
H3330	021	1	1	01	01	H3330_021_1	6	3	Preferred Brand	000001	
H3330	021	1	1	01	01	H3330_021_1	6	4	Non-Preferred Brand	100000	
H3330	021	1	1	01	01	H3330_021_1	6	5	Specialty Tier	010010	
H3330	021	2	1	01	01	H3330_021_2	7	1	Preferred Generic	001000	
H3330	021	2	1	01	01	H3330_021_2	7	2	Non-Preferred Generic	000100	
H3330	021	2	1	01	01	H3330_021_2	7	3	Preferred Brand	000001	
H3330	021	2	1	01	01	H3330_021_2	7	4	Non-Preferred Brand	100000	
H3330	021	2	1	01	01	H3330_021_2	7	5	Specialty Tier	010010	
H3330	021	3	1	01	01	H3330_021_3	7	2	Non-Preferred Generic	000100	
H3330	021	3	1	01	01	H3330_021_3	7	3	Preferred Brand	000001	
H3330	021	3	1	01	01	H3330_021_3	7	4	Non-Preferred Brand	100000	
H3330	021	3	1	01	01	H3330_021_3	7	1	Preferred Generic	001000	
H3330	021	3	1	01	01	H3330_021_3	7	5	Specialty Tier	010010	
H3330	029	0	1	01	01	H3330_029_0	9	1	Preferred Generic	001000	
H3330	029	0	1	01	01	H3330_029_0	9	2	Non-Preferred Generic	000100	
H3330	029	0	1	01	01	H3330_029_0	9	4	Non-Preferred Brand	100000	
H3330	029	0	1	01	01	H3330_029_0	9	3	Preferred Brand	000001	
H3330	029	0	1	01	01	H3330_029_0	9	5	Specialty Tier	010010	
H3330	032	1	1	01	01	H3330_032_1	8	3	Preferred Brand	000001	
H3330	032	1	1	01	01	H3330_032_1	8	1	Preferred Generic	001000	
H3330	032	1	1	01	01	H3330_032_1	8	2	Non-Preferred Generic	000100	
H3330	032	1	1	01	01	H3330_032_1	8	5	Specialty Tier	010010	
H3330	032	1	1	01	01	H3330_032_1	8	4	Non-Preferred Brand	100000	
H3330	032	2	1	01	01	H3330_032_2	8	5	Specialty Tier	010010	
H3330	032	2	1	01	01	H3330_032_2	8	4	Non-Preferred Brand	100000	
H3330	032	2	1	01	01	H3330_032_2	8	3	Preferred Brand	000001	
H3330	032	2	1	01	01	H3330_032_2	8	2	Non-Preferred Generic	000100	
H3330	032	2	1	01	01	H3330_032_2	8	1	Preferred Generic	001000	
H3330	032	3	1	01	01	H3330_032_3	8	5	Specialty Tier	010010	
H3330	032	3	1	01	01	H3330_032_3	8	1	Preferred Generic	001000	
H3330	032	3	1	01	01	H3330_032_3	8	2	Non-Preferred Generic	000100	
H3330	032	3	1	01	01	H3330_032_3	8	3	Preferred Brand	000001	
H3330	032	3	1	01	01	H3330_032_3	8	4	Non-Preferred Brand	100000	
H3330	033	1	1	01	01	H3330_033_1	7	5	Specialty Tier	010010	
H3330	033	1	1	01	01	H3330_033_1	7	1	Preferred Generic	001000	
H3330	033	1	1	01	01	H3330_033_1	7	2	Non-Preferred Generic	000100	
H3330	033	1	1	01	01	H3330_033_1	7	3	Preferred Brand	000001	
H3330	033	1	1	01	01	H3330_033_1	7	4	Non-Preferred Brand	100000	
H3330	033	2	1	01	01	H3330_033_2	7	4	Non-Preferred Brand	100000	
H3330	033	2	1	01	01	H3330_033_2	7	1	Preferred Generic	001000	
H3330	033	2	1	01	01	H3330_033_2	7	2	Non-Preferred Generic	000100	
H3330	033	2	1	01	01	H3330_033_2	7	3	Preferred Brand	000001	
H3330	033	2	1	01	01	H3330_033_2	7	5	Specialty Tier	010010	
H3330	033	3	1	01	01	H3330_033_3	7	5	Specialty Tier	010010	
H3330	033	3	1	01	01	H3330_033_3	7	1	Preferred Generic	001000	
H3330	033	3	1	01	01	H3330_033_3	7	2	Non-Preferred Generic	000100	
H3330	033	3	1	01	01	H3330_033_3	7	3	Preferred Brand	000001	
H3330	033	3	1	01	01	H3330_033_3	7	4	Non-Preferred Brand	100000	
H3333	055	0	1	09	04	H3333_055_0	6	3	Preferred Brand	000101	
H3333	055	0	1	09	04	H3333_055_0	6	2	Non-Preferred Generic	000100	
H3333	055	0	1	09	04	H3333_055_0	6	1	Preferred Generic	001000	
H3333	055	0	1	09	04	H3333_055_0	6	4	Non-Preferred Brand	100100	
H3333	055	0	1	09	04	H3333_055_0	6	5	Specialty Tier	010010	
H3333	057	0	1	09	04	H3333_057_0	6	4	Non-Preferred Brand	100100	
H3333	057	0	1	09	04	H3333_057_0	6	3	Preferred Brand	000101	
H3333	057	0	1	09	04	H3333_057_0	6	5	Specialty Tier	010010	
H3333	057	0	1	09	04	H3333_057_0	6	1	Preferred Generic	001000	
H3333	057	0	1	09	04	H3333_057_0	6	2	Non-Preferred Generic	000100	
H3333	165	0	1	09	04	H3333_165_0	5	1	Preferred Generic	001000	
H3333	165	0	1	09	04	H3333_165_0	5	2	Non-Preferred Generic	000100	
H3333	165	0	1	09	04	H3333_165_0	5	3	Preferred Brand	000101	
H3333	165	0	1	09	04	H3333_165_0	5	4	Non-Preferred Brand	100100	
H3333	165	0	1	09	04	H3333_165_0	5	5	Specialty Tier	010010	
H3333	166	0	1	09	04	H3333_166_0	5	1	Preferred Generic	001000	
H3333	166	0	1	09	04	H3333_166_0	5	4	Non-Preferred Brand	100100	
H3333	166	0	1	09	04	H3333_166_0	5	3	Preferred Brand	000101	
H3333	166	0	1	09	04	H3333_166_0	5	2	Non-Preferred Generic	000100	
H3333	166	0	1	09	04	H3333_166_0	5	5	Specialty Tier	010010	
H3335	002	0	1	04	01	H3335_002_0	6	1	Generic	010000	
H3335	002	0	1	04	01	H3335_002_0	6	2	Preferred Brand	000001	
H3335	002	0	1	04	01	H3335_002_0	6	4	Specialty Tier	010010	
H3335	002	0	1	04	01	H3335_002_0	6	3	Non-Preferred Brand	100000	
H3335	005	0	1	04	01	H3335_005_0	7	4	Specialty Tier	010010	
H3335	005	0	1	04	01	H3335_005_0	7	2	Preferred Brand	000001	
H3335	005	0	1	04	01	H3335_005_0	7	3	Non-Preferred Brand	100000	
H3335	005	0	1	04	01	H3335_005_0	7	1	Generic	010000	
H3335	006	0	1	04	01	H3335_006_0	7	3	Non-Preferred Brand	100000	
H3335	006	0	1	04	01	H3335_006_0	7	2	Preferred Brand	000001	
H3335	006	0	1	04	01	H3335_006_0	7	4	Specialty Tier	010010	
H3335	006	0	1	04	01	H3335_006_0	7	1	Generic	010000	
H3335	008	0	1	04	01	H3335_008_0	7	4	Specialty Tier	010010	
H3335	008	0	1	04	01	H3335_008_0	7	2	Preferred Brand	000001	
H3335	008	0	1	04	01	H3335_008_0	7	3	Non-Preferred Brand	100000	
H3335	008	0	1	04	01	H3335_008_0	7	1	Generic	010000	
H3335	009	0	1	04	01	H3335_009_0	7	1	Generic	010000	
H3335	009	0	1	04	01	H3335_009_0	7	2	Preferred Brand	000001	
H3335	009	0	1	04	01	H3335_009_0	7	4	Specialty Tier	010010	
H3335	009	0	1	04	01	H3335_009_0	7	3	Non-Preferred Brand	100000	
H3335	014	0	1	04	01	H3335_014_0	7	1	Generic	010000	
H3335	014	0	1	04	01	H3335_014_0	7	2	Preferred Brand	000001	
H3335	014	0	1	04	01	H3335_014_0	7	3	Non-Preferred Brand	100000	
H3335	014	0	1	04	01	H3335_014_0	7	4	Specialty Tier	010010	
H3335	015	0	1	04	01	H3335_015_0	7	4	Specialty Tier	010010	
H3335	015	0	1	04	01	H3335_015_0	7	2	Preferred Brand	000001	
H3335	015	0	1	04	01	H3335_015_0	7	1	Generic	010000	
H3335	015	0	1	04	01	H3335_015_0	7	3	Non-Preferred Brand	100000	
H3335	018	0	1	04	01	H3335_018_0	8	3	Non-Preferred Brand	100000	
H3335	018	0	1	04	01	H3335_018_0	8	2	Preferred Brand	000001	
H3335	018	0	1	04	01	H3335_018_0	8	1	Generic	010000	
H3335	018	0	1	04	01	H3335_018_0	8	4	Specialty Tier	010010	
H3335	021	0	1	04	01	H3335_021_0	8	1	Generic	010000	
H3335	021	0	1	04	01	H3335_021_0	8	2	Preferred Brand	000001	
H3335	021	0	1	04	01	H3335_021_0	8	3	Non-Preferred Brand	100000	
H3335	021	0	1	04	01	H3335_021_0	8	4	Specialty Tier	010010	
H3335	032	0	1	04	01	H3335_032_0	7	4	Specialty Tier	010010	
H3335	032	0	1	04	01	H3335_032_0	7	1	Generic	010000	
H3335	032	0	1	04	01	H3335_032_0	7	3	Non-Preferred Brand	100000	
H3335	032	0	1	04	01	H3335_032_0	7	2	Preferred Brand	000001	
H3335	037	0	1	04	01	H3335_037_0	7	1	Generic	010000	
H3335	037	0	1	04	01	H3335_037_0	7	4	Specialty Tier	010010	
H3335	037	0	1	04	01	H3335_037_0	7	3	Non-Preferred Brand	100000	
H3335	037	0	1	04	01	H3335_037_0	7	2	Preferred Brand	000001	
H3335	038	0	1	04	01	H3335_038_0	7	2	Preferred Brand	000001	
H3335	038	0	1	04	01	H3335_038_0	7	3	Non-Preferred Brand	100000	
H3335	038	0	1	04	01	H3335_038_0	7	4	Specialty Tier	010010	
H3335	038	0	1	04	01	H3335_038_0	7	1	Generic	010000	
H3335	051	0	1	04	01	H3335_051_0	7	4	Specialty Tier	010010	
H3335	051	0	1	04	01	H3335_051_0	7	2	Preferred Brand	000001	
H3335	051	0	1	04	01	H3335_051_0	7	1	Generic	010000	
H3335	051	0	1	04	01	H3335_051_0	7	3	Non-Preferred Brand	100000	
H3337	001	0	1	01	01	H3337_001_0	4	1	Preferred Generic	001000	
H3337	001	0	1	01	01	H3337_001_0	4	2	Non-Preferred Generic	000100	
H3337	001	0	1	01	01	H3337_001_0	4	3	Preferred Brand	000001	
H3337	001	0	1	01	01	H3337_001_0	4	4	Non-Preferred Brand	100000	
H3337	001	0	1	01	01	H3337_001_0	4	5	Specialty Tier	010010	
H3337	001	0	1	01	01	H3337_001_0	4	1	Preferred Generic	001000	1
H3337	001	0	1	01	01	H3337_001_0	4	2	Non-Preferred Generic	000100	1
H3342	001	0	1	04	01	H3342_001_0	7	4	Non-Preferred Brand	100100	
H3342	001	0	1	04	01	H3342_001_0	7	3	Preferred Brand	000101	
H3342	001	0	1	04	01	H3342_001_0	7	2	Non-Preferred Generic	000100	
H3342	001	0	1	04	01	H3342_001_0	7	1	Preferred Generic	001000	
H3342	001	0	1	04	01	H3342_001_0	7	6	Specialty Tier	010010	
H3342	001	0	1	04	01	H3342_001_0	7	5	Injectable Drugs	010010	
H3342	012	0	1	04	01	H3342_012_0	6	1	Preferred Generic	001000	
H3342	012	0	1	04	01	H3342_012_0	6	2	Non-Preferred Generic	000100	
H3342	012	0	1	04	01	H3342_012_0	6	3	Preferred Brand	000101	
H3342	012	0	1	04	01	H3342_012_0	6	4	Non-Preferred Brand	100100	
H3342	012	0	1	04	01	H3342_012_0	6	5	Injectable Drugs	010010	
H3342	012	0	1	04	01	H3342_012_0	6	6	Specialty Tier	010010	
H3342	013	0	1	04	01	H3342_013_0	7	6	Specialty Tier	010010	
H3342	013	0	1	04	01	H3342_013_0	7	4	Non-Preferred Brand	100100	
H3342	013	0	1	04	01	H3342_013_0	7	5	Injectable Drugs	010010	
H3342	013	0	1	04	01	H3342_013_0	7	3	Preferred Brand	000101	
H3342	013	0	1	04	01	H3342_013_0	7	2	Non-Preferred Generic	000100	
H3342	013	0	1	04	01	H3342_013_0	7	1	Preferred Generic	001000	
H3342	014	0	1	04	01	H3342_014_0	7	5	Injectable Drugs	010010	
H3342	014	0	1	04	01	H3342_014_0	7	4	Non-Preferred Brand	100100	
H3342	014	0	1	04	01	H3342_014_0	7	3	Preferred Brand	000101	
H3342	014	0	1	04	01	H3342_014_0	7	2	Non-Preferred Generic	000100	
H3342	014	0	1	04	01	H3342_014_0	7	1	Preferred Generic	001000	
H3342	014	0	1	04	01	H3342_014_0	7	6	Specialty Tier	010010	
H3344	005	0	1	04	01	H3344_005_0	7	2	Non-Preferred Generic	000110	2
H3344	005	0	1	04	01	H3344_005_0	7	1	Preferred Generic	001000	1
H3344	005	0	1	04	01	H3344_005_0	7	5	Specialty Tier	010010	
H3344	005	0	1	04	01	H3344_005_0	7	4	Non-Preferred Brand	100100	
H3344	005	0	1	04	01	H3344_005_0	7	3	Preferred Brand	000001	
H3344	005	0	1	04	01	H3344_005_0	7	1	Preferred Generic	001000	
H3344	005	0	1	04	01	H3344_005_0	7	2	Non-Preferred Generic	000110	
H3347	005	0	1	01	01	H3347_005_0	10	1	Generic	010000	
H3347	005	0	1	01	01	H3347_005_0	10	2	Preferred Brand	010001	
H3347	005	0	1	01	01	H3347_005_0	10	3	Non-Preferred Brand	110000	
H3347	005	0	1	01	01	H3347_005_0	10	4	Specialty Tier	010010	
H3351	002	0	1	02	01	H3351_002_0	6	1	Generic	010000	
H3351	002	0	1	02	01	H3351_002_0	6	3	Non-Preferred Brand	100000	
H3351	002	0	1	02	01	H3351_002_0	6	4	Specialty Tier	010010	
H3351	002	0	1	02	01	H3351_002_0	6	2	Preferred Brand	000001	
H3351	006	0	1	02	01	H3351_006_0	6	1	Generic	010000	
H3351	006	0	1	02	01	H3351_006_0	6	2	Preferred Brand	000001	
H3351	006	0	1	02	01	H3351_006_0	6	4	Specialty Tier	010010	
H3351	006	0	1	02	01	H3351_006_0	6	3	Non-Preferred Brand	100000	
H3351	010	0	1	01	01	H3351_010_0	6	1	Generic	010000	
H3351	010	0	1	01	01	H3351_010_0	6	3	Non-Preferred Brand	100000	
H3351	010	0	1	01	01	H3351_010_0	6	2	Preferred Brand	000001	
H3351	010	0	1	01	01	H3351_010_0	6	4	Specialty Tier	010010	
H3351	011	0	1	01	01	H3351_011_0	6	1	Generic	010000	
H3351	011	0	1	01	01	H3351_011_0	6	2	Preferred Brand	000001	
H3351	011	0	1	01	01	H3351_011_0	6	4	Specialty Tier	010010	
H3351	011	0	1	01	01	H3351_011_0	6	3	Non-Preferred Brand	100000	
H3351	012	0	1	01	01	H3351_012_0	6	1	Generic	010000	
H3351	012	0	1	01	01	H3351_012_0	6	2	Preferred Brand	000001	
H3351	012	0	1	01	01	H3351_012_0	6	3	Non-Preferred Brand	100000	
H3351	012	0	1	01	01	H3351_012_0	6	4	Specialty Tier	010010	
H3351	013	0	1	01	01	H3351_013_0	6	1	Generic	010000	
H3351	013	0	1	01	01	H3351_013_0	6	2	Preferred Brand	000001	
H3351	013	0	1	01	01	H3351_013_0	6	4	Specialty Tier	010010	
H3351	013	0	1	01	01	H3351_013_0	6	3	Non-Preferred Brand	100000	
H3359	001	0	1	01	01	H3359_001_0	12	1	Generic	010000	
H3359	001	0	1	01	01	H3359_001_0	12	2	Preferred Brand	000001	
H3359	001	0	1	01	01	H3359_001_0	12	3	Non-Preferred Brand	100000	
H3359	001	0	1	01	01	H3359_001_0	12	4	Specialty Tier	010010	
H3361	043	0	1	01	01	H3361_043_0	5	4	Non-Preferred Brand	110000	
H3361	043	0	1	01	01	H3361_043_0	5	3	Preferred Brand	010001	
H3361	043	0	1	01	01	H3361_043_0	5	2	Non-Preferred Generic	000100	
H3361	043	0	1	01	01	H3361_043_0	5	1	Preferred Generic	001000	
H3361	043	0	1	01	01	H3361_043_0	5	5	Specialty Tier	010010	
H3361	065	0	1	01	01	H3361_065_0	5	1	Preferred Generic	001000	
H3361	065	0	1	01	01	H3361_065_0	5	2	Non-Preferred Generic	000100	
H3361	065	0	1	01	01	H3361_065_0	5	3	Preferred Brand	010001	
H3361	065	0	1	01	01	H3361_065_0	5	4	Non-Preferred Brand	110000	
H3361	065	0	1	01	01	H3361_065_0	5	5	Specialty Tier	010010	
H3361	098	0	1	01	01	H3361_098_0	5	4	Non-Preferred Brand	110000	
H3361	098	0	1	01	01	H3361_098_0	5	3	Preferred Brand	010001	
H3361	098	0	1	01	01	H3361_098_0	5	2	Non-Preferred Generic	000100	
H3361	098	0	1	01	01	H3361_098_0	5	1	Preferred Generic	001000	
H3361	098	0	1	01	01	H3361_098_0	5	5	Specialty Tier	010010	
H3361	099	0	1	02	01	H3361_099_0	5	2	Non-Preferred Generic	000100	
H3361	099	0	1	02	01	H3361_099_0	5	1	Preferred Generic	001000	
H3361	099	0	1	02	01	H3361_099_0	5	3	Preferred Brand	010001	
H3361	099	0	1	02	01	H3361_099_0	5	4	Non-Preferred Brand	110000	
H3361	099	0	1	02	01	H3361_099_0	5	5	Specialty Tier	010010	
H3361	106	0	1	02	01	H3361_106_0	5	2	Non-Preferred Generic	000100	
H3361	106	0	1	02	01	H3361_106_0	5	1	Preferred Generic	001000	
H3361	106	0	1	02	01	H3361_106_0	5	3	Preferred Brand	010001	
H3361	106	0	1	02	01	H3361_106_0	5	5	Specialty Tier	010010	
H3361	106	0	1	02	01	H3361_106_0	5	4	Non-Preferred Brand	110000	
H3361	109	0	1	01	01	H3361_109_0	5	1	Preferred Generic	001000	
H3361	109	0	1	01	01	H3361_109_0	5	2	Non-Preferred Generic	000100	
H3361	109	0	1	01	01	H3361_109_0	5	4	Non-Preferred Brand	110000	
H3361	109	0	1	01	01	H3361_109_0	5	3	Preferred Brand	010001	
H3361	109	0	1	01	01	H3361_109_0	5	5	Specialty Tier	010010	
H3361	130	0	1	01	01	H3361_130_0	6	3	Preferred Brand	010001	
H3361	130	0	1	01	01	H3361_130_0	6	4	Non-Preferred Brand	110000	
H3361	130	0	1	01	01	H3361_130_0	6	5	Specialty Tier	010010	
H3361	130	0	1	01	01	H3361_130_0	6	1	Preferred Generic	001000	
H3361	130	0	1	01	01	H3361_130_0	6	2	Non-Preferred Generic	000100	
H3361	132	0	1	02	01	H3361_132_0	5	3	Preferred Brand	010001	
H3361	132	0	1	02	01	H3361_132_0	5	2	Non-Preferred Generic	000100	
H3361	132	0	1	02	01	H3361_132_0	5	1	Preferred Generic	001000	
H3361	132	0	1	02	01	H3361_132_0	5	4	Non-Preferred Brand	110000	
H3361	132	0	1	02	01	H3361_132_0	5	5	Specialty Tier	010010	
H3361	133	0	1	01	01	H3361_133_0	4	3	Preferred Brand	010001	
H3361	133	0	1	01	01	H3361_133_0	4	2	Non-Preferred Generic	000100	
H3361	133	0	1	01	01	H3361_133_0	4	1	Preferred Generic	001000	
H3361	133	0	1	01	01	H3361_133_0	4	4	Non-Preferred Brand	110000	
H3361	133	0	1	01	01	H3361_133_0	4	5	Specialty Tier	010010	
H3362	017	0	1	01	01	H3362_017_0	6	2	Non-Preferred Generic	000110	2
H3362	017	0	1	01	01	H3362_017_0	6	1	Preferred Generic	001000	1
H3362	017	0	1	01	01	H3362_017_0	6	5	Specialty Tier	010010	
H3362	017	0	1	01	01	H3362_017_0	6	4	Non-Preferred Brand	100100	
H3362	017	0	1	01	01	H3362_017_0	6	1	Preferred Generic	001000	
H3362	017	0	1	01	01	H3362_017_0	6	2	Non-Preferred Generic	000110	
H3362	017	0	1	01	01	H3362_017_0	6	3	Preferred Brand	000001	
H3362	020	0	1	01	01	H3362_020_0	6	2	Non-Preferred Generic	000110	
H3362	020	0	1	01	01	H3362_020_0	6	2	Non-Preferred Generic	000110	2
H3362	020	0	1	01	01	H3362_020_0	6	1	Preferred Generic	001000	1
H3362	020	0	1	01	01	H3362_020_0	6	5	Specialty Tier	010010	
H3362	020	0	1	01	01	H3362_020_0	6	4	Non-Preferred Brand	100100	
H3362	020	0	1	01	01	H3362_020_0	6	3	Preferred Brand	000001	
H3362	020	0	1	01	01	H3362_020_0	6	1	Preferred Generic	001000	
H3362	025	0	1	01	01	H3362_025_0	8	4	Non-Preferred Brand	100100	
H3362	025	0	1	01	01	H3362_025_0	8	2	Non-Preferred Generic	000110	2
H3362	025	0	1	01	01	H3362_025_0	8	1	Preferred Generic	001000	1
H3362	025	0	1	01	01	H3362_025_0	8	5	Specialty Tier	010010	
H3362	025	0	1	01	01	H3362_025_0	8	1	Preferred Generic	001000	
H3362	025	0	1	01	01	H3362_025_0	8	2	Non-Preferred Generic	000110	
H3362	025	0	1	01	01	H3362_025_0	8	3	Preferred Brand	000001	
H3362	026	0	1	02	01	H3362_026_0	5	1	Preferred Generic	001000	1
H3362	026	0	1	02	01	H3362_026_0	5	2	Non-Preferred Generic	000110	2
H3362	026	0	1	02	01	H3362_026_0	5	4	Non-Preferred Brand	100100	
H3362	026	0	1	02	01	H3362_026_0	5	5	Specialty Tier	010010	
H3362	026	0	1	02	01	H3362_026_0	5	3	Preferred Brand	000001	
H3362	026	0	1	02	01	H3362_026_0	5	2	Non-Preferred Generic	000110	
H3362	026	0	1	02	01	H3362_026_0	5	1	Preferred Generic	001000	
H3362	027	0	1	01	01	H3362_027_0	5	5	Specialty Tier	010010	
H3362	027	0	1	01	01	H3362_027_0	5	4	Non-Preferred Brand	100100	
H3362	027	0	1	01	01	H3362_027_0	5	1	Preferred Generic	001000	1
H3362	027	0	1	01	01	H3362_027_0	5	3	Preferred Brand	000001	
H3362	027	0	1	01	01	H3362_027_0	5	2	Non-Preferred Generic	000110	2
H3362	027	0	1	01	01	H3362_027_0	5	1	Preferred Generic	001000	
H3362	027	0	1	01	01	H3362_027_0	5	2	Non-Preferred Generic	000110	
H3370	001	0	1	01	01	H3370_001_0	5	1	Preferred Generic	001000	
H3370	001	0	1	01	01	H3370_001_0	5	2	Non-Preferred Generic	000100	
H3370	001	0	1	01	01	H3370_001_0	5	6	Specialty Tier	010010	
H3370	001	0	1	01	01	H3370_001_0	5	5	Injectable Drugs	010010	
H3370	001	0	1	01	01	H3370_001_0	5	4	Non-Preferred Brand	100100	
H3370	001	0	1	01	01	H3370_001_0	5	3	Preferred Brand	000101	
H3370	002	0	1	01	01	H3370_002_0	5	5	Injectable Drugs	010010	
H3370	002	0	1	01	01	H3370_002_0	5	4	Non-Preferred Brand	100100	
H3370	002	0	1	01	01	H3370_002_0	5	1	Preferred Generic	001000	
H3370	002	0	1	01	01	H3370_002_0	5	3	Preferred Brand	000101	
H3370	002	0	1	01	01	H3370_002_0	5	6	Specialty Tier	010010	
H3370	002	0	1	01	01	H3370_002_0	5	2	Non-Preferred Generic	000100	
H3370	003	0	1	01	01	H3370_003_0	5	5	Injectable Drugs	010010	
H3370	003	0	1	01	01	H3370_003_0	5	6	Specialty Tier	010010	
H3370	003	0	1	01	01	H3370_003_0	5	4	Non-Preferred Brand	100100	
H3370	003	0	1	01	01	H3370_003_0	5	2	Non-Preferred Generic	000100	
H3370	003	0	1	01	01	H3370_003_0	5	1	Preferred Generic	001000	
H3370	003	0	1	01	01	H3370_003_0	5	3	Preferred Brand	000101	
H3370	004	0	1	01	01	H3370_004_0	5	6	Specialty Tier	010010	
H3370	004	0	1	01	01	H3370_004_0	5	5	Injectable Drugs	010010	
H3370	004	0	1	01	01	H3370_004_0	5	4	Non-Preferred Brand	100100	
H3370	004	0	1	01	01	H3370_004_0	5	2	Non-Preferred Generic	000100	
H3370	004	0	1	01	01	H3370_004_0	5	1	Preferred Generic	001000	
H3370	004	0	1	01	01	H3370_004_0	5	3	Preferred Brand	000101	
H3370	014	0	1	01	01	H3370_014_0	5	2	Non-Preferred Generic	000100	
H3370	014	0	1	01	01	H3370_014_0	5	6	Specialty Tier	010010	
H3370	014	0	1	01	01	H3370_014_0	5	5	Injectable Drugs	010010	
H3370	014	0	1	01	01	H3370_014_0	5	4	Non-Preferred Brand	100100	
H3370	014	0	1	01	01	H3370_014_0	5	1	Preferred Generic	001000	
H3370	014	0	1	01	01	H3370_014_0	5	3	Preferred Brand	000101	
H3379	001	0	1	01	01	H3379_001_0	6	1	Preferred Generic	001000	
H3379	001	0	1	01	01	H3379_001_0	6	2	Non-Preferred Generic	000100	
H3379	001	0	1	01	01	H3379_001_0	6	3	Preferred Brand	010001	
H3379	001	0	1	01	01	H3379_001_0	6	4	Non-Preferred Brand	100100	
H3379	001	0	1	01	01	H3379_001_0	6	5	Specialty Tier	010010	
H3384	013	0	1	01	01	H3384_013_0	5	3	Preferred Brand	000001	
H3384	013	0	1	01	01	H3384_013_0	5	2	Non-Preferred Generic	000100	
H3384	013	0	1	01	01	H3384_013_0	5	1	Preferred Generic	001000	
H3384	013	0	1	01	01	H3384_013_0	5	4	Non-Preferred Brand	100000	
H3384	013	0	1	01	01	H3384_013_0	5	5	Specialty Tier	010010	
H3384	019	0	1	01	01	H3384_019_0	6	1	Preferred Generic	001000	
H3384	019	0	1	01	01	H3384_019_0	6	2	Non-Preferred Generic	000100	
H3384	019	0	1	01	01	H3384_019_0	6	3	Preferred Brand	000001	
H3384	019	0	1	01	01	H3384_019_0	6	4	Non-Preferred Brand	100000	
H3384	019	0	1	01	01	H3384_019_0	6	5	Specialty Tier	010010	
H3384	056	0	1	01	01	H3384_056_0	6	5	Specialty Tier	010010	
H3384	056	0	1	01	01	H3384_056_0	6	1	Preferred Generic	001000	
H3384	056	0	1	01	01	H3384_056_0	6	2	Non-Preferred Generic	000100	
H3384	056	0	1	01	01	H3384_056_0	6	3	Preferred Brand	000001	
H3384	056	0	1	01	01	H3384_056_0	6	4	Non-Preferred Brand	100000	
H3384	057	0	1	02	01	H3384_057_0	6	5	Specialty Tier	010010	
H3384	057	0	1	02	01	H3384_057_0	6	4	Non-Preferred Brand	100000	
H3384	057	0	1	02	01	H3384_057_0	6	3	Preferred Brand	000001	
H3384	057	0	1	02	01	H3384_057_0	6	2	Non-Preferred Generic	000100	
H3384	057	0	1	02	01	H3384_057_0	6	1	Preferred Generic	001000	
H3384	058	0	1	02	01	H3384_058_0	6	5	Specialty Tier	010010	
H3384	058	0	1	02	01	H3384_058_0	6	1	Preferred Generic	001000	
H3384	058	0	1	02	01	H3384_058_0	6	2	Non-Preferred Generic	000100	
H3384	058	0	1	02	01	H3384_058_0	6	3	Preferred Brand	000001	
H3384	058	0	1	02	01	H3384_058_0	6	4	Non-Preferred Brand	100000	
H3384	059	0	1	02	01	H3384_059_0	6	5	Specialty Tier	010010	
H3384	059	0	1	02	01	H3384_059_0	6	1	Preferred Generic	001000	
H3384	059	0	1	02	01	H3384_059_0	6	2	Non-Preferred Generic	000100	
H3384	059	0	1	02	01	H3384_059_0	6	3	Preferred Brand	000001	
H3384	059	0	1	02	01	H3384_059_0	6	4	Non-Preferred Brand	100000	
H3388	002	0	1	01	01	H3388_002_0	8	1	Preferred Generic	001000	
H3388	002	0	1	01	01	H3388_002_0	8	2	Non-Preferred Generic	000100	1
H3388	002	0	1	01	01	H3388_002_0	8	1	Preferred Generic	001000	1
H3388	002	0	1	01	01	H3388_002_0	8	5	Specialty Tier	010010	
H3388	002	0	1	01	01	H3388_002_0	8	4	Non-Preferred Brand	110000	
H3388	002	0	1	01	01	H3388_002_0	8	2	Non-Preferred Generic	000100	
H3388	002	0	1	01	01	H3388_002_0	8	3	Preferred Brand	010001	
H3388	004	0	1	01	01	H3388_004_0	6	2	Non-Preferred Generic	000100	
H3388	004	0	1	01	01	H3388_004_0	6	1	Preferred Generic	001000	
H3388	004	0	1	01	01	H3388_004_0	6	4	Non-Preferred Brand	110000	
H3388	004	0	1	01	01	H3388_004_0	6	3	Preferred Brand	010001	
H3388	004	0	1	01	01	H3388_004_0	6	5	Specialty Tier	010010	
H3404	001	0	1	04	01	H3404_001_0	7	2	Non-Preferred Generic	000100	
H3404	001	0	1	04	01	H3404_001_0	7	3	Preferred Brand	000001	
H3404	001	0	1	04	01	H3404_001_0	7	4	Non-Preferred Brand	110000	
H3404	001	0	1	04	01	H3404_001_0	7	1	Preferred Generic	001000	
H3404	001	0	1	04	01	H3404_001_0	7	5	Specialty Tier	010010	
H3404	002	0	1	04	01	H3404_002_0	8	1	Preferred Generic	001000	
H3404	002	0	1	04	01	H3404_002_0	8	2	Non-Preferred Generic	000100	
H3404	002	0	1	04	01	H3404_002_0	8	4	Non-Preferred Brand	110000	
H3404	002	0	1	04	01	H3404_002_0	8	3	Preferred Brand	000001	
H3404	002	0	1	04	01	H3404_002_0	8	1	Preferred Generic	001000	1
H3404	002	0	1	04	01	H3404_002_0	8	5	Specialty Tier	010010	
H3405	001	0	1	04	01	H3405_001_0	9	1	Preferred Generic	001010	
H3405	001	0	1	04	01	H3405_001_0	9	2	Non-Preferred Generic	000101	
H3405	001	0	1	04	01	H3405_001_0	9	3	Preferred Brand	000101	
H3405	001	0	1	04	01	H3405_001_0	9	4	Non-Preferred Brand	110000	
H3405	001	0	1	04	01	H3405_001_0	9	5	Specialty Tier	010010	2
H3405	001	0	1	04	01	H3405_001_0	9	1	Preferred Generic	001010	2
H3405	001	0	1	04	01	H3405_001_0	9	2	Non-Preferred Generic	000101	2
H3405	001	0	1	04	01	H3405_001_0	9	4	Non-Preferred Brand	110000	2
H3405	001	0	1	04	01	H3405_001_0	9	3	Preferred Brand	000101	2
H3405	001	0	1	04	01	H3405_001_0	9	5	Specialty Tier	010010	
H3405	002	0	1	04	01	H3405_002_0	9	4	Non-Preferred Brand	110000	2
H3405	002	0	1	04	01	H3405_002_0	9	3	Preferred Brand	000101	2
H3405	002	0	1	04	01	H3405_002_0	9	2	Non-Preferred Generic	000101	2
H3405	002	0	1	04	01	H3405_002_0	9	1	Preferred Generic	001010	2
H3405	002	0	1	04	01	H3405_002_0	9	5	Specialty Tier	010010	
H3405	002	0	1	04	01	H3405_002_0	9	4	Non-Preferred Brand	110000	
H3405	002	0	1	04	01	H3405_002_0	9	3	Preferred Brand	000101	
H3405	002	0	1	04	01	H3405_002_0	9	2	Non-Preferred Generic	000101	
H3405	002	0	1	04	01	H3405_002_0	9	1	Preferred Generic	001010	
H3405	002	0	1	04	01	H3405_002_0	9	5	Specialty Tier	010010	2
H3405	005	0	1	04	01	H3405_005_0	10	4	Non-Preferred Brand	110000	
H3405	005	0	1	04	01	H3405_005_0	10	3	Preferred Brand	000101	
H3405	005	0	1	04	01	H3405_005_0	10	2	Non-Preferred Generic	000101	
H3405	005	0	1	04	01	H3405_005_0	10	1	Preferred Generic	001010	
H3405	005	0	1	04	01	H3405_005_0	10	5	Specialty Tier	010010	2
H3405	005	0	1	04	01	H3405_005_0	10	1	Preferred Generic	001010	2
H3405	005	0	1	04	01	H3405_005_0	10	2	Non-Preferred Generic	000101	2
H3405	005	0	1	04	01	H3405_005_0	10	3	Preferred Brand	000101	2
H3405	005	0	1	04	01	H3405_005_0	10	4	Non-Preferred Brand	110000	2
H3405	005	0	1	04	01	H3405_005_0	10	5	Specialty Tier	010010	
H3405	007	0	1	04	01	H3405_007_0	10	4	Non-Preferred Brand	110000	
H3405	007	0	1	04	01	H3405_007_0	10	3	Preferred Brand	000101	
H3405	007	0	1	04	01	H3405_007_0	10	2	Non-Preferred Generic	000101	
H3405	007	0	1	04	01	H3405_007_0	10	1	Preferred Generic	001010	
H3405	007	0	1	04	01	H3405_007_0	10	5	Specialty Tier	010010	
H3405	007	0	1	04	01	H3405_007_0	10	5	Specialty Tier	010010	2
H3405	007	0	1	04	01	H3405_007_0	10	4	Non-Preferred Brand	110000	2
H3405	007	0	1	04	01	H3405_007_0	10	3	Preferred Brand	000101	2
H3405	007	0	1	04	01	H3405_007_0	10	2	Non-Preferred Generic	000101	2
H3405	007	0	1	04	01	H3405_007_0	10	1	Preferred Generic	001010	2
H3405	008	0	1	04	01	H3405_008_0	6	1	Preferred Generic	001010	
H3405	008	0	1	04	01	H3405_008_0	6	2	Non-Preferred Generic	000101	
H3405	008	0	1	04	01	H3405_008_0	6	3	Preferred Brand	000101	
H3405	008	0	1	04	01	H3405_008_0	6	4	Non-Preferred Brand	110000	
H3405	008	0	1	04	01	H3405_008_0	6	5	Specialty Tier	010010	2
H3405	008	0	1	04	01	H3405_008_0	6	3	Preferred Brand	000101	2
H3405	008	0	1	04	01	H3405_008_0	6	2	Non-Preferred Generic	000101	2
H3405	008	0	1	04	01	H3405_008_0	6	1	Preferred Generic	001010	2
H3405	008	0	1	04	01	H3405_008_0	6	5	Specialty Tier	010010	
H3405	008	0	1	04	01	H3405_008_0	6	4	Non-Preferred Brand	110000	2
H3421	002	0	1	09	04	H3421_002_0	5	1	Preferred Generic	001010	
H3421	002	0	1	09	04	H3421_002_0	5	4	Specialty Tier	100100	
H3421	002	0	1	09	04	H3421_002_0	5	3	Non-Preferred Brand	100100	
H3421	002	0	1	09	04	H3421_002_0	5	2	Preferred Brand	000101	
H3447	001	0	1	01	01	H3447_001_0	8	1	Preferred Generic	001000	
H3447	001	0	1	01	01	H3447_001_0	8	2	Non-Preferred Generic	000100	
H3447	001	0	1	01	01	H3447_001_0	8	3	Preferred Brand	000001	
H3447	001	0	1	01	01	H3447_001_0	8	4	Non-Preferred Brand	100000	
H3447	001	0	1	01	01	H3447_001_0	8	5	Specialty Tier	010010	
H3447	001	0	1	01	01	H3447_001_0	8	6	Select Care Drugs	000010	
H3447	001	0	1	01	01	H3447_001_0	8	1	Preferred Generic	001000	1
H3447	001	0	1	01	01	H3447_001_0	8	2	Non-Preferred Generic	000100	1
H3447	001	0	1	01	01	H3447_001_0	8	6	Select Care Drugs	000010	2
H3447	003	0	1	01	01	H3447_003_0	8	3	Preferred Brand	000001	
H3447	003	0	1	01	01	H3447_003_0	8	4	Non-Preferred Brand	100000	
H3447	003	0	1	01	01	H3447_003_0	8	1	Preferred Generic	001000	
H3447	003	0	1	01	01	H3447_003_0	8	2	Non-Preferred Generic	000100	
H3447	003	0	1	01	01	H3447_003_0	8	5	Specialty Tier	010010	
H3447	003	0	1	01	01	H3447_003_0	8	6	Select Care Drugs	000010	
H3447	003	0	1	01	01	H3447_003_0	8	1	Preferred Generic	001000	1
H3447	003	0	1	01	01	H3447_003_0	8	2	Non-Preferred Generic	000100	1
H3447	003	0	1	01	01	H3447_003_0	8	3	Preferred Brand	000001	2
H3447	003	0	1	01	01	H3447_003_0	8	4	Non-Preferred Brand	100000	2
H3447	003	0	1	01	01	H3447_003_0	8	6	Select Care Drugs	000010	1
H3447	004	0	1	01	01	H3447_004_0	9	6	Select Care Drugs	000010	1
H3447	004	0	1	01	01	H3447_004_0	9	4	Non-Preferred Brand	100000	2
H3447	004	0	1	01	01	H3447_004_0	9	3	Preferred Brand	000001	2
H3447	004	0	1	01	01	H3447_004_0	9	1	Preferred Generic	001000	
H3447	004	0	1	01	01	H3447_004_0	9	2	Non-Preferred Generic	000100	
H3447	004	0	1	01	01	H3447_004_0	9	2	Non-Preferred Generic	000100	1
H3447	004	0	1	01	01	H3447_004_0	9	4	Non-Preferred Brand	100000	
H3447	004	0	1	01	01	H3447_004_0	9	5	Specialty Tier	010010	
H3447	004	0	1	01	01	H3447_004_0	9	6	Select Care Drugs	000010	
H3447	004	0	1	01	01	H3447_004_0	9	1	Preferred Generic	001000	1
H3447	004	0	1	01	01	H3447_004_0	9	3	Preferred Brand	000001	
H3447	005	0	1	01	01	H3447_005_0	9	6	Select Care Drugs	000010	
H3447	005	0	1	01	01	H3447_005_0	9	5	Specialty Tier	010010	
H3447	005	0	1	01	01	H3447_005_0	9	4	Non-Preferred Brand	100000	
H3447	005	0	1	01	01	H3447_005_0	9	2	Non-Preferred Generic	000100	
H3447	005	0	1	01	01	H3447_005_0	9	3	Preferred Brand	000001	
H3447	005	0	1	01	01	H3447_005_0	9	1	Preferred Generic	001000	
H3447	008	0	1	01	01	H3447_008_0	7	5	Specialty Tier	010010	
H3447	008	0	1	01	01	H3447_008_0	7	2	Non-Preferred Generic	000100	1
H3447	008	0	1	01	01	H3447_008_0	7	3	Preferred Brand	000001	
H3447	008	0	1	01	01	H3447_008_0	7	2	Non-Preferred Generic	000100	
H3447	008	0	1	01	01	H3447_008_0	7	1	Preferred Generic	001000	
H3447	008	0	1	01	01	H3447_008_0	7	4	Non-Preferred Brand	100000	
H3447	008	0	1	01	01	H3447_008_0	7	1	Preferred Generic	001000	1
H3447	008	0	1	01	01	H3447_008_0	7	6	Select Care Drugs	010010	
H3449	005	0	1	01	01	H3449_005_0	7	3	Preferred Brand	000001	
H3449	005	0	1	01	01	H3449_005_0	7	2	Non-Preferred Generic	000100	
H3449	005	0	1	01	01	H3449_005_0	7	5	Specialty Tier	010010	
H3449	005	0	1	01	01	H3449_005_0	7	1	Preferred Generic	001000	1
H3449	005	0	1	01	01	H3449_005_0	7	1	Preferred Generic	001000	
H3449	005	0	1	01	01	H3449_005_0	7	4	Non-Preferred Brand	110000	
H3449	013	0	1	01	01	H3449_013_0	6	2	Non-Preferred Generic	000100	
H3449	013	0	1	01	01	H3449_013_0	6	3	Preferred Brand	000001	
H3449	013	0	1	01	01	H3449_013_0	6	4	Non-Preferred Brand	110000	
H3449	013	0	1	01	01	H3449_013_0	6	5	Specialty Tier	010010	
H3449	013	0	1	01	01	H3449_013_0	6	1	Preferred Generic	001000	
H3456	001	0	1	01	01	H3456_001_0	4	1	Preferred Generic	001000	
H3456	001	0	1	01	01	H3456_001_0	4	2	Non-Preferred Generic	000100	
H3456	001	0	1	01	01	H3456_001_0	4	3	Preferred Brand	010001	
H3456	001	0	1	01	01	H3456_001_0	4	4	Non-Preferred Brand	100100	
H3456	001	0	1	01	01	H3456_001_0	4	5	Specialty Tier	010010	
H3456	023	0	1	01	01	H3456_023_0	4	1	Preferred Generic	001000	
H3456	023	0	1	01	01	H3456_023_0	4	2	Non-Preferred Generic	000100	
H3456	023	0	1	01	01	H3456_023_0	4	3	Preferred Brand	010001	
H3456	023	0	1	01	01	H3456_023_0	4	4	Non-Preferred Brand	100100	
H3456	023	0	1	01	01	H3456_023_0	4	5	Specialty Tier	010010	
H3471	001	0	1	01	01	H3471_001_0	6	5	Specialty Tier	100000	
H3471	001	0	1	01	01	H3471_001_0	6	4	Non-Preferred Brand	100000	
H3471	001	0	1	01	01	H3471_001_0	6	3	Preferred Brand	000001	
H3471	001	0	1	01	01	H3471_001_0	6	2	Non-Preferred Generic	000100	
H3471	001	0	1	01	01	H3471_001_0	6	1	Preferred Generic	001000	
H3471	002	0	1	01	01	H3471_002_0	6	5	Specialty Tier	100000	
H3471	002	0	1	01	01	H3471_002_0	6	4	Non-Preferred Brand	100000	
H3471	002	0	1	01	01	H3471_002_0	6	3	Preferred Brand	000001	
H3471	002	0	1	01	01	H3471_002_0	6	2	Non-Preferred Generic	000100	
H3471	002	0	1	01	01	H3471_002_0	6	1	Preferred Generic	001000	
H3480	001	0	1	48	05	H3480_001_0	10	1	Generic Drugs	010000	
H3480	001	0	1	48	05	H3480_001_0	10	4	Non-Medicare OTC Drugs	010010	
H3480	001	0	1	48	05	H3480_001_0	10	3	Non-Medicare Rx Drugs	010010	
H3480	001	0	1	48	05	H3480_001_0	10	2	Brand Drugs	000010	
H3528	001	0	1	01	01	H3528_001_0	8	2	Non-Preferred Generic	000100	
H3528	001	0	1	01	01	H3528_001_0	8	1	Preferred Generic	001000	
H3528	001	0	1	01	01	H3528_001_0	8	5	Specialty Tier	010010	
H3528	001	0	1	01	01	H3528_001_0	8	4	Non-Preferred Brand	100000	
H3528	001	0	1	01	01	H3528_001_0	8	3	Preferred Brand	000001	
H3528	002	0	1	01	01	H3528_002_0	7	5	Specialty Tier	010010	
H3528	002	0	1	01	01	H3528_002_0	7	2	Non-Preferred Generic	000100	1
H3528	002	0	1	01	01	H3528_002_0	7	1	Preferred Generic	001000	1
H3528	002	0	1	01	01	H3528_002_0	7	4	Non-Preferred Brand	100000	
H3528	002	0	1	01	01	H3528_002_0	7	3	Preferred Brand	000001	
H3528	002	0	1	01	01	H3528_002_0	7	2	Non-Preferred Generic	000100	
H3528	002	0	1	01	01	H3528_002_0	7	1	Preferred Generic	001000	
H3528	006	0	1	02	01	H3528_006_0	7	2	Non-Preferred Generic	000100	
H3528	006	0	1	02	01	H3528_006_0	7	4	Non-Preferred Brand	100000	
H3528	006	0	1	02	01	H3528_006_0	7	5	Specialty Tier	010010	
H3528	006	0	1	02	01	H3528_006_0	7	1	Preferred Generic	001000	1
H3528	006	0	1	02	01	H3528_006_0	7	3	Preferred Brand	000001	
H3528	006	0	1	02	01	H3528_006_0	7	1	Preferred Generic	001000	
H3528	006	0	1	02	01	H3528_006_0	7	2	Non-Preferred Generic	000100	1
H3528	008	0	1	02	01	H3528_008_0	7	5	Specialty Tier	010010	
H3528	008	0	1	02	01	H3528_008_0	7	4	Non-Preferred Brand	100000	
H3528	008	0	1	02	01	H3528_008_0	7	2	Non-Preferred Generic	000100	
H3528	008	0	1	02	01	H3528_008_0	7	1	Preferred Generic	001000	
H3528	008	0	1	02	01	H3528_008_0	7	3	Preferred Brand	000001	
H3528	009	0	1	01	01	H3528_009_0	6	2	Non-Preferred Generic	000100	
H3528	009	0	1	01	01	H3528_009_0	6	1	Preferred Generic	001000	
H3528	009	0	1	01	01	H3528_009_0	6	3	Preferred Brand	000001	
H3528	009	0	1	01	01	H3528_009_0	6	4	Non-Preferred Brand	100000	
H3528	009	0	1	01	01	H3528_009_0	6	5	Specialty Tier	010010	
H3533	002	0	1	01	01	H3533_002_0	5	1	Preferred Generic	001010	
H3533	002	0	1	01	01	H3533_002_0	5	2	Non-Preferred Generic	000101	
H3533	002	0	1	01	01	H3533_002_0	5	5	Specialty Tier	010010	
H3533	002	0	1	01	01	H3533_002_0	5	4	Non-Preferred Brand	110000	
H3533	002	0	1	01	01	H3533_002_0	5	3	Preferred Brand	000101	
H3533	004	0	1	01	01	H3533_004_0	4	1	Preferred Generic	001010	
H3533	004	0	1	01	01	H3533_004_0	4	4	Non-Preferred Brand	110000	
H3533	004	0	1	01	01	H3533_004_0	4	3	Preferred Brand	000101	
H3533	004	0	1	01	01	H3533_004_0	4	2	Non-Preferred Generic	000101	
H3533	004	0	1	01	01	H3533_004_0	4	5	Specialty Tier	010010	
H3533	005	0	1	01	01	H3533_005_0	4	5	Specialty Tier	010010	2
H3533	005	0	1	01	01	H3533_005_0	4	1	Preferred Generic	001010	
H3533	005	0	1	01	01	H3533_005_0	4	2	Non-Preferred Generic	000101	
H3533	005	0	1	01	01	H3533_005_0	4	3	Preferred Brand	000101	
H3533	005	0	1	01	01	H3533_005_0	4	4	Non-Preferred Brand	110000	
H3533	005	0	1	01	01	H3533_005_0	4	5	Specialty Tier	010010	
H3533	005	0	1	01	01	H3533_005_0	4	1	Preferred Generic	001010	2
H3533	005	0	1	01	01	H3533_005_0	4	2	Non-Preferred Generic	000101	2
H3533	005	0	1	01	01	H3533_005_0	4	3	Preferred Brand	000101	2
H3533	005	0	1	01	01	H3533_005_0	4	4	Non-Preferred Brand	110000	2
H3533	006	0	1	01	01	H3533_006_0	4	5	Specialty Tier	010010	
H3533	006	0	1	01	01	H3533_006_0	4	1	Preferred Generic	001010	2
H3533	006	0	1	01	01	H3533_006_0	4	4	Non-Preferred Brand	110000	
H3533	006	0	1	01	01	H3533_006_0	4	3	Preferred Brand	000101	
H3533	006	0	1	01	01	H3533_006_0	4	5	Specialty Tier	010010	2
H3533	006	0	1	01	01	H3533_006_0	4	1	Preferred Generic	001010	
H3533	006	0	1	01	01	H3533_006_0	4	2	Non-Preferred Generic	000101	2
H3533	006	0	1	01	01	H3533_006_0	4	3	Preferred Brand	000101	2
H3533	006	0	1	01	01	H3533_006_0	4	4	Non-Preferred Brand	110000	2
H3533	006	0	1	01	01	H3533_006_0	4	2	Non-Preferred Generic	000101	
H3533	007	0	1	01	01	H3533_007_0	4	2	Non-Preferred Generic	000101	
H3533	007	0	1	01	01	H3533_007_0	4	1	Preferred Generic	001010	
H3533	007	0	1	01	01	H3533_007_0	4	3	Preferred Brand	000101	
H3533	007	0	1	01	01	H3533_007_0	4	5	Specialty Tier	010010	2
H3533	007	0	1	01	01	H3533_007_0	4	4	Non-Preferred Brand	110000	2
H3533	007	0	1	01	01	H3533_007_0	4	3	Preferred Brand	000101	2
H3533	007	0	1	01	01	H3533_007_0	4	2	Non-Preferred Generic	000101	2
H3533	007	0	1	01	01	H3533_007_0	4	4	Non-Preferred Brand	110000	
H3533	007	0	1	01	01	H3533_007_0	4	5	Specialty Tier	010010	
H3533	007	0	1	01	01	H3533_007_0	4	1	Preferred Generic	001010	2
H3533	008	0	1	01	01	H3533_008_0	4	1	Preferred Generic	001010	
H3533	008	0	1	01	01	H3533_008_0	4	4	Non-Preferred Brand	110000	
H3533	008	0	1	01	01	H3533_008_0	4	3	Preferred Brand	000101	
H3533	008	0	1	01	01	H3533_008_0	4	2	Non-Preferred Generic	000101	
H3533	008	0	1	01	01	H3533_008_0	4	5	Specialty Tier	010010	
H3533	009	0	1	01	01	H3533_009_0	4	1	Preferred Generic	001010	2
H3533	009	0	1	01	01	H3533_009_0	4	5	Specialty Tier	010010	
H3533	009	0	1	01	01	H3533_009_0	4	4	Non-Preferred Brand	110000	
H3533	009	0	1	01	01	H3533_009_0	4	3	Preferred Brand	000101	
H3533	009	0	1	01	01	H3533_009_0	4	2	Non-Preferred Generic	000101	
H3533	009	0	1	01	01	H3533_009_0	4	1	Preferred Generic	001010	
H3533	009	0	1	01	01	H3533_009_0	4	2	Non-Preferred Generic	000101	2
H3533	009	0	1	01	01	H3533_009_0	4	5	Specialty Tier	010010	2
H3533	009	0	1	01	01	H3533_009_0	4	4	Non-Preferred Brand	110000	2
H3533	009	0	1	01	01	H3533_009_0	4	3	Preferred Brand	000101	2
H3533	010	0	1	01	01	H3533_010_0	4	1	Preferred Generic	001010	
H3533	010	0	1	01	01	H3533_010_0	4	2	Non-Preferred Generic	000101	
H3533	010	0	1	01	01	H3533_010_0	4	3	Preferred Brand	000101	
H3533	010	0	1	01	01	H3533_010_0	4	4	Non-Preferred Brand	110000	
H3533	010	0	1	01	01	H3533_010_0	4	5	Specialty Tier	010010	2
H3533	010	0	1	01	01	H3533_010_0	4	1	Preferred Generic	001010	2
H3533	010	0	1	01	01	H3533_010_0	4	2	Non-Preferred Generic	000101	2
H3533	010	0	1	01	01	H3533_010_0	4	3	Preferred Brand	000101	2
H3533	010	0	1	01	01	H3533_010_0	4	4	Non-Preferred Brand	110000	2
H3533	010	0	1	01	01	H3533_010_0	4	5	Specialty Tier	010010	
H3536	001	0	1	01	01	H3536_001_0	7	3	Preferred Brand	000101	
H3536	001	0	1	01	01	H3536_001_0	7	6	Specialty Tier	010010	
H3536	001	0	1	01	01	H3536_001_0	7	4	Non-Preferred Brand	100100	
H3536	001	0	1	01	01	H3536_001_0	7	5	Injectable Drugs	010010	
H3536	001	0	1	01	01	H3536_001_0	7	2	Non-Preferred Generic	000100	
H3536	001	0	1	01	01	H3536_001_0	7	1	Preferred Generic	001000	
H3597	001	0	1	01	01	H3597_001_0	5	2	Preferred Brand	010001	
H3597	001	0	1	01	01	H3597_001_0	5	3	Non-Preferred Brand	110000	
H3597	001	0	1	01	01	H3597_001_0	5	4	Specialty Tier	010010	
H3597	001	0	1	01	01	H3597_001_0	5	5	Select Care Drugs	010000	
H3597	001	0	1	01	01	H3597_001_0	5	5	Select Care Drugs	010000	1
H3597	001	0	1	01	01	H3597_001_0	5	1	Generic	010000	
H3597	002	0	1	01	01	H3597_002_0	5	5	Select Care Drugs	010000	
H3597	002	0	1	01	01	H3597_002_0	5	4	Specialty Tier	010010	
H3597	002	0	1	01	01	H3597_002_0	5	3	Non-Preferred Brand	110000	
H3597	002	0	1	01	01	H3597_002_0	5	2	Preferred Brand	010001	
H3597	002	0	1	01	01	H3597_002_0	5	1	Generic	010000	
H3597	002	0	1	01	01	H3597_002_0	5	5	Select Care Drugs	010000	1
H3620	004	0	1	04	01	H3620_004_0	4	4	Non-Preferred Brand	100000	
H3620	004	0	1	04	01	H3620_004_0	4	3	Preferred Brand	000001	
H3620	004	0	1	04	01	H3620_004_0	4	2	Non-Preferred Generic	000100	
H3620	004	0	1	04	01	H3620_004_0	4	1	Preferred Generic	001000	
H3620	004	0	1	04	01	H3620_004_0	4	5	Specialty Tier	000010	
H3623	001	0	1	01	01	H3623_001_0	5	2	Preferred Brand	010001	
H3623	001	0	1	01	01	H3623_001_0	5	5	Select Care Drugs	010000	1
H3623	001	0	1	01	01	H3623_001_0	5	5	Select Care Drugs	010000	
H3623	001	0	1	01	01	H3623_001_0	5	4	Specialty Tier	010010	
H3623	001	0	1	01	01	H3623_001_0	5	3	Non-Preferred Brand	110000	
H3623	001	0	1	01	01	H3623_001_0	5	1	Generic	010000	
H3623	003	0	1	01	01	H3623_003_0	6	1	Generic	010000	
H3623	003	0	1	01	01	H3623_003_0	6	3	Non-Preferred Brand	110000	
H3623	003	0	1	01	01	H3623_003_0	6	4	Specialty Tier	010010	
H3623	003	0	1	01	01	H3623_003_0	6	2	Preferred Brand	010001	
H3623	003	0	1	01	01	H3623_003_0	6	5	Select Care Drugs	010000	
H3623	003	0	1	01	01	H3623_003_0	6	5	Select Care Drugs	010000	1
H3623	004	0	1	01	01	H3623_004_0	5	2	Preferred Brand	010001	
H3623	004	0	1	01	01	H3623_004_0	5	5	Select Care Drugs	010000	1
H3623	004	0	1	01	01	H3623_004_0	5	5	Select Care Drugs	010000	
H3623	004	0	1	01	01	H3623_004_0	5	4	Specialty Tier	010010	
H3623	004	0	1	01	01	H3623_004_0	5	3	Non-Preferred Brand	110000	
H3623	004	0	1	01	01	H3623_004_0	5	1	Generic	010000	
H3623	018	0	1	01	01	H3623_018_0	5	5	Select Care Drugs	010000	1
H3623	018	0	1	01	01	H3623_018_0	5	5	Select Care Drugs	010000	
H3623	018	0	1	01	01	H3623_018_0	5	1	Generic	010000	
H3623	018	0	1	01	01	H3623_018_0	5	2	Preferred Brand	010001	
H3623	018	0	1	01	01	H3623_018_0	5	3	Non-Preferred Brand	110000	
H3623	018	0	1	01	01	H3623_018_0	5	4	Specialty Tier	010010	
H3623	019	0	1	01	01	H3623_019_0	5	5	Select Care Drugs	010000	1
H3623	019	0	1	01	01	H3623_019_0	5	5	Select Care Drugs	010000	
H3623	019	0	1	01	01	H3623_019_0	5	4	Specialty Tier	010010	
H3623	019	0	1	01	01	H3623_019_0	5	3	Non-Preferred Brand	110000	
H3623	019	0	1	01	01	H3623_019_0	5	2	Preferred Brand	010001	
H3623	019	0	1	01	01	H3623_019_0	5	1	Generic	010000	
H3623	020	0	1	01	01	H3623_020_0	5	5	Select Care Drugs	010000	
H3623	020	0	1	01	01	H3623_020_0	5	4	Specialty Tier	010010	
H3623	020	0	1	01	01	H3623_020_0	5	3	Non-Preferred Brand	110000	
H3623	020	0	1	01	01	H3623_020_0	5	2	Preferred Brand	010001	
H3623	020	0	1	01	01	H3623_020_0	5	1	Generic	010000	
H3623	020	0	1	01	01	H3623_020_0	5	5	Select Care Drugs	010000	1
H3653	004	0	1	01	01	H3653_004_0	8	2	Non-Preferred Generic	000100	
H3653	004	0	1	01	01	H3653_004_0	8	3	Preferred Brand	000001	
H3653	004	0	1	01	01	H3653_004_0	8	4	Injectable Drugs	010010	
H3653	004	0	1	01	01	H3653_004_0	8	5	Specialty Tier	010010	
H3653	004	0	1	01	01	H3653_004_0	8	1	Preferred Generic	001000	
H3653	015	0	1	01	01	H3653_015_0	7	1	Preferred Generic	001000	
H3653	015	0	1	01	01	H3653_015_0	7	2	Non-Preferred Generic	000100	
H3653	015	0	1	01	01	H3653_015_0	7	3	Preferred Brand	000001	
H3653	015	0	1	01	01	H3653_015_0	7	4	Injectable Drugs	010010	
H3653	015	0	1	01	01	H3653_015_0	7	5	Specialty Tier	010010	
H3655	013	0	1	01	01	H3655_013_0	6	6	Specialty Tier	010010	
H3655	013	0	1	01	01	H3655_013_0	6	5	Injectable Drugs	010010	
H3655	013	0	1	01	01	H3655_013_0	6	4	Non-Preferred Brand	100100	
H3655	013	0	1	01	01	H3655_013_0	6	1	Preferred Generic	001000	
H3655	013	0	1	01	01	H3655_013_0	6	2	Non-Preferred Generic	000100	
H3655	013	0	1	01	01	H3655_013_0	6	3	Preferred Brand	000101	
H3655	030	0	1	01	01	H3655_030_0	5	4	Non-Preferred Brand	100100	
H3655	030	0	1	01	01	H3655_030_0	5	3	Preferred Brand	000101	
H3655	030	0	1	01	01	H3655_030_0	5	2	Non-Preferred Generic	000100	
H3655	030	0	1	01	01	H3655_030_0	5	1	Preferred Generic	001000	
H3655	030	0	1	01	01	H3655_030_0	5	5	Injectable Drugs	010010	
H3655	030	0	1	01	01	H3655_030_0	5	6	Specialty Tier	010010	
H3659	001	0	1	01	01	H3659_001_0	4	5	Specialty Tier	010010	
H3659	001	0	1	01	01	H3659_001_0	4	4	Non-Preferred Brand	100100	
H3659	001	0	1	01	01	H3659_001_0	4	3	Preferred Brand	010001	
H3659	001	0	1	01	01	H3659_001_0	4	2	Non-Preferred Generic	000100	
H3659	001	0	1	01	01	H3659_001_0	4	1	Preferred Generic	001000	
H3659	003	0	1	01	01	H3659_003_0	5	1	Preferred Generic	001000	1
H3659	003	0	1	01	01	H3659_003_0	5	5	Specialty Tier	010010	
H3659	003	0	1	01	01	H3659_003_0	5	4	Non-Preferred Brand	100100	
H3659	003	0	1	01	01	H3659_003_0	5	3	Preferred Brand	010001	
H3659	003	0	1	01	01	H3659_003_0	5	2	Non-Preferred Generic	000100	
H3659	003	0	1	01	01	H3659_003_0	5	1	Preferred Generic	001000	
H3659	031	0	1	01	01	H3659_031_0	4	2	Non-Preferred Generic	000100	
H3659	031	0	1	01	01	H3659_031_0	4	3	Preferred Brand	010001	
H3659	031	0	1	01	01	H3659_031_0	4	4	Non-Preferred Brand	100100	
H3659	031	0	1	01	01	H3659_031_0	4	5	Specialty Tier	010010	
H3659	031	0	1	01	01	H3659_031_0	4	1	Preferred Generic	001000	
H3660	028	0	1	02	01	H3660_028_0	6	2	Non-Preferred Generic	000100	
H3660	028	0	1	02	01	H3660_028_0	6	1	Preferred Generic	001000	
H3660	028	0	1	02	01	H3660_028_0	6	3	Preferred Brand	000001	
H3660	028	0	1	02	01	H3660_028_0	6	4	Non-Preferred Brand	100000	
H3660	028	0	1	02	01	H3660_028_0	6	5	Specialty Tier	010010	
H3660	029	0	1	02	01	H3660_029_0	5	2	Non-Preferred Generic	000100	
H3660	029	0	1	02	01	H3660_029_0	5	1	Preferred Generic	001000	
H3660	029	0	1	02	01	H3660_029_0	5	3	Preferred Brand	000001	
H3660	029	0	1	02	01	H3660_029_0	5	5	Specialty Tier	010010	
H3660	029	0	1	02	01	H3660_029_0	5	4	Non-Preferred Brand	100000	
H3660	044	0	1	01	01	H3660_044_0	5	1	Preferred Generic	001000	
H3660	044	0	1	01	01	H3660_044_0	5	2	Non-Preferred Generic	000100	
H3660	044	0	1	01	01	H3660_044_0	5	4	Non-Preferred Brand	100000	
H3660	044	0	1	01	01	H3660_044_0	5	3	Preferred Brand	000001	
H3660	044	0	1	01	01	H3660_044_0	5	5	Specialty Tier	010010	
H3660	047	0	1	01	01	H3660_047_0	5	1	Preferred Generic	001000	
H3660	047	0	1	01	01	H3660_047_0	5	2	Non-Preferred Generic	000100	
H3660	047	0	1	01	01	H3660_047_0	5	3	Preferred Brand	000001	
H3660	047	0	1	01	01	H3660_047_0	5	4	Non-Preferred Brand	100000	
H3660	047	0	1	01	01	H3660_047_0	5	5	Specialty Tier	010010	
H3660	048	0	1	02	01	H3660_048_0	5	5	Specialty Tier	010010	
H3660	048	0	1	02	01	H3660_048_0	5	2	Non-Preferred Generic	000100	
H3660	048	0	1	02	01	H3660_048_0	5	1	Preferred Generic	001000	
H3660	048	0	1	02	01	H3660_048_0	5	4	Non-Preferred Brand	100000	
H3660	048	0	1	02	01	H3660_048_0	5	3	Preferred Brand	000001	
H3664	017	0	1	02	01	H3664_017_0	4	1	Preferred Generic	001000	
H3664	017	0	1	02	01	H3664_017_0	4	3	Preferred Brand	000001	
H3664	017	0	1	02	01	H3664_017_0	4	2	Non-Preferred Generic	000100	
H3664	017	0	1	02	01	H3664_017_0	4	4	Non-Preferred Brand	100000	
H3664	017	0	1	02	01	H3664_017_0	4	5	Specialty Tier	000010	
H3664	020	0	1	02	01	H3664_020_0	4	5	Specialty Tier	000010	
H3664	020	0	1	02	01	H3664_020_0	4	4	Non-Preferred Brand	100000	
H3664	020	0	1	02	01	H3664_020_0	4	3	Preferred Brand	000001	
H3664	020	0	1	02	01	H3664_020_0	4	2	Non-Preferred Generic	000100	
H3664	020	0	1	02	01	H3664_020_0	4	1	Preferred Generic	001000	
H3668	005	0	1	01	01	H3668_005_0	4	2	Non-Preferred Generic	000101	1
H3668	005	0	1	01	01	H3668_005_0	4	1	Preferred Generic	001001	
H3668	005	0	1	01	01	H3668_005_0	4	2	Non-Preferred Generic	000101	
H3668	005	0	1	01	01	H3668_005_0	4	3	Preferred Brand	000101	
H3668	005	0	1	01	01	H3668_005_0	4	1	Preferred Generic	001001	1
H3668	005	0	1	01	01	H3668_005_0	4	5	Specialty Tier	010010	
H3668	005	0	1	01	01	H3668_005_0	4	4	Non-Preferred Brand	100100	
H3668	011	0	1	01	01	H3668_011_0	5	4	Non-Preferred Brand	100100	
H3668	011	0	1	01	01	H3668_011_0	5	3	Preferred Brand	000101	
H3668	011	0	1	01	01	H3668_011_0	5	1	Preferred Generic	001001	1
H3668	011	0	1	01	01	H3668_011_0	5	5	Specialty Tier	010010	
H3668	011	0	1	01	01	H3668_011_0	5	2	Non-Preferred Generic	000101	
H3668	011	0	1	01	01	H3668_011_0	5	1	Preferred Generic	001001	
H3668	014	0	1	01	01	H3668_014_0	4	2	Non-Preferred Generic	000101	1
H3668	014	0	1	01	01	H3668_014_0	4	1	Preferred Generic	001001	1
H3668	014	0	1	01	01	H3668_014_0	4	5	Specialty Tier	010010	
H3668	014	0	1	01	01	H3668_014_0	4	4	Non-Preferred Brand	100100	
H3668	014	0	1	01	01	H3668_014_0	4	3	Preferred Brand	000101	
H3668	014	0	1	01	01	H3668_014_0	4	2	Non-Preferred Generic	000101	
H3668	014	0	1	01	01	H3668_014_0	4	1	Preferred Generic	001001	
H3668	015	0	1	01	01	H3668_015_0	6	1	Preferred Generic	001001	
H3668	015	0	1	01	01	H3668_015_0	6	5	Specialty Tier	010010	
H3668	015	0	1	01	01	H3668_015_0	6	1	Preferred Generic	001001	1
H3668	015	0	1	01	01	H3668_015_0	6	4	Non-Preferred Brand	100100	
H3668	015	0	1	01	01	H3668_015_0	6	3	Preferred Brand	000101	
H3668	015	0	1	01	01	H3668_015_0	6	2	Non-Preferred Generic	000101	
H3668	016	0	1	01	01	H3668_016_0	4	1	Preferred Generic	001001	
H3668	016	0	1	01	01	H3668_016_0	4	2	Non-Preferred Generic	000101	
H3668	016	0	1	01	01	H3668_016_0	4	4	Non-Preferred Brand	100100	
H3668	016	0	1	01	01	H3668_016_0	4	5	Specialty Tier	010010	
H3668	016	0	1	01	01	H3668_016_0	4	1	Preferred Generic	001001	1
H3668	016	0	1	01	01	H3668_016_0	4	2	Non-Preferred Generic	000101	1
H3668	016	0	1	01	01	H3668_016_0	4	3	Preferred Brand	000101	
H3668	017	0	1	01	01	H3668_017_0	6	1	Preferred Generic	001001	
H3668	017	0	1	01	01	H3668_017_0	6	2	Non-Preferred Generic	000101	
H3668	017	0	1	01	01	H3668_017_0	6	3	Preferred Brand	000101	
H3668	017	0	1	01	01	H3668_017_0	6	4	Non-Preferred Brand	100100	
H3668	017	0	1	01	01	H3668_017_0	6	5	Specialty Tier	010010	
H3668	017	0	1	01	01	H3668_017_0	6	1	Preferred Generic	001001	1
H3672	013	0	1	01	01	H3672_013_0	10	1	Preferred Generic	001000	
H3672	013	0	1	01	01	H3672_013_0	10	2	Non-Preferred Generic	000100	
H3672	013	0	1	01	01	H3672_013_0	10	3	Preferred Brand	000001	
H3672	013	0	1	01	01	H3672_013_0	10	4	Specialty Tier	010010	
H3672	013	0	1	01	01	H3672_013_0	10	1	Preferred Generic	001000	1
H3672	013	0	1	01	01	H3672_013_0	10	2	Non-Preferred Generic	000100	1
H3672	016	0	1	01	01	H3672_016_0	10	1	Preferred Generic	001000	
H3672	016	0	1	01	01	H3672_016_0	10	2	Non-Preferred Generic	000100	
H3672	016	0	1	01	01	H3672_016_0	10	3	Preferred Brand	000001	
H3672	016	0	1	01	01	H3672_016_0	10	4	Specialty Tier	010010	
H3672	016	0	1	01	01	H3672_016_0	10	1	Preferred Generic	001000	1
H3672	016	0	1	01	01	H3672_016_0	10	2	Non-Preferred Generic	000100	1
H3672	018	0	1	01	01	H3672_018_0	12	1	Preferred Generic	001000	
H3672	018	0	1	01	01	H3672_018_0	12	2	Non-Preferred Generic	000100	
H3672	018	0	1	01	01	H3672_018_0	12	3	Preferred Brand	000001	
H3672	018	0	1	01	01	H3672_018_0	12	4	Specialty Tier	010010	
H3672	018	0	1	01	01	H3672_018_0	12	1	Preferred Generic	001000	1
H3706	001	0	1	01	01	H3706_001_0	7	3	Preferred Brand	000101	
H3706	001	0	1	01	01	H3706_001_0	7	2	Non-Preferred Generic	000100	
H3706	001	0	1	01	01	H3706_001_0	7	1	Preferred Generic	001000	
H3706	001	0	1	01	01	H3706_001_0	7	5	Specialty Tier	010010	
H3706	001	0	1	01	01	H3706_001_0	7	4	Non-Preferred Brand	100100	
H3712	001	0	1	01	01	H3712_001_0	11	5	Specialty Tier	010010	
H3712	001	0	1	01	01	H3712_001_0	11	4	Non-Preferred Brand	100000	
H3712	001	0	1	01	01	H3712_001_0	11	3	Preferred Brand	000001	
H3712	001	0	1	01	01	H3712_001_0	11	1	Preferred Generic	001000	1
H3712	001	0	1	01	01	H3712_001_0	11	2	Non-Preferred Generic	000100	1
H3712	001	0	1	01	01	H3712_001_0	11	3	Preferred Brand	000001	1
H3712	001	0	1	01	01	H3712_001_0	11	2	Non-Preferred Generic	000100	
H3712	001	0	1	01	01	H3712_001_0	11	1	Preferred Generic	001000	
H3712	001	0	1	01	01	H3712_001_0	11	4	Non-Preferred Brand	100000	1
H3712	002	0	1	01	01	H3712_002_0	10	1	Preferred Generic	001000	1
H3712	002	0	1	01	01	H3712_002_0	10	5	Specialty Tier	010010	
H3712	002	0	1	01	01	H3712_002_0	10	4	Non-Preferred Brand	100000	
H3712	002	0	1	01	01	H3712_002_0	10	3	Preferred Brand	000001	
H3712	002	0	1	01	01	H3712_002_0	10	2	Non-Preferred Generic	000100	
H3712	002	0	1	01	01	H3712_002_0	10	1	Preferred Generic	001000	
H3749	001	0	1	01	01	H3749_001_0	4	1	Preferred Generic	001000	
H3749	001	0	1	01	01	H3749_001_0	4	2	Non-Preferred Generic	000100	
H3749	001	0	1	01	01	H3749_001_0	4	3	Preferred Brand	010001	
H3749	001	0	1	01	01	H3749_001_0	4	4	Non-Preferred Brand	100100	
H3749	001	0	1	01	01	H3749_001_0	4	5	Specialty Tier	010010	
H3749	004	0	1	01	01	H3749_004_0	4	5	Specialty Tier	010010	
H3749	004	0	1	01	01	H3749_004_0	4	1	Preferred Generic	001000	
H3749	004	0	1	01	01	H3749_004_0	4	2	Non-Preferred Generic	000100	
H3749	004	0	1	01	01	H3749_004_0	4	3	Preferred Brand	010001	
H3749	004	0	1	01	01	H3749_004_0	4	4	Non-Preferred Brand	100100	
H3749	017	0	1	01	01	H3749_017_0	4	5	Specialty Tier	010010	
H3749	017	0	1	01	01	H3749_017_0	4	3	Preferred Brand	010001	
H3749	017	0	1	01	01	H3749_017_0	4	2	Non-Preferred Generic	000100	
H3749	017	0	1	01	01	H3749_017_0	4	1	Preferred Generic	001000	
H3749	017	0	1	01	01	H3749_017_0	4	4	Non-Preferred Brand	100100	
H3755	001	0	1	01	01	H3755_001_0	5	6	Injectable Drugs	100000	
H3755	001	0	1	01	01	H3755_001_0	5	5	Specialty Tier	100000	
H3755	001	0	1	01	01	H3755_001_0	5	4	Non-Preferred Brand	100000	
H3755	001	0	1	01	01	H3755_001_0	5	3	Preferred Brand	000001	
H3755	001	0	1	01	01	H3755_001_0	5	1	Preferred Generic	001000	
H3755	001	0	1	01	01	H3755_001_0	5	2	Non-Preferred Generic	000100	
H3755	004	0	1	01	01	H3755_004_0	7	6	Injectable Drugs	100000	
H3755	004	0	1	01	01	H3755_004_0	7	1	Preferred Generic	001000	
H3755	004	0	1	01	01	H3755_004_0	7	2	Non-Preferred Generic	000100	
H3755	004	0	1	01	01	H3755_004_0	7	3	Preferred Brand	000001	
H3755	004	0	1	01	01	H3755_004_0	7	4	Non-Preferred Brand	100000	
H3755	004	0	1	01	01	H3755_004_0	7	5	Specialty Tier	100000	
H3755	005	0	1	01	01	H3755_005_0	4	6	Injectable Drugs	100000	
H3755	005	0	1	01	01	H3755_005_0	4	1	Preferred Generic	001000	
H3755	005	0	1	01	01	H3755_005_0	4	2	Non-Preferred Generic	000100	
H3755	005	0	1	01	01	H3755_005_0	4	3	Preferred Brand	000001	
H3755	005	0	1	01	01	H3755_005_0	4	4	Non-Preferred Brand	100000	
H3755	005	0	1	01	01	H3755_005_0	4	5	Specialty Tier	100000	
H3805	001	0	1	01	01	H3805_001_0	5	4	Non-Preferred Brand	100100	
H3805	001	0	1	01	01	H3805_001_0	5	3	Preferred Brand	010001	
H3805	001	0	1	01	01	H3805_001_0	5	2	Non-Preferred Generic	000100	
H3805	001	0	1	01	01	H3805_001_0	5	1	Preferred Generic	001000	
H3805	001	0	1	01	01	H3805_001_0	5	5	Specialty Tier	010010	
H3805	007	0	1	01	01	H3805_007_0	5	4	Non-Preferred Brand	100100	
H3805	007	0	1	01	01	H3805_007_0	5	3	Preferred Brand	010001	
H3805	007	0	1	01	01	H3805_007_0	5	2	Non-Preferred Generic	000100	
H3805	007	0	1	01	01	H3805_007_0	5	1	Preferred Generic	001000	
H3805	007	0	1	01	01	H3805_007_0	5	5	Specialty Tier	010010	
H3805	012	0	1	01	01	H3805_012_0	5	1	Preferred Generic	001000	
H3805	012	0	1	01	01	H3805_012_0	5	2	Non-Preferred Generic	000100	
H3805	012	0	1	01	01	H3805_012_0	5	3	Preferred Brand	010001	
H3805	012	0	1	01	01	H3805_012_0	5	4	Non-Preferred Brand	100100	
H3805	012	0	1	01	01	H3805_012_0	5	5	Specialty Tier	010010	
H3805	013	0	1	01	01	H3805_013_0	5	1	Preferred Generic	001000	
H3805	013	0	1	01	01	H3805_013_0	5	2	Non-Preferred Generic	000100	
H3805	013	0	1	01	01	H3805_013_0	5	3	Preferred Brand	010001	
H3805	013	0	1	01	01	H3805_013_0	5	4	Non-Preferred Brand	100100	
H3805	013	0	1	01	01	H3805_013_0	5	5	Specialty Tier	010010	
H3810	003	0	1	01	01	H3810_003_0	12	1	Preferred Generic	001000	
H3810	003	0	1	01	01	H3810_003_0	12	1	Preferred Generic	001000	1
H3810	003	0	1	01	01	H3810_003_0	12	5	Specialty Tier	100000	
H3810	003	0	1	01	01	H3810_003_0	12	4	Non-Preferred Brand	100000	
H3810	003	0	1	01	01	H3810_003_0	12	3	Preferred Brand	000001	
H3810	003	0	1	01	01	H3810_003_0	12	2	Non-Preferred Generic	000100	
H3810	007	0	1	01	01	H3810_007_0	13	2	Non-Preferred Generic	000100	
H3810	007	0	1	01	01	H3810_007_0	13	1	Preferred Generic	001000	
H3810	007	0	1	01	01	H3810_007_0	13	3	Preferred Brand	000001	
H3810	007	0	1	01	01	H3810_007_0	13	4	Non-Preferred Brand	100000	
H3810	007	0	1	01	01	H3810_007_0	13	5	Specialty Tier	100000	
H3810	007	0	1	01	01	H3810_007_0	13	1	Preferred Generic	001000	1
H3811	002	0	1	01	01	H3811_002_0	6	5	Specialty Tier	000001	
H3811	002	0	1	01	01	H3811_002_0	6	4	Non-Preferred Brand	100000	
H3811	002	0	1	01	01	H3811_002_0	6	3	Preferred Brand	000001	
H3811	002	0	1	01	01	H3811_002_0	6	2	Non-Preferred Generic	000100	
H3811	002	0	1	01	01	H3811_002_0	6	1	Preferred Generic	001000	
H3811	009	0	1	01	01	H3811_009_0	6	5	Specialty Tier	000010	
H3811	009	0	1	01	01	H3811_009_0	6	1	Preferred Generic	001000	1
H3811	009	0	1	01	01	H3811_009_0	6	1	Preferred Generic	001000	
H3811	009	0	1	01	01	H3811_009_0	6	2	Non-Preferred Generic	000100	
H3811	009	0	1	01	01	H3811_009_0	6	4	Non-Preferred Brand	100000	
H3811	009	0	1	01	01	H3811_009_0	6	3	Preferred Brand	000001	
H3811	009	0	1	01	01	H3811_009_0	6	2	Non-Preferred Generic	000100	1
H3812	001	0	1	04	01	H3812_001_0	6	5	Specialty Tier	010010	
H3812	001	0	1	04	01	H3812_001_0	6	3	Preferred Brand	010001	
H3812	001	0	1	04	01	H3812_001_0	6	4	Non-Preferred Brand	100100	
H3812	001	0	1	04	01	H3812_001_0	6	2	Non-Preferred Generic	000100	
H3812	001	0	1	04	01	H3812_001_0	6	1	Preferred Generic	001000	
H3813	004	0	1	04	01	H3813_004_0	4	5	Specialty Tier	100100	
H3813	004	0	1	04	01	H3813_004_0	4	4	Non-Preferred Brand	100000	
H3813	004	0	1	04	01	H3813_004_0	4	3	Preferred Brand	000001	
H3813	004	0	1	04	01	H3813_004_0	4	2	Non-Preferred Generic	000100	
H3813	004	0	1	04	01	H3813_004_0	4	1	Preferred Generic	001000	
H3813	005	0	1	04	01	H3813_005_0	4	5	Specialty Tier	100100	
H3813	005	0	1	04	01	H3813_005_0	4	4	Non-Preferred Brand	100000	
H3813	005	0	1	04	01	H3813_005_0	4	3	Preferred Brand	000001	
H3813	005	0	1	04	01	H3813_005_0	4	2	Non-Preferred Generic	000100	
H3813	005	0	1	04	01	H3813_005_0	4	1	Preferred Generic	001000	
H3813	006	0	1	04	01	H3813_006_0	3	2	Non-Preferred Generic	000100	
H3813	006	0	1	04	01	H3813_006_0	3	4	Non-Preferred Brand	100000	
H3813	006	0	1	04	01	H3813_006_0	3	5	Specialty Tier	100000	
H3813	006	0	1	04	01	H3813_006_0	3	3	Preferred Brand	000001	
H3813	006	0	1	04	01	H3813_006_0	3	1	Preferred Generic	001000	
H3815	001	0	1	01	01	H3815_001_0	11	4	Injectable Drugs	010010	
H3815	001	0	1	01	01	H3815_001_0	11	5	Specialty Tier	010010	
H3815	001	0	1	01	01	H3815_001_0	11	3	Non-Preferred Brand	100000	
H3815	001	0	1	01	01	H3815_001_0	11	1	Generic	010000	
H3815	001	0	1	01	01	H3815_001_0	11	2	Preferred Brand	000001	
H3815	006	0	1	01	01	H3815_006_0	11	1	Generic	010000	
H3815	006	0	1	01	01	H3815_006_0	11	2	Preferred Brand	000001	
H3815	006	0	1	01	01	H3815_006_0	11	3	Non-Preferred Brand	100000	
H3815	006	0	1	01	01	H3815_006_0	11	4	Injectable Drugs	010010	
H3815	006	0	1	01	01	H3815_006_0	11	5	Specialty Tier	010010	
H3815	007	0	1	01	01	H3815_007_0	11	2	Preferred Brand	000001	
H3815	007	0	1	01	01	H3815_007_0	11	3	Non-Preferred Brand	100000	
H3815	007	0	1	01	01	H3815_007_0	11	4	Injectable Drugs	010010	
H3815	007	0	1	01	01	H3815_007_0	11	5	Specialty Tier	010010	
H3815	007	0	1	01	01	H3815_007_0	11	1	Generic	010000	
H3817	002	0	1	04	01	H3817_002_0	15	4	Non-Preferred Brand	100000	
H3817	002	0	1	04	01	H3817_002_0	15	5	Specialty Tier	010010	
H3817	002	0	1	04	01	H3817_002_0	15	2	Non-Preferred Generic	000100	
H3817	002	0	1	04	01	H3817_002_0	15	1	Preferred Generic	001000	
H3817	002	0	1	04	01	H3817_002_0	15	3	Preferred Brand	000001	
H3817	003	0	1	04	01	H3817_003_0	11	1	Preferred Generic	001000	
H3817	003	0	1	04	01	H3817_003_0	11	2	Non-Preferred Generic	000100	
H3817	003	0	1	04	01	H3817_003_0	11	3	Preferred Brand	000001	
H3817	003	0	1	04	01	H3817_003_0	11	4	Non-Preferred Brand	100000	
H3817	003	0	1	04	01	H3817_003_0	11	5	Specialty Tier	010010	
H3817	003	0	1	04	01	H3817_003_0	11	1	Preferred Generic	001000	1
H3818	003	0	1	01	01	H3818_003_0	18	1	Preferred Generic	001001	
H3818	003	0	1	01	01	H3818_003_0	18	2	Non-Preferred Generic	000101	
H3818	003	0	1	01	01	H3818_003_0	18	3	Preferred Brand	000101	
H3818	003	0	1	01	01	H3818_003_0	18	4	Non-Preferred Brand	100100	
H3818	003	0	1	01	01	H3818_003_0	18	5	Specialty Tier	010010	
H3818	014	0	1	01	01	H3818_014_0	18	1	Preferred Generic	001001	
H3818	014	0	1	01	01	H3818_014_0	18	2	Non-Preferred Generic	000101	
H3818	014	0	1	01	01	H3818_014_0	18	3	Preferred Brand	000101	
H3818	014	0	1	01	01	H3818_014_0	18	4	Non-Preferred Brand	100100	
H3818	014	0	1	01	01	H3818_014_0	18	5	Specialty Tier	010010	
H3822	001	0	1	01	01	H3822_001_0	14	1	Preferred Generic	001000	
H3822	001	0	1	01	01	H3822_001_0	14	2	Non-Preferred Generic	000100	
H3822	001	0	1	01	01	H3822_001_0	14	3	Preferred Brand	000001	
H3822	001	0	1	01	01	H3822_001_0	14	4	Non-Preferred Brand	110000	
H3822	001	0	1	01	01	H3822_001_0	14	5	Specialty Tier	010010	
H3822	002	0	1	01	01	H3822_002_0	12	5	Specialty Tier	010010	
H3822	002	0	1	01	01	H3822_002_0	12	4	Non-Preferred Brand	110000	
H3822	002	0	1	01	01	H3822_002_0	12	3	Preferred Brand	000001	
H3822	002	0	1	01	01	H3822_002_0	12	1	Preferred Generic	001000	
H3822	002	0	1	01	01	H3822_002_0	12	2	Non-Preferred Generic	000100	
H3822	003	0	1	01	01	H3822_003_0	11	4	Non-Preferred Brand	110000	
H3822	003	0	1	01	01	H3822_003_0	11	3	Preferred Brand	000001	
H3822	003	0	1	01	01	H3822_003_0	11	2	Non-Preferred Generic	000100	
H3822	003	0	1	01	01	H3822_003_0	11	1	Preferred Generic	001000	
H3822	003	0	1	01	01	H3822_003_0	11	5	Specialty Tier	010010	
H3822	004	0	1	01	01	H3822_004_0	13	5	Specialty Tier	010010	
H3822	004	0	1	01	01	H3822_004_0	13	4	Non-Preferred Brand	110000	
H3822	004	0	1	01	01	H3822_004_0	13	3	Preferred Brand	000001	
H3822	004	0	1	01	01	H3822_004_0	13	1	Preferred Generic	001000	
H3822	004	0	1	01	01	H3822_004_0	13	2	Non-Preferred Generic	000100	
H3822	005	0	1	02	01	H3822_005_0	12	4	Non-Preferred Brand	110000	
H3822	005	0	1	02	01	H3822_005_0	12	3	Preferred Brand	000001	
H3822	005	0	1	02	01	H3822_005_0	12	2	Non-Preferred Generic	000100	
H3822	005	0	1	02	01	H3822_005_0	12	1	Preferred Generic	001000	
H3822	005	0	1	02	01	H3822_005_0	12	5	Specialty Tier	010010	
H3822	007	0	1	02	01	H3822_007_0	14	5	Specialty Tier	010010	
H3822	007	0	1	02	01	H3822_007_0	14	4	Non-Preferred Brand	110000	
H3822	007	0	1	02	01	H3822_007_0	14	3	Preferred Brand	000001	
H3822	007	0	1	02	01	H3822_007_0	14	1	Preferred Generic	001000	
H3822	007	0	1	02	01	H3822_007_0	14	2	Non-Preferred Generic	000100	
H3822	008	0	1	02	01	H3822_008_0	16	4	Non-Preferred Brand	110000	
H3822	008	0	1	02	01	H3822_008_0	16	3	Preferred Brand	000001	
H3822	008	0	1	02	01	H3822_008_0	16	2	Non-Preferred Generic	000100	
H3822	008	0	1	02	01	H3822_008_0	16	1	Preferred Generic	001000	
H3822	008	0	1	02	01	H3822_008_0	16	5	Specialty Tier	010010	
H3832	001	0	1	04	01	H3832_001_0	9	1	Generic	010000	
H3832	001	0	1	04	01	H3832_001_0	9	1	Generic	010000	2
H3832	001	0	1	04	01	H3832_001_0	9	4	Specialty Tier	010010	
H3832	001	0	1	04	01	H3832_001_0	9	3	Non-Preferred Brand	100000	
H3832	001	0	1	04	01	H3832_001_0	9	2	Preferred Brand	000001	
H3832	006	0	1	04	01	H3832_006_0	11	1	Generic	010000	
H3832	006	0	1	04	01	H3832_006_0	11	1	Generic	010000	2
H3832	006	0	1	04	01	H3832_006_0	11	4	Specialty Tier	010001	
H3832	006	0	1	04	01	H3832_006_0	11	3	Non-Preferred Brand	100000	
H3832	006	0	1	04	01	H3832_006_0	11	2	Preferred Brand	000001	
H3864	006	0	1	01	01	H3864_006_0	9	1	Preferred Generic	001000	
H3864	006	0	1	01	01	H3864_006_0	9	2	Non-Preferred Generic	000100	
H3864	006	0	1	01	01	H3864_006_0	9	3	Preferred Brand	000001	
H3864	006	0	1	01	01	H3864_006_0	9	4	Non-Preferred Brand	100000	
H3864	006	0	1	01	01	H3864_006_0	9	5	Specialty Tier	110001	
H3864	006	0	1	01	01	H3864_006_0	9	1	Preferred Generic	001000	1
H3864	014	0	1	01	01	H3864_014_0	7	2	Non-Preferred Generic	000100	
H3864	014	0	1	01	01	H3864_014_0	7	1	Preferred Generic	001000	
H3864	014	0	1	01	01	H3864_014_0	7	3	Preferred Brand	000001	
H3864	014	0	1	01	01	H3864_014_0	7	1	Preferred Generic	001000	1
H3864	014	0	1	01	01	H3864_014_0	7	5	Specialty Tier	110001	
H3864	014	0	1	01	01	H3864_014_0	7	4	Non-Preferred Brand	100000	
H3864	015	0	1	01	01	H3864_015_0	8	1	Preferred Generic	001000	
H3864	015	0	1	01	01	H3864_015_0	8	2	Non-Preferred Generic	000100	
H3864	015	0	1	01	01	H3864_015_0	8	5	Specialty Tier	110001	
H3864	015	0	1	01	01	H3864_015_0	8	4	Non-Preferred Brand	100000	
H3864	015	0	1	01	01	H3864_015_0	8	3	Preferred Brand	000001	
H3864	015	0	1	01	01	H3864_015_0	8	1	Preferred Generic	001000	1
H3864	016	0	1	01	01	H3864_016_0	7	2	Non-Preferred Generic	000100	
H3864	016	0	1	01	01	H3864_016_0	7	1	Preferred Generic	001000	
H3864	016	0	1	01	01	H3864_016_0	7	3	Preferred Brand	000001	
H3864	016	0	1	01	01	H3864_016_0	7	1	Preferred Generic	001000	1
H3864	016	0	1	01	01	H3864_016_0	7	5	Specialty Tier	110001	
H3864	016	0	1	01	01	H3864_016_0	7	4	Non-Preferred Brand	100000	
H3864	019	0	1	01	01	H3864_019_0	7	2	Non-Preferred Generic	000100	
H3864	019	0	1	01	01	H3864_019_0	7	1	Preferred Generic	001000	
H3864	019	0	1	01	01	H3864_019_0	7	3	Preferred Brand	000001	
H3864	019	0	1	01	01	H3864_019_0	7	4	Non-Preferred Brand	100000	
H3864	019	0	1	01	01	H3864_019_0	7	5	Specialty Tier	110001	
H3864	019	0	1	01	01	H3864_019_0	7	1	Preferred Generic	001000	1
H3864	020	0	1	01	01	H3864_020_0	8	2	Non-Preferred Generic	000100	
H3864	020	0	1	01	01	H3864_020_0	8	1	Preferred Generic	001000	
H3864	020	0	1	01	01	H3864_020_0	8	3	Preferred Brand	000001	
H3864	020	0	1	01	01	H3864_020_0	8	1	Preferred Generic	001000	1
H3864	020	0	1	01	01	H3864_020_0	8	5	Specialty Tier	110001	
H3864	020	0	1	01	01	H3864_020_0	8	4	Non-Preferred Brand	100000	
H3864	021	0	1	01	01	H3864_021_0	7	1	Preferred Generic	001000	
H3864	021	0	1	01	01	H3864_021_0	7	2	Non-Preferred Generic	000100	
H3864	021	0	1	01	01	H3864_021_0	7	3	Preferred Brand	000001	
H3864	021	0	1	01	01	H3864_021_0	7	4	Non-Preferred Brand	100000	
H3864	021	0	1	01	01	H3864_021_0	7	5	Specialty Tier	110001	
H3864	021	0	1	01	01	H3864_021_0	7	1	Preferred Generic	001000	1
H3887	003	0	1	02	01	H3887_003_0	5	1	Preferred Generic	001000	
H3887	003	0	1	02	01	H3887_003_0	5	2	Non-Preferred Generic	000100	
H3887	003	0	1	02	01	H3887_003_0	5	5	Specialty Tier	010010	
H3887	003	0	1	02	01	H3887_003_0	5	4	Non-Preferred Brand	100100	
H3887	003	0	1	02	01	H3887_003_0	5	3	Preferred Brand	010001	
H3907	006	0	1	01	01	H3907_006_0	8	3	Non-Preferred Brand	100000	
H3907	006	0	1	01	01	H3907_006_0	8	2	Preferred Brand	000001	
H3907	006	0	1	01	01	H3907_006_0	8	1	Generic	010000	
H3907	006	0	1	01	01	H3907_006_0	8	4	Specialty Tier	010010	
H3907	006	0	1	01	01	H3907_006_0	8	5	Select Care Drugs	010000	
H3907	029	0	1	01	01	H3907_029_0	10	1	Generic	010000	
H3907	029	0	1	01	01	H3907_029_0	10	2	Preferred Brand	000001	
H3907	029	0	1	01	01	H3907_029_0	10	3	Non-Preferred Brand	100000	
H3907	029	0	1	01	01	H3907_029_0	10	4	Specialty Tier	010010	
H3907	029	0	1	01	01	H3907_029_0	10	5	Select Care Drugs	010000	
H3907	037	0	1	01	01	H3907_037_0	9	3	Non-Preferred Brand	100000	
H3907	037	0	1	01	01	H3907_037_0	9	2	Preferred Brand	000001	
H3907	037	0	1	01	01	H3907_037_0	9	1	Generic	010000	
H3907	037	0	1	01	01	H3907_037_0	9	4	Specialty Tier	010010	
H3907	037	0	1	01	01	H3907_037_0	9	5	Select Care Drugs	010000	
H3907	039	0	1	01	01	H3907_039_0	7	1	Generic	010000	
H3907	039	0	1	01	01	H3907_039_0	7	2	Preferred Brand	000001	
H3907	039	0	1	01	01	H3907_039_0	7	3	Non-Preferred Brand	100000	
H3907	039	0	1	01	01	H3907_039_0	7	4	Specialty Tier	010010	
H3907	039	0	1	01	01	H3907_039_0	7	5	Select Care Drugs	010000	
H3909	001	0	1	04	01	H3909_001_0	8	1	Generic	010000	
H3909	001	0	1	04	01	H3909_001_0	8	2	Preferred Brand	000001	
H3909	001	0	1	04	01	H3909_001_0	8	4	Specialty Tier	110001	
H3909	001	0	1	04	01	H3909_001_0	8	3	Non-Preferred Brand	100000	
H3909	009	0	1	04	01	H3909_009_0	9	1	Generic	010000	
H3909	009	0	1	04	01	H3909_009_0	9	3	Non-Preferred Brand	100000	
H3909	009	0	1	04	01	H3909_009_0	9	2	Preferred Brand	000001	
H3909	009	0	1	04	01	H3909_009_0	9	4	Specialty Tier	110001	
H3916	001	0	1	04	01	H3916_001_0	5	1	Generic	010000	
H3916	001	0	1	04	01	H3916_001_0	5	2	Preferred Brand	000001	
H3916	001	0	1	04	01	H3916_001_0	5	3	Non-Preferred Brand	100000	
H3916	001	0	1	04	01	H3916_001_0	5	4	Specialty Tier	010010	
H3916	001	0	1	04	01	H3916_001_0	5	1	Generic	010000	1
H3916	002	0	1	04	01	H3916_002_0	5	1	Generic	010000	1
H3916	002	0	1	04	01	H3916_002_0	5	4	Specialty Tier	010010	
H3916	002	0	1	04	01	H3916_002_0	5	3	Non-Preferred Brand	100000	
H3916	002	0	1	04	01	H3916_002_0	5	2	Preferred Brand	000001	
H3916	002	0	1	04	01	H3916_002_0	5	1	Generic	010000	
H3916	005	0	1	04	01	H3916_005_0	5	3	Non-Preferred Brand	100000	
H3916	005	0	1	04	01	H3916_005_0	5	2	Preferred Brand	000001	
H3916	005	0	1	04	01	H3916_005_0	5	1	Generic	010000	
H3916	005	0	1	04	01	H3916_005_0	5	4	Specialty Tier	010010	
H3916	005	0	1	04	01	H3916_005_0	5	1	Generic	010000	1
H3916	015	0	1	04	01	H3916_015_0	5	4	Specialty Tier	010010	
H3916	015	0	1	04	01	H3916_015_0	5	3	Non-Preferred Brand	100000	
H3916	015	0	1	04	01	H3916_015_0	5	2	Preferred Brand	000001	
H3916	015	0	1	04	01	H3916_015_0	5	1	Generic	010000	
H3916	018	0	1	04	01	H3916_018_0	5	3	Non-Preferred Brand	100000	
H3916	018	0	1	04	01	H3916_018_0	5	2	Preferred Brand	000001	
H3916	018	0	1	04	01	H3916_018_0	5	1	Generic	010000	
H3916	018	0	1	04	01	H3916_018_0	5	4	Specialty Tier	010010	
H3916	019	0	1	04	01	H3916_019_0	5	5	Specialty Tier	010010	
H3916	019	0	1	04	01	H3916_019_0	5	4	Non-Preferred Brand	100000	
H3916	019	0	1	04	01	H3916_019_0	5	3	Preferred Brand	000001	
H3916	019	0	1	04	01	H3916_019_0	5	1	Preferred Generic	001000	
H3916	019	0	1	04	01	H3916_019_0	5	2	Non-Preferred Generic	000100	
H3916	020	0	1	04	01	H3916_020_0	5	3	Preferred Brand	000001	
H3916	020	0	1	04	01	H3916_020_0	5	2	Non-Preferred Generic	000100	
H3916	020	0	1	04	01	H3916_020_0	5	1	Preferred Generic	001000	
H3916	020	0	1	04	01	H3916_020_0	5	4	Non-Preferred Brand	100000	
H3916	020	0	1	04	01	H3916_020_0	5	5	Specialty Tier	010010	
H3916	022	0	1	04	01	H3916_022_0	5	4	Specialty Tier	010010	
H3916	022	0	1	04	01	H3916_022_0	5	3	Non-Preferred Brand	100000	
H3916	022	0	1	04	01	H3916_022_0	5	2	Preferred Brand	000001	
H3916	022	0	1	04	01	H3916_022_0	5	1	Generic	010000	
H3916	024	0	1	04	01	H3916_024_0	5	3	Non-Preferred Brand	100000	
H3916	024	0	1	04	01	H3916_024_0	5	2	Preferred Brand	000001	
H3916	024	0	1	04	01	H3916_024_0	5	1	Generic	010000	
H3916	024	0	1	04	01	H3916_024_0	5	4	Specialty Tier	010010	
H3916	025	0	1	04	01	H3916_025_0	5	5	Specialty Tier	010010	
H3916	025	0	1	04	01	H3916_025_0	5	4	Non-Preferred Brand	100000	
H3916	025	0	1	04	01	H3916_025_0	5	3	Preferred Brand	000001	
H3916	025	0	1	04	01	H3916_025_0	5	1	Preferred Generic	001000	
H3916	025	0	1	04	01	H3916_025_0	5	2	Non-Preferred Generic	000100	
H3916	032	0	1	04	01	H3916_032_0	5	1	Preferred Generic	001000	
H3916	032	0	1	04	01	H3916_032_0	5	2	Non-Preferred Generic	000100	
H3916	032	0	1	04	01	H3916_032_0	5	3	Preferred Brand	000001	
H3916	032	0	1	04	01	H3916_032_0	5	5	Specialty Tier	010010	
H3916	032	0	1	04	01	H3916_032_0	5	4	Non-Preferred Brand	100000	
H3916	033	0	1	04	01	H3916_033_0	5	5	Specialty Tier	010010	
H3916	033	0	1	04	01	H3916_033_0	5	3	Preferred Brand	000001	
H3916	033	0	1	04	01	H3916_033_0	5	2	Non-Preferred Generic	000100	
H3916	033	0	1	04	01	H3916_033_0	5	1	Preferred Generic	001000	
H3916	033	0	1	04	01	H3916_033_0	5	4	Non-Preferred Brand	100000	
H3921	001	0	1	04	01	H3921_001_0	6	5	Specialty Tier	010010	
H3921	001	0	1	04	01	H3921_001_0	6	4	Non-Preferred Brand	100100	
H3921	001	0	1	04	01	H3921_001_0	6	3	Preferred Brand	010001	
H3921	001	0	1	04	01	H3921_001_0	6	2	Non-Preferred Generic	000100	
H3921	001	0	1	04	01	H3921_001_0	6	1	Preferred Generic	001000	
H3921	008	0	1	04	01	H3921_008_0	6	5	Specialty Tier	010010	
H3921	008	0	1	04	01	H3921_008_0	6	4	Non-Preferred Brand	100100	
H3921	008	0	1	04	01	H3921_008_0	6	3	Preferred Brand	010001	
H3921	008	0	1	04	01	H3921_008_0	6	2	Non-Preferred Generic	000100	
H3921	008	0	1	04	01	H3921_008_0	6	1	Preferred Generic	001000	
H3921	009	0	1	04	01	H3921_009_0	6	2	Non-Preferred Generic	000100	
H3921	009	0	1	04	01	H3921_009_0	6	3	Preferred Brand	010001	
H3921	009	0	1	04	01	H3921_009_0	6	4	Non-Preferred Brand	100100	
H3921	009	0	1	04	01	H3921_009_0	6	5	Specialty Tier	010010	
H3921	009	0	1	04	01	H3921_009_0	6	1	Preferred Generic	001000	
H3923	013	0	1	04	01	H3923_013_0	8	2	Non-Preferred Generic	000100	
H3923	013	0	1	04	01	H3923_013_0	8	3	Preferred Brand	000001	
H3923	013	0	1	04	01	H3923_013_0	8	4	Non-Preferred Brand	100000	
H3923	013	0	1	04	01	H3923_013_0	8	5	Specialty Tier	010010	
H3923	013	0	1	04	01	H3923_013_0	8	1	Preferred Generic	001000	
H3923	017	0	1	04	01	H3923_017_0	8	4	Non-Preferred Brand	100000	
H3923	017	0	1	04	01	H3923_017_0	8	5	Specialty Tier	010010	
H3923	017	0	1	04	01	H3923_017_0	8	3	Preferred Brand	000001	
H3923	017	0	1	04	01	H3923_017_0	8	2	Non-Preferred Generic	000100	
H3923	017	0	1	04	01	H3923_017_0	8	1	Preferred Generic	001000	
H3924	003	0	1	04	01	H3924_003_0	5	3	Preferred Brand	000001	
H3924	003	0	1	04	01	H3924_003_0	5	4	Non-Preferred Brand	100000	
H3924	003	0	1	04	01	H3924_003_0	5	5	Specialty Tier	000010	
H3924	003	0	1	04	01	H3924_003_0	5	1	Preferred Generic	001000	1
H3924	003	0	1	04	01	H3924_003_0	5	2	Non-Preferred Generic	000100	
H3924	003	0	1	04	01	H3924_003_0	5	1	Preferred Generic	001000	
H3924	023	0	1	04	01	H3924_023_0	4	3	Preferred Brand	000001	
H3924	023	0	1	04	01	H3924_023_0	4	1	Preferred Generic	001000	1
H3924	023	0	1	04	01	H3924_023_0	4	5	Specialty Tier	000010	
H3924	023	0	1	04	01	H3924_023_0	4	4	Non-Preferred Brand	100000	
H3924	023	0	1	04	01	H3924_023_0	4	2	Non-Preferred Generic	000100	
H3924	023	0	1	04	01	H3924_023_0	4	1	Preferred Generic	001000	
H3924	046	0	1	04	01	H3924_046_0	5	1	Preferred Generic	001000	
H3924	046	0	1	04	01	H3924_046_0	5	2	Non-Preferred Generic	000100	
H3924	046	0	1	04	01	H3924_046_0	5	3	Preferred Brand	000001	
H3924	046	0	1	04	01	H3924_046_0	5	4	Non-Preferred Brand	100000	
H3924	046	0	1	04	01	H3924_046_0	5	5	Specialty Tier	000010	
H3924	046	0	1	04	01	H3924_046_0	5	1	Preferred Generic	001000	1
H3924	048	0	1	04	01	H3924_048_0	4	1	Preferred Generic	001000	
H3924	048	0	1	04	01	H3924_048_0	4	2	Non-Preferred Generic	000100	
H3924	048	0	1	04	01	H3924_048_0	4	1	Preferred Generic	001000	1
H3924	048	0	1	04	01	H3924_048_0	4	5	Specialty Tier	000010	
H3924	048	0	1	04	01	H3924_048_0	4	4	Non-Preferred Brand	100000	
H3924	048	0	1	04	01	H3924_048_0	4	3	Preferred Brand	000001	
H3924	052	0	1	04	01	H3924_052_0	4	2	Non-Preferred Generic	000100	
H3924	052	0	1	04	01	H3924_052_0	4	3	Preferred Brand	000001	
H3924	052	0	1	04	01	H3924_052_0	4	4	Non-Preferred Brand	100000	
H3924	052	0	1	04	01	H3924_052_0	4	5	Specialty Tier	000010	
H3924	052	0	1	04	01	H3924_052_0	4	1	Preferred Generic	001000	1
H3924	052	0	1	04	01	H3924_052_0	4	1	Preferred Generic	001000	
H3924	054	0	1	04	01	H3924_054_0	4	1	Preferred Generic	001000	1
H3924	054	0	1	04	01	H3924_054_0	4	5	Specialty Tier	000010	
H3924	054	0	1	04	01	H3924_054_0	4	4	Non-Preferred Brand	100000	
H3924	054	0	1	04	01	H3924_054_0	4	3	Preferred Brand	000001	
H3924	054	0	1	04	01	H3924_054_0	4	2	Non-Preferred Generic	000100	
H3924	054	0	1	04	01	H3924_054_0	4	1	Preferred Generic	001000	
H3928	001	0	1	01	01	H3928_001_0	9	4	Non-Preferred Brand	100100	
H3928	001	0	1	01	01	H3928_001_0	9	3	Preferred Brand	000001	
H3928	001	0	1	01	01	H3928_001_0	9	2	Non-Preferred Generic	000100	
H3928	001	0	1	01	01	H3928_001_0	9	1	Preferred Generic	001000	
H3928	001	0	1	01	01	H3928_001_0	9	2	Non-Preferred Generic	000100	1
H3928	001	0	1	01	01	H3928_001_0	9	5	Specialty Tier	010010	
H3928	001	0	1	01	01	H3928_001_0	9	1	Preferred Generic	001000	1
H3931	004	0	1	01	01	H3931_004_0	5	1	Generic	010000	
H3931	004	0	1	01	01	H3931_004_0	5	2	Preferred Brand	010001	
H3931	004	0	1	01	01	H3931_004_0	5	3	Non-Preferred Brand	110000	
H3931	004	0	1	01	01	H3931_004_0	5	4	Specialty Tier	010010	
H3931	004	0	1	01	01	H3931_004_0	5	5	Select Care Drugs	010000	
H3931	004	0	1	01	01	H3931_004_0	5	5	Select Care Drugs	010000	1
H3931	058	0	1	01	01	H3931_058_0	5	5	Select Care Drugs	010000	1
H3931	058	0	1	01	01	H3931_058_0	5	5	Select Care Drugs	010000	
H3931	058	0	1	01	01	H3931_058_0	5	4	Specialty Tier	010010	
H3931	058	0	1	01	01	H3931_058_0	5	3	Non-Preferred Brand	110000	
H3931	058	0	1	01	01	H3931_058_0	5	1	Generic	010000	
H3931	058	0	1	01	01	H3931_058_0	5	2	Preferred Brand	010001	
H3931	064	0	1	01	01	H3931_064_0	6	5	Select Care Drugs	010000	
H3931	064	0	1	01	01	H3931_064_0	6	4	Specialty Tier	010010	
H3931	064	0	1	01	01	H3931_064_0	6	3	Non-Preferred Brand	110000	
H3931	064	0	1	01	01	H3931_064_0	6	2	Preferred Brand	010001	
H3931	064	0	1	01	01	H3931_064_0	6	1	Generic	010000	
H3931	065	0	1	01	01	H3931_065_0	7	5	Select Care Drugs	010000	
H3931	065	0	1	01	01	H3931_065_0	7	4	Specialty Tier	010010	
H3931	065	0	1	01	01	H3931_065_0	7	1	Generic	010000	
H3931	065	0	1	01	01	H3931_065_0	7	2	Preferred Brand	010001	
H3931	065	0	1	01	01	H3931_065_0	7	3	Non-Preferred Brand	110000	
H3931	070	0	1	01	01	H3931_070_0	5	5	Select Care Drugs	010000	
H3931	070	0	1	01	01	H3931_070_0	5	4	Specialty Tier	010010	
H3931	070	0	1	01	01	H3931_070_0	5	3	Non-Preferred Brand	110000	
H3931	070	0	1	01	01	H3931_070_0	5	2	Preferred Brand	010001	
H3931	070	0	1	01	01	H3931_070_0	5	1	Generic	010000	
H3931	070	0	1	01	01	H3931_070_0	5	5	Select Care Drugs	010000	1
H3931	081	0	1	01	01	H3931_081_0	5	5	Select Care Drugs	010000	1
H3931	081	0	1	01	01	H3931_081_0	5	5	Select Care Drugs	010000	
H3931	081	0	1	01	01	H3931_081_0	5	4	Specialty Tier	010010	
H3931	081	0	1	01	01	H3931_081_0	5	3	Non-Preferred Brand	110000	
H3931	081	0	1	01	01	H3931_081_0	5	1	Generic	010000	
H3931	081	0	1	01	01	H3931_081_0	5	2	Preferred Brand	010001	
H3931	082	0	1	01	01	H3931_082_0	5	5	Select Care Drugs	010000	
H3931	082	0	1	01	01	H3931_082_0	5	4	Specialty Tier	010010	
H3931	082	0	1	01	01	H3931_082_0	5	3	Non-Preferred Brand	110000	
H3931	082	0	1	01	01	H3931_082_0	5	2	Preferred Brand	010001	
H3931	082	0	1	01	01	H3931_082_0	5	5	Select Care Drugs	010000	1
H3931	082	0	1	01	01	H3931_082_0	5	1	Generic	010000	
H3931	083	0	1	01	01	H3931_083_0	6	5	Select Care Drugs	010000	
H3931	083	0	1	01	01	H3931_083_0	6	4	Specialty Tier	010010	
H3931	083	0	1	01	01	H3931_083_0	6	3	Non-Preferred Brand	110000	
H3931	083	0	1	01	01	H3931_083_0	6	1	Generic	010000	
H3931	083	0	1	01	01	H3931_083_0	6	2	Preferred Brand	010001	
H3931	084	0	1	01	01	H3931_084_0	5	5	Select Care Drugs	010000	
H3931	084	0	1	01	01	H3931_084_0	5	4	Specialty Tier	010010	
H3931	084	0	1	01	01	H3931_084_0	5	3	Non-Preferred Brand	110000	
H3931	084	0	1	01	01	H3931_084_0	5	2	Preferred Brand	010001	
H3931	084	0	1	01	01	H3931_084_0	5	1	Generic	010000	
H3931	084	0	1	01	01	H3931_084_0	5	5	Select Care Drugs	010000	1
H3945	003	0	1	02	01	H3945_003_0	5	4	Non-Preferred Brand	100100	
H3945	003	0	1	02	01	H3945_003_0	5	5	Specialty Tier	010010	
H3945	003	0	1	02	01	H3945_003_0	5	1	Preferred Generic	001000	
H3945	003	0	1	02	01	H3945_003_0	5	2	Non-Preferred Generic	000100	
H3945	003	0	1	02	01	H3945_003_0	5	3	Preferred Brand	000001	
H3945	006	0	1	01	01	H3945_006_0	5	1	Preferred Generic	001000	1
H3945	006	0	1	01	01	H3945_006_0	5	5	Specialty Tier	010010	
H3945	006	0	1	01	01	H3945_006_0	5	4	Non-Preferred Brand	100100	
H3945	006	0	1	01	01	H3945_006_0	5	3	Preferred Brand	000001	
H3945	006	0	1	01	01	H3945_006_0	5	2	Non-Preferred Generic	000100	
H3945	006	0	1	01	01	H3945_006_0	5	2	Non-Preferred Generic	000100	1
H3945	006	0	1	01	01	H3945_006_0	5	1	Preferred Generic	001000	
H3949	002	0	1	01	01	H3949_002_0	2	4	Non-Preferred Brand	100100	
H3949	002	0	1	01	01	H3949_002_0	2	3	Preferred Brand	000001	
H3949	002	0	1	01	01	H3949_002_0	2	2	Non-Preferred Generic	000100	
H3949	002	0	1	01	01	H3949_002_0	2	1	Preferred Generic	001000	
H3949	002	0	1	01	01	H3949_002_0	2	5	Specialty Tier	010010	
H3949	013	0	1	01	01	H3949_013_0	2	2	Non-Preferred Generic	000100	
H3949	013	0	1	01	01	H3949_013_0	2	1	Preferred Generic	001000	
H3949	013	0	1	01	01	H3949_013_0	2	3	Preferred Brand	000001	
H3949	013	0	1	01	01	H3949_013_0	2	4	Non-Preferred Brand	100100	
H3949	013	0	1	01	01	H3949_013_0	2	5	Specialty Tier	010010	
H3949	024	0	1	01	01	H3949_024_0	2	2	Non-Preferred Generic	000100	
H3949	024	0	1	01	01	H3949_024_0	2	1	Preferred Generic	001000	
H3949	024	0	1	01	01	H3949_024_0	2	3	Preferred Brand	000001	
H3949	024	0	1	01	01	H3949_024_0	2	6	Select Diabetic Drugs	010010	
H3949	024	0	1	01	01	H3949_024_0	2	5	Specialty Tier	010010	
H3949	024	0	1	01	01	H3949_024_0	2	4	Non-Preferred Brand	100100	
H3949	027	0	1	02	01	H3949_027_0	2	1	Preferred Generic	001000	
H3949	027	0	1	02	01	H3949_027_0	2	4	Non-Preferred Brand	100100	
H3949	027	0	1	02	01	H3949_027_0	2	3	Preferred Brand	000001	
H3949	027	0	1	02	01	H3949_027_0	2	2	Non-Preferred Generic	000100	
H3949	027	0	1	02	01	H3949_027_0	2	5	Specialty Tier	010010	
H3952	020	0	1	01	01	H3952_020_0	7	1	Generic	010000	
H3952	020	0	1	01	01	H3952_020_0	7	2	Preferred Brand	000001	
H3952	020	0	1	01	01	H3952_020_0	7	1	Generic	010000	1
H3952	020	0	1	01	01	H3952_020_0	7	3	Non-Preferred Brand	100000	
H3952	020	0	1	01	01	H3952_020_0	7	4	Specialty Tier	110001	
H3952	045	0	1	01	01	H3952_045_0	7	1	Generic	010000	
H3952	045	0	1	01	01	H3952_045_0	7	2	Preferred Brand	000001	
H3952	045	0	1	01	01	H3952_045_0	7	3	Non-Preferred Brand	100000	
H3952	045	0	1	01	01	H3952_045_0	7	4	Specialty Tier	110001	
H3952	045	0	1	01	01	H3952_045_0	7	1	Generic	010000	1
H3952	049	0	1	01	01	H3952_049_0	7	2	Non-Preferred Generic	000100	
H3952	049	0	1	01	01	H3952_049_0	7	1	Preferred Generic	001000	
H3952	049	0	1	01	01	H3952_049_0	7	3	Preferred Brand	000001	
H3952	049	0	1	01	01	H3952_049_0	7	5	Specialty Tier	101101	
H3952	049	0	1	01	01	H3952_049_0	7	4	Non-Preferred Brand	100000	
H3952	051	0	1	01	01	H3952_051_0	7	5	Specialty Tier	101101	
H3952	051	0	1	01	01	H3952_051_0	7	4	Non-Preferred Brand	100000	
H3952	051	0	1	01	01	H3952_051_0	7	3	Preferred Brand	000001	
H3952	051	0	1	01	01	H3952_051_0	7	2	Non-Preferred Generic	000100	
H3952	051	0	1	01	01	H3952_051_0	7	1	Preferred Generic	001000	
H3954	021	0	1	01	01	H3954_021_0	5	2	Non-Preferred Generic	000100	
H3954	021	0	1	01	01	H3954_021_0	5	1	Preferred Generic	001000	
H3954	021	0	1	01	01	H3954_021_0	5	1	Preferred Generic	001000	1
H3954	021	0	1	01	01	H3954_021_0	5	5	Specialty Tier	000010	
H3954	021	0	1	01	01	H3954_021_0	5	3	Preferred Brand	000001	
H3954	021	0	1	01	01	H3954_021_0	5	4	Non-Preferred Brand	100000	
H3954	027	0	1	01	01	H3954_027_0	5	1	Preferred Generic	001000	1
H3954	027	0	1	01	01	H3954_027_0	5	4	Non-Preferred Brand	100000	
H3954	027	0	1	01	01	H3954_027_0	5	3	Preferred Brand	000001	
H3954	027	0	1	01	01	H3954_027_0	5	2	Non-Preferred Generic	000100	
H3954	027	0	1	01	01	H3954_027_0	5	1	Preferred Generic	001000	
H3954	027	0	1	01	01	H3954_027_0	5	5	Specialty Tier	000010	
H3954	033	0	1	01	01	H3954_033_0	5	5	Specialty Tier	000010	
H3954	033	0	1	01	01	H3954_033_0	5	4	Non-Preferred Brand	100000	
H3954	033	0	1	01	01	H3954_033_0	5	1	Preferred Generic	001000	1
H3954	033	0	1	01	01	H3954_033_0	5	3	Preferred Brand	000001	
H3954	033	0	1	01	01	H3954_033_0	5	1	Preferred Generic	001000	
H3954	033	0	1	01	01	H3954_033_0	5	2	Non-Preferred Generic	000100	
H3954	100	0	1	01	01	H3954_100_0	4	5	Specialty Tier	000010	
H3954	100	0	1	01	01	H3954_100_0	4	4	Non-Preferred Brand	100000	
H3954	100	0	1	01	01	H3954_100_0	4	3	Preferred Brand	000001	
H3954	100	0	1	01	01	H3954_100_0	4	2	Non-Preferred Generic	000100	
H3954	100	0	1	01	01	H3954_100_0	4	1	Preferred Generic	001000	
H3954	100	0	1	01	01	H3954_100_0	4	1	Preferred Generic	001000	1
H3954	137	0	1	01	01	H3954_137_0	5	1	Preferred Generic	001000	
H3954	137	0	1	01	01	H3954_137_0	5	2	Non-Preferred Generic	000100	
H3954	137	0	1	01	01	H3954_137_0	5	3	Preferred Brand	000001	
H3954	137	0	1	01	01	H3954_137_0	5	4	Non-Preferred Brand	100000	
H3954	137	0	1	01	01	H3954_137_0	5	5	Specialty Tier	000010	
H3954	137	0	1	01	01	H3954_137_0	5	1	Preferred Generic	001000	1
H3954	139	0	1	01	01	H3954_139_0	4	1	Preferred Generic	001000	
H3954	139	0	1	01	01	H3954_139_0	4	2	Non-Preferred Generic	000100	
H3954	139	0	1	01	01	H3954_139_0	4	3	Preferred Brand	000001	
H3954	139	0	1	01	01	H3954_139_0	4	4	Non-Preferred Brand	100000	
H3954	139	0	1	01	01	H3954_139_0	4	5	Specialty Tier	000010	
H3954	139	0	1	01	01	H3954_139_0	4	1	Preferred Generic	001000	1
H3954	141	0	1	02	01	H3954_141_0	4	1	Preferred Generic	001000	
H3954	141	0	1	02	01	H3954_141_0	4	2	Non-Preferred Generic	000100	
H3954	141	0	1	02	01	H3954_141_0	4	3	Preferred Brand	000001	
H3954	141	0	1	02	01	H3954_141_0	4	4	Non-Preferred Brand	100000	
H3954	141	0	1	02	01	H3954_141_0	4	5	Specialty Tier	000010	
H3954	141	0	1	02	01	H3954_141_0	4	1	Preferred Generic	001000	1
H3954	143	0	1	02	01	H3954_143_0	4	2	Non-Preferred Generic	000100	
H3954	143	0	1	02	01	H3954_143_0	4	3	Preferred Brand	000001	
H3954	143	0	1	02	01	H3954_143_0	4	4	Non-Preferred Brand	100000	
H3954	143	0	1	02	01	H3954_143_0	4	5	Specialty Tier	000010	
H3954	143	0	1	02	01	H3954_143_0	4	1	Preferred Generic	001000	1
H3954	143	0	1	02	01	H3954_143_0	4	1	Preferred Generic	001000	
H3954	146	0	1	01	01	H3954_146_0	6	2	Non-Preferred Generic	000100	
H3954	146	0	1	01	01	H3954_146_0	6	3	Preferred Brand	000001	
H3954	146	0	1	01	01	H3954_146_0	6	1	Preferred Generic	001000	
H3954	146	0	1	01	01	H3954_146_0	6	5	Specialty Tier	000010	
H3954	146	0	1	01	01	H3954_146_0	6	1	Preferred Generic	001000	1
H3954	146	0	1	01	01	H3954_146_0	6	4	Non-Preferred Brand	100000	
H3954	148	0	1	01	01	H3954_148_0	5	2	Non-Preferred Generic	000100	
H3954	148	0	1	01	01	H3954_148_0	5	3	Preferred Brand	000001	
H3954	148	0	1	01	01	H3954_148_0	5	4	Non-Preferred Brand	100000	
H3954	148	0	1	01	01	H3954_148_0	5	5	Specialty Tier	000010	
H3954	148	0	1	01	01	H3954_148_0	5	1	Preferred Generic	001000	1
H3954	148	0	1	01	01	H3954_148_0	5	1	Preferred Generic	001000	
H3954	151	0	1	02	01	H3954_151_0	4	1	Preferred Generic	001000	1
H3954	151	0	1	02	01	H3954_151_0	4	5	Specialty Tier	000010	
H3954	151	0	1	02	01	H3954_151_0	4	4	Non-Preferred Brand	100000	
H3954	151	0	1	02	01	H3954_151_0	4	3	Preferred Brand	000001	
H3954	151	0	1	02	01	H3954_151_0	4	2	Non-Preferred Generic	000100	
H3954	151	0	1	02	01	H3954_151_0	4	1	Preferred Generic	001000	
H3954	153	0	1	02	01	H3954_153_0	4	1	Preferred Generic	001000	1
H3954	153	0	1	02	01	H3954_153_0	4	5	Specialty Tier	000010	
H3954	153	0	1	02	01	H3954_153_0	4	4	Non-Preferred Brand	100000	
H3954	153	0	1	02	01	H3954_153_0	4	3	Preferred Brand	000001	
H3954	153	0	1	02	01	H3954_153_0	4	2	Non-Preferred Generic	000100	
H3954	153	0	1	02	01	H3954_153_0	4	1	Preferred Generic	001000	
H3954	155	0	1	02	01	H3954_155_0	4	1	Preferred Generic	001000	
H3954	155	0	1	02	01	H3954_155_0	4	2	Non-Preferred Generic	000100	
H3954	155	0	1	02	01	H3954_155_0	4	3	Preferred Brand	000001	
H3954	155	0	1	02	01	H3954_155_0	4	4	Non-Preferred Brand	100000	
H3954	155	0	1	02	01	H3954_155_0	4	5	Specialty Tier	000010	
H3954	155	0	1	02	01	H3954_155_0	4	1	Preferred Generic	001000	1
H3957	003	0	1	01	01	H3957_003_0	11	1	Generic	010000	
H3957	003	0	1	01	01	H3957_003_0	11	2	Preferred Brand	000001	
H3957	003	0	1	01	01	H3957_003_0	11	3	Non-Preferred Brand	100000	
H3957	003	0	1	01	01	H3957_003_0	11	4	Specialty Tier	010010	
H3957	006	0	1	01	01	H3957_006_0	11	4	Specialty Tier	010010	
H3957	006	0	1	01	01	H3957_006_0	11	3	Non-Preferred Brand	100000	
H3957	006	0	1	01	01	H3957_006_0	11	2	Preferred Brand	000001	
H3957	006	0	1	01	01	H3957_006_0	11	1	Generic	010000	
H3957	020	0	1	01	01	H3957_020_0	11	1	Generic	010000	1
H3957	020	0	1	01	01	H3957_020_0	11	4	Specialty Tier	010010	
H3957	020	0	1	01	01	H3957_020_0	11	3	Non-Preferred Brand	100000	
H3957	020	0	1	01	01	H3957_020_0	11	2	Preferred Brand	000001	
H3957	020	0	1	01	01	H3957_020_0	11	1	Generic	010000	
H3957	021	0	1	01	01	H3957_021_0	11	1	Generic	010000	1
H3957	021	0	1	01	01	H3957_021_0	11	4	Specialty Tier	010010	
H3957	021	0	1	01	01	H3957_021_0	11	1	Generic	010000	
H3957	021	0	1	01	01	H3957_021_0	11	2	Preferred Brand	000001	
H3957	021	0	1	01	01	H3957_021_0	11	3	Non-Preferred Brand	100000	
H3957	031	0	1	01	01	H3957_031_0	11	2	Preferred Brand	000001	
H3957	031	0	1	01	01	H3957_031_0	11	3	Non-Preferred Brand	100000	
H3957	031	0	1	01	01	H3957_031_0	11	4	Specialty Tier	010010	
H3957	031	0	1	01	01	H3957_031_0	11	1	Generic	010000	
H3957	032	0	1	01	01	H3957_032_0	11	1	Generic	010000	
H3957	032	0	1	01	01	H3957_032_0	11	4	Specialty Tier	010010	
H3957	032	0	1	01	01	H3957_032_0	11	3	Non-Preferred Brand	100000	
H3957	032	0	1	01	01	H3957_032_0	11	2	Preferred Brand	000001	
H3957	036	0	1	01	01	H3957_036_0	11	2	Non-Preferred Generic	000100	
H3957	036	0	1	01	01	H3957_036_0	11	5	Specialty Tier	010010	
H3957	036	0	1	01	01	H3957_036_0	11	1	Preferred Generic	001000	
H3957	036	0	1	01	01	H3957_036_0	11	3	Preferred Brand	000001	
H3957	036	0	1	01	01	H3957_036_0	11	4	Non-Preferred Brand	100000	
H3957	037	0	1	01	01	H3957_037_0	11	4	Non-Preferred Brand	100000	
H3957	037	0	1	01	01	H3957_037_0	11	3	Preferred Brand	000001	
H3957	037	0	1	01	01	H3957_037_0	11	2	Non-Preferred Generic	000100	
H3957	037	0	1	01	01	H3957_037_0	11	1	Preferred Generic	001000	
H3957	037	0	1	01	01	H3957_037_0	11	5	Specialty Tier	010010	
H3959	001	0	1	01	01	H3959_001_0	16	5	Specialty Tier	010010	
H3959	001	0	1	01	01	H3959_001_0	16	2	Non-Preferred Generic	000100	
H3959	001	0	1	01	01	H3959_001_0	16	3	Preferred Brand	000001	
H3959	001	0	1	01	01	H3959_001_0	16	4	Non-Preferred Brand	100100	
H3959	001	0	1	01	01	H3959_001_0	16	1	Preferred Generic	001000	1
H3959	001	0	1	01	01	H3959_001_0	16	1	Preferred Generic	001000	
H3959	002	0	1	01	01	H3959_002_0	9	1	Preferred Generic	001000	1
H3959	002	0	1	01	01	H3959_002_0	9	5	Specialty Tier	010010	
H3959	002	0	1	01	01	H3959_002_0	9	4	Non-Preferred Brand	100100	
H3959	002	0	1	01	01	H3959_002_0	9	3	Preferred Brand	000001	
H3959	002	0	1	01	01	H3959_002_0	9	2	Non-Preferred Generic	000100	
H3959	002	0	1	01	01	H3959_002_0	9	1	Preferred Generic	001000	
H3959	010	0	1	01	01	H3959_010_0	8	2	Non-Preferred Generic	000100	
H3959	010	0	1	01	01	H3959_010_0	8	3	Preferred Brand	000001	
H3959	010	0	1	01	01	H3959_010_0	8	4	Non-Preferred Brand	100100	
H3959	010	0	1	01	01	H3959_010_0	8	5	Specialty Tier	010010	
H3959	010	0	1	01	01	H3959_010_0	8	1	Preferred Generic	001000	
H3959	011	0	1	01	01	H3959_011_0	9	2	Non-Preferred Generic	000100	
H3959	011	0	1	01	01	H3959_011_0	9	3	Preferred Brand	000001	
H3959	011	0	1	01	01	H3959_011_0	9	4	Non-Preferred Brand	100100	
H3959	011	0	1	01	01	H3959_011_0	9	5	Specialty Tier	010010	
H3959	011	0	1	01	01	H3959_011_0	9	1	Preferred Generic	001000	
H3959	031	0	1	01	01	H3959_031_0	8	5	Specialty Tier	010010	
H3959	031	0	1	01	01	H3959_031_0	8	3	Preferred Brand	000001	
H3959	031	0	1	01	01	H3959_031_0	8	4	Non-Preferred Brand	100100	
H3959	031	0	1	01	01	H3959_031_0	8	2	Non-Preferred Generic	000100	
H3959	031	0	1	01	01	H3959_031_0	8	1	Preferred Generic	001000	
H3959	032	0	1	01	01	H3959_032_0	14	2	Non-Preferred Generic	000100	
H3959	032	0	1	01	01	H3959_032_0	14	4	Non-Preferred Brand	100100	
H3959	032	0	1	01	01	H3959_032_0	14	5	Specialty Tier	010010	
H3959	032	0	1	01	01	H3959_032_0	14	3	Preferred Brand	000001	
H3959	032	0	1	01	01	H3959_032_0	14	1	Preferred Generic	001000	
H3959	033	0	1	01	01	H3959_033_0	8	1	Preferred Generic	001000	
H3959	033	0	1	01	01	H3959_033_0	8	2	Non-Preferred Generic	000100	
H3959	033	0	1	01	01	H3959_033_0	8	5	Specialty Tier	010010	
H3959	033	0	1	01	01	H3959_033_0	8	4	Non-Preferred Brand	100100	
H3959	033	0	1	01	01	H3959_033_0	8	3	Preferred Brand	000001	
H3959	037	0	1	01	01	H3959_037_0	16	5	Specialty Tier	010010	
H3959	037	0	1	01	01	H3959_037_0	16	4	Non-Preferred Brand	100100	
H3959	037	0	1	01	01	H3959_037_0	16	3	Preferred Brand	000001	
H3959	037	0	1	01	01	H3959_037_0	16	1	Preferred Generic	001000	1
H3959	037	0	1	01	01	H3959_037_0	16	2	Non-Preferred Generic	000100	
H3959	037	0	1	01	01	H3959_037_0	16	1	Preferred Generic	001000	
H3962	001	0	1	01	01	H3962_001_0	6	1	Preferred Generic	001000	
H3962	001	0	1	01	01	H3962_001_0	6	2	Non-Preferred Generic	000100	
H3962	001	0	1	01	01	H3962_001_0	6	3	Preferred Brand	000001	
H3962	001	0	1	01	01	H3962_001_0	6	4	Non-Preferred Brand	100000	
H3962	001	0	1	01	01	H3962_001_0	6	5	Specialty Tier	010010	
H3962	001	0	1	01	01	H3962_001_0	6	1	Preferred Generic	001000	1
H3962	001	0	1	01	01	H3962_001_0	6	2	Non-Preferred Generic	000100	1
H3962	004	0	1	01	01	H3962_004_0	5	1	Preferred Generic	001000	
H3962	004	0	1	01	01	H3962_004_0	5	5	Specialty Tier	010010	
H3962	004	0	1	01	01	H3962_004_0	5	4	Non-Preferred Brand	100000	
H3962	004	0	1	01	01	H3962_004_0	5	3	Preferred Brand	000001	
H3962	004	0	1	01	01	H3962_004_0	5	2	Non-Preferred Generic	000100	
H3962	007	0	1	01	01	H3962_007_0	7	2	Non-Preferred Generic	000100	
H3962	007	0	1	01	01	H3962_007_0	7	1	Preferred Generic	001000	
H3962	007	0	1	01	01	H3962_007_0	7	3	Preferred Brand	000001	
H3962	007	0	1	01	01	H3962_007_0	7	4	Specialty Tier	010010	
H3979	001	0	1	01	01	H3979_001_0	11	1	Preferred Generic	001000	
H3979	001	0	1	01	01	H3979_001_0	11	2	Non-Preferred Generic	000100	
H3979	001	0	1	01	01	H3979_001_0	11	3	Preferred Brand	000001	
H3979	001	0	1	01	01	H3979_001_0	11	4	Non-Preferred Brand	110000	
H3979	001	0	1	01	01	H3979_001_0	11	5	Specialty Tier	010010	
H3979	002	0	1	02	01	H3979_002_0	12	1	Preferred Generic	001000	
H3979	002	0	1	02	01	H3979_002_0	12	2	Non-Preferred Generic	000100	
H3979	002	0	1	02	01	H3979_002_0	12	3	Preferred Brand	000001	
H3979	002	0	1	02	01	H3979_002_0	12	4	Non-Preferred Brand	110000	
H3979	002	0	1	02	01	H3979_002_0	12	5	Specialty Tier	010010	
H4003	001	0	1	02	01	H4003_001_0	8	1	Preferred Generic	001000	
H4003	001	0	1	02	01	H4003_001_0	8	2	Preferred Brand	000001	
H4003	001	0	1	02	01	H4003_001_0	8	3	Non-Preferred Brand	100000	
H4003	001	0	1	02	01	H4003_001_0	8	4	Specialty Tier	001001	
H4003	001	0	1	02	01	H4003_001_0	8	1	Preferred Generic	001000	2
H4003	009	0	1	01	01	H4003_009_0	8	3	Preferred Brand	000001	
H4003	009	0	1	01	01	H4003_009_0	8	2	Non-Preferred Generic	000100	
H4003	009	0	1	01	01	H4003_009_0	8	1	Preferred Generic	001000	
H4003	009	0	1	01	01	H4003_009_0	8	4	Specialty Tier	001001	
H4003	009	0	1	01	01	H4003_009_0	8	2	Non-Preferred Generic	000100	2
H4003	009	0	1	01	01	H4003_009_0	8	1	Preferred Generic	001000	2
H4003	009	0	1	01	01	H4003_009_0	8	5	Select Diabetic Drugs	000001	
H4003	015	0	1	01	01	H4003_015_0	6	1	Preferred Generic	001000	
H4003	015	0	1	01	01	H4003_015_0	6	4	Specialty Tier	001001	
H4003	015	0	1	01	01	H4003_015_0	6	3	Non-Preferred Brand	100000	
H4003	015	0	1	01	01	H4003_015_0	6	2	Preferred Brand	000001	
H4003	015	0	1	01	01	H4003_015_0	6	1	Preferred Generic	001000	2
H4003	019	0	1	01	01	H4003_019_0	7	3	Non-Preferred Brand	100000	
H4003	019	0	1	01	01	H4003_019_0	7	2	Preferred Brand	000001	
H4003	019	0	1	01	01	H4003_019_0	7	1	Preferred Generic	001000	
H4003	019	0	1	01	01	H4003_019_0	7	4	Specialty Tier	001001	
H4003	019	0	1	01	01	H4003_019_0	7	1	Preferred Generic	001000	2
H4003	025	0	1	02	01	H4003_025_0	8	2	Non-Preferred Generic	000100	
H4003	025	0	1	02	01	H4003_025_0	8	1	Preferred Generic	001000	
H4003	025	0	1	02	01	H4003_025_0	8	3	Preferred Brand	000001	
H4003	025	0	1	02	01	H4003_025_0	8	4	Non-Preferred Brand	100000	
H4003	025	0	1	02	01	H4003_025_0	8	5	Specialty Tier	001001	
H4003	025	0	1	02	01	H4003_025_0	8	1	Preferred Generic	001000	2
H4003	025	0	1	02	01	H4003_025_0	8	2	Non-Preferred Generic	000100	2
H4003	027	0	1	02	01	H4003_027_0	8	2	Preferred Brand	000001	
H4003	027	0	1	02	01	H4003_027_0	8	1	Preferred Generic	001000	
H4003	027	0	1	02	01	H4003_027_0	8	3	Specialty Tier	001001	
H4003	027	0	1	02	01	H4003_027_0	8	1	Preferred Generic	001000	2
H4004	015	0	1	02	01	H4004_015_0	7	1	Preferred Generic	001000	
H4004	015	0	1	02	01	H4004_015_0	7	2	Preferred Brand	000001	
H4004	015	0	1	02	01	H4004_015_0	7	3	Non-Preferred Brand	100000	
H4004	015	0	1	02	01	H4004_015_0	7	4	Specialty Tier	001001	
H4004	015	0	1	02	01	H4004_015_0	7	1	Preferred Generic	001000	2
H4004	050	0	1	01	01	H4004_050_0	7	1	Preferred Generic	001000	
H4004	050	0	1	01	01	H4004_050_0	7	2	Preferred Brand	000001	
H4004	050	0	1	01	01	H4004_050_0	7	3	Specialty Tier	001001	
H4004	050	0	1	01	01	H4004_050_0	7	1	Preferred Generic	001000	2
H4004	053	0	1	02	01	H4004_053_0	9	2	Preferred Brand	000001	
H4004	053	0	1	02	01	H4004_053_0	9	3	Specialty Tier	001001	
H4004	053	0	1	02	01	H4004_053_0	9	1	Preferred Generic	001000	2
H4004	053	0	1	02	01	H4004_053_0	9	1	Preferred Generic	001000	
H4005	004	0	1	04	01	H4005_004_0	12	1	Preferred Generic	001000	1
H4005	004	0	1	04	01	H4005_004_0	12	5	Specialty Tier	100100	
H4005	004	0	1	04	01	H4005_004_0	12	4	Non-Preferred Brand	100000	
H4005	004	0	1	04	01	H4005_004_0	12	3	Preferred Brand	000001	
H4005	004	0	1	04	01	H4005_004_0	12	2	Non-Preferred Generic	000100	
H4005	004	0	1	04	01	H4005_004_0	12	1	Preferred Generic	001000	
H4005	004	0	1	04	01	H4005_004_0	12	2	Non-Preferred Generic	000100	1
H4006	007	0	1	01	01	H4006_007_0	12	1	Preferred Generic	001000	
H4006	007	0	1	01	01	H4006_007_0	12	2	Non-Preferred Generic	000100	
H4006	007	0	1	01	01	H4006_007_0	12	3	Preferred Brand	000001	
H4006	007	0	1	01	01	H4006_007_0	12	4	Non-Preferred Brand	100000	
H4006	007	0	1	01	01	H4006_007_0	12	5	Specialty Tier	101101	
H4006	007	0	1	01	01	H4006_007_0	12	1	Preferred Generic	001000	1
H4006	007	0	1	01	01	H4006_007_0	12	2	Non-Preferred Generic	000100	1
H4006	008	0	1	02	01	H4006_008_0	14	1	Preferred Generic	001000	1
H4006	008	0	1	02	01	H4006_008_0	14	5	Specialty Tier	101101	
H4006	008	0	1	02	01	H4006_008_0	14	4	Non-Preferred Brand	100000	
H4006	008	0	1	02	01	H4006_008_0	14	3	Preferred Brand	000001	
H4006	008	0	1	02	01	H4006_008_0	14	2	Non-Preferred Generic	000100	
H4006	008	0	1	02	01	H4006_008_0	14	1	Preferred Generic	001000	
H4006	008	0	1	02	01	H4006_008_0	14	2	Non-Preferred Generic	000100	1
H4007	005	0	1	01	01	H4007_005_0	6	3	Non-Preferred Brand	100100	
H4007	005	0	1	01	01	H4007_005_0	6	2	Preferred Brand	000101	
H4007	005	0	1	01	01	H4007_005_0	6	1	Preferred Generic	001010	
H4007	012	0	1	01	01	H4007_012_0	5	4	Specialty Tier	010010	
H4007	012	0	1	01	01	H4007_012_0	5	1	Preferred Generic	001010	2
H4007	012	0	1	01	01	H4007_012_0	5	2	Preferred Brand	010001	2
H4007	012	0	1	01	01	H4007_012_0	5	3	Non-Preferred Brand	100100	
H4007	012	0	1	01	01	H4007_012_0	5	2	Preferred Brand	010001	
H4007	012	0	1	01	01	H4007_012_0	5	1	Preferred Generic	001010	
H4007	012	0	1	01	01	H4007_012_0	5	3	Non-Preferred Brand	100100	2
H4007	012	0	1	01	01	H4007_012_0	5	4	Specialty Tier	010010	2
H4007	013	0	1	01	01	H4007_013_0	5	1	Preferred Generic	001010	
H4007	013	0	1	01	01	H4007_013_0	5	2	Preferred Brand	000101	
H4007	013	0	1	01	01	H4007_013_0	5	3	Non-Preferred Brand	100100	
H4007	013	0	1	01	01	H4007_013_0	5	1	Preferred Generic	001010	2
H4007	013	0	1	01	01	H4007_013_0	5	2	Preferred Brand	000101	2
H4007	013	0	1	01	01	H4007_013_0	5	3	Non-Preferred Brand	100100	2
H4007	016	0	1	01	01	H4007_016_0	6	1	Preferred Generic	001010	
H4007	016	0	1	01	01	H4007_016_0	6	2	Preferred Brand	000101	
H4007	016	0	1	01	01	H4007_016_0	6	3	Non-Preferred Brand	100100	
H4011	003	0	1	04	01	H4011_003_0	12	3	Preferred Brand	000001	
H4011	003	0	1	04	01	H4011_003_0	12	2	Non-Preferred Generic	000100	1
H4011	003	0	1	04	01	H4011_003_0	12	1	Preferred Generic	001000	1
H4011	003	0	1	04	01	H4011_003_0	12	5	Specialty Tier	010010	
H4011	003	0	1	04	01	H4011_003_0	12	4	Non-Preferred Brand	100000	
H4011	003	0	1	04	01	H4011_003_0	12	2	Non-Preferred Generic	000100	
H4011	003	0	1	04	01	H4011_003_0	12	1	Preferred Generic	001000	
H4012	008	0	1	01	01	H4012_008_0	12	2	Non-Preferred Generic	000100	1
H4012	008	0	1	01	01	H4012_008_0	12	1	Preferred Generic	001000	1
H4012	008	0	1	01	01	H4012_008_0	12	5	Specialty Tier	100100	
H4012	008	0	1	01	01	H4012_008_0	12	4	Non-Preferred Brand	100000	
H4012	008	0	1	01	01	H4012_008_0	12	3	Preferred Brand	000001	
H4012	008	0	1	01	01	H4012_008_0	12	2	Non-Preferred Generic	000100	
H4012	008	0	1	01	01	H4012_008_0	12	1	Preferred Generic	001000	
H4036	004	0	1	04	01	H4036_004_0	5	2	Non-Preferred Generic	000100	
H4036	004	0	1	04	01	H4036_004_0	5	1	Preferred Generic	001000	
H4036	004	0	1	04	01	H4036_004_0	5	3	Preferred Brand	000101	
H4036	004	0	1	04	01	H4036_004_0	5	4	Non-Preferred Brand	100100	
H4036	004	0	1	04	01	H4036_004_0	5	5	Injectable Drugs	010010	
H4036	004	0	1	04	01	H4036_004_0	5	6	Specialty Tier	010010	
H4036	005	0	1	04	01	H4036_005_0	6	2	Non-Preferred Generic	000100	
H4036	005	0	1	04	01	H4036_005_0	6	1	Preferred Generic	001000	
H4036	005	0	1	04	01	H4036_005_0	6	3	Preferred Brand	000101	
H4036	005	0	1	04	01	H4036_005_0	6	6	Specialty Tier	010010	
H4036	005	0	1	04	01	H4036_005_0	6	5	Injectable Drugs	010010	
H4036	005	0	1	04	01	H4036_005_0	6	4	Non-Preferred Brand	100100	
H4036	007	0	1	04	01	H4036_007_0	4	1	Preferred Generic	001000	
H4036	007	0	1	04	01	H4036_007_0	4	2	Non-Preferred Generic	000100	
H4036	007	0	1	04	01	H4036_007_0	4	5	Injectable Drugs	010010	
H4036	007	0	1	04	01	H4036_007_0	4	4	Non-Preferred Brand	100100	
H4036	007	0	1	04	01	H4036_007_0	4	3	Preferred Brand	000101	
H4036	007	0	1	04	01	H4036_007_0	4	6	Specialty Tier	010010	
H4102	001	0	1	01	01	H4102_001_0	5	1	Preferred Generic	001000	
H4102	001	0	1	01	01	H4102_001_0	5	2	Non-Preferred Generic	000100	
H4102	001	0	1	01	01	H4102_001_0	5	5	Specialty Tier	010010	
H4102	001	0	1	01	01	H4102_001_0	5	4	Non-Preferred Brand	100100	
H4102	001	0	1	01	01	H4102_001_0	5	3	Preferred Brand	010001	
H4123	001	0	1	02	01	H4123_001_0	6	3	Non-Preferred Brand	100100	
H4123	001	0	1	02	01	H4123_001_0	6	4	Specialty Tier	010010	
H4123	001	0	1	02	01	H4123_001_0	6	1	Preferred Generic	001000	
H4123	001	0	1	02	01	H4123_001_0	6	2	Preferred Brand	000001	
H4123	004	0	1	02	01	H4123_004_0	8	1	Preferred Generic	001000	
H4123	004	0	1	02	01	H4123_004_0	8	4	Specialty Tier	010010	
H4123	004	0	1	02	01	H4123_004_0	8	3	Non-Preferred Brand	100100	
H4123	004	0	1	02	01	H4123_004_0	8	2	Preferred Brand	000001	
H4125	001	0	1	01	01	H4125_001_0	4	1	Preferred Generic	001000	
H4125	001	0	1	01	01	H4125_001_0	4	2	Non-Preferred Generic	000100	
H4125	001	0	1	01	01	H4125_001_0	4	3	Preferred Brand	000001	
H4125	001	0	1	01	01	H4125_001_0	4	4	Non-Preferred Brand	100100	
H4125	001	0	1	01	01	H4125_001_0	4	5	Specialty Tier	010010	
H4141	001	0	1	01	01	H4141_001_0	5	1	Preferred Generic	001010	
H4141	001	0	1	01	01	H4141_001_0	5	2	Non-Preferred Generic	000101	
H4141	001	0	1	01	01	H4141_001_0	5	3	Preferred Brand	000101	
H4141	001	0	1	01	01	H4141_001_0	5	4	Non-Preferred Brand	110000	
H4141	001	0	1	01	01	H4141_001_0	5	5	Specialty Tier	010010	2
H4141	001	0	1	01	01	H4141_001_0	5	1	Preferred Generic	001010	2
H4141	001	0	1	01	01	H4141_001_0	5	2	Non-Preferred Generic	000101	2
H4141	001	0	1	01	01	H4141_001_0	5	3	Preferred Brand	000101	2
H4141	001	0	1	01	01	H4141_001_0	5	4	Non-Preferred Brand	110000	2
H4141	001	0	1	01	01	H4141_001_0	5	5	Specialty Tier	010010	
H4141	003	0	1	01	01	H4141_003_0	4	1	Preferred Generic	001010	
H4141	003	0	1	01	01	H4141_003_0	4	4	Non-Preferred Brand	110000	
H4141	003	0	1	01	01	H4141_003_0	4	5	Specialty Tier	010010	
H4141	003	0	1	01	01	H4141_003_0	4	3	Preferred Brand	000101	
H4141	003	0	1	01	01	H4141_003_0	4	2	Non-Preferred Generic	000101	
H4141	004	0	1	01	01	H4141_004_0	5	3	Preferred Brand	000101	
H4141	004	0	1	01	01	H4141_004_0	5	2	Non-Preferred Generic	000101	
H4141	004	0	1	01	01	H4141_004_0	5	1	Preferred Generic	001010	
H4141	004	0	1	01	01	H4141_004_0	5	1	Preferred Generic	001010	2
H4141	004	0	1	01	01	H4141_004_0	5	5	Specialty Tier	010010	
H4141	004	0	1	01	01	H4141_004_0	5	3	Preferred Brand	000101	2
H4141	004	0	1	01	01	H4141_004_0	5	5	Specialty Tier	010010	2
H4141	004	0	1	01	01	H4141_004_0	5	4	Non-Preferred Brand	110000	2
H4141	004	0	1	01	01	H4141_004_0	5	4	Non-Preferred Brand	110000	
H4141	004	0	1	01	01	H4141_004_0	5	2	Non-Preferred Generic	000101	2
H4141	006	0	1	01	01	H4141_006_0	5	1	Preferred Generic	001010	2
H4141	006	0	1	01	01	H4141_006_0	5	2	Non-Preferred Generic	000101	2
H4141	006	0	1	01	01	H4141_006_0	5	3	Preferred Brand	000101	2
H4141	006	0	1	01	01	H4141_006_0	5	4	Non-Preferred Brand	110000	2
H4141	006	0	1	01	01	H4141_006_0	5	5	Specialty Tier	010010	2
H4141	006	0	1	01	01	H4141_006_0	5	1	Preferred Generic	001010	
H4141	006	0	1	01	01	H4141_006_0	5	2	Non-Preferred Generic	000101	
H4141	006	0	1	01	01	H4141_006_0	5	3	Preferred Brand	000101	
H4141	006	0	1	01	01	H4141_006_0	5	5	Specialty Tier	010010	
H4141	006	0	1	01	01	H4141_006_0	5	4	Non-Preferred Brand	110000	
H4141	007	0	1	01	01	H4141_007_0	6	2	Non-Preferred Generic	000101	
H4141	007	0	1	01	01	H4141_007_0	6	3	Preferred Brand	000101	
H4141	007	0	1	01	01	H4141_007_0	6	4	Non-Preferred Brand	110000	
H4141	007	0	1	01	01	H4141_007_0	6	5	Specialty Tier	010010	
H4141	007	0	1	01	01	H4141_007_0	6	1	Preferred Generic	001010	
H4141	008	0	1	01	01	H4141_008_0	6	5	Specialty Tier	010010	2
H4141	008	0	1	01	01	H4141_008_0	6	4	Non-Preferred Brand	110000	2
H4141	008	0	1	01	01	H4141_008_0	6	3	Preferred Brand	000101	2
H4141	008	0	1	01	01	H4141_008_0	6	2	Non-Preferred Generic	000101	2
H4141	008	0	1	01	01	H4141_008_0	6	1	Preferred Generic	001010	2
H4141	008	0	1	01	01	H4141_008_0	6	4	Non-Preferred Brand	110000	
H4141	008	0	1	01	01	H4141_008_0	6	5	Specialty Tier	010010	
H4141	008	0	1	01	01	H4141_008_0	6	1	Preferred Generic	001010	
H4141	008	0	1	01	01	H4141_008_0	6	2	Non-Preferred Generic	000101	
H4141	008	0	1	01	01	H4141_008_0	6	3	Preferred Brand	000101	
H4141	009	0	1	01	01	H4141_009_0	5	5	Specialty Tier	010010	
H4141	009	0	1	01	01	H4141_009_0	5	4	Non-Preferred Brand	110000	
H4141	009	0	1	01	01	H4141_009_0	5	3	Preferred Brand	000101	
H4141	009	0	1	01	01	H4141_009_0	5	2	Non-Preferred Generic	000101	
H4141	009	0	1	01	01	H4141_009_0	5	4	Non-Preferred Brand	110000	2
H4141	009	0	1	01	01	H4141_009_0	5	1	Preferred Generic	001010	2
H4141	009	0	1	01	01	H4141_009_0	5	2	Non-Preferred Generic	000101	2
H4141	009	0	1	01	01	H4141_009_0	5	3	Preferred Brand	000101	2
H4141	009	0	1	01	01	H4141_009_0	5	5	Specialty Tier	010010	2
H4141	009	0	1	01	01	H4141_009_0	5	1	Preferred Generic	001010	
H4141	010	0	1	01	01	H4141_010_0	7	2	Non-Preferred Generic	000101	
H4141	010	0	1	01	01	H4141_010_0	7	1	Preferred Generic	001010	
H4141	010	0	1	01	01	H4141_010_0	7	5	Specialty Tier	010010	
H4141	010	0	1	01	01	H4141_010_0	7	4	Non-Preferred Brand	110000	
H4141	010	0	1	01	01	H4141_010_0	7	3	Preferred Brand	000101	
H4141	011	0	1	01	01	H4141_011_0	5	1	Preferred Generic	001010	2
H4141	011	0	1	01	01	H4141_011_0	5	2	Non-Preferred Generic	000101	2
H4141	011	0	1	01	01	H4141_011_0	5	5	Specialty Tier	010010	
H4141	011	0	1	01	01	H4141_011_0	5	4	Non-Preferred Brand	110000	
H4141	011	0	1	01	01	H4141_011_0	5	3	Preferred Brand	000101	
H4141	011	0	1	01	01	H4141_011_0	5	2	Non-Preferred Generic	000101	
H4141	011	0	1	01	01	H4141_011_0	5	1	Preferred Generic	001010	
H4141	011	0	1	01	01	H4141_011_0	5	3	Preferred Brand	000101	2
H4141	011	0	1	01	01	H4141_011_0	5	5	Specialty Tier	010010	2
H4141	011	0	1	01	01	H4141_011_0	5	4	Non-Preferred Brand	110000	2
H4141	012	0	1	01	01	H4141_012_0	5	1	Preferred Generic	001010	
H4141	012	0	1	01	01	H4141_012_0	5	2	Non-Preferred Generic	000101	
H4141	012	0	1	01	01	H4141_012_0	5	3	Preferred Brand	000101	
H4141	012	0	1	01	01	H4141_012_0	5	4	Non-Preferred Brand	110000	
H4141	012	0	1	01	01	H4141_012_0	5	5	Specialty Tier	010010	2
H4141	012	0	1	01	01	H4141_012_0	5	1	Preferred Generic	001010	2
H4141	012	0	1	01	01	H4141_012_0	5	2	Non-Preferred Generic	000101	2
H4141	012	0	1	01	01	H4141_012_0	5	4	Non-Preferred Brand	110000	2
H4141	012	0	1	01	01	H4141_012_0	5	3	Preferred Brand	000101	2
H4141	012	0	1	01	01	H4141_012_0	5	5	Specialty Tier	010010	
H4141	013	0	1	01	01	H4141_013_0	5	2	Non-Preferred Generic	000101	2
H4141	013	0	1	01	01	H4141_013_0	5	3	Preferred Brand	000101	2
H4141	013	0	1	01	01	H4141_013_0	5	4	Non-Preferred Brand	110000	2
H4141	013	0	1	01	01	H4141_013_0	5	5	Specialty Tier	010010	2
H4141	013	0	1	01	01	H4141_013_0	5	1	Preferred Generic	001010	
H4141	013	0	1	01	01	H4141_013_0	5	2	Non-Preferred Generic	000101	
H4141	013	0	1	01	01	H4141_013_0	5	3	Preferred Brand	000101	
H4141	013	0	1	01	01	H4141_013_0	5	4	Non-Preferred Brand	110000	
H4141	013	0	1	01	01	H4141_013_0	5	5	Specialty Tier	010010	
H4141	013	0	1	01	01	H4141_013_0	5	1	Preferred Generic	001010	2
H4145	001	0	1	01	01	H4145_001_0	4	1	Preferred Generic	001010	
H4145	001	0	1	01	01	H4145_001_0	4	2	Non-Preferred Generic	000101	
H4145	001	0	1	01	01	H4145_001_0	4	3	Preferred Brand	000101	
H4145	001	0	1	01	01	H4145_001_0	4	4	Non-Preferred Brand	110000	
H4145	001	0	1	01	01	H4145_001_0	4	5	Specialty Tier	010010	2
H4145	001	0	1	01	01	H4145_001_0	4	1	Preferred Generic	001010	2
H4145	001	0	1	01	01	H4145_001_0	4	2	Non-Preferred Generic	000101	2
H4145	001	0	1	01	01	H4145_001_0	4	3	Preferred Brand	000101	2
H4145	001	0	1	01	01	H4145_001_0	4	4	Non-Preferred Brand	110000	2
H4145	001	0	1	01	01	H4145_001_0	4	5	Specialty Tier	010010	
H4152	005	0	1	01	01	H4152_005_0	5	4	Specialty Tier	010010	
H4152	005	0	1	01	01	H4152_005_0	5	3	Non-Preferred Brand	100100	
H4152	005	0	1	01	01	H4152_005_0	5	2	Preferred Brand	000101	
H4152	005	0	1	01	01	H4152_005_0	5	1	Generic	010000	
H4152	007	0	1	02	01	H4152_007_0	5	4	Specialty Tier	010010	
H4152	007	0	1	02	01	H4152_007_0	5	3	Non-Preferred Brand	100100	
H4152	007	0	1	02	01	H4152_007_0	5	2	Preferred Brand	000101	
H4152	007	0	1	02	01	H4152_007_0	5	1	Generic	010000	
H4152	007	0	1	02	01	H4152_007_0	5	1	Generic	010000	1
H4152	013	0	1	01	01	H4152_013_0	5	1	Generic	010000	
H4152	013	0	1	01	01	H4152_013_0	5	2	Preferred Brand	000101	
H4152	013	0	1	01	01	H4152_013_0	5	3	Non-Preferred Brand	100100	
H4152	013	0	1	01	01	H4152_013_0	5	4	Specialty Tier	010010	
H4152	016	0	1	02	01	H4152_016_0	6	1	Generic	010000	
H4152	016	0	1	02	01	H4152_016_0	6	2	Preferred Brand	000101	
H4152	016	0	1	02	01	H4152_016_0	6	3	Non-Preferred Brand	100100	
H4152	016	0	1	02	01	H4152_016_0	6	4	Specialty Tier	010010	
H4199	001	0	1	01	01	H4199_001_0	7	2	Preferred Brand	000001	
H4199	001	0	1	01	01	H4199_001_0	7	1	Generic	010000	
H4199	001	0	1	01	01	H4199_001_0	7	3	Non-Preferred Brand	100000	
H4199	001	0	1	01	01	H4199_001_0	7	4	Specialty Tier	010010	
H4199	001	0	1	01	01	H4199_001_0	7	1	Generic	010000	1
H4199	002	0	1	01	01	H4199_002_0	6	1	Generic	010000	
H4199	002	0	1	01	01	H4199_002_0	6	2	Preferred Brand	000001	
H4199	002	0	1	01	01	H4199_002_0	6	3	Non-Preferred Brand	100000	
H4199	002	0	1	01	01	H4199_002_0	6	4	Specialty Tier	010010	
H4199	002	0	1	01	01	H4199_002_0	6	1	Generic	010000	1
H4199	005	0	1	01	01	H4199_005_0	5	2	Preferred Brand	000001	
H4199	005	0	1	01	01	H4199_005_0	5	1	Generic	010000	
H4199	005	0	1	01	01	H4199_005_0	5	3	Non-Preferred Brand	100000	
H4199	005	0	1	01	01	H4199_005_0	5	1	Generic	010000	1
H4199	005	0	1	01	01	H4199_005_0	5	4	Specialty Tier	010010	
H4199	006	0	1	01	01	H4199_006_0	6	1	Generic	010000	
H4199	006	0	1	01	01	H4199_006_0	6	2	Preferred Brand	000001	
H4199	006	0	1	01	01	H4199_006_0	6	3	Non-Preferred Brand	100000	
H4199	006	0	1	01	01	H4199_006_0	6	4	Specialty Tier	010010	
H4199	006	0	1	01	01	H4199_006_0	6	1	Generic	010000	1
H4199	007	0	1	01	01	H4199_007_0	8	1	Generic	010000	
H4199	007	0	1	01	01	H4199_007_0	8	2	Preferred Brand	000001	
H4199	007	0	1	01	01	H4199_007_0	8	4	Specialty Tier	010010	
H4199	007	0	1	01	01	H4199_007_0	8	3	Non-Preferred Brand	100000	
H4199	007	0	1	01	01	H4199_007_0	8	1	Generic	010000	1
H4199	008	0	1	01	01	H4199_008_0	6	3	Non-Preferred Brand	100000	
H4199	008	0	1	01	01	H4199_008_0	6	4	Specialty Tier	010010	
H4199	008	0	1	01	01	H4199_008_0	6	1	Generic	010000	1
H4199	008	0	1	01	01	H4199_008_0	6	1	Generic	010000	
H4199	008	0	1	01	01	H4199_008_0	6	2	Preferred Brand	000001	
H4199	010	0	1	01	01	H4199_010_0	5	1	Generic	010000	
H4199	010	0	1	01	01	H4199_010_0	5	2	Preferred Brand	000001	
H4199	010	0	1	01	01	H4199_010_0	5	3	Non-Preferred Brand	100000	
H4199	010	0	1	01	01	H4199_010_0	5	4	Specialty Tier	010010	
H4199	010	0	1	01	01	H4199_010_0	5	1	Generic	010000	1
H4199	011	0	1	01	01	H4199_011_0	7	4	Specialty Tier	010010	
H4199	011	0	1	01	01	H4199_011_0	7	3	Non-Preferred Brand	100000	
H4199	011	0	1	01	01	H4199_011_0	7	2	Preferred Brand	000001	
H4199	011	0	1	01	01	H4199_011_0	7	1	Generic	010000	
H4199	011	0	1	01	01	H4199_011_0	7	1	Generic	010000	1
H4199	012	0	1	01	01	H4199_012_0	8	1	Generic	010000	
H4199	012	0	1	01	01	H4199_012_0	8	2	Preferred Brand	000001	
H4199	012	0	1	01	01	H4199_012_0	8	3	Non-Preferred Brand	100000	
H4199	012	0	1	01	01	H4199_012_0	8	4	Specialty Tier	010010	
H4199	012	0	1	01	01	H4199_012_0	8	1	Generic	010000	1
H4199	013	0	1	01	01	H4199_013_0	7	1	Generic	010000	
H4199	013	0	1	01	01	H4199_013_0	7	2	Preferred Brand	000001	
H4199	013	0	1	01	01	H4199_013_0	7	3	Non-Preferred Brand	100000	
H4199	013	0	1	01	01	H4199_013_0	7	4	Specialty Tier	010010	
H4199	013	0	1	01	01	H4199_013_0	7	1	Generic	010000	1
H4199	015	0	1	01	01	H4199_015_0	5	4	Specialty Tier	010010	
H4199	015	0	1	01	01	H4199_015_0	5	3	Non-Preferred Brand	100000	
H4199	015	0	1	01	01	H4199_015_0	5	2	Preferred Brand	000001	
H4199	015	0	1	01	01	H4199_015_0	5	1	Generic	010000	
H4199	015	0	1	01	01	H4199_015_0	5	1	Generic	010000	1
H4199	016	0	1	01	01	H4199_016_0	6	2	Preferred Brand	000001	
H4199	016	0	1	01	01	H4199_016_0	6	1	Generic	010000	
H4199	016	0	1	01	01	H4199_016_0	6	3	Non-Preferred Brand	100000	
H4199	016	0	1	01	01	H4199_016_0	6	4	Specialty Tier	010010	
H4199	016	0	1	01	01	H4199_016_0	6	1	Generic	010000	1
H4199	017	0	1	01	01	H4199_017_0	8	1	Generic	010000	
H4199	017	0	1	01	01	H4199_017_0	8	2	Preferred Brand	000001	
H4199	017	0	1	01	01	H4199_017_0	8	3	Non-Preferred Brand	100000	
H4199	017	0	1	01	01	H4199_017_0	8	4	Specialty Tier	010010	
H4199	017	0	1	01	01	H4199_017_0	8	1	Generic	010000	1
H4199	018	0	1	01	01	H4199_018_0	7	2	Preferred Brand	000001	
H4199	018	0	1	01	01	H4199_018_0	7	1	Generic	010000	
H4199	018	0	1	01	01	H4199_018_0	7	3	Non-Preferred Brand	100000	
H4199	018	0	1	01	01	H4199_018_0	7	1	Generic	010000	1
H4199	018	0	1	01	01	H4199_018_0	7	4	Specialty Tier	010010	
H4199	020	0	1	01	01	H4199_020_0	7	1	Generic	010000	
H4199	020	0	1	01	01	H4199_020_0	7	2	Preferred Brand	000001	
H4199	020	0	1	01	01	H4199_020_0	7	3	Non-Preferred Brand	100000	
H4199	020	0	1	01	01	H4199_020_0	7	4	Specialty Tier	010010	
H4199	020	0	1	01	01	H4199_020_0	7	1	Generic	010000	1
H4199	021	0	1	01	01	H4199_021_0	7	1	Generic	010000	
H4199	021	0	1	01	01	H4199_021_0	7	2	Preferred Brand	000001	
H4199	021	0	1	01	01	H4199_021_0	7	4	Specialty Tier	010010	
H4199	021	0	1	01	01	H4199_021_0	7	3	Non-Preferred Brand	100000	
H4199	021	0	1	01	01	H4199_021_0	7	1	Generic	010000	1
H4209	001	0	1	04	01	H4209_001_0	11	3	Preferred Brand	000001	
H4209	001	0	1	04	01	H4209_001_0	11	2	Non-Preferred Generic	000100	1
H4209	001	0	1	04	01	H4209_001_0	11	1	Preferred Generic	001000	1
H4209	001	0	1	04	01	H4209_001_0	11	5	Specialty Tier	010010	
H4209	001	0	1	04	01	H4209_001_0	11	4	Non-Preferred Brand	110000	
H4209	001	0	1	04	01	H4209_001_0	11	2	Non-Preferred Generic	000100	
H4209	001	0	1	04	01	H4209_001_0	11	1	Preferred Generic	001000	
H4209	003	0	1	04	01	H4209_003_0	12	3	Preferred Brand	000001	
H4209	003	0	1	04	01	H4209_003_0	12	2	Non-Preferred Generic	000100	
H4209	003	0	1	04	01	H4209_003_0	12	1	Preferred Generic	001000	
H4209	003	0	1	04	01	H4209_003_0	12	2	Non-Preferred Generic	000100	1
H4209	003	0	1	04	01	H4209_003_0	12	4	Non-Preferred Brand	110000	
H4209	003	0	1	04	01	H4209_003_0	12	5	Specialty Tier	010010	
H4209	003	0	1	04	01	H4209_003_0	12	1	Preferred Generic	001000	1
H4209	009	0	1	04	01	H4209_009_0	10	2	Non-Preferred Generic	000100	1
H4209	009	0	1	04	01	H4209_009_0	10	1	Preferred Generic	001000	1
H4209	009	0	1	04	01	H4209_009_0	10	4	Non-Preferred Brand	110000	
H4209	009	0	1	04	01	H4209_009_0	10	5	Specialty Tier	010010	
H4209	009	0	1	04	01	H4209_009_0	10	3	Preferred Brand	000001	
H4209	009	0	1	04	01	H4209_009_0	10	2	Non-Preferred Generic	000100	
H4209	009	0	1	04	01	H4209_009_0	10	1	Preferred Generic	001000	
H4211	001	0	1	01	01	H4211_001_0	6	1	Preferred Generic	001000	1
H4211	001	0	1	01	01	H4211_001_0	6	2	Non-Preferred Generic	000100	1
H4211	001	0	1	01	01	H4211_001_0	6	1	Preferred Generic	001000	
H4211	001	0	1	01	01	H4211_001_0	6	2	Non-Preferred Generic	000100	
H4211	001	0	1	01	01	H4211_001_0	6	3	Preferred Brand	000001	
H4211	001	0	1	01	01	H4211_001_0	6	4	Non-Preferred Brand	100000	
H4211	001	0	1	01	01	H4211_001_0	6	5	Specialty Tier	010010	
H4211	003	0	1	01	01	H4211_003_0	6	5	Specialty Tier	010010	
H4211	003	0	1	01	01	H4211_003_0	6	1	Preferred Generic	001000	1
H4211	003	0	1	01	01	H4211_003_0	6	4	Non-Preferred Brand	100000	
H4211	003	0	1	01	01	H4211_003_0	6	3	Preferred Brand	000001	
H4211	003	0	1	01	01	H4211_003_0	6	2	Non-Preferred Generic	000100	
H4211	003	0	1	01	01	H4211_003_0	6	1	Preferred Generic	001000	
H4213	004	0	1	09	04	H4213_004_0	6	2	Non-Preferred Generic	000100	
H4213	004	0	1	09	04	H4213_004_0	6	3	Preferred Brand	000001	
H4213	004	0	1	09	04	H4213_004_0	6	4	Non-Preferred Brand	110000	
H4213	004	0	1	09	04	H4213_004_0	6	1	Preferred Generic	001000	
H4213	004	0	1	09	04	H4213_004_0	6	5	Specialty Tier	010010	
H4213	005	0	1	09	04	H4213_005_0	6	1	Preferred Generic	001000	
H4213	005	0	1	09	04	H4213_005_0	6	2	Non-Preferred Generic	000100	
H4213	005	0	1	09	04	H4213_005_0	6	3	Preferred Brand	000001	
H4213	005	0	1	09	04	H4213_005_0	6	4	Non-Preferred Brand	110000	
H4213	005	0	1	09	04	H4213_005_0	6	5	Specialty Tier	010010	
H4213	006	0	1	09	04	H4213_006_0	4	1	Preferred Generic	001000	
H4213	006	0	1	09	04	H4213_006_0	4	2	Non-Preferred Generic	000100	
H4213	006	0	1	09	04	H4213_006_0	4	3	Preferred Brand	000001	
H4213	006	0	1	09	04	H4213_006_0	4	5	Specialty Tier	010010	
H4213	006	0	1	09	04	H4213_006_0	4	4	Non-Preferred Brand	110000	
H4213	007	0	1	09	04	H4213_007_0	7	4	Non-Preferred Brand	110000	
H4213	007	0	1	09	04	H4213_007_0	7	1	Preferred Generic	001000	
H4213	007	0	1	09	04	H4213_007_0	7	3	Preferred Brand	000001	
H4213	007	0	1	09	04	H4213_007_0	7	2	Non-Preferred Generic	000100	
H4213	007	0	1	09	04	H4213_007_0	7	5	Specialty Tier	010010	
H4268	002	0	1	09	04	H4268_002_0	5	3	Non-Preferred Brand	100100	
H4268	002	0	1	09	04	H4268_002_0	5	2	Preferred Brand	000101	
H4268	002	0	1	09	04	H4268_002_0	5	1	Preferred Generic	001010	
H4268	002	0	1	09	04	H4268_002_0	5	4	Specialty Tier	100100	
H4270	003	0	1	02	01	H4270_003_0	8	4	Non-Preferred Brand	100000	
H4270	003	0	1	02	01	H4270_003_0	8	3	Preferred Brand	000001	
H4270	003	0	1	02	01	H4270_003_0	8	2	Non-Preferred Generic	000100	
H4270	003	0	1	02	01	H4270_003_0	8	5	Specialty Tier	010010	
H4270	003	0	1	02	01	H4270_003_0	8	1	Preferred Generic	001000	
H4270	006	0	1	02	01	H4270_006_0	6	4	Non-Preferred Brand	100000	
H4270	006	0	1	02	01	H4270_006_0	6	3	Preferred Brand	000001	
H4270	006	0	1	02	01	H4270_006_0	6	2	Non-Preferred Generic	000100	
H4270	006	0	1	02	01	H4270_006_0	6	1	Preferred Generic	001000	
H4270	006	0	1	02	01	H4270_006_0	6	5	Specialty Tier	010010	
H4279	001	0	1	01	01	H4279_001_0	8	4	Specialty Tier	110001	
H4279	001	0	1	01	01	H4279_001_0	8	3	Non-Preferred Brand	100000	
H4279	001	0	1	01	01	H4279_001_0	8	2	Preferred Brand	000001	
H4279	001	0	1	01	01	H4279_001_0	8	1	Generic	010000	
H4279	001	0	1	01	01	H4279_001_0	8	5	Select Care Drugs	010000	
H4346	001	0	1	01	01	H4346_001_0	8	3	Preferred Brand	000001	
H4346	001	0	1	01	01	H4346_001_0	8	6	Select Care Drugs	000010	2
H4346	001	0	1	01	01	H4346_001_0	8	2	Non-Preferred Generic	000100	1
H4346	001	0	1	01	01	H4346_001_0	8	1	Preferred Generic	001000	1
H4346	001	0	1	01	01	H4346_001_0	8	2	Non-Preferred Generic	000100	
H4346	001	0	1	01	01	H4346_001_0	8	5	Specialty Tier	010010	
H4346	001	0	1	01	01	H4346_001_0	8	4	Non-Preferred Brand	100000	
H4346	001	0	1	01	01	H4346_001_0	8	1	Preferred Generic	001000	
H4346	001	0	1	01	01	H4346_001_0	8	6	Select Care Drugs	000010	
H4346	005	0	1	01	01	H4346_005_0	13	4	Non-Preferred Brand	100000	2
H4346	005	0	1	01	01	H4346_005_0	13	3	Preferred Brand	000001	2
H4346	005	0	1	01	01	H4346_005_0	13	2	Non-Preferred Generic	000100	1
H4346	005	0	1	01	01	H4346_005_0	13	1	Preferred Generic	001000	1
H4346	005	0	1	01	01	H4346_005_0	13	6	Select Care Drugs	000010	
H4346	005	0	1	01	01	H4346_005_0	13	5	Specialty Tier	010010	
H4346	005	0	1	01	01	H4346_005_0	13	4	Non-Preferred Brand	100000	
H4346	005	0	1	01	01	H4346_005_0	13	3	Preferred Brand	000001	
H4346	005	0	1	01	01	H4346_005_0	13	2	Non-Preferred Generic	000100	
H4346	005	0	1	01	01	H4346_005_0	13	6	Select Care Drugs	000010	1
H4346	005	0	1	01	01	H4346_005_0	13	1	Preferred Generic	001000	
H4346	006	0	1	01	01	H4346_006_0	8	3	Preferred Brand	000001	
H4346	006	0	1	01	01	H4346_006_0	8	2	Non-Preferred Generic	000100	
H4346	006	0	1	01	01	H4346_006_0	8	1	Preferred Generic	001000	
H4346	006	0	1	01	01	H4346_006_0	8	4	Non-Preferred Brand	100000	
H4346	006	0	1	01	01	H4346_006_0	8	6	Select Care Drugs	000010	1
H4346	006	0	1	01	01	H4346_006_0	8	4	Non-Preferred Brand	100000	2
H4346	006	0	1	01	01	H4346_006_0	8	3	Preferred Brand	000001	2
H4346	006	0	1	01	01	H4346_006_0	8	2	Non-Preferred Generic	000100	1
H4346	006	0	1	01	01	H4346_006_0	8	1	Preferred Generic	001000	1
H4346	006	0	1	01	01	H4346_006_0	8	6	Select Care Drugs	000010	
H4346	006	0	1	01	01	H4346_006_0	8	5	Specialty Tier	010010	
H4346	008	0	1	01	01	H4346_008_0	8	1	Preferred Generic	001000	
H4346	008	0	1	01	01	H4346_008_0	8	2	Non-Preferred Generic	000100	
H4346	008	0	1	01	01	H4346_008_0	8	4	Non-Preferred Brand	100000	2
H4346	008	0	1	01	01	H4346_008_0	8	6	Select Care Drugs	000010	1
H4346	008	0	1	01	01	H4346_008_0	8	3	Preferred Brand	000001	2
H4346	008	0	1	01	01	H4346_008_0	8	2	Non-Preferred Generic	000100	1
H4346	008	0	1	01	01	H4346_008_0	8	1	Preferred Generic	001000	1
H4346	008	0	1	01	01	H4346_008_0	8	3	Preferred Brand	000001	
H4346	008	0	1	01	01	H4346_008_0	8	4	Non-Preferred Brand	100000	
H4346	008	0	1	01	01	H4346_008_0	8	5	Specialty Tier	010010	
H4346	008	0	1	01	01	H4346_008_0	8	6	Select Care Drugs	000010	
H4346	009	0	1	01	01	H4346_009_0	8	3	Preferred Brand	000001	
H4346	009	0	1	01	01	H4346_009_0	8	4	Non-Preferred Brand	100000	
H4346	009	0	1	01	01	H4346_009_0	8	5	Specialty Tier	010010	
H4346	009	0	1	01	01	H4346_009_0	8	1	Preferred Generic	001000	
H4346	009	0	1	01	01	H4346_009_0	8	2	Non-Preferred Generic	000100	
H4346	009	0	1	01	01	H4346_009_0	8	6	Select Care Drugs	000010	
H4406	001	0	1	01	01	H4406_001_0	4	1	Preferred Generic	001000	
H4406	001	0	1	01	01	H4406_001_0	4	5	Specialty Tier	010010	
H4406	001	0	1	01	01	H4406_001_0	4	4	Non-Preferred Brand	100100	
H4406	001	0	1	01	01	H4406_001_0	4	3	Preferred Brand	010001	
H4406	001	0	1	01	01	H4406_001_0	4	2	Non-Preferred Generic	000100	
H4407	002	0	1	01	01	H4407_002_0	2	1	Preferred Generic	001000	1
H4407	002	0	1	01	01	H4407_002_0	2	5	Specialty Tier	010010	
H4407	002	0	1	01	01	H4407_002_0	2	4	Non-Preferred Brand	100100	
H4407	002	0	1	01	01	H4407_002_0	2	3	Preferred Brand	000001	
H4407	002	0	1	01	01	H4407_002_0	2	2	Non-Preferred Generic	000100	
H4407	002	0	1	01	01	H4407_002_0	2	2	Non-Preferred Generic	000100	1
H4407	002	0	1	01	01	H4407_002_0	2	1	Preferred Generic	001000	
H4407	022	0	1	02	01	H4407_022_0	5	2	Non-Preferred Generic	000100	
H4407	022	0	1	02	01	H4407_022_0	5	3	Preferred Brand	000001	
H4407	022	0	1	02	01	H4407_022_0	5	4	Non-Preferred Brand	100100	
H4407	022	0	1	02	01	H4407_022_0	5	5	Specialty Tier	010010	
H4407	022	0	1	02	01	H4407_022_0	5	1	Preferred Generic	001000	1
H4407	022	0	1	02	01	H4407_022_0	5	2	Non-Preferred Generic	000100	1
H4407	022	0	1	02	01	H4407_022_0	5	1	Preferred Generic	001000	
H4408	001	0	1	04	01	H4408_001_0	4	4	Non-Preferred Brand	110000	
H4408	001	0	1	04	01	H4408_001_0	4	3	Preferred Brand	000101	
H4408	001	0	1	04	01	H4408_001_0	4	5	Specialty Tier	010010	2
H4408	001	0	1	04	01	H4408_001_0	4	4	Non-Preferred Brand	110000	2
H4408	001	0	1	04	01	H4408_001_0	4	3	Preferred Brand	000101	2
H4408	001	0	1	04	01	H4408_001_0	4	2	Non-Preferred Generic	000101	2
H4408	001	0	1	04	01	H4408_001_0	4	1	Preferred Generic	001010	2
H4408	001	0	1	04	01	H4408_001_0	4	5	Specialty Tier	010010	
H4408	001	0	1	04	01	H4408_001_0	4	1	Preferred Generic	001010	
H4408	001	0	1	04	01	H4408_001_0	4	2	Non-Preferred Generic	000101	
H4408	002	0	1	04	01	H4408_002_0	4	1	Preferred Generic	001010	
H4408	002	0	1	04	01	H4408_002_0	4	4	Non-Preferred Brand	110000	2
H4408	002	0	1	04	01	H4408_002_0	4	3	Preferred Brand	000101	2
H4408	002	0	1	04	01	H4408_002_0	4	2	Non-Preferred Generic	000101	2
H4408	002	0	1	04	01	H4408_002_0	4	5	Specialty Tier	010010	2
H4408	002	0	1	04	01	H4408_002_0	4	5	Specialty Tier	010010	
H4408	002	0	1	04	01	H4408_002_0	4	4	Non-Preferred Brand	110000	
H4408	002	0	1	04	01	H4408_002_0	4	3	Preferred Brand	000101	
H4408	002	0	1	04	01	H4408_002_0	4	2	Non-Preferred Generic	000101	
H4408	002	0	1	04	01	H4408_002_0	4	1	Preferred Generic	001010	2
H4408	006	0	1	04	01	H4408_006_0	4	4	Non-Preferred Brand	110000	
H4408	006	0	1	04	01	H4408_006_0	4	3	Preferred Brand	000101	
H4408	006	0	1	04	01	H4408_006_0	4	2	Non-Preferred Generic	000101	
H4408	006	0	1	04	01	H4408_006_0	4	1	Preferred Generic	001010	
H4408	006	0	1	04	01	H4408_006_0	4	5	Specialty Tier	010010	
H4408	006	0	1	04	01	H4408_006_0	4	5	Specialty Tier	010010	2
H4408	006	0	1	04	01	H4408_006_0	4	4	Non-Preferred Brand	110000	2
H4408	006	0	1	04	01	H4408_006_0	4	3	Preferred Brand	000101	2
H4408	006	0	1	04	01	H4408_006_0	4	2	Non-Preferred Generic	000101	2
H4408	006	0	1	04	01	H4408_006_0	4	1	Preferred Generic	001010	2
H4408	007	0	1	04	01	H4408_007_0	4	1	Preferred Generic	001010	
H4408	007	0	1	04	01	H4408_007_0	4	2	Non-Preferred Generic	000101	
H4408	007	0	1	04	01	H4408_007_0	4	5	Specialty Tier	010010	2
H4408	007	0	1	04	01	H4408_007_0	4	4	Non-Preferred Brand	110000	2
H4408	007	0	1	04	01	H4408_007_0	4	3	Preferred Brand	000101	2
H4408	007	0	1	04	01	H4408_007_0	4	2	Non-Preferred Generic	000101	2
H4408	007	0	1	04	01	H4408_007_0	4	1	Preferred Generic	001010	2
H4408	007	0	1	04	01	H4408_007_0	4	5	Specialty Tier	010010	
H4408	007	0	1	04	01	H4408_007_0	4	4	Non-Preferred Brand	110000	
H4408	007	0	1	04	01	H4408_007_0	4	3	Preferred Brand	000101	
H4408	008	0	1	04	01	H4408_008_0	4	1	Preferred Generic	001010	
H4408	008	0	1	04	01	H4408_008_0	4	5	Specialty Tier	010010	
H4408	008	0	1	04	01	H4408_008_0	4	1	Preferred Generic	001010	2
H4408	008	0	1	04	01	H4408_008_0	4	2	Non-Preferred Generic	000101	2
H4408	008	0	1	04	01	H4408_008_0	4	5	Specialty Tier	010010	2
H4408	008	0	1	04	01	H4408_008_0	4	4	Non-Preferred Brand	110000	2
H4408	008	0	1	04	01	H4408_008_0	4	4	Non-Preferred Brand	110000	
H4408	008	0	1	04	01	H4408_008_0	4	3	Preferred Brand	000101	
H4408	008	0	1	04	01	H4408_008_0	4	2	Non-Preferred Generic	000101	
H4408	008	0	1	04	01	H4408_008_0	4	3	Preferred Brand	000101	2
H4454	002	0	1	01	01	H4454_002_0	4	1	Preferred Generic	001000	
H4454	002	0	1	01	01	H4454_002_0	4	2	Non-Preferred Generic	000100	
H4454	002	0	1	01	01	H4454_002_0	4	3	Preferred Brand	000001	
H4454	002	0	1	01	01	H4454_002_0	4	4	Non-Preferred Brand	100100	
H4454	002	0	1	01	01	H4454_002_0	4	5	Specialty Tier	010010	
H4454	002	0	1	01	01	H4454_002_0	4	1	Preferred Generic	001000	1
H4454	002	0	1	01	01	H4454_002_0	4	2	Non-Preferred Generic	000100	1
H4454	030	0	1	02	01	H4454_030_0	5	1	Preferred Generic	001000	
H4454	030	0	1	02	01	H4454_030_0	5	2	Non-Preferred Generic	000100	
H4454	030	0	1	02	01	H4454_030_0	5	3	Preferred Brand	000001	
H4454	030	0	1	02	01	H4454_030_0	5	4	Non-Preferred Brand	100100	
H4454	030	0	1	02	01	H4454_030_0	5	2	Non-Preferred Generic	000100	1
H4454	030	0	1	02	01	H4454_030_0	5	1	Preferred Generic	001000	1
H4454	030	0	1	02	01	H4454_030_0	5	5	Specialty Tier	010010	
H4454	031	0	1	01	01	H4454_031_0	4	4	Non-Preferred Brand	100100	
H4454	031	0	1	01	01	H4454_031_0	4	3	Preferred Brand	000001	
H4454	031	0	1	01	01	H4454_031_0	4	5	Specialty Tier	010010	
H4454	031	0	1	01	01	H4454_031_0	4	1	Preferred Generic	001000	
H4454	031	0	1	01	01	H4454_031_0	4	2	Non-Preferred Generic	000100	
H4454	031	0	1	01	01	H4454_031_0	4	1	Preferred Generic	001000	1
H4454	031	0	1	01	01	H4454_031_0	4	2	Non-Preferred Generic	000100	1
H4454	032	0	1	02	01	H4454_032_0	5	4	Non-Preferred Brand	100100	
H4454	032	0	1	02	01	H4454_032_0	5	3	Preferred Brand	000001	
H4454	032	0	1	02	01	H4454_032_0	5	2	Non-Preferred Generic	000100	
H4454	032	0	1	02	01	H4454_032_0	5	1	Preferred Generic	001000	
H4454	032	0	1	02	01	H4454_032_0	5	5	Specialty Tier	010010	
H4454	032	0	1	02	01	H4454_032_0	5	1	Preferred Generic	001000	1
H4454	032	0	1	02	01	H4454_032_0	5	2	Non-Preferred Generic	000100	1
H4456	010	0	1	01	01	H4456_010_0	4	5	Specialty Tier	010010	
H4456	010	0	1	01	01	H4456_010_0	4	4	Non-Preferred Brand	100100	
H4456	010	0	1	01	01	H4456_010_0	4	3	Preferred Brand	010001	
H4456	010	0	1	01	01	H4456_010_0	4	1	Preferred Generic	001000	
H4456	010	0	1	01	01	H4456_010_0	4	2	Non-Preferred Generic	000100	
H4456	013	0	1	01	01	H4456_013_0	5	1	Preferred Generic	001000	
H4456	013	0	1	01	01	H4456_013_0	5	2	Non-Preferred Generic	000100	
H4456	013	0	1	01	01	H4456_013_0	5	3	Preferred Brand	010001	
H4456	013	0	1	01	01	H4456_013_0	5	4	Non-Preferred Brand	100100	
H4456	013	0	1	01	01	H4456_013_0	5	5	Specialty Tier	010010	
H4456	015	0	1	01	01	H4456_015_0	4	5	Specialty Tier	010010	
H4456	015	0	1	01	01	H4456_015_0	4	1	Preferred Generic	001000	
H4456	015	0	1	01	01	H4456_015_0	4	2	Non-Preferred Generic	000100	
H4456	015	0	1	01	01	H4456_015_0	4	3	Preferred Brand	010001	
H4456	015	0	1	01	01	H4456_015_0	4	4	Non-Preferred Brand	100100	
H4456	021	0	1	01	01	H4456_021_0	4	5	Specialty Tier	010010	
H4456	021	0	1	01	01	H4456_021_0	4	3	Preferred Brand	010001	
H4456	021	0	1	01	01	H4456_021_0	4	2	Non-Preferred Generic	000100	
H4456	021	0	1	01	01	H4456_021_0	4	1	Preferred Generic	001000	
H4456	021	0	1	01	01	H4456_021_0	4	4	Non-Preferred Brand	100100	
H4456	025	0	1	01	01	H4456_025_0	4	5	Specialty Tier	010010	
H4456	025	0	1	01	01	H4456_025_0	4	4	Non-Preferred Brand	100100	
H4456	025	0	1	01	01	H4456_025_0	4	3	Preferred Brand	010001	
H4456	025	0	1	01	01	H4456_025_0	4	2	Non-Preferred Generic	000100	
H4456	025	0	1	01	01	H4456_025_0	4	1	Preferred Generic	001000	
H4461	001	0	1	01	01	H4461_001_0	4	2	Non-Preferred Generic	000101	2
H4461	001	0	1	01	01	H4461_001_0	4	1	Preferred Generic	001010	2
H4461	001	0	1	01	01	H4461_001_0	4	5	Specialty Tier	010010	
H4461	001	0	1	01	01	H4461_001_0	4	4	Non-Preferred Brand	110000	
H4461	001	0	1	01	01	H4461_001_0	4	4	Non-Preferred Brand	110000	2
H4461	001	0	1	01	01	H4461_001_0	4	2	Non-Preferred Generic	000101	
H4461	001	0	1	01	01	H4461_001_0	4	1	Preferred Generic	001010	
H4461	001	0	1	01	01	H4461_001_0	4	5	Specialty Tier	010010	2
H4461	001	0	1	01	01	H4461_001_0	4	3	Preferred Brand	000101	2
H4461	001	0	1	01	01	H4461_001_0	4	3	Preferred Brand	000101	
H4461	015	0	1	01	01	H4461_015_0	4	1	Preferred Generic	001010	2
H4461	015	0	1	01	01	H4461_015_0	4	2	Non-Preferred Generic	000101	2
H4461	015	0	1	01	01	H4461_015_0	4	3	Preferred Brand	000101	2
H4461	015	0	1	01	01	H4461_015_0	4	4	Non-Preferred Brand	110000	2
H4461	015	0	1	01	01	H4461_015_0	4	5	Specialty Tier	010010	2
H4461	015	0	1	01	01	H4461_015_0	4	1	Preferred Generic	001010	
H4461	015	0	1	01	01	H4461_015_0	4	2	Non-Preferred Generic	000101	
H4461	015	0	1	01	01	H4461_015_0	4	3	Preferred Brand	000101	
H4461	015	0	1	01	01	H4461_015_0	4	5	Specialty Tier	010010	
H4461	015	0	1	01	01	H4461_015_0	4	4	Non-Preferred Brand	110000	
H4461	018	0	1	01	01	H4461_018_0	4	1	Preferred Generic	001010	2
H4461	018	0	1	01	01	H4461_018_0	4	2	Non-Preferred Generic	000101	2
H4461	018	0	1	01	01	H4461_018_0	4	3	Preferred Brand	000101	2
H4461	018	0	1	01	01	H4461_018_0	4	4	Non-Preferred Brand	110000	2
H4461	018	0	1	01	01	H4461_018_0	4	5	Specialty Tier	010010	2
H4461	018	0	1	01	01	H4461_018_0	4	3	Preferred Brand	000101	
H4461	018	0	1	01	01	H4461_018_0	4	5	Specialty Tier	010010	
H4461	018	0	1	01	01	H4461_018_0	4	4	Non-Preferred Brand	110000	
H4461	018	0	1	01	01	H4461_018_0	4	2	Non-Preferred Generic	000101	
H4461	018	0	1	01	01	H4461_018_0	4	1	Preferred Generic	001010	
H4461	022	0	1	01	01	H4461_022_0	5	4	Non-Preferred Brand	110000	
H4461	022	0	1	01	01	H4461_022_0	5	5	Specialty Tier	010010	
H4461	022	0	1	01	01	H4461_022_0	5	3	Preferred Brand	000101	
H4461	022	0	1	01	01	H4461_022_0	5	2	Non-Preferred Generic	000101	
H4461	022	0	1	01	01	H4461_022_0	5	1	Preferred Generic	001010	
H4461	025	0	1	01	01	H4461_025_0	4	3	Preferred Brand	000101	2
H4461	025	0	1	01	01	H4461_025_0	4	4	Non-Preferred Brand	110000	2
H4461	025	0	1	01	01	H4461_025_0	4	5	Specialty Tier	010010	2
H4461	025	0	1	01	01	H4461_025_0	4	2	Non-Preferred Generic	000101	2
H4461	025	0	1	01	01	H4461_025_0	4	1	Preferred Generic	001010	2
H4461	025	0	1	01	01	H4461_025_0	4	5	Specialty Tier	010010	
H4461	025	0	1	01	01	H4461_025_0	4	4	Non-Preferred Brand	110000	
H4461	025	0	1	01	01	H4461_025_0	4	3	Preferred Brand	000101	
H4461	025	0	1	01	01	H4461_025_0	4	2	Non-Preferred Generic	000101	
H4461	025	0	1	01	01	H4461_025_0	4	1	Preferred Generic	001010	
H4461	029	0	1	01	01	H4461_029_0	4	2	Non-Preferred Generic	000101	
H4461	029	0	1	01	01	H4461_029_0	4	1	Preferred Generic	001010	
H4461	029	0	1	01	01	H4461_029_0	4	3	Preferred Brand	000101	
H4461	029	0	1	01	01	H4461_029_0	4	4	Non-Preferred Brand	110000	
H4461	029	0	1	01	01	H4461_029_0	4	5	Specialty Tier	010010	2
H4461	029	0	1	01	01	H4461_029_0	4	1	Preferred Generic	001010	2
H4461	029	0	1	01	01	H4461_029_0	4	2	Non-Preferred Generic	000101	2
H4461	029	0	1	01	01	H4461_029_0	4	3	Preferred Brand	000101	2
H4461	029	0	1	01	01	H4461_029_0	4	4	Non-Preferred Brand	110000	2
H4461	029	0	1	01	01	H4461_029_0	4	5	Specialty Tier	010010	
H4506	003	0	1	01	01	H4506_003_0	8	1	Preferred Generic	001000	
H4506	003	0	1	01	01	H4506_003_0	8	2	Non-Preferred Generic	000100	
H4506	003	0	1	01	01	H4506_003_0	8	3	Preferred Brand	000001	2
H4506	003	0	1	01	01	H4506_003_0	8	2	Non-Preferred Generic	000100	1
H4506	003	0	1	01	01	H4506_003_0	8	1	Preferred Generic	001000	1
H4506	003	0	1	01	01	H4506_003_0	8	5	Specialty Tier	010010	
H4506	003	0	1	01	01	H4506_003_0	8	4	Non-Preferred Brand	100000	
H4506	003	0	1	01	01	H4506_003_0	8	3	Preferred Brand	000001	
H4506	029	0	1	02	01	H4506_029_0	8	1	Preferred Generic	001000	
H4506	029	0	1	02	01	H4506_029_0	8	2	Non-Preferred Generic	000100	1
H4506	029	0	1	02	01	H4506_029_0	8	1	Preferred Generic	001000	1
H4506	029	0	1	02	01	H4506_029_0	8	5	Specialty Tier	010010	
H4506	029	0	1	02	01	H4506_029_0	8	4	Non-Preferred Brand	100000	
H4506	029	0	1	02	01	H4506_029_0	8	3	Preferred Brand	000001	
H4506	029	0	1	02	01	H4506_029_0	8	2	Non-Preferred Generic	000100	
H4506	029	0	1	02	01	H4506_029_0	8	3	Preferred Brand	000001	2
H4510	012	0	1	01	01	H4510_012_0	5	4	Specialty Tier	010010	
H4510	012	0	1	01	01	H4510_012_0	5	3	Non-Preferred Brand	100100	
H4510	012	0	1	01	01	H4510_012_0	5	2	Preferred Brand	010001	
H4510	012	0	1	01	01	H4510_012_0	5	1	Preferred Generic	001010	
H4510	012	0	1	01	01	H4510_012_0	5	1	Preferred Generic	001010	2
H4510	012	0	1	01	01	H4510_012_0	5	2	Preferred Brand	010001	2
H4510	012	0	1	01	01	H4510_012_0	5	3	Non-Preferred Brand	100100	2
H4510	012	0	1	01	01	H4510_012_0	5	4	Specialty Tier	010010	2
H4510	015	0	1	01	01	H4510_015_0	5	4	Specialty Tier	010010	
H4510	015	0	1	01	01	H4510_015_0	5	3	Non-Preferred Brand	100100	
H4510	015	0	1	01	01	H4510_015_0	5	2	Preferred Brand	010001	
H4510	015	0	1	01	01	H4510_015_0	5	1	Preferred Generic	001010	
H4510	015	0	1	01	01	H4510_015_0	5	1	Preferred Generic	001010	2
H4510	015	0	1	01	01	H4510_015_0	5	4	Specialty Tier	010010	2
H4510	015	0	1	01	01	H4510_015_0	5	3	Non-Preferred Brand	100100	2
H4510	015	0	1	01	01	H4510_015_0	5	2	Preferred Brand	010001	2
H4510	018	0	1	01	01	H4510_018_0	4	1	Preferred Generic	001010	
H4510	018	0	1	01	01	H4510_018_0	4	2	Non-Preferred Generic	000101	
H4510	018	0	1	01	01	H4510_018_0	4	3	Preferred Brand	000101	
H4510	018	0	1	01	01	H4510_018_0	4	4	Non-Preferred Brand	110000	
H4510	018	0	1	01	01	H4510_018_0	4	5	Specialty Tier	010010	2
H4510	018	0	1	01	01	H4510_018_0	4	1	Preferred Generic	001010	2
H4510	018	0	1	01	01	H4510_018_0	4	4	Non-Preferred Brand	110000	2
H4510	018	0	1	01	01	H4510_018_0	4	3	Preferred Brand	000101	2
H4510	018	0	1	01	01	H4510_018_0	4	2	Non-Preferred Generic	000101	2
H4510	018	0	1	01	01	H4510_018_0	4	5	Specialty Tier	010010	
H4510	022	0	1	01	01	H4510_022_0	4	1	Preferred Generic	001010	
H4510	022	0	1	01	01	H4510_022_0	4	2	Non-Preferred Generic	000101	
H4510	022	0	1	01	01	H4510_022_0	4	5	Specialty Tier	010010	2
H4510	022	0	1	01	01	H4510_022_0	4	4	Non-Preferred Brand	110000	2
H4510	022	0	1	01	01	H4510_022_0	4	3	Preferred Brand	000101	2
H4510	022	0	1	01	01	H4510_022_0	4	2	Non-Preferred Generic	000101	2
H4510	022	0	1	01	01	H4510_022_0	4	1	Preferred Generic	001010	2
H4510	022	0	1	01	01	H4510_022_0	4	5	Specialty Tier	010010	
H4510	022	0	1	01	01	H4510_022_0	4	4	Non-Preferred Brand	110000	
H4510	022	0	1	01	01	H4510_022_0	4	3	Preferred Brand	000101	
H4510	027	0	1	01	01	H4510_027_0	4	1	Preferred Generic	001010	
H4510	027	0	1	01	01	H4510_027_0	4	2	Non-Preferred Generic	000101	
H4510	027	0	1	01	01	H4510_027_0	4	5	Specialty Tier	010010	2
H4510	027	0	1	01	01	H4510_027_0	4	4	Non-Preferred Brand	110000	2
H4510	027	0	1	01	01	H4510_027_0	4	3	Preferred Brand	000101	2
H4510	027	0	1	01	01	H4510_027_0	4	2	Non-Preferred Generic	000101	2
H4510	027	0	1	01	01	H4510_027_0	4	1	Preferred Generic	001010	2
H4510	027	0	1	01	01	H4510_027_0	4	5	Specialty Tier	010010	
H4510	027	0	1	01	01	H4510_027_0	4	4	Non-Preferred Brand	110000	
H4510	027	0	1	01	01	H4510_027_0	4	3	Preferred Brand	000101	
H4510	028	0	1	01	01	H4510_028_0	4	1	Preferred Generic	001010	
H4510	028	0	1	01	01	H4510_028_0	4	2	Non-Preferred Generic	000101	
H4510	028	0	1	01	01	H4510_028_0	4	3	Preferred Brand	000101	
H4510	028	0	1	01	01	H4510_028_0	4	4	Non-Preferred Brand	110000	
H4510	028	0	1	01	01	H4510_028_0	4	5	Specialty Tier	010010	2
H4510	028	0	1	01	01	H4510_028_0	4	1	Preferred Generic	001010	2
H4510	028	0	1	01	01	H4510_028_0	4	2	Non-Preferred Generic	000101	2
H4510	028	0	1	01	01	H4510_028_0	4	3	Preferred Brand	000101	2
H4510	028	0	1	01	01	H4510_028_0	4	4	Non-Preferred Brand	110000	2
H4510	028	0	1	01	01	H4510_028_0	4	5	Specialty Tier	010010	
H4510	029	0	1	01	01	H4510_029_0	6	3	Non-Preferred Brand	100100	2
H4510	029	0	1	01	01	H4510_029_0	6	4	Specialty Tier	010010	2
H4510	029	0	1	01	01	H4510_029_0	6	1	Preferred Generic	001010	
H4510	029	0	1	01	01	H4510_029_0	6	2	Preferred Brand	010001	
H4510	029	0	1	01	01	H4510_029_0	6	3	Non-Preferred Brand	100100	
H4510	029	0	1	01	01	H4510_029_0	6	4	Specialty Tier	010010	
H4510	029	0	1	01	01	H4510_029_0	6	1	Preferred Generic	001010	2
H4510	029	0	1	01	01	H4510_029_0	6	2	Preferred Brand	010001	2
H4510	030	0	1	01	01	H4510_030_0	6	2	Preferred Brand	010001	2
H4510	030	0	1	01	01	H4510_030_0	6	1	Preferred Generic	001010	2
H4510	030	0	1	01	01	H4510_030_0	6	4	Specialty Tier	010010	
H4510	030	0	1	01	01	H4510_030_0	6	3	Non-Preferred Brand	100100	
H4510	030	0	1	01	01	H4510_030_0	6	2	Preferred Brand	010001	
H4510	030	0	1	01	01	H4510_030_0	6	1	Preferred Generic	001010	
H4510	030	0	1	01	01	H4510_030_0	6	3	Non-Preferred Brand	100100	2
H4510	030	0	1	01	01	H4510_030_0	6	4	Specialty Tier	010010	2
H4510	032	0	1	01	01	H4510_032_0	4	1	Preferred Generic	001010	2
H4510	032	0	1	01	01	H4510_032_0	4	5	Specialty Tier	010010	
H4510	032	0	1	01	01	H4510_032_0	4	4	Non-Preferred Brand	110000	
H4510	032	0	1	01	01	H4510_032_0	4	3	Preferred Brand	000101	
H4510	032	0	1	01	01	H4510_032_0	4	2	Non-Preferred Generic	000101	
H4510	032	0	1	01	01	H4510_032_0	4	1	Preferred Generic	001010	
H4510	032	0	1	01	01	H4510_032_0	4	2	Non-Preferred Generic	000101	2
H4510	032	0	1	01	01	H4510_032_0	4	5	Specialty Tier	010010	2
H4510	032	0	1	01	01	H4510_032_0	4	4	Non-Preferred Brand	110000	2
H4510	032	0	1	01	01	H4510_032_0	4	3	Preferred Brand	000101	2
H4513	001	0	1	01	01	H4513_001_0	4	2	Non-Preferred Generic	000100	
H4513	001	0	1	01	01	H4513_001_0	4	3	Preferred Brand	000001	
H4513	001	0	1	01	01	H4513_001_0	4	4	Non-Preferred Brand	100100	
H4513	001	0	1	01	01	H4513_001_0	4	1	Preferred Generic	001000	
H4513	001	0	1	01	01	H4513_001_0	4	1	Preferred Generic	001000	1
H4513	001	0	1	01	01	H4513_001_0	4	5	Specialty Tier	010010	
H4513	001	0	1	01	01	H4513_001_0	4	2	Non-Preferred Generic	000100	1
H4514	007	0	1	01	01	H4514_007_0	4	5	Specialty Tier	010010	
H4514	007	0	1	01	01	H4514_007_0	4	3	Preferred Brand	010001	
H4514	007	0	1	01	01	H4514_007_0	4	2	Non-Preferred Generic	000100	
H4514	007	0	1	01	01	H4514_007_0	4	1	Preferred Generic	001000	
H4514	007	0	1	01	01	H4514_007_0	4	4	Non-Preferred Brand	100100	
H4520	006	0	1	04	01	H4520_006_0	5	4	Non-Preferred Brand	110000	
H4520	006	0	1	04	01	H4520_006_0	5	3	Preferred Brand	000101	
H4520	006	0	1	04	01	H4520_006_0	5	2	Non-Preferred Generic	000101	
H4520	006	0	1	04	01	H4520_006_0	5	1	Preferred Generic	001010	
H4520	006	0	1	04	01	H4520_006_0	5	5	Specialty Tier	010010	2
H4520	006	0	1	04	01	H4520_006_0	5	1	Preferred Generic	001010	2
H4520	006	0	1	04	01	H4520_006_0	5	2	Non-Preferred Generic	000101	2
H4520	006	0	1	04	01	H4520_006_0	5	3	Preferred Brand	000101	2
H4520	006	0	1	04	01	H4520_006_0	5	4	Non-Preferred Brand	110000	2
H4520	006	0	1	04	01	H4520_006_0	5	5	Specialty Tier	010010	
H4520	022	0	1	04	01	H4520_022_0	4	1	Preferred Generic	001010	
H4520	022	0	1	04	01	H4520_022_0	4	5	Specialty Tier	010010	
H4520	022	0	1	04	01	H4520_022_0	4	4	Non-Preferred Brand	110000	
H4520	022	0	1	04	01	H4520_022_0	4	3	Preferred Brand	000101	
H4520	022	0	1	04	01	H4520_022_0	4	2	Non-Preferred Generic	000101	
H4522	001	0	1	04	01	H4522_001_0	5	1	Preferred Generic	001000	
H4522	001	0	1	04	01	H4522_001_0	5	5	Specialty Tier	010010	
H4522	001	0	1	04	01	H4522_001_0	5	4	Non-Preferred Brand	100100	
H4522	001	0	1	04	01	H4522_001_0	5	3	Preferred Brand	010001	
H4522	001	0	1	04	01	H4522_001_0	5	2	Non-Preferred Generic	000100	
H4522	001	0	1	04	01	H4522_001_0	5	1	Preferred Generic	001000	1
H4523	001	0	1	01	01	H4523_001_0	5	4	Specialty Tier	010010	
H4523	001	0	1	01	01	H4523_001_0	5	3	Non-Preferred Brand	110000	
H4523	001	0	1	01	01	H4523_001_0	5	2	Preferred Brand	010001	
H4523	001	0	1	01	01	H4523_001_0	5	1	Generic	010000	
H4523	001	0	1	01	01	H4523_001_0	5	5	Select Care Drugs	010000	
H4523	001	0	1	01	01	H4523_001_0	5	5	Select Care Drugs	010000	1
H4523	005	0	1	01	01	H4523_005_0	5	5	Select Care Drugs	010000	
H4523	005	0	1	01	01	H4523_005_0	5	4	Specialty Tier	010010	
H4523	005	0	1	01	01	H4523_005_0	5	3	Non-Preferred Brand	110000	
H4523	005	0	1	01	01	H4523_005_0	5	2	Preferred Brand	010001	
H4523	005	0	1	01	01	H4523_005_0	5	1	Generic	010000	
H4523	005	0	1	01	01	H4523_005_0	5	5	Select Care Drugs	010000	1
H4523	015	0	1	01	01	H4523_015_0	5	5	Select Care Drugs	010000	
H4523	015	0	1	01	01	H4523_015_0	5	4	Specialty Tier	010010	
H4523	015	0	1	01	01	H4523_015_0	5	3	Non-Preferred Brand	110000	
H4523	015	0	1	01	01	H4523_015_0	5	2	Preferred Brand	010001	
H4523	015	0	1	01	01	H4523_015_0	5	1	Generic	010000	
H4523	015	0	1	01	01	H4523_015_0	5	5	Select Care Drugs	010000	1
H4523	016	0	1	01	01	H4523_016_0	5	1	Generic	010000	
H4523	016	0	1	01	01	H4523_016_0	5	2	Preferred Brand	010001	
H4523	016	0	1	01	01	H4523_016_0	5	3	Non-Preferred Brand	110000	
H4523	016	0	1	01	01	H4523_016_0	5	4	Specialty Tier	010010	
H4523	016	0	1	01	01	H4523_016_0	5	5	Select Care Drugs	010000	
H4523	016	0	1	01	01	H4523_016_0	5	5	Select Care Drugs	010000	1
H4523	017	0	1	01	01	H4523_017_0	5	1	Generic	010000	
H4523	017	0	1	01	01	H4523_017_0	5	2	Preferred Brand	010001	
H4523	017	0	1	01	01	H4523_017_0	5	3	Non-Preferred Brand	110000	
H4523	017	0	1	01	01	H4523_017_0	5	4	Specialty Tier	010010	
H4523	017	0	1	01	01	H4523_017_0	5	5	Select Care Drugs	010000	
H4523	017	0	1	01	01	H4523_017_0	5	5	Select Care Drugs	010000	1
H4523	018	0	1	01	01	H4523_018_0	5	2	Preferred Brand	010001	
H4523	018	0	1	01	01	H4523_018_0	5	3	Non-Preferred Brand	110000	
H4523	018	0	1	01	01	H4523_018_0	5	4	Specialty Tier	010010	
H4523	018	0	1	01	01	H4523_018_0	5	5	Select Care Drugs	010000	
H4523	018	0	1	01	01	H4523_018_0	5	5	Select Care Drugs	010000	1
H4523	018	0	1	01	01	H4523_018_0	5	1	Generic	010000	
H4523	019	0	1	01	01	H4523_019_0	5	2	Preferred Brand	010001	
H4523	019	0	1	01	01	H4523_019_0	5	3	Non-Preferred Brand	110000	
H4523	019	0	1	01	01	H4523_019_0	5	4	Specialty Tier	010010	
H4523	019	0	1	01	01	H4523_019_0	5	5	Select Care Drugs	010000	
H4523	019	0	1	01	01	H4523_019_0	5	5	Select Care Drugs	010000	1
H4523	019	0	1	01	01	H4523_019_0	5	1	Generic	010000	
H4524	001	0	1	04	01	H4524_001_0	5	5	Select Care Drugs	010000	1
H4524	001	0	1	04	01	H4524_001_0	5	5	Select Care Drugs	010000	
H4524	001	0	1	04	01	H4524_001_0	5	4	Specialty Tier	010010	
H4524	001	0	1	04	01	H4524_001_0	5	3	Non-Preferred Brand	110000	
H4524	001	0	1	04	01	H4524_001_0	5	1	Generic	010000	
H4524	001	0	1	04	01	H4524_001_0	5	2	Preferred Brand	010001	
H4524	007	0	1	04	01	H4524_007_0	5	1	Generic	010000	
H4524	007	0	1	04	01	H4524_007_0	5	2	Preferred Brand	010001	
H4524	007	0	1	04	01	H4524_007_0	5	3	Non-Preferred Brand	110000	
H4524	007	0	1	04	01	H4524_007_0	5	4	Specialty Tier	010010	
H4524	007	0	1	04	01	H4524_007_0	5	5	Select Care Drugs	010000	1
H4524	007	0	1	04	01	H4524_007_0	5	5	Select Care Drugs	010000	
H4524	013	0	1	04	01	H4524_013_0	5	5	Select Care Drugs	010000	1
H4524	013	0	1	04	01	H4524_013_0	5	4	Specialty Tier	010010	
H4524	013	0	1	04	01	H4524_013_0	5	3	Non-Preferred Brand	110000	
H4524	013	0	1	04	01	H4524_013_0	5	2	Preferred Brand	010001	
H4524	013	0	1	04	01	H4524_013_0	5	1	Generic	010000	
H4524	013	0	1	04	01	H4524_013_0	5	5	Select Care Drugs	010000	
H4525	001	0	1	01	01	H4525_001_0	7	2	Non-Preferred Generic	000100	
H4525	001	0	1	01	01	H4525_001_0	7	3	Preferred Brand	000001	
H4525	001	0	1	01	01	H4525_001_0	7	4	Specialty Tier	100000	
H4525	001	0	1	01	01	H4525_001_0	7	1	Preferred Generic	001000	
H4525	002	0	1	01	01	H4525_002_0	7	1	Preferred Generic	001000	
H4525	002	0	1	01	01	H4525_002_0	7	2	Non-Preferred Generic	000100	
H4525	002	0	1	01	01	H4525_002_0	7	3	Preferred Brand	000001	
H4525	002	0	1	01	01	H4525_002_0	7	4	Specialty Tier	100000	
H4525	010	0	1	01	01	H4525_010_0	7	1	Preferred Generic	001000	
H4525	010	0	1	01	01	H4525_010_0	7	2	Non-Preferred Generic	000100	
H4525	010	0	1	01	01	H4525_010_0	7	3	Preferred Brand	000001	
H4525	010	0	1	01	01	H4525_010_0	7	4	Specialty Tier	100000	
H4527	001	0	1	01	01	H4527_001_0	5	1	Preferred Generic	001000	1
H4527	001	0	1	01	01	H4527_001_0	5	2	Non-Preferred Generic	000100	1
H4527	001	0	1	01	01	H4527_001_0	5	1	Preferred Generic	001000	
H4527	001	0	1	01	01	H4527_001_0	5	5	Specialty Tier	010010	
H4527	001	0	1	01	01	H4527_001_0	5	4	Non-Preferred Brand	100100	
H4527	001	0	1	01	01	H4527_001_0	5	3	Preferred Brand	010001	
H4527	001	0	1	01	01	H4527_001_0	5	2	Non-Preferred Generic	000100	
H4527	002	0	1	01	01	H4527_002_0	6	1	Preferred Generic	001000	
H4527	002	0	1	01	01	H4527_002_0	6	2	Non-Preferred Generic	000100	
H4527	002	0	1	01	01	H4527_002_0	6	3	Preferred Brand	010001	
H4527	002	0	1	01	01	H4527_002_0	6	2	Non-Preferred Generic	000100	1
H4527	002	0	1	01	01	H4527_002_0	6	1	Preferred Generic	001000	1
H4527	002	0	1	01	01	H4527_002_0	6	5	Specialty Tier	010010	
H4527	002	0	1	01	01	H4527_002_0	6	4	Non-Preferred Brand	100100	
H4527	005	0	1	01	01	H4527_005_0	6	5	Specialty Tier	010010	
H4527	005	0	1	01	01	H4527_005_0	6	1	Preferred Generic	001000	1
H4527	005	0	1	01	01	H4527_005_0	6	4	Non-Preferred Brand	100100	
H4527	005	0	1	01	01	H4527_005_0	6	2	Non-Preferred Generic	000100	1
H4527	005	0	1	01	01	H4527_005_0	6	3	Preferred Brand	010001	
H4527	005	0	1	01	01	H4527_005_0	6	2	Non-Preferred Generic	000100	
H4527	005	0	1	01	01	H4527_005_0	6	1	Preferred Generic	001000	
H4527	013	0	1	01	01	H4527_013_0	5	3	Preferred Brand	010001	
H4527	013	0	1	01	01	H4527_013_0	5	2	Non-Preferred Generic	000100	
H4527	013	0	1	01	01	H4527_013_0	5	1	Preferred Generic	001000	
H4527	013	0	1	01	01	H4527_013_0	5	4	Non-Preferred Brand	100100	
H4527	013	0	1	01	01	H4527_013_0	5	5	Specialty Tier	010010	
H4527	013	0	1	01	01	H4527_013_0	5	1	Preferred Generic	001000	1
H4527	013	0	1	01	01	H4527_013_0	5	2	Non-Preferred Generic	000100	1
H4528	001	0	1	01	01	H4528_001_0	4	2	Non-Preferred Generic	000100	
H4528	001	0	1	01	01	H4528_001_0	4	1	Preferred Generic	001000	
H4528	001	0	1	01	01	H4528_001_0	4	3	Preferred Brand	000001	
H4528	001	0	1	01	01	H4528_001_0	4	4	Non-Preferred Brand	100100	
H4528	001	0	1	01	01	H4528_001_0	4	5	Specialty Tier	010010	
H4528	014	0	1	01	01	H4528_014_0	4	1	Preferred Generic	001000	
H4528	014	0	1	01	01	H4528_014_0	4	2	Non-Preferred Generic	000100	
H4528	014	0	1	01	01	H4528_014_0	4	3	Preferred Brand	000001	
H4528	014	0	1	01	01	H4528_014_0	4	4	Non-Preferred Brand	100100	
H4528	014	0	1	01	01	H4528_014_0	4	5	Specialty Tier	010010	
H4528	014	0	1	01	01	H4528_014_0	4	6	Select Diabetic Drugs	010010	
H4564	001	0	1	18	06	H4564_001_0	8	2	Non-Preferred Generic	000100	
H4564	001	0	1	18	06	H4564_001_0	8	1	Preferred Generic	001000	
H4564	001	0	1	18	06	H4564_001_0	8	3	Preferred Brand	000001	
H4564	001	0	1	18	06	H4564_001_0	8	4	Non-Preferred Brand	100100	
H4564	001	0	1	18	06	H4564_001_0	8	5	Specialty Tier	010010	
H4564	002	0	1	18	06	H4564_002_0	4	1	Preferred Generic	001000	
H4564	002	0	1	18	06	H4564_002_0	4	2	Non-Preferred Generic	000100	
H4564	002	0	1	18	06	H4564_002_0	4	3	Preferred Brand	000001	
H4564	002	0	1	18	06	H4564_002_0	4	4	Non-Preferred Brand	100100	
H4564	002	0	1	18	06	H4564_002_0	4	5	Specialty Tier	010010	
H4564	003	0	1	18	06	H4564_003_0	4	1	Preferred Generic	001000	
H4564	003	0	1	18	06	H4564_003_0	4	5	Specialty Tier	010010	
H4564	003	0	1	18	06	H4564_003_0	4	4	Non-Preferred Brand	100100	
H4564	003	0	1	18	06	H4564_003_0	4	3	Preferred Brand	000001	
H4564	003	0	1	18	06	H4564_003_0	4	2	Non-Preferred Generic	000100	
H4564	004	0	1	18	06	H4564_004_0	6	1	Preferred Generic	001000	
H4564	004	0	1	18	06	H4564_004_0	6	5	Specialty Tier	010010	
H4564	004	0	1	18	06	H4564_004_0	6	4	Non-Preferred Brand	100100	
H4564	004	0	1	18	06	H4564_004_0	6	3	Preferred Brand	000001	
H4564	004	0	1	18	06	H4564_004_0	6	2	Non-Preferred Generic	000100	
H4564	004	0	1	18	06	H4564_004_0	6	1	Preferred Generic	001000	1
H4564	005	0	1	18	06	H4564_005_0	5	2	Non-Preferred Generic	000100	
H4564	005	0	1	18	06	H4564_005_0	5	1	Preferred Generic	001000	
H4564	005	0	1	18	06	H4564_005_0	5	3	Preferred Brand	000001	
H4564	005	0	1	18	06	H4564_005_0	5	1	Preferred Generic	001000	1
H4564	005	0	1	18	06	H4564_005_0	5	5	Specialty Tier	010010	
H4564	005	0	1	18	06	H4564_005_0	5	4	Non-Preferred Brand	100100	
H4564	006	0	1	18	06	H4564_006_0	5	4	Non-Preferred Brand	100100	
H4564	006	0	1	18	06	H4564_006_0	5	3	Preferred Brand	000001	
H4564	006	0	1	18	06	H4564_006_0	5	2	Non-Preferred Generic	000100	
H4564	006	0	1	18	06	H4564_006_0	5	1	Preferred Generic	001000	
H4564	006	0	1	18	06	H4564_006_0	5	5	Specialty Tier	010010	
H4564	006	0	1	18	06	H4564_006_0	5	1	Preferred Generic	001000	1
H4564	013	0	1	18	06	H4564_013_0	4	4	Non-Preferred Brand	100100	
H4564	013	0	1	18	06	H4564_013_0	4	3	Preferred Brand	000001	
H4564	013	0	1	18	06	H4564_013_0	4	2	Non-Preferred Generic	000100	
H4564	013	0	1	18	06	H4564_013_0	4	1	Preferred Generic	001000	
H4564	013	0	1	18	06	H4564_013_0	4	5	Specialty Tier	010010	
H4564	014	0	1	18	06	H4564_014_0	4	1	Preferred Generic	001000	
H4564	014	0	1	18	06	H4564_014_0	4	2	Non-Preferred Generic	000100	
H4564	014	0	1	18	06	H4564_014_0	4	3	Preferred Brand	000001	
H4564	014	0	1	18	06	H4564_014_0	4	4	Non-Preferred Brand	100100	
H4564	014	0	1	18	06	H4564_014_0	4	5	Specialty Tier	010010	
H4564	015	0	1	18	06	H4564_015_0	4	1	Preferred Generic	001000	
H4564	015	0	1	18	06	H4564_015_0	4	4	Non-Preferred Brand	100100	
H4564	015	0	1	18	06	H4564_015_0	4	3	Preferred Brand	000001	
H4564	015	0	1	18	06	H4564_015_0	4	2	Non-Preferred Generic	000100	
H4564	015	0	1	18	06	H4564_015_0	4	5	Specialty Tier	010010	
H4564	017	0	1	18	06	H4564_017_0	4	2	Non-Preferred Generic	000100	
H4564	017	0	1	18	06	H4564_017_0	4	3	Preferred Brand	000001	
H4564	017	0	1	18	06	H4564_017_0	4	4	Non-Preferred Brand	100100	
H4564	017	0	1	18	06	H4564_017_0	4	5	Specialty Tier	010010	
H4564	017	0	1	18	06	H4564_017_0	4	1	Preferred Generic	001000	
H4564	018	0	1	18	06	H4564_018_0	5	2	Non-Preferred Generic	000100	
H4564	018	0	1	18	06	H4564_018_0	5	1	Preferred Generic	001000	
H4564	018	0	1	18	06	H4564_018_0	5	3	Preferred Brand	000001	
H4564	018	0	1	18	06	H4564_018_0	5	4	Non-Preferred Brand	100100	
H4564	018	0	1	18	06	H4564_018_0	5	5	Specialty Tier	010010	
H4564	018	0	1	18	06	H4564_018_0	5	1	Preferred Generic	001000	1
H4564	019	0	1	18	06	H4564_019_0	4	1	Preferred Generic	001000	
H4564	019	0	1	18	06	H4564_019_0	4	2	Non-Preferred Generic	000100	
H4564	019	0	1	18	06	H4564_019_0	4	3	Preferred Brand	000001	
H4564	019	0	1	18	06	H4564_019_0	4	4	Non-Preferred Brand	100100	
H4564	019	0	1	18	06	H4564_019_0	4	5	Specialty Tier	010010	
H4564	021	0	1	18	06	H4564_021_0	4	2	Non-Preferred Generic	000100	
H4564	021	0	1	18	06	H4564_021_0	4	1	Preferred Generic	001000	
H4564	021	0	1	18	06	H4564_021_0	4	3	Preferred Brand	000001	
H4564	021	0	1	18	06	H4564_021_0	4	5	Specialty Tier	010010	
H4564	021	0	1	18	06	H4564_021_0	4	4	Non-Preferred Brand	100100	
H4564	022	0	1	18	06	H4564_022_0	5	1	Preferred Generic	001000	
H4564	022	0	1	18	06	H4564_022_0	5	2	Non-Preferred Generic	000100	
H4564	022	0	1	18	06	H4564_022_0	5	3	Preferred Brand	000001	
H4564	022	0	1	18	06	H4564_022_0	5	4	Non-Preferred Brand	100100	
H4564	022	0	1	18	06	H4564_022_0	5	5	Specialty Tier	010010	
H4564	022	0	1	18	06	H4564_022_0	5	1	Preferred Generic	001000	1
H4564	023	0	1	18	06	H4564_023_0	4	1	Preferred Generic	001000	
H4564	023	0	1	18	06	H4564_023_0	4	2	Non-Preferred Generic	000100	
H4564	023	0	1	18	06	H4564_023_0	4	4	Non-Preferred Brand	100100	
H4564	023	0	1	18	06	H4564_023_0	4	3	Preferred Brand	000001	
H4564	023	0	1	18	06	H4564_023_0	4	5	Specialty Tier	010010	
H4590	010	0	1	01	01	H4590_010_0	4	5	Specialty Tier	010010	
H4590	010	0	1	01	01	H4590_010_0	4	4	Non-Preferred Brand	100100	
H4590	010	0	1	01	01	H4590_010_0	4	3	Preferred Brand	010001	
H4590	010	0	1	01	01	H4590_010_0	4	2	Non-Preferred Generic	000100	
H4590	010	0	1	01	01	H4590_010_0	4	1	Preferred Generic	001000	
H4590	010	0	1	01	01	H4590_010_0	4	1	Preferred Generic	001000	1
H4590	010	0	1	01	01	H4590_010_0	4	2	Non-Preferred Generic	000100	1
H4590	012	0	1	01	01	H4590_012_0	4	5	Specialty Tier	010010	
H4590	012	0	1	01	01	H4590_012_0	4	4	Non-Preferred Brand	100100	
H4590	012	0	1	01	01	H4590_012_0	4	3	Preferred Brand	010001	
H4590	012	0	1	01	01	H4590_012_0	4	2	Non-Preferred Generic	000100	
H4590	012	0	1	01	01	H4590_012_0	4	1	Preferred Generic	001000	
H4590	012	0	1	01	01	H4590_012_0	4	1	Preferred Generic	001000	1
H4590	012	0	1	01	01	H4590_012_0	4	2	Non-Preferred Generic	000100	1
H4590	025	0	1	01	01	H4590_025_0	4	1	Preferred Generic	001000	
H4590	025	0	1	01	01	H4590_025_0	4	5	Specialty Tier	010010	
H4590	025	0	1	01	01	H4590_025_0	4	4	Non-Preferred Brand	100100	
H4590	025	0	1	01	01	H4590_025_0	4	3	Preferred Brand	010001	
H4590	025	0	1	01	01	H4590_025_0	4	2	Non-Preferred Generic	000100	
H4590	037	0	1	01	01	H4590_037_0	4	1	Preferred Generic	001000	1
H4590	037	0	1	01	01	H4590_037_0	4	5	Specialty Tier	010010	
H4590	037	0	1	01	01	H4590_037_0	4	4	Non-Preferred Brand	100100	
H4590	037	0	1	01	01	H4590_037_0	4	3	Preferred Brand	010001	
H4590	037	0	1	01	01	H4590_037_0	4	2	Non-Preferred Generic	000100	
H4590	037	0	1	01	01	H4590_037_0	4	2	Non-Preferred Generic	000100	1
H4590	037	0	1	01	01	H4590_037_0	4	1	Preferred Generic	001000	
H4604	003	0	1	01	01	H4604_003_0	5	1	Preferred Generic	001000	
H4604	003	0	1	01	01	H4604_003_0	5	2	Non-Preferred Generic	000100	
H4604	003	0	1	01	01	H4604_003_0	5	3	Preferred Brand	010001	
H4604	003	0	1	01	01	H4604_003_0	5	4	Non-Preferred Brand	100100	
H4604	003	0	1	01	01	H4604_003_0	5	5	Specialty Tier	010010	
H4605	002	0	1	04	01	H4605_002_0	15	5	Specialty Tier	010010	
H4605	002	0	1	04	01	H4605_002_0	15	4	Non-Preferred Brand	100000	
H4605	002	0	1	04	01	H4605_002_0	15	3	Preferred Brand	000001	
H4605	002	0	1	04	01	H4605_002_0	15	1	Preferred Generic	001000	
H4605	002	0	1	04	01	H4605_002_0	15	2	Non-Preferred Generic	000100	
H4605	004	0	1	04	01	H4605_004_0	10	3	Preferred Brand	000001	
H4605	004	0	1	04	01	H4605_004_0	10	5	Specialty Tier	010010	
H4605	004	0	1	04	01	H4605_004_0	10	4	Non-Preferred Brand	100000	
H4605	004	0	1	04	01	H4605_004_0	10	1	Preferred Generic	001000	1
H4605	004	0	1	04	01	H4605_004_0	10	1	Preferred Generic	001000	
H4605	004	0	1	04	01	H4605_004_0	10	2	Non-Preferred Generic	000100	
H4606	001	0	1	04	01	H4606_001_0	6	2	Non-Preferred Generic	000101	2
H4606	001	0	1	04	01	H4606_001_0	6	3	Preferred Brand	000101	2
H4606	001	0	1	04	01	H4606_001_0	6	4	Non-Preferred Brand	110000	2
H4606	001	0	1	04	01	H4606_001_0	6	1	Preferred Generic	001010	2
H4606	001	0	1	04	01	H4606_001_0	6	5	Specialty Tier	010010	
H4606	001	0	1	04	01	H4606_001_0	6	4	Non-Preferred Brand	110000	
H4606	001	0	1	04	01	H4606_001_0	6	3	Preferred Brand	000101	
H4606	001	0	1	04	01	H4606_001_0	6	1	Preferred Generic	001010	
H4606	001	0	1	04	01	H4606_001_0	6	5	Specialty Tier	010010	2
H4606	001	0	1	04	01	H4606_001_0	6	2	Non-Preferred Generic	000101	
H4738	002	0	1	04	01	H4738_002_0	5	1	Preferred Generic	001010	
H4738	002	0	1	04	01	H4738_002_0	5	2	Preferred Brand	000101	
H4738	002	0	1	04	01	H4738_002_0	5	3	Non-Preferred Brand	100100	
H4738	002	0	1	04	01	H4738_002_0	5	4	Specialty Tier	100100	
H4754	001	0	1	04	01	H4754_001_0	8	2	Non-Preferred Generic	000100	
H4754	001	0	1	04	01	H4754_001_0	8	1	Preferred Generic	001000	
H4754	001	0	1	04	01	H4754_001_0	8	3	Preferred Brand	000001	
H4754	001	0	1	04	01	H4754_001_0	8	4	Non-Preferred Brand	100000	
H4754	001	0	1	04	01	H4754_001_0	8	5	Specialty Tier	110001	
H4754	001	0	1	04	01	H4754_001_0	8	1	Preferred Generic	001000	1
H4754	002	0	1	04	01	H4754_002_0	8	1	Preferred Generic	001000	
H4754	002	0	1	04	01	H4754_002_0	8	2	Non-Preferred Generic	000100	
H4754	002	0	1	04	01	H4754_002_0	8	3	Preferred Brand	000001	
H4754	002	0	1	04	01	H4754_002_0	8	4	Non-Preferred Brand	100000	
H4754	002	0	1	04	01	H4754_002_0	8	5	Specialty Tier	110001	
H4754	002	0	1	04	01	H4754_002_0	8	1	Preferred Generic	001000	1
H4754	004	0	1	04	01	H4754_004_0	9	1	Preferred Generic	001000	1
H4754	004	0	1	04	01	H4754_004_0	9	5	Specialty Tier	110001	
H4754	004	0	1	04	01	H4754_004_0	9	4	Non-Preferred Brand	100000	
H4754	004	0	1	04	01	H4754_004_0	9	3	Preferred Brand	000001	
H4754	004	0	1	04	01	H4754_004_0	9	2	Non-Preferred Generic	000100	
H4754	004	0	1	04	01	H4754_004_0	9	1	Preferred Generic	001000	
H4754	007	0	1	04	01	H4754_007_0	7	2	Non-Preferred Generic	000100	
H4754	007	0	1	04	01	H4754_007_0	7	3	Preferred Brand	000001	
H4754	007	0	1	04	01	H4754_007_0	7	4	Non-Preferred Brand	100000	
H4754	007	0	1	04	01	H4754_007_0	7	5	Specialty Tier	110001	
H4754	007	0	1	04	01	H4754_007_0	7	1	Preferred Generic	001000	1
H4754	007	0	1	04	01	H4754_007_0	7	1	Preferred Generic	001000	
H4754	009	0	1	04	01	H4754_009_0	7	1	Preferred Generic	001000	
H4754	009	0	1	04	01	H4754_009_0	7	2	Non-Preferred Generic	000100	
H4754	009	0	1	04	01	H4754_009_0	7	3	Preferred Brand	000001	
H4754	009	0	1	04	01	H4754_009_0	7	4	Non-Preferred Brand	100000	
H4754	009	0	1	04	01	H4754_009_0	7	1	Preferred Generic	001000	1
H4754	009	0	1	04	01	H4754_009_0	7	5	Specialty Tier	110001	
H4754	011	0	1	04	01	H4754_011_0	8	1	Preferred Generic	001000	
H4754	011	0	1	04	01	H4754_011_0	8	1	Preferred Generic	001000	1
H4754	011	0	1	04	01	H4754_011_0	8	5	Specialty Tier	110001	
H4754	011	0	1	04	01	H4754_011_0	8	4	Non-Preferred Brand	100000	
H4754	011	0	1	04	01	H4754_011_0	8	3	Preferred Brand	000001	
H4754	011	0	1	04	01	H4754_011_0	8	2	Non-Preferred Generic	000100	
H4866	003	0	1	01	01	H4866_003_0	9	3	Preferred Brand	000001	
H4866	003	0	1	01	01	H4866_003_0	9	2	Non-Preferred Generic	000100	
H4866	003	0	1	01	01	H4866_003_0	9	1	Preferred Generic	001000	
H4866	003	0	1	01	01	H4866_003_0	9	5	Specialty Tier	010010	
H4866	003	0	1	01	01	H4866_003_0	9	4	Non-Preferred Brand	100000	
H4871	001	0	1	04	01	H4871_001_0	5	1	Preferred Generic	001000	
H4871	001	0	1	04	01	H4871_001_0	5	4	Non-Preferred Brand	100100	
H4871	001	0	1	04	01	H4871_001_0	5	3	Preferred Brand	000001	
H4871	001	0	1	04	01	H4871_001_0	5	2	Non-Preferred Generic	000100	
H4871	001	0	1	04	01	H4871_001_0	5	5	Specialty Tier	010010	
H4875	016	1	1	04	01	H4875_016_1	9	1	Generic	010010	
H4875	016	1	1	04	01	H4875_016_1	9	4	Specialty Tier	010010	
H4875	016	1	1	04	01	H4875_016_1	9	3	Non-Preferred Brand	110000	
H4875	016	1	1	04	01	H4875_016_1	9	2	Preferred Brand	000001	
H4875	016	2	1	04	01	H4875_016_2	8	4	Specialty Tier	010010	
H4875	016	2	1	04	01	H4875_016_2	8	2	Preferred Brand	000001	
H4875	016	2	1	04	01	H4875_016_2	8	1	Generic	010010	
H4875	016	2	1	04	01	H4875_016_2	8	3	Non-Preferred Brand	110000	
H4875	016	3	1	04	01	H4875_016_3	9	1	Generic	010010	
H4875	016	3	1	04	01	H4875_016_3	9	2	Preferred Brand	000001	
H4875	016	3	1	04	01	H4875_016_3	9	4	Specialty Tier	010010	
H4875	016	3	1	04	01	H4875_016_3	9	3	Non-Preferred Brand	110000	
H4875	016	4	1	04	01	H4875_016_4	8	4	Specialty Tier	010010	
H4875	016	4	1	04	01	H4875_016_4	8	3	Non-Preferred Brand	110000	
H4875	016	4	1	04	01	H4875_016_4	8	1	Generic	010010	
H4875	016	4	1	04	01	H4875_016_4	8	2	Preferred Brand	000001	
H4875	016	5	1	04	01	H4875_016_5	8	3	Non-Preferred Brand	110000	
H4875	016	5	1	04	01	H4875_016_5	8	4	Specialty Tier	010010	
H4875	016	5	1	04	01	H4875_016_5	8	2	Preferred Brand	000001	
H4875	016	5	1	04	01	H4875_016_5	8	1	Generic	010010	
H4875	017	1	1	04	01	H4875_017_1	8	1	Generic	010010	
H4875	017	1	1	04	01	H4875_017_1	8	3	Non-Preferred Brand	110000	
H4875	017	1	1	04	01	H4875_017_1	8	4	Specialty Tier	010010	
H4875	017	1	1	04	01	H4875_017_1	8	2	Preferred Brand	000001	
H4875	017	2	1	04	01	H4875_017_2	8	1	Generic	010010	
H4875	017	2	1	04	01	H4875_017_2	8	2	Preferred Brand	000001	
H4875	017	2	1	04	01	H4875_017_2	8	3	Non-Preferred Brand	110000	
H4875	017	2	1	04	01	H4875_017_2	8	4	Specialty Tier	010010	
H4875	017	3	1	04	01	H4875_017_3	8	4	Specialty Tier	010010	
H4875	017	3	1	04	01	H4875_017_3	8	3	Non-Preferred Brand	110000	
H4875	017	3	1	04	01	H4875_017_3	8	1	Generic	010010	
H4875	017	3	1	04	01	H4875_017_3	8	2	Preferred Brand	000001	
H4875	017	4	1	04	01	H4875_017_4	9	1	Generic	010010	
H4875	017	4	1	04	01	H4875_017_4	9	2	Preferred Brand	000001	
H4875	017	4	1	04	01	H4875_017_4	9	3	Non-Preferred Brand	110000	
H4875	017	4	1	04	01	H4875_017_4	9	4	Specialty Tier	010010	
H4875	017	5	1	04	01	H4875_017_5	9	2	Preferred Brand	000001	
H4875	017	5	1	04	01	H4875_017_5	9	1	Generic	010010	
H4875	017	5	1	04	01	H4875_017_5	9	4	Specialty Tier	010010	
H4875	017	5	1	04	01	H4875_017_5	9	3	Non-Preferred Brand	110000	
H4876	001	0	1	04	01	H4876_001_0	7	3	Non-Preferred Brand	100000	
H4876	001	0	1	04	01	H4876_001_0	7	1	Generic	010000	1
H4876	001	0	1	04	01	H4876_001_0	7	1	Generic	010000	
H4876	001	0	1	04	01	H4876_001_0	7	2	Preferred Brand	000001	
H4876	001	0	1	04	01	H4876_001_0	7	4	Specialty Tier	100000	
H4909	009	0	1	04	01	H4909_009_0	9	6	Specialty Tier	010010	
H4909	009	0	1	04	01	H4909_009_0	9	5	Injectable Drugs	010010	
H4909	009	0	1	04	01	H4909_009_0	9	4	Non-Preferred Brand	100100	
H4909	009	0	1	04	01	H4909_009_0	9	3	Preferred Brand	000101	
H4909	009	0	1	04	01	H4909_009_0	9	2	Non-Preferred Generic	000100	
H4909	009	0	1	04	01	H4909_009_0	9	1	Preferred Generic	001000	
H4909	010	0	1	04	01	H4909_010_0	8	5	Injectable Drugs	010010	
H4909	010	0	1	04	01	H4909_010_0	8	6	Specialty Tier	010010	
H4909	010	0	1	04	01	H4909_010_0	8	4	Non-Preferred Brand	100100	
H4909	010	0	1	04	01	H4909_010_0	8	3	Preferred Brand	000101	
H4909	010	0	1	04	01	H4909_010_0	8	2	Non-Preferred Generic	000100	
H4909	010	0	1	04	01	H4909_010_0	8	1	Preferred Generic	001000	
H4910	005	0	1	01	01	H4910_005_0	6	3	Non-Preferred Brand	110000	
H4910	005	0	1	01	01	H4910_005_0	6	2	Preferred Brand	010001	
H4910	005	0	1	01	01	H4910_005_0	6	1	Generic	010000	
H4910	005	0	1	01	01	H4910_005_0	6	4	Specialty Tier	010010	
H4910	005	0	1	01	01	H4910_005_0	6	5	Select Care Drugs	010000	
H4910	006	0	1	01	01	H4910_006_0	5	3	Non-Preferred Brand	110000	
H4910	006	0	1	01	01	H4910_006_0	5	4	Specialty Tier	010010	
H4910	006	0	1	01	01	H4910_006_0	5	5	Select Care Drugs	010000	
H4910	006	0	1	01	01	H4910_006_0	5	5	Select Care Drugs	010000	1
H4910	006	0	1	01	01	H4910_006_0	5	2	Preferred Brand	010001	
H4910	006	0	1	01	01	H4910_006_0	5	1	Generic	010000	
H4956	001	0	1	04	01	H4956_001_0	4	3	Preferred Brand	000101	
H4956	001	0	1	04	01	H4956_001_0	4	2	Non-Preferred Generic	000101	
H4956	001	0	1	04	01	H4956_001_0	4	1	Preferred Generic	001010	
H4956	001	0	1	04	01	H4956_001_0	4	4	Non-Preferred Brand	110000	
H4956	001	0	1	04	01	H4956_001_0	4	5	Specialty Tier	010010	2
H4956	001	0	1	04	01	H4956_001_0	4	4	Non-Preferred Brand	110000	2
H4956	001	0	1	04	01	H4956_001_0	4	3	Preferred Brand	000101	2
H4956	001	0	1	04	01	H4956_001_0	4	2	Non-Preferred Generic	000101	2
H4956	001	0	1	04	01	H4956_001_0	4	1	Preferred Generic	001010	2
H4956	001	0	1	04	01	H4956_001_0	4	5	Specialty Tier	010010	
H4956	002	0	1	04	01	H4956_002_0	4	1	Preferred Generic	001010	
H4956	002	0	1	04	01	H4956_002_0	4	2	Non-Preferred Generic	000101	
H4956	002	0	1	04	01	H4956_002_0	4	5	Specialty Tier	010010	2
H4956	002	0	1	04	01	H4956_002_0	4	4	Non-Preferred Brand	110000	2
H4956	002	0	1	04	01	H4956_002_0	4	3	Preferred Brand	000101	2
H4956	002	0	1	04	01	H4956_002_0	4	2	Non-Preferred Generic	000101	2
H4956	002	0	1	04	01	H4956_002_0	4	1	Preferred Generic	001010	2
H4956	002	0	1	04	01	H4956_002_0	4	5	Specialty Tier	010010	
H4956	002	0	1	04	01	H4956_002_0	4	4	Non-Preferred Brand	110000	
H4956	002	0	1	04	01	H4956_002_0	4	3	Preferred Brand	000101	
H4956	003	0	1	04	01	H4956_003_0	4	1	Preferred Generic	001010	
H4956	003	0	1	04	01	H4956_003_0	4	4	Non-Preferred Brand	110000	
H4956	003	0	1	04	01	H4956_003_0	4	5	Specialty Tier	010010	
H4956	003	0	1	04	01	H4956_003_0	4	1	Preferred Generic	001010	2
H4956	003	0	1	04	01	H4956_003_0	4	5	Specialty Tier	010010	2
H4956	003	0	1	04	01	H4956_003_0	4	3	Preferred Brand	000101	2
H4956	003	0	1	04	01	H4956_003_0	4	4	Non-Preferred Brand	110000	2
H4956	003	0	1	04	01	H4956_003_0	4	3	Preferred Brand	000101	
H4956	003	0	1	04	01	H4956_003_0	4	2	Non-Preferred Generic	000101	
H4956	003	0	1	04	01	H4956_003_0	4	2	Non-Preferred Generic	000101	2
H5005	011	0	1	01	01	H5005_011_0	5	1	Preferred Generic	001000	
H5005	011	0	1	01	01	H5005_011_0	5	2	Non-Preferred Generic	000100	
H5005	011	0	1	01	01	H5005_011_0	5	3	Preferred Brand	010001	
H5005	011	0	1	01	01	H5005_011_0	5	4	Non-Preferred Brand	100100	
H5005	011	0	1	01	01	H5005_011_0	5	5	Specialty Tier	010010	
H5005	011	0	1	01	01	H5005_011_0	5	1	Preferred Generic	001000	1
H5005	011	0	1	01	01	H5005_011_0	5	2	Non-Preferred Generic	000100	1
H5005	019	0	1	01	01	H5005_019_0	7	3	Preferred Brand	010001	
H5005	019	0	1	01	01	H5005_019_0	7	4	Non-Preferred Brand	100100	
H5005	019	0	1	01	01	H5005_019_0	7	5	Specialty Tier	010010	
H5005	019	0	1	01	01	H5005_019_0	7	1	Preferred Generic	001000	
H5005	019	0	1	01	01	H5005_019_0	7	2	Non-Preferred Generic	000100	
H5009	002	0	1	04	01	H5009_002_0	12	1	Preferred Generic	001000	
H5009	002	0	1	04	01	H5009_002_0	12	2	Non-Preferred Generic	000100	
H5009	002	0	1	04	01	H5009_002_0	12	3	Preferred Brand	000001	
H5009	002	0	1	04	01	H5009_002_0	12	4	Non-Preferred Brand	100000	
H5009	002	0	1	04	01	H5009_002_0	12	5	Specialty Tier	010010	
H5010	002	0	1	04	01	H5010_002_0	14	5	Specialty Tier	010010	
H5010	002	0	1	04	01	H5010_002_0	14	4	Non-Preferred Brand	100000	
H5010	002	0	1	04	01	H5010_002_0	14	3	Preferred Brand	000001	
H5010	002	0	1	04	01	H5010_002_0	14	2	Non-Preferred Generic	000100	
H5010	002	0	1	04	01	H5010_002_0	14	1	Preferred Generic	001000	
H5010	004	0	1	04	01	H5010_004_0	13	5	Specialty Tier	010010	
H5010	004	0	1	04	01	H5010_004_0	13	4	Non-Preferred Brand	100000	
H5010	004	0	1	04	01	H5010_004_0	13	3	Preferred Brand	000001	
H5010	004	0	1	04	01	H5010_004_0	13	2	Non-Preferred Generic	000100	
H5010	004	0	1	04	01	H5010_004_0	13	1	Preferred Generic	001000	1
H5010	004	0	1	04	01	H5010_004_0	13	1	Preferred Generic	001000	
H5041	001	0	1	04	01	H5041_001_0	4	1	Preferred Generic	001010	
H5041	001	0	1	04	01	H5041_001_0	4	2	Non-Preferred Generic	000101	
H5041	001	0	1	04	01	H5041_001_0	4	3	Preferred Brand	000101	
H5041	001	0	1	04	01	H5041_001_0	4	4	Non-Preferred Brand	110000	
H5041	001	0	1	04	01	H5041_001_0	4	5	Specialty Tier	010010	2
H5041	001	0	1	04	01	H5041_001_0	4	1	Preferred Generic	001010	2
H5041	001	0	1	04	01	H5041_001_0	4	2	Non-Preferred Generic	000101	2
H5041	001	0	1	04	01	H5041_001_0	4	3	Preferred Brand	000101	2
H5041	001	0	1	04	01	H5041_001_0	4	4	Non-Preferred Brand	110000	2
H5041	001	0	1	04	01	H5041_001_0	4	5	Specialty Tier	010010	
H5041	002	0	1	04	01	H5041_002_0	5	5	Specialty Tier	010010	2
H5041	002	0	1	04	01	H5041_002_0	5	1	Preferred Generic	001010	
H5041	002	0	1	04	01	H5041_002_0	5	2	Non-Preferred Generic	000101	
H5041	002	0	1	04	01	H5041_002_0	5	3	Preferred Brand	000101	
H5041	002	0	1	04	01	H5041_002_0	5	4	Non-Preferred Brand	110000	
H5041	002	0	1	04	01	H5041_002_0	5	5	Specialty Tier	010010	
H5041	002	0	1	04	01	H5041_002_0	5	1	Preferred Generic	001010	2
H5041	002	0	1	04	01	H5041_002_0	5	2	Non-Preferred Generic	000101	2
H5041	002	0	1	04	01	H5041_002_0	5	3	Preferred Brand	000101	2
H5041	002	0	1	04	01	H5041_002_0	5	4	Non-Preferred Brand	110000	2
H5041	006	0	1	04	01	H5041_006_0	6	4	Non-Preferred Brand	110000	
H5041	006	0	1	04	01	H5041_006_0	6	3	Preferred Brand	000101	
H5041	006	0	1	04	01	H5041_006_0	6	5	Specialty Tier	010010	2
H5041	006	0	1	04	01	H5041_006_0	6	4	Non-Preferred Brand	110000	2
H5041	006	0	1	04	01	H5041_006_0	6	3	Preferred Brand	000101	2
H5041	006	0	1	04	01	H5041_006_0	6	2	Non-Preferred Generic	000101	2
H5041	006	0	1	04	01	H5041_006_0	6	1	Preferred Generic	001010	2
H5041	006	0	1	04	01	H5041_006_0	6	5	Specialty Tier	010010	
H5041	006	0	1	04	01	H5041_006_0	6	1	Preferred Generic	001010	
H5041	006	0	1	04	01	H5041_006_0	6	2	Non-Preferred Generic	000101	
H5041	007	0	1	04	01	H5041_007_0	6	1	Preferred Generic	001010	
H5041	007	0	1	04	01	H5041_007_0	6	4	Non-Preferred Brand	110000	2
H5041	007	0	1	04	01	H5041_007_0	6	3	Preferred Brand	000101	2
H5041	007	0	1	04	01	H5041_007_0	6	2	Non-Preferred Generic	000101	2
H5041	007	0	1	04	01	H5041_007_0	6	5	Specialty Tier	010010	2
H5041	007	0	1	04	01	H5041_007_0	6	5	Specialty Tier	010010	
H5041	007	0	1	04	01	H5041_007_0	6	4	Non-Preferred Brand	110000	
H5041	007	0	1	04	01	H5041_007_0	6	3	Preferred Brand	000101	
H5041	007	0	1	04	01	H5041_007_0	6	2	Non-Preferred Generic	000101	
H5041	007	0	1	04	01	H5041_007_0	6	1	Preferred Generic	001010	2
H5041	008	0	1	04	01	H5041_008_0	6	4	Non-Preferred Brand	110000	
H5041	008	0	1	04	01	H5041_008_0	6	3	Preferred Brand	000101	
H5041	008	0	1	04	01	H5041_008_0	6	2	Non-Preferred Generic	000101	
H5041	008	0	1	04	01	H5041_008_0	6	1	Preferred Generic	001010	
H5041	008	0	1	04	01	H5041_008_0	6	5	Specialty Tier	010010	
H5041	008	0	1	04	01	H5041_008_0	6	5	Specialty Tier	010010	2
H5041	008	0	1	04	01	H5041_008_0	6	4	Non-Preferred Brand	110000	2
H5041	008	0	1	04	01	H5041_008_0	6	3	Preferred Brand	000101	2
H5041	008	0	1	04	01	H5041_008_0	6	2	Non-Preferred Generic	000101	2
H5041	008	0	1	04	01	H5041_008_0	6	1	Preferred Generic	001010	2
H5041	009	0	1	04	01	H5041_009_0	6	1	Preferred Generic	001010	
H5041	009	0	1	04	01	H5041_009_0	6	2	Non-Preferred Generic	000101	
H5041	009	0	1	04	01	H5041_009_0	6	5	Specialty Tier	010010	2
H5041	009	0	1	04	01	H5041_009_0	6	4	Non-Preferred Brand	110000	2
H5041	009	0	1	04	01	H5041_009_0	6	3	Preferred Brand	000101	2
H5041	009	0	1	04	01	H5041_009_0	6	2	Non-Preferred Generic	000101	2
H5041	009	0	1	04	01	H5041_009_0	6	1	Preferred Generic	001010	2
H5041	009	0	1	04	01	H5041_009_0	6	5	Specialty Tier	010010	
H5041	009	0	1	04	01	H5041_009_0	6	4	Non-Preferred Brand	110000	
H5041	009	0	1	04	01	H5041_009_0	6	3	Preferred Brand	000101	
H5041	012	0	1	04	01	H5041_012_0	7	1	Preferred Generic	001010	
H5041	012	0	1	04	01	H5041_012_0	7	5	Specialty Tier	010010	
H5041	012	0	1	04	01	H5041_012_0	7	1	Preferred Generic	001010	2
H5041	012	0	1	04	01	H5041_012_0	7	2	Non-Preferred Generic	000101	2
H5041	012	0	1	04	01	H5041_012_0	7	5	Specialty Tier	010010	2
H5041	012	0	1	04	01	H5041_012_0	7	4	Non-Preferred Brand	110000	2
H5041	012	0	1	04	01	H5041_012_0	7	4	Non-Preferred Brand	110000	
H5041	012	0	1	04	01	H5041_012_0	7	3	Preferred Brand	000101	
H5041	012	0	1	04	01	H5041_012_0	7	2	Non-Preferred Generic	000101	
H5041	012	0	1	04	01	H5041_012_0	7	3	Preferred Brand	000101	2
H5041	013	0	1	04	01	H5041_013_0	6	1	Preferred Generic	001010	
H5041	013	0	1	04	01	H5041_013_0	6	2	Non-Preferred Generic	000101	
H5041	013	0	1	04	01	H5041_013_0	6	3	Preferred Brand	000101	
H5041	013	0	1	04	01	H5041_013_0	6	4	Non-Preferred Brand	110000	
H5041	013	0	1	04	01	H5041_013_0	6	5	Specialty Tier	010010	
H5041	013	0	1	04	01	H5041_013_0	6	1	Preferred Generic	001010	2
H5041	013	0	1	04	01	H5041_013_0	6	2	Non-Preferred Generic	000101	2
H5041	013	0	1	04	01	H5041_013_0	6	3	Preferred Brand	000101	2
H5041	013	0	1	04	01	H5041_013_0	6	4	Non-Preferred Brand	110000	2
H5041	013	0	1	04	01	H5041_013_0	6	5	Specialty Tier	010010	2
H5041	015	0	1	04	01	H5041_015_0	6	1	Preferred Generic	001010	
H5041	015	0	1	04	01	H5041_015_0	6	2	Non-Preferred Generic	000101	
H5041	015	0	1	04	01	H5041_015_0	6	5	Specialty Tier	010010	2
H5041	015	0	1	04	01	H5041_015_0	6	4	Non-Preferred Brand	110000	2
H5041	015	0	1	04	01	H5041_015_0	6	3	Preferred Brand	000101	2
H5041	015	0	1	04	01	H5041_015_0	6	2	Non-Preferred Generic	000101	2
H5041	015	0	1	04	01	H5041_015_0	6	1	Preferred Generic	001010	2
H5041	015	0	1	04	01	H5041_015_0	6	5	Specialty Tier	010010	
H5041	015	0	1	04	01	H5041_015_0	6	4	Non-Preferred Brand	110000	
H5041	015	0	1	04	01	H5041_015_0	6	3	Preferred Brand	000101	
H5041	016	0	1	04	01	H5041_016_0	6	1	Preferred Generic	001010	
H5041	016	0	1	04	01	H5041_016_0	6	4	Non-Preferred Brand	110000	2
H5041	016	0	1	04	01	H5041_016_0	6	3	Preferred Brand	000101	2
H5041	016	0	1	04	01	H5041_016_0	6	2	Non-Preferred Generic	000101	2
H5041	016	0	1	04	01	H5041_016_0	6	5	Specialty Tier	010010	2
H5041	016	0	1	04	01	H5041_016_0	6	5	Specialty Tier	010010	
H5041	016	0	1	04	01	H5041_016_0	6	4	Non-Preferred Brand	110000	
H5041	016	0	1	04	01	H5041_016_0	6	3	Preferred Brand	000101	
H5041	016	0	1	04	01	H5041_016_0	6	2	Non-Preferred Generic	000101	
H5041	016	0	1	04	01	H5041_016_0	6	1	Preferred Generic	001010	2
H5042	001	0	1	04	01	H5042_001_0	8	5	Specialty Tier	010010	
H5042	001	0	1	04	01	H5042_001_0	8	2	Non-Preferred Generic	000100	1
H5042	001	0	1	04	01	H5042_001_0	8	1	Preferred Generic	001000	1
H5042	001	0	1	04	01	H5042_001_0	8	4	Non-Preferred Brand	110000	
H5042	001	0	1	04	01	H5042_001_0	8	3	Preferred Brand	010001	
H5042	001	0	1	04	01	H5042_001_0	8	2	Non-Preferred Generic	000100	
H5042	001	0	1	04	01	H5042_001_0	8	1	Preferred Generic	001000	
H5042	005	0	1	04	01	H5042_005_0	8	4	Non-Preferred Brand	110000	
H5042	005	0	1	04	01	H5042_005_0	8	5	Specialty Tier	010010	
H5042	005	0	1	04	01	H5042_005_0	8	3	Preferred Brand	010001	
H5042	005	0	1	04	01	H5042_005_0	8	2	Non-Preferred Generic	000100	
H5042	005	0	1	04	01	H5042_005_0	8	1	Preferred Generic	001000	
H5042	007	0	1	04	01	H5042_007_0	6	5	Specialty Tier	010010	
H5042	007	0	1	04	01	H5042_007_0	6	4	Non-Preferred Brand	110000	
H5042	007	0	1	04	01	H5042_007_0	6	3	Preferred Brand	010001	
H5042	007	0	1	04	01	H5042_007_0	6	2	Non-Preferred Generic	000100	
H5042	007	0	1	04	01	H5042_007_0	6	1	Preferred Generic	001000	
H5042	007	0	1	04	01	H5042_007_0	6	1	Preferred Generic	001000	1
H5042	007	0	1	04	01	H5042_007_0	6	2	Non-Preferred Generic	000100	1
H5048	001	0	1	01	01	H5048_001_0	7	1	Preferred Generic	001000	
H5048	001	0	1	01	01	H5048_001_0	7	2	Non-Preferred Generic	000100	1
H5048	001	0	1	01	01	H5048_001_0	7	1	Preferred Generic	001000	1
H5048	001	0	1	01	01	H5048_001_0	7	5	Specialty Tier	010010	
H5048	001	0	1	01	01	H5048_001_0	7	4	Non-Preferred Brand	100100	
H5048	001	0	1	01	01	H5048_001_0	7	3	Preferred Brand	000001	
H5048	001	0	1	01	01	H5048_001_0	7	2	Non-Preferred Generic	000100	
H5048	002	0	1	01	01	H5048_002_0	7	5	Specialty Tier	010010	
H5048	002	0	1	01	01	H5048_002_0	7	1	Preferred Generic	001000	
H5048	002	0	1	01	01	H5048_002_0	7	2	Non-Preferred Generic	000100	
H5048	002	0	1	01	01	H5048_002_0	7	3	Preferred Brand	000001	
H5048	002	0	1	01	01	H5048_002_0	7	4	Non-Preferred Brand	100100	
H5048	002	0	1	01	01	H5048_002_0	7	2	Non-Preferred Generic	000100	1
H5048	002	0	1	01	01	H5048_002_0	7	1	Preferred Generic	001000	1
H5050	004	0	1	01	01	H5050_004_0	7	3	Preferred Brand	000001	
H5050	004	0	1	01	01	H5050_004_0	7	2	Non-Preferred Generic	000100	
H5050	004	0	1	01	01	H5050_004_0	7	4	Non-Preferred Brand	100000	
H5050	004	0	1	01	01	H5050_004_0	7	1	Preferred Generic	001000	
H5050	009	0	1	01	01	H5050_009_0	6	2	Non-Preferred Generic	000100	
H5050	009	0	1	01	01	H5050_009_0	6	1	Preferred Generic	001000	
H5050	009	0	1	01	01	H5050_009_0	6	3	Preferred Brand	000001	
H5050	009	0	1	01	01	H5050_009_0	6	4	Non-Preferred Brand	100000	
H5050	013	0	1	01	01	H5050_013_0	6	3	Preferred Brand	000001	
H5050	013	0	1	01	01	H5050_013_0	6	2	Non-Preferred Generic	000100	
H5050	013	0	1	01	01	H5050_013_0	6	1	Preferred Generic	001000	
H5050	013	0	1	01	01	H5050_013_0	6	4	Non-Preferred Brand	100000	
H5050	014	0	1	01	01	H5050_014_0	7	3	Preferred Brand	000001	
H5050	014	0	1	01	01	H5050_014_0	7	4	Non-Preferred Brand	100000	
H5050	014	0	1	01	01	H5050_014_0	7	1	Preferred Generic	001000	
H5050	014	0	1	01	01	H5050_014_0	7	2	Non-Preferred Generic	000100	
H5087	001	0	1	01	01	H5087_001_0	5	4	Non-Preferred Brand	100000	
H5087	001	0	1	01	01	H5087_001_0	5	3	Preferred Brand	000001	
H5087	001	0	1	01	01	H5087_001_0	5	2	Non-Preferred Generic	000100	
H5087	001	0	1	01	01	H5087_001_0	5	1	Preferred Generic	001010	
H5087	001	0	1	01	01	H5087_001_0	5	5	Specialty Tier	010010	
H5087	001	0	1	01	01	H5087_001_0	5	1	Preferred Generic	001010	2
H5087	002	0	1	01	01	H5087_002_0	5	1	Preferred Generic	001010	
H5087	002	0	1	01	01	H5087_002_0	5	2	Non-Preferred Generic	000100	
H5087	002	0	1	01	01	H5087_002_0	5	3	Preferred Brand	000001	
H5087	002	0	1	01	01	H5087_002_0	5	4	Non-Preferred Brand	100000	
H5087	002	0	1	01	01	H5087_002_0	5	5	Specialty Tier	010010	
H5087	002	0	1	01	01	H5087_002_0	5	1	Preferred Generic	001010	2
H5087	005	0	1	01	01	H5087_005_0	5	1	Preferred Generic	001010	
H5087	005	0	1	01	01	H5087_005_0	5	2	Non-Preferred Generic	000100	1
H5087	005	0	1	01	01	H5087_005_0	5	1	Preferred Generic	001010	1
H5087	005	0	1	01	01	H5087_005_0	5	5	Specialty Tier	010010	
H5087	005	0	1	01	01	H5087_005_0	5	4	Non-Preferred Brand	100000	
H5087	005	0	1	01	01	H5087_005_0	5	3	Preferred Brand	000001	
H5087	005	0	1	01	01	H5087_005_0	5	2	Non-Preferred Generic	000100	
H5087	009	0	1	01	01	H5087_009_0	5	1	Preferred Generic	001010	1
H5087	009	0	1	01	01	H5087_009_0	5	5	Specialty Tier	010010	
H5087	009	0	1	01	01	H5087_009_0	5	4	Non-Preferred Brand	100000	
H5087	009	0	1	01	01	H5087_009_0	5	3	Preferred Brand	000001	
H5087	009	0	1	01	01	H5087_009_0	5	2	Non-Preferred Generic	000100	
H5087	009	0	1	01	01	H5087_009_0	5	1	Preferred Generic	001010	
H5087	009	0	1	01	01	H5087_009_0	5	2	Non-Preferred Generic	000100	1
H5087	010	0	1	01	01	H5087_010_0	5	4	Non-Preferred Brand	100000	
H5087	010	0	1	01	01	H5087_010_0	5	3	Preferred Brand	000001	
H5087	010	0	1	01	01	H5087_010_0	5	2	Non-Preferred Generic	000100	
H5087	010	0	1	01	01	H5087_010_0	5	1	Preferred Generic	001010	
H5087	010	0	1	01	01	H5087_010_0	5	5	Specialty Tier	010010	
H5087	010	0	1	01	01	H5087_010_0	5	2	Non-Preferred Generic	000100	1
H5087	010	0	1	01	01	H5087_010_0	5	1	Preferred Generic	001010	1
H5087	011	0	1	01	01	H5087_011_0	5	1	Preferred Generic	001010	1
H5087	011	0	1	01	01	H5087_011_0	5	5	Specialty Tier	010010	
H5087	011	0	1	01	01	H5087_011_0	5	4	Non-Preferred Brand	100000	
H5087	011	0	1	01	01	H5087_011_0	5	3	Preferred Brand	000001	
H5087	011	0	1	01	01	H5087_011_0	5	2	Non-Preferred Generic	000100	
H5087	011	0	1	01	01	H5087_011_0	5	1	Preferred Generic	001010	
H5087	011	0	1	01	01	H5087_011_0	5	2	Non-Preferred Generic	000100	1
H5087	012	0	1	01	01	H5087_012_0	6	1	Preferred Generic	001010	1
H5087	012	0	1	01	01	H5087_012_0	6	5	Specialty Tier	010010	
H5087	012	0	1	01	01	H5087_012_0	6	4	Non-Preferred Brand	100000	
H5087	012	0	1	01	01	H5087_012_0	6	3	Preferred Brand	000001	
H5087	012	0	1	01	01	H5087_012_0	6	2	Non-Preferred Generic	000100	
H5087	012	0	1	01	01	H5087_012_0	6	1	Preferred Generic	001010	
H5087	012	0	1	01	01	H5087_012_0	6	2	Non-Preferred Generic	000100	1
H5087	014	0	1	01	01	H5087_014_0	6	1	Preferred Generic	001010	
H5087	014	0	1	01	01	H5087_014_0	6	2	Non-Preferred Generic	000100	
H5087	014	0	1	01	01	H5087_014_0	6	3	Preferred Brand	000001	
H5087	014	0	1	01	01	H5087_014_0	6	4	Non-Preferred Brand	100000	
H5087	014	0	1	01	01	H5087_014_0	6	5	Specialty Tier	010010	
H5087	014	0	1	01	01	H5087_014_0	6	1	Preferred Generic	001010	1
H5087	014	0	1	01	01	H5087_014_0	6	2	Non-Preferred Generic	000100	1
H5087	015	0	1	01	01	H5087_015_0	6	1	Preferred Generic	001010	
H5087	015	0	1	01	01	H5087_015_0	6	2	Non-Preferred Generic	000100	
H5087	015	0	1	01	01	H5087_015_0	6	3	Preferred Brand	000001	
H5087	015	0	1	01	01	H5087_015_0	6	4	Non-Preferred Brand	100000	
H5087	015	0	1	01	01	H5087_015_0	6	1	Preferred Generic	001010	1
H5087	015	0	1	01	01	H5087_015_0	6	5	Specialty Tier	010010	
H5087	015	0	1	01	01	H5087_015_0	6	2	Non-Preferred Generic	000100	1
H5106	013	0	1	04	01	H5106_013_0	8	2	Preferred Brand	000001	
H5106	013	0	1	04	01	H5106_013_0	8	1	Generic	010000	
H5106	013	0	1	04	01	H5106_013_0	8	3	Non-Preferred Brand	100000	
H5106	013	0	1	04	01	H5106_013_0	8	4	Specialty Tier	010010	
H5106	014	0	1	04	01	H5106_014_0	8	2	Preferred Brand	000001	
H5106	014	0	1	04	01	H5106_014_0	8	1	Generic	010000	
H5106	014	0	1	04	01	H5106_014_0	8	3	Non-Preferred Brand	100000	
H5106	014	0	1	04	01	H5106_014_0	8	1	Generic	010000	1
H5106	014	0	1	04	01	H5106_014_0	8	4	Specialty Tier	010010	
H5106	015	0	1	04	01	H5106_015_0	8	1	Generic	010000	
H5106	015	0	1	04	01	H5106_015_0	8	3	Non-Preferred Brand	100000	
H5106	015	0	1	04	01	H5106_015_0	8	2	Preferred Brand	000001	
H5106	015	0	1	04	01	H5106_015_0	8	4	Specialty Tier	010010	
H5106	016	0	1	04	01	H5106_016_0	8	1	Generic	010000	
H5106	016	0	1	04	01	H5106_016_0	8	1	Generic	010000	1
H5106	016	0	1	04	01	H5106_016_0	8	4	Specialty Tier	010010	
H5106	016	0	1	04	01	H5106_016_0	8	3	Non-Preferred Brand	100000	
H5106	016	0	1	04	01	H5106_016_0	8	2	Preferred Brand	000001	
H5106	025	0	1	04	01	H5106_025_0	10	1	Preferred Generic	001000	
H5106	025	0	1	04	01	H5106_025_0	10	2	Non-Preferred Generic	000100	
H5106	025	0	1	04	01	H5106_025_0	10	3	Preferred Brand	000001	
H5106	025	0	1	04	01	H5106_025_0	10	4	Non-Preferred Brand	100000	
H5106	025	0	1	04	01	H5106_025_0	10	5	Specialty Tier	010010	
H5106	027	0	1	04	01	H5106_027_0	7	4	Non-Preferred Brand	100000	
H5106	027	0	1	04	01	H5106_027_0	7	3	Preferred Brand	000001	
H5106	027	0	1	04	01	H5106_027_0	7	2	Non-Preferred Generic	000100	
H5106	027	0	1	04	01	H5106_027_0	7	1	Preferred Generic	001000	
H5106	027	0	1	04	01	H5106_027_0	7	5	Specialty Tier	010010	
H5106	028	0	1	04	01	H5106_028_0	7	3	Preferred Brand	000001	
H5106	028	0	1	04	01	H5106_028_0	7	4	Non-Preferred Brand	100000	
H5106	028	0	1	04	01	H5106_028_0	7	5	Specialty Tier	010010	
H5106	028	0	1	04	01	H5106_028_0	7	1	Preferred Generic	001000	
H5106	028	0	1	04	01	H5106_028_0	7	2	Non-Preferred Generic	000100	
H5141	001	0	1	04	01	H5141_001_0	8	1	Preferred Generic	001000	
H5141	001	0	1	04	01	H5141_001_0	8	2	Non-Preferred Generic	000100	
H5141	001	0	1	04	01	H5141_001_0	8	3	Preferred Brand	000001	
H5141	001	0	1	04	01	H5141_001_0	8	4	Non-Preferred Brand	100000	
H5141	001	0	1	04	01	H5141_001_0	8	5	Specialty Tier	010010	
H5151	002	0	1	01	01	H5151_002_0	8	1	Preferred Generic	001000	1
H5151	002	0	1	01	01	H5151_002_0	8	4	Specialty Tier	010010	
H5151	002	0	1	01	01	H5151_002_0	8	3	Preferred Brand	000001	
H5151	002	0	1	01	01	H5151_002_0	8	1	Preferred Generic	001000	
H5151	002	0	1	01	01	H5151_002_0	8	2	Non-Preferred Generic	000100	
H5151	006	0	1	01	01	H5151_006_0	9	2	Non-Preferred Generic	000100	1
H5151	006	0	1	01	01	H5151_006_0	9	4	Specialty Tier	010010	
H5151	006	0	1	01	01	H5151_006_0	9	1	Preferred Generic	001000	1
H5151	006	0	1	01	01	H5151_006_0	9	1	Preferred Generic	001000	
H5151	006	0	1	01	01	H5151_006_0	9	2	Non-Preferred Generic	000100	
H5151	006	0	1	01	01	H5151_006_0	9	3	Preferred Brand	000001	
H5172	002	0	1	48	05	H5172_002_0	4	1	Generic Drugs	010000	
H5172	002	0	1	48	05	H5172_002_0	4	5	Non-Medicare OTC Drugs	010010	
H5172	002	0	1	48	05	H5172_002_0	4	4	Non-Medicare Rx Brand Drugs	000010	
H5172	002	0	1	48	05	H5172_002_0	4	3	Non-Medicare Rx Generic Drugs	010000	
H5172	002	0	1	48	05	H5172_002_0	4	2	Brand Drugs	000010	
H5190	001	0	1	01	01	H5190_001_0	8	1	Generic	010000	
H5190	001	0	1	01	01	H5190_001_0	8	4	Injectable Drugs	000001	
H5190	001	0	1	01	01	H5190_001_0	8	3	Non-Preferred Brand	100000	
H5190	001	0	1	01	01	H5190_001_0	8	2	Preferred Brand	000001	
H5190	002	0	1	01	01	H5190_002_0	8	4	Injectable Drugs	000001	
H5190	002	0	1	01	01	H5190_002_0	8	3	Non-Preferred Brand	100000	
H5190	002	0	1	01	01	H5190_002_0	8	2	Preferred Brand	000001	
H5190	002	0	1	01	01	H5190_002_0	8	1	Generic	010000	
H5190	003	0	1	01	01	H5190_003_0	8	2	Preferred Brand	000001	
H5190	003	0	1	01	01	H5190_003_0	8	3	Non-Preferred Brand	100000	
H5190	003	0	1	01	01	H5190_003_0	8	4	Injectable Drugs	000001	
H5190	003	0	1	01	01	H5190_003_0	8	1	Generic	010000	1
H5190	003	0	1	01	01	H5190_003_0	8	1	Generic	010000	
H5211	002	0	1	02	01	H5211_002_0	13	4	Non-Preferred Brand	100000	
H5211	002	0	1	02	01	H5211_002_0	13	3	Preferred Brand	000001	
H5211	002	0	1	02	01	H5211_002_0	13	2	Non-Preferred Generic	000100	
H5211	002	0	1	02	01	H5211_002_0	13	1	Preferred Generic	001000	
H5211	002	0	1	02	01	H5211_002_0	13	5	Specialty Tier	010010	
H5211	002	0	1	02	01	H5211_002_0	13	6	Vaccines	000010	1
H5211	002	0	1	02	01	H5211_002_0	13	6	Vaccines	000010	
H5211	004	0	1	02	01	H5211_004_0	13	3	Preferred Brand	000001	
H5211	004	0	1	02	01	H5211_004_0	13	4	Non-Preferred Brand	100000	
H5211	004	0	1	02	01	H5211_004_0	13	1	Preferred Generic	001000	
H5211	004	0	1	02	01	H5211_004_0	13	2	Non-Preferred Generic	000100	
H5211	004	0	1	02	01	H5211_004_0	13	5	Specialty Tier	010010	
H5211	004	0	1	02	01	H5211_004_0	13	6	Vaccines	000010	
H5211	004	0	1	02	01	H5211_004_0	13	6	Vaccines	000010	1
H5211	005	0	1	02	01	H5211_005_0	13	4	Non-Preferred Brand	100000	
H5211	005	0	1	02	01	H5211_005_0	13	3	Preferred Brand	000001	
H5211	005	0	1	02	01	H5211_005_0	13	2	Non-Preferred Generic	000100	
H5211	005	0	1	02	01	H5211_005_0	13	1	Preferred Generic	001000	
H5211	005	0	1	02	01	H5211_005_0	13	5	Specialty Tier	010010	
H5211	005	0	1	02	01	H5211_005_0	13	6	Vaccines	000010	
H5211	005	0	1	02	01	H5211_005_0	13	6	Vaccines	000010	1
H5214	003	0	1	04	01	H5214_003_0	8	1	Preferred Generic	001010	
H5214	003	0	1	04	01	H5214_003_0	8	2	Non-Preferred Generic	000101	
H5214	003	0	1	04	01	H5214_003_0	8	3	Preferred Brand	000101	
H5214	003	0	1	04	01	H5214_003_0	8	4	Non-Preferred Brand	110000	
H5214	003	0	1	04	01	H5214_003_0	8	5	Specialty Tier	010010	2
H5214	003	0	1	04	01	H5214_003_0	8	1	Preferred Generic	001010	2
H5214	003	0	1	04	01	H5214_003_0	8	2	Non-Preferred Generic	000101	2
H5214	003	0	1	04	01	H5214_003_0	8	3	Preferred Brand	000101	2
H5214	003	0	1	04	01	H5214_003_0	8	4	Non-Preferred Brand	110000	2
H5214	003	0	1	04	01	H5214_003_0	8	5	Specialty Tier	010010	
H5214	004	0	1	04	01	H5214_004_0	6	5	Specialty Tier	010010	2
H5214	004	0	1	04	01	H5214_004_0	6	1	Preferred Generic	001010	
H5214	004	0	1	04	01	H5214_004_0	6	2	Non-Preferred Generic	000101	
H5214	004	0	1	04	01	H5214_004_0	6	3	Preferred Brand	000101	
H5214	004	0	1	04	01	H5214_004_0	6	4	Non-Preferred Brand	110000	
H5214	004	0	1	04	01	H5214_004_0	6	5	Specialty Tier	010010	
H5214	004	0	1	04	01	H5214_004_0	6	1	Preferred Generic	001010	2
H5214	004	0	1	04	01	H5214_004_0	6	2	Non-Preferred Generic	000101	2
H5214	004	0	1	04	01	H5214_004_0	6	3	Preferred Brand	000101	2
H5214	004	0	1	04	01	H5214_004_0	6	4	Non-Preferred Brand	110000	2
H5214	008	0	1	04	01	H5214_008_0	5	4	Non-Preferred Brand	110000	
H5214	008	0	1	04	01	H5214_008_0	5	3	Preferred Brand	000101	
H5214	008	0	1	04	01	H5214_008_0	5	5	Specialty Tier	010010	2
H5214	008	0	1	04	01	H5214_008_0	5	4	Non-Preferred Brand	110000	2
H5214	008	0	1	04	01	H5214_008_0	5	3	Preferred Brand	000101	2
H5214	008	0	1	04	01	H5214_008_0	5	2	Non-Preferred Generic	000101	2
H5214	008	0	1	04	01	H5214_008_0	5	1	Preferred Generic	001010	2
H5214	008	0	1	04	01	H5214_008_0	5	5	Specialty Tier	010010	
H5214	008	0	1	04	01	H5214_008_0	5	1	Preferred Generic	001010	
H5214	008	0	1	04	01	H5214_008_0	5	2	Non-Preferred Generic	000101	
H5214	009	0	1	04	01	H5214_009_0	5	1	Preferred Generic	001010	
H5214	009	0	1	04	01	H5214_009_0	5	4	Non-Preferred Brand	110000	2
H5214	009	0	1	04	01	H5214_009_0	5	3	Preferred Brand	000101	2
H5214	009	0	1	04	01	H5214_009_0	5	2	Non-Preferred Generic	000101	2
H5214	009	0	1	04	01	H5214_009_0	5	5	Specialty Tier	010010	2
H5214	009	0	1	04	01	H5214_009_0	5	5	Specialty Tier	010010	
H5214	009	0	1	04	01	H5214_009_0	5	4	Non-Preferred Brand	110000	
H5214	009	0	1	04	01	H5214_009_0	5	3	Preferred Brand	000101	
H5214	009	0	1	04	01	H5214_009_0	5	2	Non-Preferred Generic	000101	
H5214	009	0	1	04	01	H5214_009_0	5	1	Preferred Generic	001010	2
H5214	011	0	1	04	01	H5214_011_0	5	4	Non-Preferred Brand	110000	
H5214	011	0	1	04	01	H5214_011_0	5	3	Preferred Brand	000101	
H5214	011	0	1	04	01	H5214_011_0	5	2	Non-Preferred Generic	000101	
H5214	011	0	1	04	01	H5214_011_0	5	1	Preferred Generic	001010	
H5214	011	0	1	04	01	H5214_011_0	5	5	Specialty Tier	010010	
H5214	011	0	1	04	01	H5214_011_0	5	5	Specialty Tier	010010	2
H5214	011	0	1	04	01	H5214_011_0	5	4	Non-Preferred Brand	110000	2
H5214	011	0	1	04	01	H5214_011_0	5	3	Preferred Brand	000101	2
H5214	011	0	1	04	01	H5214_011_0	5	2	Non-Preferred Generic	000101	2
H5214	011	0	1	04	01	H5214_011_0	5	1	Preferred Generic	001010	2
H5214	012	0	1	04	01	H5214_012_0	6	1	Preferred Generic	001010	
H5214	012	0	1	04	01	H5214_012_0	6	2	Non-Preferred Generic	000101	
H5214	012	0	1	04	01	H5214_012_0	6	5	Specialty Tier	010010	2
H5214	012	0	1	04	01	H5214_012_0	6	4	Non-Preferred Brand	110000	2
H5214	012	0	1	04	01	H5214_012_0	6	3	Preferred Brand	000101	2
H5214	012	0	1	04	01	H5214_012_0	6	2	Non-Preferred Generic	000101	2
H5214	012	0	1	04	01	H5214_012_0	6	1	Preferred Generic	001010	2
H5214	012	0	1	04	01	H5214_012_0	6	5	Specialty Tier	010010	
H5214	012	0	1	04	01	H5214_012_0	6	4	Non-Preferred Brand	110000	
H5214	012	0	1	04	01	H5214_012_0	6	3	Preferred Brand	000101	
H5214	014	0	1	04	01	H5214_014_0	5	1	Preferred Generic	001010	
H5214	014	0	1	04	01	H5214_014_0	5	5	Specialty Tier	010010	
H5214	014	0	1	04	01	H5214_014_0	5	1	Preferred Generic	001010	2
H5214	014	0	1	04	01	H5214_014_0	5	2	Non-Preferred Generic	000101	2
H5214	014	0	1	04	01	H5214_014_0	5	5	Specialty Tier	010010	2
H5214	014	0	1	04	01	H5214_014_0	5	4	Non-Preferred Brand	110000	2
H5214	014	0	1	04	01	H5214_014_0	5	4	Non-Preferred Brand	110000	
H5214	014	0	1	04	01	H5214_014_0	5	3	Preferred Brand	000101	
H5214	014	0	1	04	01	H5214_014_0	5	2	Non-Preferred Generic	000101	
H5214	014	0	1	04	01	H5214_014_0	5	3	Preferred Brand	000101	2
H5215	002	0	1	04	01	H5215_002_0	9	1	Preferred Generic	001000	
H5215	002	0	1	04	01	H5215_002_0	9	2	Non-Preferred Generic	001100	
H5215	002	0	1	04	01	H5215_002_0	9	3	Preferred Brand	000101	
H5215	002	0	1	04	01	H5215_002_0	9	4	Non-Preferred Brand	100000	
H5215	002	0	1	04	01	H5215_002_0	9	5	Specialty Tier	010010	
H5215	002	0	1	04	01	H5215_002_0	9	1	Preferred Generic	001000	1
H5215	002	0	1	04	01	H5215_002_0	9	2	Non-Preferred Generic	001100	1
H5215	005	0	1	04	01	H5215_005_0	9	1	Preferred Generic	001000	
H5215	005	0	1	04	01	H5215_005_0	9	2	Non-Preferred Generic	001100	
H5215	005	0	1	04	01	H5215_005_0	9	3	Preferred Brand	000101	
H5215	005	0	1	04	01	H5215_005_0	9	4	Non-Preferred Brand	100000	
H5215	005	0	1	04	01	H5215_005_0	9	5	Specialty Tier	010010	
H5215	005	0	1	04	01	H5215_005_0	9	1	Preferred Generic	001000	1
H5215	005	0	1	04	01	H5215_005_0	9	2	Non-Preferred Generic	001100	1
H5215	007	0	1	04	01	H5215_007_0	9	1	Preferred Generic	001000	
H5215	007	0	1	04	01	H5215_007_0	9	2	Non-Preferred Generic	001100	
H5215	007	0	1	04	01	H5215_007_0	9	3	Preferred Brand	000101	
H5215	007	0	1	04	01	H5215_007_0	9	4	Non-Preferred Brand	100000	
H5215	007	0	1	04	01	H5215_007_0	9	5	Specialty Tier	010010	
H5215	008	0	1	04	01	H5215_008_0	9	3	Preferred Brand	000101	
H5215	008	0	1	04	01	H5215_008_0	9	4	Non-Preferred Brand	100000	
H5215	008	0	1	04	01	H5215_008_0	9	5	Specialty Tier	010010	
H5215	008	0	1	04	01	H5215_008_0	9	1	Preferred Generic	001000	
H5215	008	0	1	04	01	H5215_008_0	9	2	Non-Preferred Generic	001100	
H5216	001	0	1	04	01	H5216_001_0	5	4	Non-Preferred Brand	110000	
H5216	001	0	1	04	01	H5216_001_0	5	3	Preferred Brand	000101	
H5216	001	0	1	04	01	H5216_001_0	5	2	Non-Preferred Generic	000101	
H5216	001	0	1	04	01	H5216_001_0	5	1	Preferred Generic	001010	
H5216	001	0	1	04	01	H5216_001_0	5	5	Specialty Tier	010010	
H5216	001	0	1	04	01	H5216_001_0	5	4	Non-Preferred Brand	110000	2
H5216	001	0	1	04	01	H5216_001_0	5	3	Preferred Brand	000101	2
H5216	001	0	1	04	01	H5216_001_0	5	2	Non-Preferred Generic	000101	2
H5216	001	0	1	04	01	H5216_001_0	5	1	Preferred Generic	001010	2
H5216	001	0	1	04	01	H5216_001_0	5	5	Specialty Tier	010010	2
H5216	003	0	1	04	01	H5216_003_0	5	5	Specialty Tier	010010	
H5216	003	0	1	04	01	H5216_003_0	5	5	Specialty Tier	010010	2
H5216	003	0	1	04	01	H5216_003_0	5	4	Non-Preferred Brand	110000	2
H5216	003	0	1	04	01	H5216_003_0	5	3	Preferred Brand	000101	2
H5216	003	0	1	04	01	H5216_003_0	5	2	Non-Preferred Generic	000101	2
H5216	003	0	1	04	01	H5216_003_0	5	1	Preferred Generic	001010	2
H5216	003	0	1	04	01	H5216_003_0	5	4	Non-Preferred Brand	110000	
H5216	003	0	1	04	01	H5216_003_0	5	3	Preferred Brand	000101	
H5216	003	0	1	04	01	H5216_003_0	5	2	Non-Preferred Generic	000101	
H5216	003	0	1	04	01	H5216_003_0	5	1	Preferred Generic	001010	
H5216	006	0	1	04	01	H5216_006_0	5	4	Non-Preferred Brand	110000	
H5216	006	0	1	04	01	H5216_006_0	5	3	Preferred Brand	000101	
H5216	006	0	1	04	01	H5216_006_0	5	2	Non-Preferred Generic	000101	
H5216	006	0	1	04	01	H5216_006_0	5	1	Preferred Generic	001010	
H5216	006	0	1	04	01	H5216_006_0	5	5	Specialty Tier	010010	
H5216	006	0	1	04	01	H5216_006_0	5	2	Non-Preferred Generic	000101	2
H5216	006	0	1	04	01	H5216_006_0	5	3	Preferred Brand	000101	2
H5216	006	0	1	04	01	H5216_006_0	5	4	Non-Preferred Brand	110000	2
H5216	006	0	1	04	01	H5216_006_0	5	5	Specialty Tier	010010	2
H5216	006	0	1	04	01	H5216_006_0	5	1	Preferred Generic	001010	2
H5216	009	0	1	04	01	H5216_009_0	5	2	Non-Preferred Generic	000101	2
H5216	009	0	1	04	01	H5216_009_0	5	3	Preferred Brand	000101	2
H5216	009	0	1	04	01	H5216_009_0	5	4	Non-Preferred Brand	110000	2
H5216	009	0	1	04	01	H5216_009_0	5	5	Specialty Tier	010010	2
H5216	009	0	1	04	01	H5216_009_0	5	5	Specialty Tier	010010	
H5216	009	0	1	04	01	H5216_009_0	5	4	Non-Preferred Brand	110000	
H5216	009	0	1	04	01	H5216_009_0	5	3	Preferred Brand	000101	
H5216	009	0	1	04	01	H5216_009_0	5	2	Non-Preferred Generic	000101	
H5216	009	0	1	04	01	H5216_009_0	5	1	Preferred Generic	001010	2
H5216	009	0	1	04	01	H5216_009_0	5	1	Preferred Generic	001010	
H5216	010	0	1	04	01	H5216_010_0	5	4	Non-Preferred Brand	110000	
H5216	010	0	1	04	01	H5216_010_0	5	3	Preferred Brand	000101	
H5216	010	0	1	04	01	H5216_010_0	5	2	Non-Preferred Generic	000101	
H5216	010	0	1	04	01	H5216_010_0	5	1	Preferred Generic	001010	
H5216	010	0	1	04	01	H5216_010_0	5	5	Specialty Tier	010010	2
H5216	010	0	1	04	01	H5216_010_0	5	4	Non-Preferred Brand	110000	2
H5216	010	0	1	04	01	H5216_010_0	5	3	Preferred Brand	000101	2
H5216	010	0	1	04	01	H5216_010_0	5	5	Specialty Tier	010010	
H5216	010	0	1	04	01	H5216_010_0	5	1	Preferred Generic	001010	2
H5216	010	0	1	04	01	H5216_010_0	5	2	Non-Preferred Generic	000101	2
H5253	004	0	1	01	01	H5253_004_0	4	1	Preferred Generic	001000	
H5253	004	0	1	01	01	H5253_004_0	4	2	Non-Preferred Generic	000100	
H5253	004	0	1	01	01	H5253_004_0	4	5	Specialty Tier	010010	
H5253	004	0	1	01	01	H5253_004_0	4	4	Non-Preferred Brand	100100	
H5253	004	0	1	01	01	H5253_004_0	4	3	Preferred Brand	010001	
H5253	011	0	1	01	01	H5253_011_0	4	3	Preferred Brand	010001	
H5253	011	0	1	01	01	H5253_011_0	4	4	Non-Preferred Brand	100100	
H5253	011	0	1	01	01	H5253_011_0	4	5	Specialty Tier	010010	
H5253	011	0	1	01	01	H5253_011_0	4	2	Non-Preferred Generic	000100	
H5253	011	0	1	01	01	H5253_011_0	4	1	Preferred Generic	001000	
H5253	030	0	1	01	01	H5253_030_0	4	2	Non-Preferred Generic	000100	
H5253	030	0	1	01	01	H5253_030_0	4	1	Preferred Generic	001000	
H5253	030	0	1	01	01	H5253_030_0	4	3	Preferred Brand	010001	
H5253	030	0	1	01	01	H5253_030_0	4	4	Non-Preferred Brand	100100	
H5253	030	0	1	01	01	H5253_030_0	4	5	Specialty Tier	010010	
H5262	001	0	1	01	01	H5262_001_0	5	2	Non-Preferred Generic	000100	
H5262	001	0	1	01	01	H5262_001_0	5	1	Preferred Generic	001000	
H5262	001	0	1	01	01	H5262_001_0	5	5	Specialty Tier	010010	
H5262	001	0	1	01	01	H5262_001_0	5	4	Non-Preferred Brand	100000	
H5262	001	0	1	01	01	H5262_001_0	5	3	Preferred Brand	000001	
H5262	003	0	1	01	01	H5262_003_0	8	5	Specialty Tier	010010	
H5262	003	0	1	01	01	H5262_003_0	8	4	Non-Preferred Brand	100000	
H5262	003	0	1	01	01	H5262_003_0	8	2	Non-Preferred Generic	000100	
H5262	003	0	1	01	01	H5262_003_0	8	1	Preferred Generic	001000	
H5262	003	0	1	01	01	H5262_003_0	8	3	Preferred Brand	000001	
H5280	001	0	1	48	05	H5280_001_0	5	4	Non-Medicare Rx Brand Drugs	000010	
H5280	001	0	1	48	05	H5280_001_0	5	5	Non-Medicare OTC Drugs	010010	
H5280	001	0	1	48	05	H5280_001_0	5	3	Non-Medicare Rx Generic Drugs	010000	
H5280	001	0	1	48	05	H5280_001_0	5	2	Brand Drugs	000010	
H5280	001	0	1	48	05	H5280_001_0	5	1	Generic Drugs	010000	
H5291	001	0	1	01	01	H5291_001_0	6	1	Preferred Generic	001010	
H5291	001	0	1	01	01	H5291_001_0	6	2	Non-Preferred Generic	000101	
H5291	001	0	1	01	01	H5291_001_0	6	3	Preferred Brand	000101	
H5291	001	0	1	01	01	H5291_001_0	6	4	Non-Preferred Brand	110000	
H5291	001	0	1	01	01	H5291_001_0	6	5	Specialty Tier	010010	2
H5291	001	0	1	01	01	H5291_001_0	6	1	Preferred Generic	001010	2
H5291	001	0	1	01	01	H5291_001_0	6	2	Non-Preferred Generic	000101	2
H5291	001	0	1	01	01	H5291_001_0	6	3	Preferred Brand	000101	2
H5291	001	0	1	01	01	H5291_001_0	6	4	Non-Preferred Brand	110000	2
H5291	001	0	1	01	01	H5291_001_0	6	5	Specialty Tier	010010	
H5291	002	0	1	01	01	H5291_002_0	5	1	Preferred Generic	001010	
H5291	002	0	1	01	01	H5291_002_0	5	2	Non-Preferred Generic	000101	
H5291	002	0	1	01	01	H5291_002_0	5	5	Specialty Tier	010010	2
H5291	002	0	1	01	01	H5291_002_0	5	4	Non-Preferred Brand	110000	2
H5291	002	0	1	01	01	H5291_002_0	5	3	Preferred Brand	000101	2
H5291	002	0	1	01	01	H5291_002_0	5	3	Preferred Brand	000101	
H5291	002	0	1	01	01	H5291_002_0	5	4	Non-Preferred Brand	110000	
H5291	002	0	1	01	01	H5291_002_0	5	5	Specialty Tier	010010	
H5291	002	0	1	01	01	H5291_002_0	5	2	Non-Preferred Generic	000101	2
H5294	001	0	1	01	01	H5294_001_0	7	2	Preferred Brand	000001	
H5294	001	0	1	01	01	H5294_001_0	7	1	Generic	010000	
H5294	001	0	1	01	01	H5294_001_0	7	3	Non-Preferred Brand	100000	
H5294	001	0	1	01	01	H5294_001_0	7	4	Injectable Drugs	000001	
H5302	003	0	1	02	01	H5302_003_0	9	4	Non-Preferred Brand	100100	
H5302	003	0	1	02	01	H5302_003_0	9	3	Preferred Brand	000001	
H5302	003	0	1	02	01	H5302_003_0	9	2	Non-Preferred Generic	000100	
H5302	003	0	1	02	01	H5302_003_0	9	1	Preferred Generic	001000	
H5302	003	0	1	02	01	H5302_003_0	9	5	Specialty Tier	010010	
H5322	016	0	1	01	01	H5322_016_0	5	2	Non-Preferred Generic	000100	
H5322	016	0	1	01	01	H5322_016_0	5	1	Preferred Generic	001000	
H5322	016	0	1	01	01	H5322_016_0	5	3	Preferred Brand	010001	
H5322	016	0	1	01	01	H5322_016_0	5	4	Non-Preferred Brand	100100	
H5322	016	0	1	01	01	H5322_016_0	5	5	Specialty Tier	010010	
H5322	017	0	1	02	01	H5322_017_0	5	1	Preferred Generic	001000	
H5322	017	0	1	02	01	H5322_017_0	5	2	Non-Preferred Generic	000100	
H5322	017	0	1	02	01	H5322_017_0	5	3	Preferred Brand	010001	
H5322	017	0	1	02	01	H5322_017_0	5	4	Non-Preferred Brand	100100	
H5322	017	0	1	02	01	H5322_017_0	5	5	Specialty Tier	010010	
H5322	019	0	1	02	01	H5322_019_0	5	4	Non-Preferred Brand	100100	
H5322	019	0	1	02	01	H5322_019_0	5	5	Specialty Tier	010010	
H5322	019	0	1	02	01	H5322_019_0	5	3	Preferred Brand	010001	
H5322	019	0	1	02	01	H5322_019_0	5	2	Non-Preferred Generic	000100	
H5322	019	0	1	02	01	H5322_019_0	5	1	Preferred Generic	001000	
H5322	020	0	1	02	01	H5322_020_0	5	1	Preferred Generic	001000	
H5322	020	0	1	02	01	H5322_020_0	5	5	Specialty Tier	010010	
H5322	020	0	1	02	01	H5322_020_0	5	4	Non-Preferred Brand	100100	
H5322	020	0	1	02	01	H5322_020_0	5	3	Preferred Brand	010001	
H5322	020	0	1	02	01	H5322_020_0	5	2	Non-Preferred Generic	000100	
H5322	021	0	1	02	01	H5322_021_0	4	2	Non-Preferred Generic	000100	
H5322	021	0	1	02	01	H5322_021_0	4	1	Preferred Generic	001000	
H5322	021	0	1	02	01	H5322_021_0	4	3	Preferred Brand	010001	
H5322	021	0	1	02	01	H5322_021_0	4	4	Non-Preferred Brand	100100	
H5322	021	0	1	02	01	H5322_021_0	4	5	Specialty Tier	010010	
H5322	023	0	1	02	01	H5322_023_0	6	2	Non-Preferred Generic	000100	
H5322	023	0	1	02	01	H5322_023_0	6	5	Specialty Tier	010010	
H5322	023	0	1	02	01	H5322_023_0	6	4	Non-Preferred Brand	100100	
H5322	023	0	1	02	01	H5322_023_0	6	3	Preferred Brand	010001	
H5322	023	0	1	02	01	H5322_023_0	6	1	Preferred Generic	001000	
H5322	024	0	1	01	01	H5322_024_0	5	4	Non-Preferred Brand	100100	
H5322	024	0	1	01	01	H5322_024_0	5	5	Specialty Tier	010010	
H5322	024	0	1	01	01	H5322_024_0	5	2	Non-Preferred Generic	000100	
H5322	024	0	1	01	01	H5322_024_0	5	3	Preferred Brand	010001	
H5322	024	0	1	01	01	H5322_024_0	5	1	Preferred Generic	001000	
H5355	001	0	1	48	05	H5355_001_0	5	3	Non-Medicare Rx/OTC Drugs	010010	
H5355	001	0	1	48	05	H5355_001_0	5	1	Generic Drugs	010000	
H5355	001	0	1	48	05	H5355_001_0	5	2	Brand Drugs	000001	
H5378	016	0	1	04	01	H5378_016_0	8	3	Preferred Brand	000101	
H5378	016	0	1	04	01	H5378_016_0	8	4	Non-Preferred Brand	100100	
H5378	016	0	1	04	01	H5378_016_0	8	2	Non-Preferred Generic	000100	
H5378	016	0	1	04	01	H5378_016_0	8	5	Specialty Tier	010010	
H5378	016	0	1	04	01	H5378_016_0	8	1	Preferred Generic	001000	
H5378	184	0	1	04	01	H5378_184_0	7	1	Preferred Generic	001000	
H5378	184	0	1	04	01	H5378_184_0	7	2	Non-Preferred Generic	000100	
H5378	184	0	1	04	01	H5378_184_0	7	3	Preferred Brand	000101	
H5378	184	0	1	04	01	H5378_184_0	7	5	Specialty Tier	010010	
H5378	184	0	1	04	01	H5378_184_0	7	4	Non-Preferred Brand	100100	
H5378	190	0	1	04	01	H5378_190_0	6	1	Preferred Generic	001000	
H5378	190	0	1	04	01	H5378_190_0	6	2	Non-Preferred Generic	000100	
H5378	190	0	1	04	01	H5378_190_0	6	3	Preferred Brand	000101	
H5378	190	0	1	04	01	H5378_190_0	6	4	Non-Preferred Brand	100100	
H5378	190	0	1	04	01	H5378_190_0	6	5	Specialty Tier	010010	
H5410	001	0	1	01	01	H5410_001_0	6	2	Brand	000010	
H5410	001	0	1	01	01	H5410_001_0	6	1	Generic	010000	
H5410	001	0	1	01	01	H5410_001_0	6	1	Generic	010000	1
H5410	001	0	1	01	01	H5410_001_0	6	3	Specialty Tier	000010	
H5410	018	0	1	02	01	H5410_018_0	4	2	Non-Preferred Generic	000100	
H5410	018	0	1	02	01	H5410_018_0	4	2	Non-Preferred Generic	000100	1
H5410	018	0	1	02	01	H5410_018_0	4	1	Preferred Generic	001000	1
H5410	018	0	1	02	01	H5410_018_0	4	5	Specialty Tier	010010	
H5410	018	0	1	02	01	H5410_018_0	4	4	Non-Preferred Brand	100100	
H5410	018	0	1	02	01	H5410_018_0	4	1	Preferred Generic	001000	
H5410	018	0	1	02	01	H5410_018_0	4	3	Preferred Brand	000001	
H5414	009	0	1	01	01	H5414_009_0	5	1	Generic	010000	
H5414	009	0	1	01	01	H5414_009_0	5	5	Select Care Drugs	010000	
H5414	009	0	1	01	01	H5414_009_0	5	2	Preferred Brand	010001	
H5414	009	0	1	01	01	H5414_009_0	5	3	Non-Preferred Brand	110000	
H5414	009	0	1	01	01	H5414_009_0	5	4	Specialty Tier	010010	
H5414	019	0	1	01	01	H5414_019_0	5	3	Non-Preferred Brand	110000	
H5414	019	0	1	01	01	H5414_019_0	5	4	Specialty Tier	010010	
H5414	019	0	1	01	01	H5414_019_0	5	5	Select Care Drugs	010000	
H5414	019	0	1	01	01	H5414_019_0	5	5	Select Care Drugs	010000	1
H5414	019	0	1	01	01	H5414_019_0	5	1	Generic	010000	
H5414	019	0	1	01	01	H5414_019_0	5	2	Preferred Brand	010001	
H5414	023	0	1	01	01	H5414_023_0	5	5	Select Care Drugs	010000	1
H5414	023	0	1	01	01	H5414_023_0	5	3	Non-Preferred Brand	110000	
H5414	023	0	1	01	01	H5414_023_0	5	2	Preferred Brand	010001	
H5414	023	0	1	01	01	H5414_023_0	5	1	Generic	010000	
H5414	023	0	1	01	01	H5414_023_0	5	4	Specialty Tier	010010	
H5414	023	0	1	01	01	H5414_023_0	5	5	Select Care Drugs	010000	
H5414	024	0	1	01	01	H5414_024_0	5	5	Select Care Drugs	010000	
H5414	024	0	1	01	01	H5414_024_0	5	5	Select Care Drugs	010000	1
H5414	024	0	1	01	01	H5414_024_0	5	3	Non-Preferred Brand	110000	
H5414	024	0	1	01	01	H5414_024_0	5	4	Specialty Tier	010010	
H5414	024	0	1	01	01	H5414_024_0	5	2	Preferred Brand	010001	
H5414	024	0	1	01	01	H5414_024_0	5	1	Generic	010000	
H5415	056	0	1	04	01	H5415_056_0	3	5	Specialty Tier	010010	
H5415	056	0	1	04	01	H5415_056_0	3	5	Specialty Tier	010010	2
H5415	056	0	1	04	01	H5415_056_0	3	4	Non-Preferred Brand	110000	2
H5415	056	0	1	04	01	H5415_056_0	3	3	Preferred Brand	000101	2
H5415	056	0	1	04	01	H5415_056_0	3	1	Preferred Generic	001010	2
H5415	056	0	1	04	01	H5415_056_0	3	2	Non-Preferred Generic	000101	
H5415	056	0	1	04	01	H5415_056_0	3	3	Preferred Brand	000101	
H5415	056	0	1	04	01	H5415_056_0	3	4	Non-Preferred Brand	110000	
H5415	056	0	1	04	01	H5415_056_0	3	2	Non-Preferred Generic	000101	2
H5415	056	0	1	04	01	H5415_056_0	3	1	Preferred Generic	001010	
H5415	066	0	1	04	01	H5415_066_0	3	5	Specialty Tier	010010	
H5415	066	0	1	04	01	H5415_066_0	3	5	Specialty Tier	010010	2
H5415	066	0	1	04	01	H5415_066_0	3	4	Non-Preferred Brand	110000	2
H5415	066	0	1	04	01	H5415_066_0	3	3	Preferred Brand	000101	2
H5415	066	0	1	04	01	H5415_066_0	3	2	Non-Preferred Generic	000101	2
H5415	066	0	1	04	01	H5415_066_0	3	1	Preferred Generic	001010	2
H5415	066	0	1	04	01	H5415_066_0	3	1	Preferred Generic	001010	
H5415	066	0	1	04	01	H5415_066_0	3	2	Non-Preferred Generic	000101	
H5415	066	0	1	04	01	H5415_066_0	3	4	Non-Preferred Brand	110000	
H5415	066	0	1	04	01	H5415_066_0	3	3	Preferred Brand	000101	
H5415	069	0	1	04	01	H5415_069_0	3	4	Non-Preferred Brand	110000	2
H5415	069	0	1	04	01	H5415_069_0	3	3	Preferred Brand	000101	2
H5415	069	0	1	04	01	H5415_069_0	3	2	Non-Preferred Generic	000101	2
H5415	069	0	1	04	01	H5415_069_0	3	1	Preferred Generic	001010	2
H5415	069	0	1	04	01	H5415_069_0	3	5	Specialty Tier	010010	2
H5415	069	0	1	04	01	H5415_069_0	3	4	Non-Preferred Brand	110000	
H5415	069	0	1	04	01	H5415_069_0	3	3	Preferred Brand	000101	
H5415	069	0	1	04	01	H5415_069_0	3	2	Non-Preferred Generic	000101	
H5415	069	0	1	04	01	H5415_069_0	3	1	Preferred Generic	001010	
H5415	069	0	1	04	01	H5415_069_0	3	5	Specialty Tier	010010	
H5415	070	0	1	04	01	H5415_070_0	4	5	Specialty Tier	010010	2
H5415	070	0	1	04	01	H5415_070_0	4	4	Non-Preferred Brand	110000	2
H5415	070	0	1	04	01	H5415_070_0	4	3	Preferred Brand	000101	2
H5415	070	0	1	04	01	H5415_070_0	4	2	Non-Preferred Generic	000101	2
H5415	070	0	1	04	01	H5415_070_0	4	1	Preferred Generic	001010	2
H5415	070	0	1	04	01	H5415_070_0	4	5	Specialty Tier	010010	
H5415	070	0	1	04	01	H5415_070_0	4	3	Preferred Brand	000101	
H5415	070	0	1	04	01	H5415_070_0	4	2	Non-Preferred Generic	000101	
H5415	070	0	1	04	01	H5415_070_0	4	1	Preferred Generic	001010	
H5415	070	0	1	04	01	H5415_070_0	4	4	Non-Preferred Brand	110000	
H5416	016	0	1	01	01	H5416_016_0	5	1	Preferred Generic	001010	
H5416	016	0	1	01	01	H5416_016_0	5	2	Non-Preferred Generic	000101	
H5416	016	0	1	01	01	H5416_016_0	5	3	Preferred Brand	000101	
H5416	016	0	1	01	01	H5416_016_0	5	4	Non-Preferred Brand	110000	
H5416	016	0	1	01	01	H5416_016_0	5	5	Specialty Tier	010010	2
H5416	016	0	1	01	01	H5416_016_0	5	1	Preferred Generic	001010	2
H5416	016	0	1	01	01	H5416_016_0	5	2	Non-Preferred Generic	000101	2
H5416	016	0	1	01	01	H5416_016_0	5	3	Preferred Brand	000101	2
H5416	016	0	1	01	01	H5416_016_0	5	4	Non-Preferred Brand	110000	2
H5416	016	0	1	01	01	H5416_016_0	5	5	Specialty Tier	010010	
H5420	001	0	1	02	01	H5420_001_0	5	1	Preferred Generic	001000	
H5420	001	0	1	02	01	H5420_001_0	5	2	Preferred Brand	010001	
H5420	001	0	1	02	01	H5420_001_0	5	3	Non-Preferred Brand	100100	
H5420	001	0	1	02	01	H5420_001_0	5	4	Specialty Tier	010010	
H5420	001	0	1	02	01	H5420_001_0	5	1	Preferred Generic	001000	1
H5420	003	0	1	01	01	H5420_003_0	3	1	Preferred Generic	001000	1
H5420	003	0	1	01	01	H5420_003_0	3	4	Specialty Tier	010010	
H5420	003	0	1	01	01	H5420_003_0	3	1	Preferred Generic	001000	
H5420	003	0	1	01	01	H5420_003_0	3	2	Preferred Brand	010001	
H5420	003	0	1	01	01	H5420_003_0	3	3	Non-Preferred Brand	100100	
H5420	006	0	1	02	01	H5420_006_0	4	4	Specialty Tier	010010	
H5420	006	0	1	02	01	H5420_006_0	4	3	Non-Preferred Brand	100100	
H5420	006	0	1	02	01	H5420_006_0	4	2	Preferred Brand	010001	
H5420	006	0	1	02	01	H5420_006_0	4	1	Preferred Generic	001000	
H5420	006	0	1	02	01	H5420_006_0	4	1	Preferred Generic	001000	1
H5422	002	0	1	01	01	H5422_002_0	7	1	Preferred Generic	001000	
H5422	002	0	1	01	01	H5422_002_0	7	2	Non-Preferred Generic	000100	
H5422	002	0	1	01	01	H5422_002_0	7	3	Preferred Brand	000101	
H5422	002	0	1	01	01	H5422_002_0	7	4	Non-Preferred Brand	100100	
H5422	002	0	1	01	01	H5422_002_0	7	5	Injectable Drugs	010010	
H5422	002	0	1	01	01	H5422_002_0	7	6	Specialty Tier	010010	
H5422	006	0	1	01	01	H5422_006_0	7	1	Preferred Generic	001000	
H5422	006	0	1	01	01	H5422_006_0	7	2	Non-Preferred Generic	000100	
H5422	006	0	1	01	01	H5422_006_0	7	3	Preferred Brand	000101	
H5422	006	0	1	01	01	H5422_006_0	7	4	Non-Preferred Brand	100100	
H5422	006	0	1	01	01	H5422_006_0	7	5	Injectable Drugs	010010	
H5422	006	0	1	01	01	H5422_006_0	7	6	Specialty Tier	010010	
H5424	001	0	1	04	01	H5424_001_0	4	4	Non-Preferred Brand	100100	
H5424	001	0	1	04	01	H5424_001_0	4	5	Specialty Tier	010010	
H5424	001	0	1	04	01	H5424_001_0	4	3	Preferred Brand	010001	
H5424	001	0	1	04	01	H5424_001_0	4	2	Non-Preferred Generic	000100	
H5424	001	0	1	04	01	H5424_001_0	4	1	Preferred Generic	001000	
H5425	001	0	1	01	01	H5425_001_0	5	2	Non-Preferred Generic	000100	
H5425	001	0	1	01	01	H5425_001_0	5	3	Preferred Brand	000001	
H5425	001	0	1	01	01	H5425_001_0	5	4	Non-Preferred Brand	100000	
H5425	001	0	1	01	01	H5425_001_0	5	5	Specialty Tier	010010	
H5425	001	0	1	01	01	H5425_001_0	5	1	Preferred Generic	001000	
H5425	001	0	1	01	01	H5425_001_0	5	6	Select Care Drugs	000010	
H5425	004	0	1	01	01	H5425_004_0	5	4	Non-Preferred Brand	100000	
H5425	004	0	1	01	01	H5425_004_0	5	3	Preferred Brand	000001	
H5425	004	0	1	01	01	H5425_004_0	5	2	Non-Preferred Generic	000100	
H5425	004	0	1	01	01	H5425_004_0	5	1	Preferred Generic	001000	
H5425	004	0	1	01	01	H5425_004_0	5	5	Specialty Tier	010010	
H5425	004	0	1	01	01	H5425_004_0	5	2	Non-Preferred Generic	000100	1
H5425	004	0	1	01	01	H5425_004_0	5	1	Preferred Generic	001000	1
H5425	004	0	1	01	01	H5425_004_0	5	6	Select Care Drugs	000010	
H5425	005	0	1	01	01	H5425_005_0	5	1	Preferred Generic	001000	
H5425	005	0	1	01	01	H5425_005_0	5	2	Non-Preferred Generic	000100	
H5425	005	0	1	01	01	H5425_005_0	5	3	Preferred Brand	000001	
H5425	005	0	1	01	01	H5425_005_0	5	6	Select Care Drugs	000010	
H5425	005	0	1	01	01	H5425_005_0	5	5	Specialty Tier	010010	
H5425	005	0	1	01	01	H5425_005_0	5	4	Non-Preferred Brand	100000	
H5425	005	0	1	01	01	H5425_005_0	5	1	Preferred Generic	001000	1
H5425	006	0	1	01	01	H5425_006_0	6	5	Specialty Tier	010010	
H5425	006	0	1	01	01	H5425_006_0	6	4	Non-Preferred Brand	100000	
H5425	006	0	1	01	01	H5425_006_0	6	3	Preferred Brand	000001	
H5425	006	0	1	01	01	H5425_006_0	6	2	Non-Preferred Generic	000100	
H5425	006	0	1	01	01	H5425_006_0	6	1	Preferred Generic	001000	
H5425	006	0	1	01	01	H5425_006_0	6	6	Select Care Drugs	000010	
H5425	006	0	1	01	01	H5425_006_0	6	2	Non-Preferred Generic	000100	1
H5425	006	0	1	01	01	H5425_006_0	6	1	Preferred Generic	001000	1
H5425	007	0	1	01	01	H5425_007_0	6	3	Preferred Brand	000001	
H5425	007	0	1	01	01	H5425_007_0	6	2	Non-Preferred Generic	000100	
H5425	007	0	1	01	01	H5425_007_0	6	1	Preferred Generic	001000	
H5425	007	0	1	01	01	H5425_007_0	6	4	Non-Preferred Brand	100000	
H5425	007	0	1	01	01	H5425_007_0	6	5	Specialty Tier	010010	
H5425	007	0	1	01	01	H5425_007_0	6	6	Select Care Drugs	000010	
H5425	007	0	1	01	01	H5425_007_0	6	1	Preferred Generic	001000	1
H5425	007	0	1	01	01	H5425_007_0	6	2	Non-Preferred Generic	000100	1
H5425	008	0	1	01	01	H5425_008_0	7	3	Preferred Brand	000001	
H5425	008	0	1	01	01	H5425_008_0	7	2	Non-Preferred Generic	000100	
H5425	008	0	1	01	01	H5425_008_0	7	1	Preferred Generic	001000	
H5425	008	0	1	01	01	H5425_008_0	7	4	Non-Preferred Brand	100000	
H5425	008	0	1	01	01	H5425_008_0	7	2	Non-Preferred Generic	000100	1
H5425	008	0	1	01	01	H5425_008_0	7	1	Preferred Generic	001000	1
H5425	008	0	1	01	01	H5425_008_0	7	6	Select Care Drugs	000010	
H5425	008	0	1	01	01	H5425_008_0	7	5	Specialty Tier	010010	
H5425	009	0	1	01	01	H5425_009_0	7	1	Preferred Generic	001000	
H5425	009	0	1	01	01	H5425_009_0	7	2	Non-Preferred Generic	000100	
H5425	009	0	1	01	01	H5425_009_0	7	3	Preferred Brand	000001	
H5425	009	0	1	01	01	H5425_009_0	7	6	Select Care Drugs	000010	
H5425	009	0	1	01	01	H5425_009_0	7	1	Preferred Generic	001000	1
H5425	009	0	1	01	01	H5425_009_0	7	5	Specialty Tier	010010	
H5425	009	0	1	01	01	H5425_009_0	7	4	Non-Preferred Brand	100000	
H5425	009	0	1	01	01	H5425_009_0	7	2	Non-Preferred Generic	000100	1
H5425	019	0	1	01	01	H5425_019_0	6	4	Non-Preferred Brand	100000	
H5425	019	0	1	01	01	H5425_019_0	6	5	Specialty Tier	010010	
H5425	019	0	1	01	01	H5425_019_0	6	6	Select Care Drugs	000010	
H5425	019	0	1	01	01	H5425_019_0	6	1	Preferred Generic	001000	
H5425	019	0	1	01	01	H5425_019_0	6	2	Non-Preferred Generic	000100	
H5425	019	0	1	01	01	H5425_019_0	6	3	Preferred Brand	000001	
H5425	020	0	1	01	01	H5425_020_0	6	1	Preferred Generic	001000	
H5425	020	0	1	01	01	H5425_020_0	6	2	Non-Preferred Generic	000100	
H5425	020	0	1	01	01	H5425_020_0	6	4	Non-Preferred Brand	100000	
H5425	020	0	1	01	01	H5425_020_0	6	6	Select Care Drugs	000010	
H5425	020	0	1	01	01	H5425_020_0	6	5	Specialty Tier	010010	
H5425	020	0	1	01	01	H5425_020_0	6	3	Preferred Brand	000001	
H5425	022	0	1	01	01	H5425_022_0	4	2	Non-Preferred Generic	000100	
H5425	022	0	1	01	01	H5425_022_0	4	3	Preferred Brand	000001	
H5425	022	0	1	01	01	H5425_022_0	4	4	Non-Preferred Brand	100000	
H5425	022	0	1	01	01	H5425_022_0	4	1	Preferred Generic	001000	
H5425	022	0	1	01	01	H5425_022_0	4	6	Select Care Drugs	000010	
H5425	022	0	1	01	01	H5425_022_0	4	5	Specialty Tier	010010	
H5425	028	0	1	01	01	H5425_028_0	5	5	Specialty Tier	010010	
H5425	028	0	1	01	01	H5425_028_0	5	6	Select Care Drugs	000010	
H5425	028	0	1	01	01	H5425_028_0	5	1	Preferred Generic	001000	1
H5425	028	0	1	01	01	H5425_028_0	5	2	Non-Preferred Generic	000100	1
H5425	028	0	1	01	01	H5425_028_0	5	6	Select Care Drugs	000010	1
H5425	028	0	1	01	01	H5425_028_0	5	1	Preferred Generic	001000	
H5425	028	0	1	01	01	H5425_028_0	5	2	Non-Preferred Generic	000100	
H5425	028	0	1	01	01	H5425_028_0	5	3	Preferred Brand	000001	
H5425	028	0	1	01	01	H5425_028_0	5	4	Non-Preferred Brand	100000	
H5425	033	0	1	01	01	H5425_033_0	5	2	Non-Preferred Generic	000100	
H5425	033	0	1	01	01	H5425_033_0	5	1	Preferred Generic	001000	
H5425	033	0	1	01	01	H5425_033_0	5	6	Select Care Drugs	000010	1
H5425	033	0	1	01	01	H5425_033_0	5	2	Non-Preferred Generic	000100	1
H5425	033	0	1	01	01	H5425_033_0	5	1	Preferred Generic	001000	1
H5425	033	0	1	01	01	H5425_033_0	5	6	Select Care Drugs	000010	
H5425	033	0	1	01	01	H5425_033_0	5	5	Specialty Tier	010010	
H5425	033	0	1	01	01	H5425_033_0	5	4	Non-Preferred Brand	100000	
H5425	033	0	1	01	01	H5425_033_0	5	3	Preferred Brand	000001	
H5425	034	0	1	01	01	H5425_034_0	5	1	Preferred Generic	001000	
H5425	034	0	1	01	01	H5425_034_0	5	2	Non-Preferred Generic	000100	1
H5425	034	0	1	01	01	H5425_034_0	5	1	Preferred Generic	001000	1
H5425	034	0	1	01	01	H5425_034_0	5	6	Select Care Drugs	000010	
H5425	034	0	1	01	01	H5425_034_0	5	6	Select Care Drugs	000010	1
H5425	034	0	1	01	01	H5425_034_0	5	4	Non-Preferred Brand	100000	
H5425	034	0	1	01	01	H5425_034_0	5	3	Preferred Brand	000001	
H5425	034	0	1	01	01	H5425_034_0	5	2	Non-Preferred Generic	000100	
H5425	034	0	1	01	01	H5425_034_0	5	5	Specialty Tier	010010	
H5425	035	0	1	01	01	H5425_035_0	4	2	Non-Preferred Generic	000100	
H5425	035	0	1	01	01	H5425_035_0	4	1	Preferred Generic	001000	
H5425	035	0	1	01	01	H5425_035_0	4	3	Preferred Brand	000001	
H5425	035	0	1	01	01	H5425_035_0	4	6	Select Care Drugs	000010	1
H5425	035	0	1	01	01	H5425_035_0	4	2	Non-Preferred Generic	000100	1
H5425	035	0	1	01	01	H5425_035_0	4	1	Preferred Generic	001000	1
H5425	035	0	1	01	01	H5425_035_0	4	6	Select Care Drugs	000010	
H5425	035	0	1	01	01	H5425_035_0	4	5	Specialty Tier	010010	
H5425	035	0	1	01	01	H5425_035_0	4	4	Non-Preferred Brand	100000	
H5425	046	0	1	01	01	H5425_046_0	5	2	Non-Preferred Generic	000100	
H5425	046	0	1	01	01	H5425_046_0	5	1	Preferred Generic	001000	
H5425	046	0	1	01	01	H5425_046_0	5	6	Select Care Drugs	000010	
H5425	046	0	1	01	01	H5425_046_0	5	5	Specialty Tier	010010	
H5425	046	0	1	01	01	H5425_046_0	5	4	Non-Preferred Brand	100000	
H5425	046	0	1	01	01	H5425_046_0	5	3	Preferred Brand	000001	
H5425	047	0	1	01	01	H5425_047_0	3	4	Non-Preferred Brand	100000	
H5425	047	0	1	01	01	H5425_047_0	3	3	Preferred Brand	000001	
H5425	047	0	1	01	01	H5425_047_0	3	5	Specialty Tier	010010	
H5425	047	0	1	01	01	H5425_047_0	3	6	Select Care Drugs	000010	
H5425	047	0	1	01	01	H5425_047_0	3	1	Preferred Generic	001000	1
H5425	047	0	1	01	01	H5425_047_0	3	2	Non-Preferred Generic	000100	1
H5425	047	0	1	01	01	H5425_047_0	3	6	Select Care Drugs	000010	1
H5425	047	0	1	01	01	H5425_047_0	3	1	Preferred Generic	001000	
H5425	047	0	1	01	01	H5425_047_0	3	2	Non-Preferred Generic	000100	
H5425	048	0	1	01	01	H5425_048_0	3	3	Preferred Brand	000001	
H5425	048	0	1	01	01	H5425_048_0	3	4	Non-Preferred Brand	100000	
H5425	048	0	1	01	01	H5425_048_0	3	5	Specialty Tier	010010	
H5425	048	0	1	01	01	H5425_048_0	3	6	Select Care Drugs	000010	
H5425	048	0	1	01	01	H5425_048_0	3	1	Preferred Generic	001000	1
H5425	048	0	1	01	01	H5425_048_0	3	2	Non-Preferred Generic	000100	1
H5425	048	0	1	01	01	H5425_048_0	3	6	Select Care Drugs	000010	1
H5425	048	0	1	01	01	H5425_048_0	3	1	Preferred Generic	001000	
H5425	048	0	1	01	01	H5425_048_0	3	2	Non-Preferred Generic	000100	
H5425	049	0	1	01	01	H5425_049_0	4	3	Preferred Brand	000001	
H5425	049	0	1	01	01	H5425_049_0	4	2	Non-Preferred Generic	000100	
H5425	049	0	1	01	01	H5425_049_0	4	1	Preferred Generic	001000	
H5425	049	0	1	01	01	H5425_049_0	4	4	Non-Preferred Brand	100000	
H5425	049	0	1	01	01	H5425_049_0	4	5	Specialty Tier	010010	
H5425	049	0	1	01	01	H5425_049_0	4	6	Select Care Drugs	000010	
H5425	050	0	1	01	01	H5425_050_0	4	3	Preferred Brand	000001	
H5425	050	0	1	01	01	H5425_050_0	4	2	Non-Preferred Generic	000100	
H5425	050	0	1	01	01	H5425_050_0	4	1	Preferred Generic	001000	
H5425	050	0	1	01	01	H5425_050_0	4	4	Non-Preferred Brand	100000	
H5425	050	0	1	01	01	H5425_050_0	4	6	Select Care Drugs	000010	1
H5425	050	0	1	01	01	H5425_050_0	4	1	Preferred Generic	001000	1
H5425	050	0	1	01	01	H5425_050_0	4	6	Select Care Drugs	000010	
H5425	050	0	1	01	01	H5425_050_0	4	5	Specialty Tier	010010	
H5425	051	0	1	01	01	H5425_051_0	4	1	Preferred Generic	001000	
H5425	051	0	1	01	01	H5425_051_0	4	5	Specialty Tier	010010	
H5425	051	0	1	01	01	H5425_051_0	4	4	Non-Preferred Brand	100000	
H5425	051	0	1	01	01	H5425_051_0	4	3	Preferred Brand	000001	
H5425	051	0	1	01	01	H5425_051_0	4	2	Non-Preferred Generic	000100	
H5425	051	0	1	01	01	H5425_051_0	4	6	Select Care Drugs	000010	
H5427	053	0	1	01	01	H5427_053_0	5	1	Preferred Generic	001010	
H5427	053	0	1	01	01	H5427_053_0	5	2	Preferred Brand	000101	
H5427	053	0	1	01	01	H5427_053_0	5	3	Non-Preferred Brand	100100	
H5427	053	0	1	01	01	H5427_053_0	5	4	Specialty Tier	100100	
H5427	054	0	1	01	01	H5427_054_0	4	4	Specialty Tier	100100	
H5427	054	0	1	01	01	H5427_054_0	4	3	Non-Preferred Brand	100100	
H5427	054	0	1	01	01	H5427_054_0	4	2	Preferred Brand	000101	
H5427	054	0	1	01	01	H5427_054_0	4	1	Preferred Generic	001010	
H5427	059	0	1	01	01	H5427_059_0	6	1	Preferred Generic	001010	1
H5427	059	0	1	01	01	H5427_059_0	6	4	Specialty Tier	100100	
H5427	059	0	1	01	01	H5427_059_0	6	1	Preferred Generic	001010	
H5427	059	0	1	01	01	H5427_059_0	6	2	Preferred Brand	000101	
H5427	059	0	1	01	01	H5427_059_0	6	3	Non-Preferred Brand	100100	
H5427	060	0	1	01	01	H5427_060_0	4	1	Preferred Generic	001010	1
H5427	060	0	1	01	01	H5427_060_0	4	3	Non-Preferred Brand	100100	
H5427	060	0	1	01	01	H5427_060_0	4	2	Preferred Brand	000101	
H5427	060	0	1	01	01	H5427_060_0	4	1	Preferred Generic	001010	
H5427	060	0	1	01	01	H5427_060_0	4	4	Specialty Tier	100100	
H5427	070	0	1	01	01	H5427_070_0	4	1	Preferred Generic	001010	
H5427	070	0	1	01	01	H5427_070_0	4	4	Specialty Tier	100100	
H5427	070	0	1	01	01	H5427_070_0	4	3	Non-Preferred Brand	100100	
H5427	070	0	1	01	01	H5427_070_0	4	1	Preferred Generic	001010	1
H5427	070	0	1	01	01	H5427_070_0	4	2	Preferred Brand	000101	
H5427	072	0	1	01	01	H5427_072_0	4	3	Non-Preferred Brand	100100	
H5427	072	0	1	01	01	H5427_072_0	4	2	Preferred Brand	000101	
H5427	072	0	1	01	01	H5427_072_0	4	1	Preferred Generic	001010	
H5427	072	0	1	01	01	H5427_072_0	4	4	Specialty Tier	100100	
H5427	076	0	1	01	01	H5427_076_0	4	3	Non-Preferred Brand	100100	
H5427	076	0	1	01	01	H5427_076_0	4	4	Specialty Tier	100100	
H5427	076	0	1	01	01	H5427_076_0	4	1	Preferred Generic	001010	1
H5427	076	0	1	01	01	H5427_076_0	4	1	Preferred Generic	001010	
H5427	076	0	1	01	01	H5427_076_0	4	2	Preferred Brand	000101	
H5427	077	0	1	01	01	H5427_077_0	4	1	Preferred Generic	001010	
H5427	077	0	1	01	01	H5427_077_0	4	2	Preferred Brand	000101	
H5427	077	0	1	01	01	H5427_077_0	4	3	Non-Preferred Brand	100100	
H5427	077	0	1	01	01	H5427_077_0	4	4	Specialty Tier	100100	
H5427	082	0	1	01	01	H5427_082_0	6	1	Preferred Generic	001010	
H5427	082	0	1	01	01	H5427_082_0	6	2	Preferred Brand	000101	
H5427	082	0	1	01	01	H5427_082_0	6	3	Non-Preferred Brand	100100	
H5427	082	0	1	01	01	H5427_082_0	6	4	Specialty Tier	100100	
H5427	083	0	1	01	01	H5427_083_0	5	1	Preferred Generic	001010	
H5427	083	0	1	01	01	H5427_083_0	5	2	Preferred Brand	000101	
H5427	083	0	1	01	01	H5427_083_0	5	4	Specialty Tier	100100	
H5427	083	0	1	01	01	H5427_083_0	5	3	Non-Preferred Brand	100100	
H5427	088	0	1	01	01	H5427_088_0	3	1	Preferred Generic	001010	
H5427	088	0	1	01	01	H5427_088_0	3	2	Preferred Brand	000101	
H5427	088	0	1	01	01	H5427_088_0	3	3	Non-Preferred Brand	100100	
H5427	088	0	1	01	01	H5427_088_0	3	4	Specialty Tier	100100	
H5427	088	0	1	01	01	H5427_088_0	3	1	Preferred Generic	001010	1
H5428	001	0	1	01	01	H5428_001_0	9	1	Generic	010000	
H5428	001	0	1	01	01	H5428_001_0	9	2	Brand	000010	
H5430	001	0	1	01	01	H5430_001_0	6	5	Specialty Tier	010010	
H5430	001	0	1	01	01	H5430_001_0	6	4	Non-Preferred Brand	100100	
H5430	001	0	1	01	01	H5430_001_0	6	3	Preferred Brand	000001	
H5430	001	0	1	01	01	H5430_001_0	6	2	Non-Preferred Generic	000100	
H5430	001	0	1	01	01	H5430_001_0	6	1	Preferred Generic	001000	
H5431	001	0	1	01	01	H5431_001_0	6	5	Specialty Tier	010010	
H5431	001	0	1	01	01	H5431_001_0	6	4	Non-Preferred Brand	100000	
H5431	001	0	1	01	01	H5431_001_0	6	3	Preferred Brand	000001	
H5431	001	0	1	01	01	H5431_001_0	6	2	Non-Preferred Generic	000100	
H5431	001	0	1	01	01	H5431_001_0	6	6	Supplemental Brand and Generic Drugs	010010	
H5431	001	0	1	01	01	H5431_001_0	6	1	Preferred Generic	001000	
H5431	002	0	1	01	01	H5431_002_0	6	1	Preferred Generic	001000	
H5431	002	0	1	01	01	H5431_002_0	6	2	Non-Preferred Generic	000100	
H5431	002	0	1	01	01	H5431_002_0	6	6	Supplemental Brand and Generic Drugs	010010	
H5431	002	0	1	01	01	H5431_002_0	6	5	Specialty Tier	010010	
H5431	002	0	1	01	01	H5431_002_0	6	4	Non-Preferred Brand	100000	
H5431	002	0	1	01	01	H5431_002_0	6	3	Preferred Brand	000001	
H5431	005	0	1	01	01	H5431_005_0	8	1	Preferred Generic	001000	
H5431	005	0	1	01	01	H5431_005_0	8	2	Non-Preferred Generic	000100	
H5431	005	0	1	01	01	H5431_005_0	8	3	Preferred Brand	000001	
H5431	005	0	1	01	01	H5431_005_0	8	4	Non-Preferred Brand	100000	
H5431	005	0	1	01	01	H5431_005_0	8	6	Supplemental Brand and Generic Drugs	010010	1
H5431	005	0	1	01	01	H5431_005_0	8	1	Preferred Generic	001000	1
H5431	005	0	1	01	01	H5431_005_0	8	6	Supplemental Brand and Generic Drugs	010010	
H5431	005	0	1	01	01	H5431_005_0	8	5	Specialty Tier	010010	
H5431	005	0	1	01	01	H5431_005_0	8	2	Non-Preferred Generic	000100	1
H5431	006	0	1	01	01	H5431_006_0	6	2	Non-Preferred Generic	000100	
H5431	006	0	1	01	01	H5431_006_0	6	3	Preferred Brand	000001	
H5431	006	0	1	01	01	H5431_006_0	6	4	Non-Preferred Brand	100000	
H5431	006	0	1	01	01	H5431_006_0	6	5	Specialty Tier	010010	
H5431	006	0	1	01	01	H5431_006_0	6	6	Supplemental Brand and Generic Drugs	010010	
H5431	006	0	1	01	01	H5431_006_0	6	6	Supplemental Brand and Generic Drugs	010010	1
H5431	006	0	1	01	01	H5431_006_0	6	1	Preferred Generic	001000	
H5431	007	0	1	01	01	H5431_007_0	6	4	Non-Preferred Brand	100000	
H5431	007	0	1	01	01	H5431_007_0	6	3	Preferred Brand	000001	
H5431	007	0	1	01	01	H5431_007_0	6	2	Non-Preferred Generic	000100	
H5431	007	0	1	01	01	H5431_007_0	6	1	Preferred Generic	001000	
H5431	007	0	1	01	01	H5431_007_0	6	5	Specialty Tier	010010	
H5431	007	0	1	01	01	H5431_007_0	6	6	Supplemental Brand and Generic Drugs	010010	
H5431	008	0	1	01	01	H5431_008_0	6	4	Non-Preferred Brand	100000	
H5431	008	0	1	01	01	H5431_008_0	6	3	Preferred Brand	000001	
H5431	008	0	1	01	01	H5431_008_0	6	2	Non-Preferred Generic	000100	
H5431	008	0	1	01	01	H5431_008_0	6	1	Preferred Generic	001000	
H5431	008	0	1	01	01	H5431_008_0	6	5	Specialty Tier	010010	
H5431	008	0	1	01	01	H5431_008_0	6	6	Supplemental Brand and Generic Drugs	010010	
H5431	009	0	1	01	01	H5431_009_0	7	1	Preferred Generic	001000	
H5431	009	0	1	01	01	H5431_009_0	7	2	Non-Preferred Generic	000100	
H5431	009	0	1	01	01	H5431_009_0	7	3	Preferred Brand	000001	
H5431	009	0	1	01	01	H5431_009_0	7	4	Non-Preferred Brand	100000	
H5431	009	0	1	01	01	H5431_009_0	7	6	Supplemental Brand and Generic Drugs	010010	1
H5431	009	0	1	01	01	H5431_009_0	7	6	Supplemental Brand and Generic Drugs	010010	
H5431	009	0	1	01	01	H5431_009_0	7	1	Preferred Generic	001000	1
H5431	009	0	1	01	01	H5431_009_0	7	2	Non-Preferred Generic	000100	1
H5431	009	0	1	01	01	H5431_009_0	7	5	Specialty Tier	010010	
H5433	001	0	1	01	01	H5433_001_0	11	2	Brand	000010	
H5433	001	0	1	01	01	H5433_001_0	11	1	Generic	010000	
H5434	002	0	1	04	01	H5434_002_0	10	1	Preferred Generic	001000	
H5434	002	0	1	04	01	H5434_002_0	10	2	Non-Preferred Generic	000100	
H5434	002	0	1	04	01	H5434_002_0	10	3	Preferred Brand	000001	
H5434	002	0	1	04	01	H5434_002_0	10	5	Specialty Tier	101101	2
H5434	002	0	1	04	01	H5434_002_0	10	5	Specialty Tier	101101	
H5434	002	0	1	04	01	H5434_002_0	10	1	Preferred Generic	001000	1
H5434	002	0	1	04	01	H5434_002_0	10	2	Non-Preferred Generic	000100	1
H5434	002	0	1	04	01	H5434_002_0	10	4	Non-Preferred Brand	110000	
H5435	014	0	1	09	04	H5435_014_0	4	1	Preferred Generic	001000	
H5435	014	0	1	09	04	H5435_014_0	4	2	Non-Preferred Generic	000100	
H5435	014	0	1	09	04	H5435_014_0	4	3	Preferred Brand	010001	
H5435	014	0	1	09	04	H5435_014_0	4	4	Non-Preferred Brand	100100	
H5435	014	0	1	09	04	H5435_014_0	4	5	Specialty Tier	010010	
H5435	024	0	1	09	04	H5435_024_0	4	1	Preferred Generic	001000	
H5435	024	0	1	09	04	H5435_024_0	4	2	Non-Preferred Generic	000100	
H5435	024	0	1	09	04	H5435_024_0	4	3	Preferred Brand	010001	
H5435	024	0	1	09	04	H5435_024_0	4	4	Non-Preferred Brand	100100	
H5435	024	0	1	09	04	H5435_024_0	4	5	Specialty Tier	010010	
H5439	001	0	1	04	01	H5439_001_0	5	1	Preferred Generic	001000	
H5439	001	0	1	04	01	H5439_001_0	5	2	Non-Preferred Generic	000100	
H5439	001	0	1	04	01	H5439_001_0	5	3	Preferred Brand	000001	
H5439	001	0	1	04	01	H5439_001_0	5	6	Select Care Drugs	010010	
H5439	001	0	1	04	01	H5439_001_0	5	5	Specialty Tier	010010	
H5439	001	0	1	04	01	H5439_001_0	5	4	Non-Preferred Brand	100000	
H5439	002	0	1	04	01	H5439_002_0	6	6	Select Care Drugs	010010	
H5439	002	0	1	04	01	H5439_002_0	6	3	Preferred Brand	000001	
H5439	002	0	1	04	01	H5439_002_0	6	4	Non-Preferred Brand	100000	
H5439	002	0	1	04	01	H5439_002_0	6	5	Specialty Tier	010010	
H5439	002	0	1	04	01	H5439_002_0	6	2	Non-Preferred Generic	000100	
H5439	002	0	1	04	01	H5439_002_0	6	1	Preferred Generic	001000	
H5439	005	0	1	04	01	H5439_005_0	7	6	Select Care Drugs	010010	
H5439	005	0	1	04	01	H5439_005_0	7	5	Specialty Tier	010010	
H5439	005	0	1	04	01	H5439_005_0	7	4	Non-Preferred Brand	100100	
H5439	005	0	1	04	01	H5439_005_0	7	1	Preferred Generic	001000	
H5439	005	0	1	04	01	H5439_005_0	7	2	Non-Preferred Generic	000100	
H5439	005	0	1	04	01	H5439_005_0	7	3	Preferred Brand	000101	
H5439	006	0	1	04	01	H5439_006_0	7	6	Select Care Drugs	010010	
H5439	006	0	1	04	01	H5439_006_0	7	1	Preferred Generic	001000	
H5439	006	0	1	04	01	H5439_006_0	7	4	Non-Preferred Brand	100100	
H5439	006	0	1	04	01	H5439_006_0	7	5	Specialty Tier	010010	
H5439	006	0	1	04	01	H5439_006_0	7	2	Non-Preferred Generic	000100	
H5439	006	0	1	04	01	H5439_006_0	7	3	Preferred Brand	000101	
H5439	007	0	1	04	01	H5439_007_0	7	6	Select Care Drugs	010010	
H5439	007	0	1	04	01	H5439_007_0	7	5	Specialty Tier	010010	
H5439	007	0	1	04	01	H5439_007_0	7	4	Non-Preferred Brand	100100	
H5439	007	0	1	04	01	H5439_007_0	7	1	Preferred Generic	001000	
H5439	007	0	1	04	01	H5439_007_0	7	2	Non-Preferred Generic	000100	
H5439	007	0	1	04	01	H5439_007_0	7	3	Preferred Brand	000101	
H5439	008	0	1	04	01	H5439_008_0	7	6	Select Care Drugs	010010	
H5439	008	0	1	04	01	H5439_008_0	7	1	Preferred Generic	001000	
H5439	008	0	1	04	01	H5439_008_0	7	4	Non-Preferred Brand	100100	
H5439	008	0	1	04	01	H5439_008_0	7	5	Specialty Tier	010010	
H5439	008	0	1	04	01	H5439_008_0	7	2	Non-Preferred Generic	000100	
H5439	008	0	1	04	01	H5439_008_0	7	3	Preferred Brand	000101	
H5439	009	0	1	04	01	H5439_009_0	7	3	Preferred Brand	000101	
H5439	009	0	1	04	01	H5439_009_0	7	2	Non-Preferred Generic	000100	
H5439	009	0	1	04	01	H5439_009_0	7	1	Preferred Generic	001000	
H5439	009	0	1	04	01	H5439_009_0	7	4	Non-Preferred Brand	100100	
H5439	009	0	1	04	01	H5439_009_0	7	5	Specialty Tier	010010	
H5439	009	0	1	04	01	H5439_009_0	7	6	Select Care Drugs	010010	
H5471	001	0	1	01	01	H5471_001_0	5	2	Non-Preferred Generic	000100	1
H5471	001	0	1	01	01	H5471_001_0	5	4	Non-Preferred Brand	100000	
H5471	001	0	1	01	01	H5471_001_0	5	3	Preferred Brand	000001	
H5471	001	0	1	01	01	H5471_001_0	5	2	Non-Preferred Generic	000100	
H5471	001	0	1	01	01	H5471_001_0	5	5	Specialty Tier	101101	
H5471	001	0	1	01	01	H5471_001_0	5	1	Preferred Generic	001000	1
H5471	001	0	1	01	01	H5471_001_0	5	1	Preferred Generic	001000	
H5471	002	0	1	01	01	H5471_002_0	6	1	Preferred Generic	001000	
H5471	002	0	1	01	01	H5471_002_0	6	2	Non-Preferred Generic	000100	
H5471	002	0	1	01	01	H5471_002_0	6	3	Preferred Brand	000001	
H5471	002	0	1	01	01	H5471_002_0	6	4	Non-Preferred Brand	100000	
H5471	002	0	1	01	01	H5471_002_0	6	5	Specialty Tier	101101	
H5471	003	0	1	02	01	H5471_003_0	6	2	Non-Preferred Generic	000100	1
H5471	003	0	1	02	01	H5471_003_0	6	1	Preferred Generic	001000	1
H5471	003	0	1	02	01	H5471_003_0	6	5	Specialty Tier	101101	
H5471	003	0	1	02	01	H5471_003_0	6	2	Non-Preferred Generic	000100	
H5471	003	0	1	02	01	H5471_003_0	6	3	Preferred Brand	000001	
H5471	003	0	1	02	01	H5471_003_0	6	4	Non-Preferred Brand	100000	
H5471	003	0	1	02	01	H5471_003_0	6	1	Preferred Generic	001000	
H5471	004	0	1	01	01	H5471_004_0	5	5	Specialty Tier	101101	
H5471	004	0	1	01	01	H5471_004_0	5	4	Non-Preferred Brand	100000	
H5471	004	0	1	01	01	H5471_004_0	5	3	Preferred Brand	000001	
H5471	004	0	1	01	01	H5471_004_0	5	2	Non-Preferred Generic	000100	
H5471	004	0	1	01	01	H5471_004_0	5	1	Preferred Generic	001000	
H5471	004	0	1	01	01	H5471_004_0	5	2	Non-Preferred Generic	000100	1
H5471	004	0	1	01	01	H5471_004_0	5	1	Preferred Generic	001000	1
H5471	005	0	1	01	01	H5471_005_0	6	2	Non-Preferred Generic	000100	1
H5471	005	0	1	01	01	H5471_005_0	6	1	Preferred Generic	001000	
H5471	005	0	1	01	01	H5471_005_0	6	2	Non-Preferred Generic	000100	
H5471	005	0	1	01	01	H5471_005_0	6	3	Preferred Brand	000001	
H5471	005	0	1	01	01	H5471_005_0	6	4	Non-Preferred Brand	100000	
H5471	005	0	1	01	01	H5471_005_0	6	5	Specialty Tier	101101	
H5471	005	0	1	01	01	H5471_005_0	6	1	Preferred Generic	001000	1
H5471	007	0	1	01	01	H5471_007_0	6	2	Non-Preferred Generic	000100	1
H5471	007	0	1	01	01	H5471_007_0	6	1	Preferred Generic	001000	1
H5471	007	0	1	01	01	H5471_007_0	6	5	Specialty Tier	101101	
H5471	007	0	1	01	01	H5471_007_0	6	4	Non-Preferred Brand	100000	
H5471	007	0	1	01	01	H5471_007_0	6	3	Preferred Brand	000001	
H5471	007	0	1	01	01	H5471_007_0	6	1	Preferred Generic	001000	
H5471	007	0	1	01	01	H5471_007_0	6	2	Non-Preferred Generic	000100	
H5471	008	0	1	01	01	H5471_008_0	5	2	Non-Preferred Generic	000100	1
H5471	008	0	1	01	01	H5471_008_0	5	1	Preferred Generic	001000	
H5471	008	0	1	01	01	H5471_008_0	5	2	Non-Preferred Generic	000100	
H5471	008	0	1	01	01	H5471_008_0	5	3	Preferred Brand	000001	
H5471	008	0	1	01	01	H5471_008_0	5	4	Non-Preferred Brand	100000	
H5471	008	0	1	01	01	H5471_008_0	5	5	Specialty Tier	101101	
H5471	008	0	1	01	01	H5471_008_0	5	1	Preferred Generic	001000	1
H5471	009	0	1	01	01	H5471_009_0	6	2	Non-Preferred Generic	000100	1
H5471	009	0	1	01	01	H5471_009_0	6	1	Preferred Generic	001000	
H5471	009	0	1	01	01	H5471_009_0	6	2	Non-Preferred Generic	000100	
H5471	009	0	1	01	01	H5471_009_0	6	3	Preferred Brand	000001	
H5471	009	0	1	01	01	H5471_009_0	6	4	Non-Preferred Brand	100000	
H5471	009	0	1	01	01	H5471_009_0	6	5	Specialty Tier	101101	
H5471	009	0	1	01	01	H5471_009_0	6	1	Preferred Generic	001000	1
H5471	010	0	1	01	01	H5471_010_0	3	1	Preferred Generic	001000	
H5471	010	0	1	01	01	H5471_010_0	3	1	Preferred Generic	001000	1
H5471	010	0	1	01	01	H5471_010_0	3	3	Preferred Brand	000001	
H5471	010	0	1	01	01	H5471_010_0	3	4	Non-Preferred Brand	100000	
H5471	010	0	1	01	01	H5471_010_0	3	5	Specialty Tier	101101	
H5471	010	0	1	01	01	H5471_010_0	3	2	Non-Preferred Generic	000100	
H5471	010	0	1	01	01	H5471_010_0	3	2	Non-Preferred Generic	000100	1
H5471	011	0	1	01	01	H5471_011_0	3	2	Non-Preferred Generic	000100	1
H5471	011	0	1	01	01	H5471_011_0	3	1	Preferred Generic	001000	
H5471	011	0	1	01	01	H5471_011_0	3	2	Non-Preferred Generic	000100	
H5471	011	0	1	01	01	H5471_011_0	3	3	Preferred Brand	000001	
H5471	011	0	1	01	01	H5471_011_0	3	4	Non-Preferred Brand	100000	
H5471	011	0	1	01	01	H5471_011_0	3	5	Specialty Tier	101101	
H5471	011	0	1	01	01	H5471_011_0	3	1	Preferred Generic	001000	1
H5471	012	0	1	01	01	H5471_012_0	4	3	Preferred Brand	000001	2
H5471	012	0	1	01	01	H5471_012_0	4	1	Preferred Generic	001000	
H5471	012	0	1	01	01	H5471_012_0	4	2	Non-Preferred Generic	000100	
H5471	012	0	1	01	01	H5471_012_0	4	3	Preferred Brand	000001	
H5471	012	0	1	01	01	H5471_012_0	4	4	Non-Preferred Brand	100000	
H5471	012	0	1	01	01	H5471_012_0	4	5	Specialty Tier	101101	
H5471	012	0	1	01	01	H5471_012_0	4	4	Non-Preferred Brand	100000	2
H5471	012	0	1	01	01	H5471_012_0	4	2	Non-Preferred Generic	000100	1
H5471	012	0	1	01	01	H5471_012_0	4	1	Preferred Generic	001000	1
H5471	013	0	1	01	01	H5471_013_0	5	2	Non-Preferred Generic	000100	1
H5471	013	0	1	01	01	H5471_013_0	5	1	Preferred Generic	001000	1
H5471	013	0	1	01	01	H5471_013_0	5	5	Specialty Tier	101101	
H5471	013	0	1	01	01	H5471_013_0	5	4	Non-Preferred Brand	100000	
H5471	013	0	1	01	01	H5471_013_0	5	2	Non-Preferred Generic	000100	
H5471	013	0	1	01	01	H5471_013_0	5	3	Preferred Brand	000001	
H5471	013	0	1	01	01	H5471_013_0	5	1	Preferred Generic	001000	
H5471	014	0	1	01	01	H5471_014_0	4	1	Preferred Generic	001000	
H5471	014	0	1	01	01	H5471_014_0	4	3	Preferred Brand	000001	
H5471	014	0	1	01	01	H5471_014_0	4	2	Non-Preferred Generic	000100	
H5471	014	0	1	01	01	H5471_014_0	4	4	Non-Preferred Brand	100000	
H5471	014	0	1	01	01	H5471_014_0	4	5	Specialty Tier	101101	
H5471	014	0	1	01	01	H5471_014_0	4	1	Preferred Generic	001000	1
H5471	014	0	1	01	01	H5471_014_0	4	2	Non-Preferred Generic	000100	1
H5471	015	0	1	02	01	H5471_015_0	6	2	Non-Preferred Generic	000100	1
H5471	015	0	1	02	01	H5471_015_0	6	1	Preferred Generic	001000	1
H5471	015	0	1	02	01	H5471_015_0	6	5	Specialty Tier	101101	
H5471	015	0	1	02	01	H5471_015_0	6	4	Non-Preferred Brand	100000	
H5471	015	0	1	02	01	H5471_015_0	6	3	Preferred Brand	000001	
H5471	015	0	1	02	01	H5471_015_0	6	2	Non-Preferred Generic	000100	
H5471	015	0	1	02	01	H5471_015_0	6	1	Preferred Generic	001000	
H5471	016	0	1	01	01	H5471_016_0	4	1	Preferred Generic	001000	
H5471	016	0	1	01	01	H5471_016_0	4	2	Non-Preferred Generic	000100	
H5471	016	0	1	01	01	H5471_016_0	4	3	Preferred Brand	000001	
H5471	016	0	1	01	01	H5471_016_0	4	4	Non-Preferred Brand	100000	
H5471	016	0	1	01	01	H5471_016_0	4	5	Specialty Tier	101101	
H5471	017	0	1	01	01	H5471_017_0	3	4	Non-Preferred Brand	100000	
H5471	017	0	1	01	01	H5471_017_0	3	2	Non-Preferred Generic	000100	
H5471	017	0	1	01	01	H5471_017_0	3	1	Preferred Generic	001000	
H5471	017	0	1	01	01	H5471_017_0	3	3	Preferred Brand	000001	
H5471	017	0	1	01	01	H5471_017_0	3	2	Non-Preferred Generic	000100	1
H5471	017	0	1	01	01	H5471_017_0	3	1	Preferred Generic	001000	1
H5471	017	0	1	01	01	H5471_017_0	3	5	Specialty Tier	101101	
H5471	018	0	1	01	01	H5471_018_0	3	1	Preferred Generic	001000	
H5471	018	0	1	01	01	H5471_018_0	3	2	Non-Preferred Generic	000100	
H5471	018	0	1	01	01	H5471_018_0	3	5	Specialty Tier	101101	
H5471	018	0	1	01	01	H5471_018_0	3	4	Non-Preferred Brand	100000	
H5471	018	0	1	01	01	H5471_018_0	3	3	Preferred Brand	000001	
H5471	018	0	1	01	01	H5471_018_0	3	1	Preferred Generic	001000	1
H5471	018	0	1	01	01	H5471_018_0	3	2	Non-Preferred Generic	000100	1
H5471	019	0	1	01	01	H5471_019_0	4	1	Preferred Generic	001000	1
H5471	019	0	1	01	01	H5471_019_0	4	2	Non-Preferred Generic	000100	1
H5471	019	0	1	01	01	H5471_019_0	4	3	Preferred Brand	000001	2
H5471	019	0	1	01	01	H5471_019_0	4	4	Non-Preferred Brand	100000	2
H5471	019	0	1	01	01	H5471_019_0	4	1	Preferred Generic	001000	
H5471	019	0	1	01	01	H5471_019_0	4	2	Non-Preferred Generic	000100	
H5471	019	0	1	01	01	H5471_019_0	4	3	Preferred Brand	000001	
H5471	019	0	1	01	01	H5471_019_0	4	4	Non-Preferred Brand	100000	
H5471	019	0	1	01	01	H5471_019_0	4	5	Specialty Tier	101101	
H5471	020	0	1	01	01	H5471_020_0	4	1	Preferred Generic	001000	
H5471	020	0	1	01	01	H5471_020_0	4	2	Non-Preferred Generic	000100	
H5471	020	0	1	01	01	H5471_020_0	4	4	Non-Preferred Brand	100000	2
H5471	020	0	1	01	01	H5471_020_0	4	3	Preferred Brand	000001	2
H5471	020	0	1	01	01	H5471_020_0	4	2	Non-Preferred Generic	000100	1
H5471	020	0	1	01	01	H5471_020_0	4	1	Preferred Generic	001000	1
H5471	020	0	1	01	01	H5471_020_0	4	5	Specialty Tier	101101	
H5471	020	0	1	01	01	H5471_020_0	4	4	Non-Preferred Brand	100000	
H5471	020	0	1	01	01	H5471_020_0	4	3	Preferred Brand	000001	
H5471	021	0	1	01	01	H5471_021_0	4	5	Specialty Tier	101101	
H5471	021	0	1	01	01	H5471_021_0	4	4	Non-Preferred Brand	100000	
H5471	021	0	1	01	01	H5471_021_0	4	3	Preferred Brand	000001	
H5471	021	0	1	01	01	H5471_021_0	4	2	Non-Preferred Generic	000100	
H5471	021	0	1	01	01	H5471_021_0	4	1	Preferred Generic	001000	
H5471	021	0	1	01	01	H5471_021_0	4	1	Preferred Generic	001000	1
H5471	021	0	1	01	01	H5471_021_0	4	2	Non-Preferred Generic	000100	1
H5471	022	0	1	01	01	H5471_022_0	4	4	Non-Preferred Brand	100000	
H5471	022	0	1	01	01	H5471_022_0	4	5	Specialty Tier	101101	
H5471	022	0	1	01	01	H5471_022_0	4	3	Preferred Brand	000001	
H5471	022	0	1	01	01	H5471_022_0	4	2	Non-Preferred Generic	000100	
H5471	022	0	1	01	01	H5471_022_0	4	1	Preferred Generic	001000	
H5471	024	0	1	01	01	H5471_024_0	4	3	Preferred Brand	000001	
H5471	024	0	1	01	01	H5471_024_0	4	2	Non-Preferred Generic	000100	
H5471	024	0	1	01	01	H5471_024_0	4	5	Specialty Tier	101101	
H5471	024	0	1	01	01	H5471_024_0	4	1	Preferred Generic	001000	
H5471	024	0	1	01	01	H5471_024_0	4	4	Non-Preferred Brand	100000	
H5471	025	0	1	01	01	H5471_025_0	5	2	Preferred Brand	000001	
H5471	025	0	1	01	01	H5471_025_0	5	3	Non-Preferred Brand	100000	
H5471	025	0	1	01	01	H5471_025_0	5	4	Specialty Tier	110001	
H5471	025	0	1	01	01	H5471_025_0	5	1	Generic	010000	
H5471	027	0	1	01	01	H5471_027_0	5	1	Preferred Generic	001000	
H5471	027	0	1	01	01	H5471_027_0	5	2	Non-Preferred Generic	000100	1
H5471	027	0	1	01	01	H5471_027_0	5	1	Preferred Generic	001000	1
H5471	027	0	1	01	01	H5471_027_0	5	3	Preferred Brand	000001	
H5471	027	0	1	01	01	H5471_027_0	5	2	Non-Preferred Generic	000100	
H5471	027	0	1	01	01	H5471_027_0	5	5	Specialty Tier	101101	
H5471	027	0	1	01	01	H5471_027_0	5	4	Non-Preferred Brand	100000	
H5471	028	0	1	01	01	H5471_028_0	4	2	Non-Preferred Generic	000100	1
H5471	028	0	1	01	01	H5471_028_0	4	1	Preferred Generic	001000	1
H5471	028	0	1	01	01	H5471_028_0	4	4	Non-Preferred Brand	100000	
H5471	028	0	1	01	01	H5471_028_0	4	5	Specialty Tier	101101	
H5471	028	0	1	01	01	H5471_028_0	4	3	Preferred Brand	000001	
H5471	028	0	1	01	01	H5471_028_0	4	2	Non-Preferred Generic	000100	
H5471	028	0	1	01	01	H5471_028_0	4	1	Preferred Generic	001000	
H5471	029	0	1	01	01	H5471_029_0	4	3	Preferred Brand	000001	
H5471	029	0	1	01	01	H5471_029_0	4	1	Preferred Generic	001000	1
H5471	029	0	1	01	01	H5471_029_0	4	4	Non-Preferred Brand	100000	
H5471	029	0	1	01	01	H5471_029_0	4	5	Specialty Tier	101101	
H5471	029	0	1	01	01	H5471_029_0	4	2	Non-Preferred Generic	000100	
H5471	029	0	1	01	01	H5471_029_0	4	1	Preferred Generic	001000	
H5471	030	0	1	01	01	H5471_030_0	6	1	Preferred Generic	001000	
H5471	030	0	1	01	01	H5471_030_0	6	2	Non-Preferred Generic	000100	
H5471	030	0	1	01	01	H5471_030_0	6	3	Preferred Brand	000001	
H5471	030	0	1	01	01	H5471_030_0	6	4	Non-Preferred Brand	100000	
H5471	030	0	1	01	01	H5471_030_0	6	4	Non-Preferred Brand	100000	2
H5471	030	0	1	01	01	H5471_030_0	6	1	Preferred Generic	001000	1
H5471	030	0	1	01	01	H5471_030_0	6	2	Non-Preferred Generic	000100	1
H5471	030	0	1	01	01	H5471_030_0	6	3	Preferred Brand	000001	2
H5471	030	0	1	01	01	H5471_030_0	6	5	Specialty Tier	101101	
H5471	032	0	1	01	01	H5471_032_0	7	1	Preferred Generic	001000	
H5471	032	0	1	01	01	H5471_032_0	7	2	Non-Preferred Generic	000100	
H5471	032	0	1	01	01	H5471_032_0	7	2	Non-Preferred Generic	000100	1
H5471	032	0	1	01	01	H5471_032_0	7	1	Preferred Generic	001000	1
H5471	032	0	1	01	01	H5471_032_0	7	5	Specialty Tier	101101	
H5471	032	0	1	01	01	H5471_032_0	7	4	Non-Preferred Brand	100000	
H5471	032	0	1	01	01	H5471_032_0	7	3	Preferred Brand	000001	
H5471	033	0	1	02	01	H5471_033_0	5	3	Preferred Brand	000001	
H5471	033	0	1	02	01	H5471_033_0	5	2	Non-Preferred Generic	000100	
H5471	033	0	1	02	01	H5471_033_0	5	1	Preferred Generic	001000	
H5471	033	0	1	02	01	H5471_033_0	5	4	Non-Preferred Brand	100000	
H5471	033	0	1	02	01	H5471_033_0	5	5	Specialty Tier	101101	
H5471	034	0	1	02	01	H5471_034_0	5	1	Preferred Generic	001000	
H5471	034	0	1	02	01	H5471_034_0	5	2	Non-Preferred Generic	000100	
H5471	034	0	1	02	01	H5471_034_0	5	3	Preferred Brand	000001	
H5471	034	0	1	02	01	H5471_034_0	5	4	Non-Preferred Brand	100000	
H5471	034	0	1	02	01	H5471_034_0	5	5	Specialty Tier	101101	
H5471	034	0	1	02	01	H5471_034_0	5	1	Preferred Generic	001000	1
H5471	034	0	1	02	01	H5471_034_0	5	2	Non-Preferred Generic	000100	1
H5471	034	0	1	02	01	H5471_034_0	5	3	Preferred Brand	000001	2
H5471	034	0	1	02	01	H5471_034_0	5	4	Non-Preferred Brand	100000	2
H5471	039	0	1	01	01	H5471_039_0	7	5	Specialty Tier	101101	
H5471	039	0	1	01	01	H5471_039_0	7	4	Non-Preferred Brand	100000	
H5471	039	0	1	01	01	H5471_039_0	7	2	Non-Preferred Generic	000100	1
H5471	039	0	1	01	01	H5471_039_0	7	1	Preferred Generic	001000	1
H5471	039	0	1	01	01	H5471_039_0	7	3	Preferred Brand	000001	
H5471	039	0	1	01	01	H5471_039_0	7	2	Non-Preferred Generic	000100	
H5471	039	0	1	01	01	H5471_039_0	7	1	Preferred Generic	001000	
H5471	042	0	1	01	01	H5471_042_0	4	5	Specialty Tier	101101	
H5471	042	0	1	01	01	H5471_042_0	4	1	Preferred Generic	001000	
H5471	042	0	1	01	01	H5471_042_0	4	2	Non-Preferred Generic	000100	1
H5471	042	0	1	01	01	H5471_042_0	4	3	Preferred Brand	000001	2
H5471	042	0	1	01	01	H5471_042_0	4	4	Non-Preferred Brand	100000	2
H5471	042	0	1	01	01	H5471_042_0	4	1	Preferred Generic	001000	1
H5471	042	0	1	01	01	H5471_042_0	4	2	Non-Preferred Generic	000100	
H5471	042	0	1	01	01	H5471_042_0	4	3	Preferred Brand	000001	
H5471	042	0	1	01	01	H5471_042_0	4	4	Non-Preferred Brand	100000	
H5471	043	0	1	01	01	H5471_043_0	4	5	Specialty Tier	101101	
H5471	043	0	1	01	01	H5471_043_0	4	1	Preferred Generic	001000	
H5471	043	0	1	01	01	H5471_043_0	4	2	Non-Preferred Generic	000100	1
H5471	043	0	1	01	01	H5471_043_0	4	1	Preferred Generic	001000	1
H5471	043	0	1	01	01	H5471_043_0	4	2	Non-Preferred Generic	000100	
H5471	043	0	1	01	01	H5471_043_0	4	3	Preferred Brand	000001	
H5471	043	0	1	01	01	H5471_043_0	4	4	Non-Preferred Brand	100000	
H5471	044	0	1	01	01	H5471_044_0	4	4	Non-Preferred Brand	100000	
H5471	044	0	1	01	01	H5471_044_0	4	3	Preferred Brand	000001	
H5471	044	0	1	01	01	H5471_044_0	4	2	Non-Preferred Generic	000100	
H5471	044	0	1	01	01	H5471_044_0	4	5	Specialty Tier	101101	
H5471	044	0	1	01	01	H5471_044_0	4	1	Preferred Generic	001000	
H5471	045	0	1	01	01	H5471_045_0	5	1	Preferred Generic	001000	1
H5471	045	0	1	01	01	H5471_045_0	5	5	Specialty Tier	101101	
H5471	045	0	1	01	01	H5471_045_0	5	4	Non-Preferred Brand	100000	
H5471	045	0	1	01	01	H5471_045_0	5	3	Preferred Brand	000001	
H5471	045	0	1	01	01	H5471_045_0	5	2	Non-Preferred Generic	000100	
H5471	045	0	1	01	01	H5471_045_0	5	1	Preferred Generic	001000	
H5471	046	0	1	01	01	H5471_046_0	4	5	Specialty Tier	101101	
H5471	046	0	1	01	01	H5471_046_0	4	3	Preferred Brand	000001	
H5471	046	0	1	01	01	H5471_046_0	4	2	Non-Preferred Generic	000100	
H5471	046	0	1	01	01	H5471_046_0	4	1	Preferred Generic	001000	
H5471	046	0	1	01	01	H5471_046_0	4	4	Non-Preferred Brand	100000	
H5475	002	0	1	01	01	H5475_002_0	7	1	Preferred Generic	001000	
H5475	002	0	1	01	01	H5475_002_0	7	2	Non-Preferred Generic	000100	
H5475	002	0	1	01	01	H5475_002_0	7	5	Specialty Tier	100000	
H5475	002	0	1	01	01	H5475_002_0	7	4	Non-Preferred Brand	100000	
H5475	002	0	1	01	01	H5475_002_0	7	3	Preferred Brand	000001	
H5507	001	0	1	04	01	H5507_001_0	4	1	Preferred Generic	001000	
H5507	001	0	1	04	01	H5507_001_0	4	2	Non-Preferred Generic	000100	
H5507	001	0	1	04	01	H5507_001_0	4	3	Preferred Brand	010001	
H5507	001	0	1	04	01	H5507_001_0	4	5	Specialty Tier	010010	
H5507	001	0	1	04	01	H5507_001_0	4	4	Non-Preferred Brand	100100	
H5508	001	0	1	04	01	H5508_001_0	10	2	Non-Preferred Generic	000100	1
H5508	001	0	1	04	01	H5508_001_0	10	1	Preferred Generic	001000	1
H5508	001	0	1	04	01	H5508_001_0	10	5	Specialty Tier	000010	
H5508	001	0	1	04	01	H5508_001_0	10	4	Non-Preferred Brand	100000	
H5508	001	0	1	04	01	H5508_001_0	10	1	Preferred Generic	001000	
H5508	001	0	1	04	01	H5508_001_0	10	3	Preferred Brand	000001	
H5508	001	0	1	04	01	H5508_001_0	10	2	Non-Preferred Generic	000100	
H5508	005	0	1	04	01	H5508_005_0	14	1	Preferred Generic	001000	
H5508	005	0	1	04	01	H5508_005_0	14	2	Non-Preferred Generic	000100	
H5508	005	0	1	04	01	H5508_005_0	14	3	Preferred Brand	000001	
H5508	005	0	1	04	01	H5508_005_0	14	2	Non-Preferred Generic	000100	1
H5508	005	0	1	04	01	H5508_005_0	14	1	Preferred Generic	001000	1
H5508	005	0	1	04	01	H5508_005_0	14	5	Specialty Tier	000010	
H5508	005	0	1	04	01	H5508_005_0	14	4	Non-Preferred Brand	100000	
H5508	006	0	1	04	01	H5508_006_0	13	2	Non-Preferred Generic	000100	1
H5508	006	0	1	04	01	H5508_006_0	13	1	Preferred Generic	001000	1
H5508	006	0	1	04	01	H5508_006_0	13	5	Specialty Tier	000010	
H5508	006	0	1	04	01	H5508_006_0	13	3	Preferred Brand	000001	
H5508	006	0	1	04	01	H5508_006_0	13	2	Non-Preferred Generic	000100	
H5508	006	0	1	04	01	H5508_006_0	13	1	Preferred Generic	001000	
H5508	006	0	1	04	01	H5508_006_0	13	4	Non-Preferred Brand	100000	
H5509	001	0	1	04	01	H5509_001_0	6	4	Non-Preferred Brand	100100	
H5509	001	0	1	04	01	H5509_001_0	6	3	Preferred Brand	000001	
H5509	001	0	1	04	01	H5509_001_0	6	2	Non-Preferred Generic	000100	
H5509	001	0	1	04	01	H5509_001_0	6	1	Preferred Generic	001000	
H5509	001	0	1	04	01	H5509_001_0	6	5	Specialty Tier	010010	
H5509	003	0	1	04	01	H5509_003_0	7	4	Non-Preferred Brand	100100	
H5509	003	0	1	04	01	H5509_003_0	7	3	Preferred Brand	000001	
H5509	003	0	1	04	01	H5509_003_0	7	2	Non-Preferred Generic	000100	
H5509	003	0	1	04	01	H5509_003_0	7	1	Preferred Generic	001000	
H5509	003	0	1	04	01	H5509_003_0	7	5	Specialty Tier	010010	
H5509	010	0	1	04	01	H5509_010_0	5	1	Preferred Generic	001000	
H5509	010	0	1	04	01	H5509_010_0	5	2	Non-Preferred Generic	000100	
H5509	010	0	1	04	01	H5509_010_0	5	3	Preferred Brand	000001	
H5509	010	0	1	04	01	H5509_010_0	5	4	Non-Preferred Brand	100100	
H5509	010	0	1	04	01	H5509_010_0	5	5	Specialty Tier	010010	
H5509	011	0	1	04	01	H5509_011_0	5	4	Non-Preferred Brand	100100	
H5509	011	0	1	04	01	H5509_011_0	5	3	Preferred Brand	000001	
H5509	011	0	1	04	01	H5509_011_0	5	2	Non-Preferred Generic	000100	
H5509	011	0	1	04	01	H5509_011_0	5	1	Preferred Generic	001000	
H5509	011	0	1	04	01	H5509_011_0	5	5	Specialty Tier	010010	
H5509	012	0	1	04	01	H5509_012_0	6	2	Non-Preferred Generic	000100	
H5509	012	0	1	04	01	H5509_012_0	6	1	Preferred Generic	001000	
H5509	012	0	1	04	01	H5509_012_0	6	3	Preferred Brand	000001	
H5509	012	0	1	04	01	H5509_012_0	6	4	Non-Preferred Brand	100100	
H5509	012	0	1	04	01	H5509_012_0	6	5	Specialty Tier	010010	
H5509	016	0	1	04	01	H5509_016_0	4	2	Non-Preferred Generic	000100	
H5509	016	0	1	04	01	H5509_016_0	4	1	Preferred Generic	001000	
H5509	016	0	1	04	01	H5509_016_0	4	3	Preferred Brand	000001	
H5509	016	0	1	04	01	H5509_016_0	4	5	Specialty Tier	010010	
H5509	016	0	1	04	01	H5509_016_0	4	4	Non-Preferred Brand	100100	
H5509	017	0	1	04	01	H5509_017_0	5	1	Preferred Generic	001000	
H5509	017	0	1	04	01	H5509_017_0	5	2	Non-Preferred Generic	000100	
H5509	017	0	1	04	01	H5509_017_0	5	4	Non-Preferred Brand	100100	
H5509	017	0	1	04	01	H5509_017_0	5	3	Preferred Brand	000001	
H5509	017	0	1	04	01	H5509_017_0	5	5	Specialty Tier	010010	
H5509	018	0	1	04	01	H5509_018_0	4	4	Non-Preferred Brand	100100	
H5509	018	0	1	04	01	H5509_018_0	4	5	Specialty Tier	010010	
H5509	018	0	1	04	01	H5509_018_0	4	1	Preferred Generic	001000	
H5509	018	0	1	04	01	H5509_018_0	4	2	Non-Preferred Generic	000100	
H5509	018	0	1	04	01	H5509_018_0	4	3	Preferred Brand	000001	
H5509	019	0	1	04	01	H5509_019_0	7	1	Preferred Generic	001000	
H5509	019	0	1	04	01	H5509_019_0	7	2	Non-Preferred Generic	000100	
H5509	019	0	1	04	01	H5509_019_0	7	5	Specialty Tier	010010	
H5509	019	0	1	04	01	H5509_019_0	7	4	Non-Preferred Brand	100100	
H5509	019	0	1	04	01	H5509_019_0	7	3	Preferred Brand	000001	
H5516	001	0	1	04	01	H5516_001_0	4	1	Preferred Generic	001000	
H5516	001	0	1	04	01	H5516_001_0	4	2	Non-Preferred Generic	000100	
H5516	001	0	1	04	01	H5516_001_0	4	5	Specialty Tier	010010	
H5516	001	0	1	04	01	H5516_001_0	4	4	Non-Preferred Brand	100100	
H5516	001	0	1	04	01	H5516_001_0	4	3	Preferred Brand	010001	
H5520	002	0	1	04	01	H5520_002_0	5	6	Select Care Drugs	010010	
H5520	002	0	1	04	01	H5520_002_0	5	5	Specialty Tier	010010	
H5520	002	0	1	04	01	H5520_002_0	5	4	Non-Preferred Brand	100000	
H5520	002	0	1	04	01	H5520_002_0	5	3	Preferred Brand	000001	
H5520	002	0	1	04	01	H5520_002_0	5	2	Non-Preferred Generic	000100	
H5520	002	0	1	04	01	H5520_002_0	5	1	Preferred Generic	001000	
H5520	004	0	1	04	01	H5520_004_0	5	6	Select Care Drugs	010010	
H5520	004	0	1	04	01	H5520_004_0	5	5	Specialty Tier	010010	
H5520	004	0	1	04	01	H5520_004_0	5	4	Non-Preferred Brand	100000	
H5520	004	0	1	04	01	H5520_004_0	5	3	Preferred Brand	000001	
H5520	004	0	1	04	01	H5520_004_0	5	2	Non-Preferred Generic	000100	
H5520	004	0	1	04	01	H5520_004_0	5	1	Preferred Generic	001000	
H5520	006	0	1	04	01	H5520_006_0	5	1	Preferred Generic	001000	
H5520	006	0	1	04	01	H5520_006_0	5	5	Specialty Tier	010010	
H5520	006	0	1	04	01	H5520_006_0	5	4	Non-Preferred Brand	100000	
H5520	006	0	1	04	01	H5520_006_0	5	3	Preferred Brand	000001	
H5520	006	0	1	04	01	H5520_006_0	5	2	Non-Preferred Generic	000100	
H5520	006	0	1	04	01	H5520_006_0	5	6	Select Care Drugs	010010	
H5520	009	0	1	04	01	H5520_009_0	5	1	Preferred Generic	001000	
H5520	009	0	1	04	01	H5520_009_0	5	6	Select Care Drugs	010010	
H5520	009	0	1	04	01	H5520_009_0	5	5	Specialty Tier	010010	
H5520	009	0	1	04	01	H5520_009_0	5	4	Non-Preferred Brand	100100	
H5520	009	0	1	04	01	H5520_009_0	5	3	Preferred Brand	000101	
H5520	009	0	1	04	01	H5520_009_0	5	2	Non-Preferred Generic	000100	
H5520	012	1	1	04	01	H5520_012_1	5	6	Select Care Drugs	010010	
H5520	012	1	1	04	01	H5520_012_1	5	5	Specialty Tier	010010	
H5520	012	1	1	04	01	H5520_012_1	5	4	Non-Preferred Brand	100000	
H5520	012	1	1	04	01	H5520_012_1	5	3	Preferred Brand	000001	
H5520	012	1	1	04	01	H5520_012_1	5	2	Non-Preferred Generic	000100	
H5520	012	1	1	04	01	H5520_012_1	5	1	Preferred Generic	001000	
H5520	012	2	1	04	01	H5520_012_2	5	6	Select Care Drugs	010010	
H5520	012	2	1	04	01	H5520_012_2	5	5	Specialty Tier	010010	
H5520	012	2	1	04	01	H5520_012_2	5	4	Non-Preferred Brand	100000	
H5520	012	2	1	04	01	H5520_012_2	5	3	Preferred Brand	000001	
H5520	012	2	1	04	01	H5520_012_2	5	2	Non-Preferred Generic	000100	
H5520	012	2	1	04	01	H5520_012_2	5	1	Preferred Generic	001000	
H5520	012	3	1	04	01	H5520_012_3	6	1	Preferred Generic	001000	
H5520	012	3	1	04	01	H5520_012_3	6	2	Non-Preferred Generic	000100	
H5520	012	3	1	04	01	H5520_012_3	6	3	Preferred Brand	000001	
H5520	012	3	1	04	01	H5520_012_3	6	4	Non-Preferred Brand	100000	
H5520	012	3	1	04	01	H5520_012_3	6	5	Specialty Tier	010010	
H5520	012	3	1	04	01	H5520_012_3	6	6	Select Care Drugs	010010	
H5521	012	0	1	04	01	H5521_012_0	5	4	Specialty Tier	010010	
H5521	012	0	1	04	01	H5521_012_0	5	5	Select Care Drugs	010000	
H5521	012	0	1	04	01	H5521_012_0	5	3	Non-Preferred Brand	110000	
H5521	012	0	1	04	01	H5521_012_0	5	2	Preferred Brand	010001	
H5521	012	0	1	04	01	H5521_012_0	5	1	Generic	010000	
H5521	012	0	1	04	01	H5521_012_0	5	5	Select Care Drugs	010000	1
H5521	013	0	1	04	01	H5521_013_0	5	2	Preferred Brand	010001	
H5521	013	0	1	04	01	H5521_013_0	5	1	Generic	010000	
H5521	013	0	1	04	01	H5521_013_0	5	3	Non-Preferred Brand	110000	
H5521	013	0	1	04	01	H5521_013_0	5	5	Select Care Drugs	010000	1
H5521	013	0	1	04	01	H5521_013_0	5	5	Select Care Drugs	010000	
H5521	013	0	1	04	01	H5521_013_0	5	4	Specialty Tier	010010	
H5521	015	0	1	04	01	H5521_015_0	5	1	Generic	010000	
H5521	015	0	1	04	01	H5521_015_0	5	2	Preferred Brand	010001	
H5521	015	0	1	04	01	H5521_015_0	5	5	Select Care Drugs	010000	
H5521	015	0	1	04	01	H5521_015_0	5	4	Specialty Tier	010010	
H5521	015	0	1	04	01	H5521_015_0	5	3	Non-Preferred Brand	110000	
H5521	015	0	1	04	01	H5521_015_0	5	5	Select Care Drugs	010000	1
H5521	016	0	1	04	01	H5521_016_0	5	5	Select Care Drugs	010000	
H5521	016	0	1	04	01	H5521_016_0	5	4	Specialty Tier	010010	
H5521	016	0	1	04	01	H5521_016_0	5	3	Non-Preferred Brand	110000	
H5521	016	0	1	04	01	H5521_016_0	5	2	Preferred Brand	010001	
H5521	016	0	1	04	01	H5521_016_0	5	1	Generic	010000	
H5521	016	0	1	04	01	H5521_016_0	5	5	Select Care Drugs	010000	1
H5521	020	0	1	04	01	H5521_020_0	5	5	Select Care Drugs	010000	
H5521	020	0	1	04	01	H5521_020_0	5	4	Specialty Tier	010010	
H5521	020	0	1	04	01	H5521_020_0	5	3	Non-Preferred Brand	110000	
H5521	020	0	1	04	01	H5521_020_0	5	2	Preferred Brand	010001	
H5521	020	0	1	04	01	H5521_020_0	5	1	Generic	010000	
H5521	020	0	1	04	01	H5521_020_0	5	5	Select Care Drugs	010000	1
H5521	022	0	1	04	01	H5521_022_0	6	5	Select Care Drugs	010000	
H5521	022	0	1	04	01	H5521_022_0	6	4	Specialty Tier	010010	
H5521	022	0	1	04	01	H5521_022_0	6	3	Non-Preferred Brand	110000	
H5521	022	0	1	04	01	H5521_022_0	6	2	Preferred Brand	010001	
H5521	022	0	1	04	01	H5521_022_0	6	1	Generic	010000	
H5521	022	0	1	04	01	H5521_022_0	6	5	Select Care Drugs	010000	1
H5521	027	0	1	04	01	H5521_027_0	5	1	Generic	010000	
H5521	027	0	1	04	01	H5521_027_0	5	2	Preferred Brand	010001	
H5521	027	0	1	04	01	H5521_027_0	5	3	Non-Preferred Brand	110000	
H5521	027	0	1	04	01	H5521_027_0	5	4	Specialty Tier	010010	
H5521	027	0	1	04	01	H5521_027_0	5	5	Select Care Drugs	010000	
H5521	027	0	1	04	01	H5521_027_0	5	5	Select Care Drugs	010000	1
H5521	028	0	1	04	01	H5521_028_0	5	1	Generic	010000	
H5521	028	0	1	04	01	H5521_028_0	5	2	Preferred Brand	010001	
H5521	028	0	1	04	01	H5521_028_0	5	3	Non-Preferred Brand	110000	
H5521	028	0	1	04	01	H5521_028_0	5	4	Specialty Tier	010010	
H5521	028	0	1	04	01	H5521_028_0	5	5	Select Care Drugs	010000	
H5521	028	0	1	04	01	H5521_028_0	5	5	Select Care Drugs	010000	1
H5521	033	0	1	04	01	H5521_033_0	5	1	Generic	010000	
H5521	033	0	1	04	01	H5521_033_0	5	2	Preferred Brand	010001	
H5521	033	0	1	04	01	H5521_033_0	5	3	Non-Preferred Brand	110000	
H5521	033	0	1	04	01	H5521_033_0	5	4	Specialty Tier	010010	
H5521	033	0	1	04	01	H5521_033_0	5	5	Select Care Drugs	010000	
H5521	037	0	1	04	01	H5521_037_0	6	1	Generic	010000	
H5521	037	0	1	04	01	H5521_037_0	6	2	Preferred Brand	010001	
H5521	037	0	1	04	01	H5521_037_0	6	3	Non-Preferred Brand	110000	
H5521	037	0	1	04	01	H5521_037_0	6	5	Select Care Drugs	010000	1
H5521	037	0	1	04	01	H5521_037_0	6	5	Select Care Drugs	010000	
H5521	037	0	1	04	01	H5521_037_0	6	4	Specialty Tier	010010	
H5521	038	0	1	04	01	H5521_038_0	6	5	Select Care Drugs	010000	1
H5521	038	0	1	04	01	H5521_038_0	6	5	Select Care Drugs	010000	
H5521	038	0	1	04	01	H5521_038_0	6	3	Non-Preferred Brand	110000	
H5521	038	0	1	04	01	H5521_038_0	6	4	Specialty Tier	010010	
H5521	038	0	1	04	01	H5521_038_0	6	2	Preferred Brand	010001	
H5521	038	0	1	04	01	H5521_038_0	6	1	Generic	010000	
H5521	040	0	1	04	01	H5521_040_0	5	3	Non-Preferred Brand	110000	
H5521	040	0	1	04	01	H5521_040_0	5	4	Specialty Tier	010010	
H5521	040	0	1	04	01	H5521_040_0	5	2	Preferred Brand	010001	
H5521	040	0	1	04	01	H5521_040_0	5	5	Select Care Drugs	010000	1
H5521	040	0	1	04	01	H5521_040_0	5	1	Generic	010000	
H5521	040	0	1	04	01	H5521_040_0	5	5	Select Care Drugs	010000	
H5522	001	0	1	04	01	H5522_001_0	7	2	Non-Preferred Generic	000100	
H5522	001	0	1	04	01	H5522_001_0	7	1	Preferred Generic	001000	
H5522	001	0	1	04	01	H5522_001_0	7	3	Preferred Brand	000001	
H5522	001	0	1	04	01	H5522_001_0	7	1	Preferred Generic	001000	1
H5522	001	0	1	04	01	H5522_001_0	7	5	Specialty Tier	010010	
H5522	001	0	1	04	01	H5522_001_0	7	4	Non-Preferred Brand	100100	
H5522	002	0	1	04	01	H5522_002_0	6	1	Preferred Generic	001000	1
H5522	002	0	1	04	01	H5522_002_0	6	5	Specialty Tier	010010	
H5522	002	0	1	04	01	H5522_002_0	6	1	Preferred Generic	001000	
H5522	002	0	1	04	01	H5522_002_0	6	2	Non-Preferred Generic	000100	
H5522	002	0	1	04	01	H5522_002_0	6	4	Non-Preferred Brand	100100	
H5522	002	0	1	04	01	H5522_002_0	6	3	Preferred Brand	000001	
H5522	004	0	1	04	01	H5522_004_0	6	5	Specialty Tier	010010	
H5522	004	0	1	04	01	H5522_004_0	6	4	Non-Preferred Brand	100100	
H5522	004	0	1	04	01	H5522_004_0	6	3	Preferred Brand	000001	
H5522	004	0	1	04	01	H5522_004_0	6	2	Non-Preferred Generic	000100	
H5522	004	0	1	04	01	H5522_004_0	6	1	Preferred Generic	001000	
H5522	005	0	1	04	01	H5522_005_0	6	2	Non-Preferred Generic	000100	
H5522	005	0	1	04	01	H5522_005_0	6	3	Preferred Brand	000001	
H5522	005	0	1	04	01	H5522_005_0	6	4	Non-Preferred Brand	100100	
H5522	005	0	1	04	01	H5522_005_0	6	5	Specialty Tier	010010	
H5522	005	0	1	04	01	H5522_005_0	6	1	Preferred Generic	001000	
H5522	008	0	1	04	01	H5522_008_0	6	1	Preferred Generic	001000	
H5522	008	0	1	04	01	H5522_008_0	6	2	Non-Preferred Generic	000100	
H5522	008	0	1	04	01	H5522_008_0	6	3	Preferred Brand	000001	
H5522	008	0	1	04	01	H5522_008_0	6	5	Specialty Tier	010010	
H5522	008	0	1	04	01	H5522_008_0	6	4	Non-Preferred Brand	100100	
H5522	009	0	1	04	01	H5522_009_0	6	1	Preferred Generic	001000	
H5522	009	0	1	04	01	H5522_009_0	6	2	Non-Preferred Generic	000100	
H5522	009	0	1	04	01	H5522_009_0	6	3	Preferred Brand	000001	
H5522	009	0	1	04	01	H5522_009_0	6	5	Specialty Tier	010010	
H5522	009	0	1	04	01	H5522_009_0	6	4	Non-Preferred Brand	100100	
H5522	013	0	1	04	01	H5522_013_0	7	1	Preferred Generic	001000	
H5522	013	0	1	04	01	H5522_013_0	7	2	Non-Preferred Generic	000100	
H5522	013	0	1	04	01	H5522_013_0	7	3	Preferred Brand	000001	
H5522	013	0	1	04	01	H5522_013_0	7	4	Non-Preferred Brand	100100	
H5522	013	0	1	04	01	H5522_013_0	7	5	Specialty Tier	010010	
H5522	014	0	1	04	01	H5522_014_0	7	1	Preferred Generic	001000	
H5522	014	0	1	04	01	H5522_014_0	7	2	Non-Preferred Generic	000100	
H5522	014	0	1	04	01	H5522_014_0	7	3	Preferred Brand	000001	
H5522	014	0	1	04	01	H5522_014_0	7	4	Non-Preferred Brand	100100	
H5522	014	0	1	04	01	H5522_014_0	7	5	Specialty Tier	010010	
H5522	015	0	1	04	01	H5522_015_0	6	1	Preferred Generic	001000	
H5522	015	0	1	04	01	H5522_015_0	6	2	Non-Preferred Generic	000100	
H5522	015	0	1	04	01	H5522_015_0	6	3	Preferred Brand	000001	
H5522	015	0	1	04	01	H5522_015_0	6	4	Non-Preferred Brand	100100	
H5522	015	0	1	04	01	H5522_015_0	6	5	Specialty Tier	010010	
H5525	004	0	1	04	01	H5525_004_0	6	4	Non-Preferred Brand	110000	2
H5525	004	0	1	04	01	H5525_004_0	6	3	Preferred Brand	000101	2
H5525	004	0	1	04	01	H5525_004_0	6	2	Non-Preferred Generic	000101	2
H5525	004	0	1	04	01	H5525_004_0	6	1	Preferred Generic	001010	2
H5525	004	0	1	04	01	H5525_004_0	6	5	Specialty Tier	010010	2
H5525	004	0	1	04	01	H5525_004_0	6	4	Non-Preferred Brand	110000	
H5525	004	0	1	04	01	H5525_004_0	6	3	Preferred Brand	000101	
H5525	004	0	1	04	01	H5525_004_0	6	2	Non-Preferred Generic	000101	
H5525	004	0	1	04	01	H5525_004_0	6	1	Preferred Generic	001010	
H5525	004	0	1	04	01	H5525_004_0	6	5	Specialty Tier	010010	
H5525	005	0	1	04	01	H5525_005_0	4	4	Non-Preferred Brand	110000	2
H5525	005	0	1	04	01	H5525_005_0	4	3	Preferred Brand	000101	2
H5525	005	0	1	04	01	H5525_005_0	4	2	Non-Preferred Generic	000101	2
H5525	005	0	1	04	01	H5525_005_0	4	1	Preferred Generic	001010	2
H5525	005	0	1	04	01	H5525_005_0	4	5	Specialty Tier	010010	
H5525	005	0	1	04	01	H5525_005_0	4	4	Non-Preferred Brand	110000	
H5525	005	0	1	04	01	H5525_005_0	4	3	Preferred Brand	000101	
H5525	005	0	1	04	01	H5525_005_0	4	2	Non-Preferred Generic	000101	
H5525	005	0	1	04	01	H5525_005_0	4	1	Preferred Generic	001010	
H5525	005	0	1	04	01	H5525_005_0	4	5	Specialty Tier	010010	2
H5525	006	0	1	04	01	H5525_006_0	4	1	Preferred Generic	001010	
H5525	006	0	1	04	01	H5525_006_0	4	2	Non-Preferred Generic	000101	
H5525	006	0	1	04	01	H5525_006_0	4	5	Specialty Tier	010010	2
H5525	006	0	1	04	01	H5525_006_0	4	4	Non-Preferred Brand	110000	2
H5525	006	0	1	04	01	H5525_006_0	4	3	Preferred Brand	000101	2
H5525	006	0	1	04	01	H5525_006_0	4	2	Non-Preferred Generic	000101	2
H5525	006	0	1	04	01	H5525_006_0	4	1	Preferred Generic	001010	2
H5525	006	0	1	04	01	H5525_006_0	4	5	Specialty Tier	010010	
H5525	006	0	1	04	01	H5525_006_0	4	4	Non-Preferred Brand	110000	
H5525	006	0	1	04	01	H5525_006_0	4	3	Preferred Brand	000101	
H5525	007	0	1	04	01	H5525_007_0	5	1	Preferred Generic	001010	
H5525	007	0	1	04	01	H5525_007_0	5	4	Non-Preferred Brand	110000	2
H5525	007	0	1	04	01	H5525_007_0	5	3	Preferred Brand	000101	2
H5525	007	0	1	04	01	H5525_007_0	5	2	Non-Preferred Generic	000101	2
H5525	007	0	1	04	01	H5525_007_0	5	5	Specialty Tier	010010	2
H5525	007	0	1	04	01	H5525_007_0	5	5	Specialty Tier	010010	
H5525	007	0	1	04	01	H5525_007_0	5	4	Non-Preferred Brand	110000	
H5525	007	0	1	04	01	H5525_007_0	5	3	Preferred Brand	000101	
H5525	007	0	1	04	01	H5525_007_0	5	2	Non-Preferred Generic	000101	
H5525	007	0	1	04	01	H5525_007_0	5	1	Preferred Generic	001010	2
H5526	004	0	1	04	01	H5526_004_0	6	1	Preferred Generic	001000	
H5526	004	0	1	04	01	H5526_004_0	6	2	Non-Preferred Generic	000100	
H5526	004	0	1	04	01	H5526_004_0	6	3	Preferred Brand	000001	
H5526	004	0	1	04	01	H5526_004_0	6	4	Non-Preferred Brand	100000	
H5526	004	0	1	04	01	H5526_004_0	6	5	Specialty Tier	010010	
H5526	014	0	1	04	01	H5526_014_0	5	1	Preferred Generic	001000	
H5526	014	0	1	04	01	H5526_014_0	5	2	Non-Preferred Generic	000100	
H5526	014	0	1	04	01	H5526_014_0	5	3	Preferred Brand	000001	
H5526	014	0	1	04	01	H5526_014_0	5	4	Non-Preferred Brand	100000	
H5526	014	0	1	04	01	H5526_014_0	5	5	Specialty Tier	010010	
H5528	002	0	1	04	01	H5528_002_0	5	1	Preferred Generic	001000	
H5528	002	0	1	04	01	H5528_002_0	5	2	Non-Preferred Generic	000100	
H5528	002	0	1	04	01	H5528_002_0	5	5	Specialty Tier	010010	
H5528	002	0	1	04	01	H5528_002_0	5	4	Non-Preferred Brand	100000	
H5528	002	0	1	04	01	H5528_002_0	5	3	Preferred Brand	000001	
H5528	003	0	1	04	01	H5528_003_0	5	1	Preferred Generic	001000	
H5528	003	0	1	04	01	H5528_003_0	5	2	Non-Preferred Generic	000100	
H5528	003	0	1	04	01	H5528_003_0	5	3	Preferred Brand	000001	
H5528	003	0	1	04	01	H5528_003_0	5	4	Non-Preferred Brand	100000	
H5528	003	0	1	04	01	H5528_003_0	5	5	Specialty Tier	010010	
H5528	003	0	1	04	01	H5528_003_0	5	1	Preferred Generic	001000	1
H5528	003	0	1	04	01	H5528_003_0	5	2	Non-Preferred Generic	000100	1
H5528	005	0	1	04	01	H5528_005_0	5	1	Preferred Generic	001000	
H5528	005	0	1	04	01	H5528_005_0	5	2	Non-Preferred Generic	000100	
H5528	005	0	1	04	01	H5528_005_0	5	3	Preferred Brand	000001	
H5528	005	0	1	04	01	H5528_005_0	5	4	Non-Preferred Brand	100000	
H5528	005	0	1	04	01	H5528_005_0	5	5	Specialty Tier	010010	
H5528	008	0	1	04	01	H5528_008_0	5	3	Preferred Brand	000001	
H5528	008	0	1	04	01	H5528_008_0	5	2	Non-Preferred Generic	000100	
H5528	008	0	1	04	01	H5528_008_0	5	1	Preferred Generic	001000	
H5528	008	0	1	04	01	H5528_008_0	5	4	Non-Preferred Brand	100000	
H5528	008	0	1	04	01	H5528_008_0	5	2	Non-Preferred Generic	000100	1
H5528	008	0	1	04	01	H5528_008_0	5	1	Preferred Generic	001000	1
H5528	008	0	1	04	01	H5528_008_0	5	5	Specialty Tier	010010	
H5528	010	0	1	04	01	H5528_010_0	5	1	Preferred Generic	001000	
H5528	010	0	1	04	01	H5528_010_0	5	4	Non-Preferred Brand	100000	
H5528	010	0	1	04	01	H5528_010_0	5	3	Preferred Brand	000001	
H5528	010	0	1	04	01	H5528_010_0	5	2	Non-Preferred Generic	000100	
H5528	010	0	1	04	01	H5528_010_0	5	5	Specialty Tier	010010	
H5528	011	0	1	04	01	H5528_011_0	5	3	Preferred Brand	000001	
H5528	011	0	1	04	01	H5528_011_0	5	2	Non-Preferred Generic	000100	
H5528	011	0	1	04	01	H5528_011_0	5	1	Preferred Generic	001000	
H5528	011	0	1	04	01	H5528_011_0	5	4	Non-Preferred Brand	100000	
H5528	011	0	1	04	01	H5528_011_0	5	2	Non-Preferred Generic	000100	1
H5528	011	0	1	04	01	H5528_011_0	5	1	Preferred Generic	001000	1
H5528	011	0	1	04	01	H5528_011_0	5	5	Specialty Tier	010010	
H5528	018	0	1	04	01	H5528_018_0	6	1	Preferred Generic	001000	
H5528	018	0	1	04	01	H5528_018_0	6	5	Specialty Tier	010010	
H5528	018	0	1	04	01	H5528_018_0	6	4	Non-Preferred Brand	100000	
H5528	018	0	1	04	01	H5528_018_0	6	3	Preferred Brand	000001	
H5528	018	0	1	04	01	H5528_018_0	6	2	Non-Preferred Generic	000100	
H5529	001	0	1	04	01	H5529_001_0	6	6	Specialty Tier	010010	
H5529	001	0	1	04	01	H5529_001_0	6	5	Injectable Drugs	010010	
H5529	001	0	1	04	01	H5529_001_0	6	1	Preferred Generic	001000	
H5529	001	0	1	04	01	H5529_001_0	6	2	Non-Preferred Generic	000100	
H5529	001	0	1	04	01	H5529_001_0	6	3	Preferred Brand	000101	
H5529	001	0	1	04	01	H5529_001_0	6	4	Non-Preferred Brand	100100	
H5529	004	0	1	04	01	H5529_004_0	7	6	Specialty Tier	010010	
H5529	004	0	1	04	01	H5529_004_0	7	5	Injectable Drugs	010010	
H5529	004	0	1	04	01	H5529_004_0	7	4	Non-Preferred Brand	100100	
H5529	004	0	1	04	01	H5529_004_0	7	3	Preferred Brand	000101	
H5529	004	0	1	04	01	H5529_004_0	7	2	Non-Preferred Generic	000100	
H5529	004	0	1	04	01	H5529_004_0	7	1	Preferred Generic	001000	
H5530	001	0	1	04	01	H5530_001_0	7	1	Preferred Generic	001000	
H5530	001	0	1	04	01	H5530_001_0	7	2	Non-Preferred Generic	000100	
H5530	001	0	1	04	01	H5530_001_0	7	6	Specialty Tier	010010	
H5530	001	0	1	04	01	H5530_001_0	7	5	Injectable Drugs	010010	
H5530	001	0	1	04	01	H5530_001_0	7	3	Preferred Brand	000101	
H5530	001	0	1	04	01	H5530_001_0	7	4	Non-Preferred Brand	100100	
H5532	001	0	1	04	01	H5532_001_0	5	5	Specialty Tier	010010	
H5532	001	0	1	04	01	H5532_001_0	5	4	Non-Preferred Brand	100100	
H5532	001	0	1	04	01	H5532_001_0	5	3	Preferred Brand	010001	
H5532	001	0	1	04	01	H5532_001_0	5	1	Preferred Generic	001000	
H5532	001	0	1	04	01	H5532_001_0	5	2	Non-Preferred Generic	000100	
H5533	003	0	1	04	01	H5533_003_0	13	4	Specialty Tier	010010	
H5533	003	0	1	04	01	H5533_003_0	13	3	Non-Preferred Brand	100000	
H5533	003	0	1	04	01	H5533_003_0	13	5	Select Care Drugs	010000	
H5533	003	0	1	04	01	H5533_003_0	13	1	Generic	010000	
H5533	003	0	1	04	01	H5533_003_0	13	2	Preferred Brand	000001	
H5533	005	0	1	04	01	H5533_005_0	7	2	Preferred Brand	000001	
H5533	005	0	1	04	01	H5533_005_0	7	3	Non-Preferred Brand	100000	
H5533	005	0	1	04	01	H5533_005_0	7	5	Select Care Drugs	010000	
H5533	005	0	1	04	01	H5533_005_0	7	4	Specialty Tier	010010	
H5533	005	0	1	04	01	H5533_005_0	7	1	Generic	010000	
H5533	006	0	1	04	01	H5533_006_0	9	5	Select Care Drugs	010000	
H5533	006	0	1	04	01	H5533_006_0	9	4	Specialty Tier	010010	
H5533	006	0	1	04	01	H5533_006_0	9	2	Preferred Brand	000001	
H5533	006	0	1	04	01	H5533_006_0	9	1	Generic	010000	
H5533	006	0	1	04	01	H5533_006_0	9	3	Non-Preferred Brand	100000	
H5549	004	0	1	01	01	H5549_004_0	6	1	Preferred Generic	001000	
H5549	004	0	1	01	01	H5549_004_0	6	2	Non-Preferred Generic	000100	
H5549	004	0	1	01	01	H5549_004_0	6	5	Specialty Tier	100000	
H5549	004	0	1	01	01	H5549_004_0	6	4	Non-Preferred Brand	100000	
H5549	004	0	1	01	01	H5549_004_0	6	3	Preferred Brand	000001	
H5576	006	0	1	02	01	H5576_006_0	8	1	Preferred Generic	001000	
H5576	006	0	1	02	01	H5576_006_0	8	2	Non-Preferred Generic	000100	1
H5576	006	0	1	02	01	H5576_006_0	8	1	Preferred Generic	001000	1
H5576	006	0	1	02	01	H5576_006_0	8	5	Specialty Tier	100000	
H5576	006	0	1	02	01	H5576_006_0	8	4	Non-Preferred Brand	100000	
H5576	006	0	1	02	01	H5576_006_0	8	3	Preferred Brand	000001	
H5576	006	0	1	02	01	H5576_006_0	8	2	Non-Preferred Generic	000100	
H5576	007	0	1	02	01	H5576_007_0	8	4	Non-Preferred Brand	100000	
H5576	007	0	1	02	01	H5576_007_0	8	5	Specialty Tier	100000	
H5576	007	0	1	02	01	H5576_007_0	8	3	Preferred Brand	000001	
H5576	007	0	1	02	01	H5576_007_0	8	2	Non-Preferred Generic	000100	
H5576	007	0	1	02	01	H5576_007_0	8	1	Preferred Generic	001000	
H5576	009	0	1	02	01	H5576_009_0	9	1	Preferred Generic	001000	
H5576	009	0	1	02	01	H5576_009_0	9	2	Non-Preferred Generic	000100	
H5576	009	0	1	02	01	H5576_009_0	9	3	Preferred Brand	000001	
H5576	009	0	1	02	01	H5576_009_0	9	5	Specialty Tier	100000	
H5576	009	0	1	02	01	H5576_009_0	9	4	Non-Preferred Brand	100000	
H5576	012	0	1	02	01	H5576_012_0	8	1	Preferred Generic	001000	
H5576	012	0	1	02	01	H5576_012_0	8	2	Non-Preferred Generic	000100	
H5576	012	0	1	02	01	H5576_012_0	8	1	Preferred Generic	001000	1
H5576	012	0	1	02	01	H5576_012_0	8	2	Non-Preferred Generic	000100	1
H5576	012	0	1	02	01	H5576_012_0	8	3	Preferred Brand	000001	
H5576	012	0	1	02	01	H5576_012_0	8	4	Non-Preferred Brand	100000	
H5576	012	0	1	02	01	H5576_012_0	8	5	Specialty Tier	100000	
H5577	005	0	1	01	01	H5577_005_0	12	1	Preferred Generic	001000	
H5577	005	0	1	01	01	H5577_005_0	12	2	Non-Preferred Generic	000100	
H5577	005	0	1	01	01	H5577_005_0	12	3	Preferred Brand	000001	
H5577	005	0	1	01	01	H5577_005_0	12	4	Non-Preferred Brand	100000	
H5577	005	0	1	01	01	H5577_005_0	12	5	Specialty Tier	101101	
H5577	005	0	1	01	01	H5577_005_0	12	1	Preferred Generic	001000	1
H5577	005	0	1	01	01	H5577_005_0	12	2	Non-Preferred Generic	000100	1
H5577	008	0	1	02	01	H5577_008_0	12	1	Preferred Generic	001000	
H5577	008	0	1	02	01	H5577_008_0	12	2	Non-Preferred Generic	000100	
H5577	008	0	1	02	01	H5577_008_0	12	3	Preferred Brand	000001	
H5577	008	0	1	02	01	H5577_008_0	12	1	Preferred Generic	001000	1
H5577	008	0	1	02	01	H5577_008_0	12	5	Specialty Tier	101101	
H5577	008	0	1	02	01	H5577_008_0	12	4	Non-Preferred Brand	100000	
H5577	008	0	1	02	01	H5577_008_0	12	2	Non-Preferred Generic	000100	1
H5591	001	0	1	02	01	H5591_001_0	10	3	Preferred Brand	000101	
H5591	001	0	1	02	01	H5591_001_0	10	2	Non-Preferred Generic	000101	
H5591	001	0	1	02	01	H5591_001_0	10	1	Preferred Generic	001001	
H5591	001	0	1	02	01	H5591_001_0	10	4	Non-Preferred Brand	100100	
H5591	001	0	1	02	01	H5591_001_0	10	5	Specialty Tier	010010	
H5591	004	0	1	02	01	H5591_004_0	9	1	Preferred Generic	001001	
H5591	004	0	1	02	01	H5591_004_0	9	2	Non-Preferred Generic	000101	
H5591	004	0	1	02	01	H5591_004_0	9	3	Preferred Brand	000101	
H5591	004	0	1	02	01	H5591_004_0	9	4	Non-Preferred Brand	100100	
H5591	004	0	1	02	01	H5591_004_0	9	5	Specialty Tier	010010	
H5591	005	0	1	02	01	H5591_005_0	7	1	Preferred Generic	001001	
H5591	005	0	1	02	01	H5591_005_0	7	2	Non-Preferred Generic	000101	
H5591	005	0	1	02	01	H5591_005_0	7	5	Specialty Tier	010010	
H5591	005	0	1	02	01	H5591_005_0	7	4	Non-Preferred Brand	100100	
H5591	005	0	1	02	01	H5591_005_0	7	3	Preferred Brand	000101	
H5594	001	0	1	02	01	H5594_001_0	7	4	Specialty Tier	100100	
H5594	001	0	1	02	01	H5594_001_0	7	3	Non-Preferred Brand	100100	
H5594	001	0	1	02	01	H5594_001_0	7	2	Preferred Brand	000101	
H5594	001	0	1	02	01	H5594_001_0	7	1	Preferred Generic	001010	
H5594	002	0	1	02	01	H5594_002_0	6	2	Preferred Brand	000101	
H5594	002	0	1	02	01	H5594_002_0	6	3	Non-Preferred Brand	100100	
H5594	002	0	1	02	01	H5594_002_0	6	4	Specialty Tier	100100	
H5594	002	0	1	02	01	H5594_002_0	6	1	Preferred Generic	001010	1
H5594	002	0	1	02	01	H5594_002_0	6	1	Preferred Generic	001010	
H5594	018	0	1	02	01	H5594_018_0	7	3	Non-Preferred Brand	100100	
H5594	018	0	1	02	01	H5594_018_0	7	2	Preferred Brand	000101	
H5594	018	0	1	02	01	H5594_018_0	7	1	Preferred Generic	001010	
H5594	018	0	1	02	01	H5594_018_0	7	4	Specialty Tier	100100	
H5594	019	0	1	02	01	H5594_019_0	5	1	Preferred Generic	001010	
H5594	019	0	1	02	01	H5594_019_0	5	2	Preferred Brand	000101	
H5594	019	0	1	02	01	H5594_019_0	5	3	Non-Preferred Brand	100100	
H5594	019	0	1	02	01	H5594_019_0	5	4	Specialty Tier	100100	
H5594	019	0	1	02	01	H5594_019_0	5	1	Preferred Generic	001010	1
H5594	022	0	1	02	01	H5594_022_0	5	1	Preferred Generic	001010	
H5594	022	0	1	02	01	H5594_022_0	5	2	Preferred Brand	000101	
H5594	022	0	1	02	01	H5594_022_0	5	4	Specialty Tier	100100	
H5594	022	0	1	02	01	H5594_022_0	5	3	Non-Preferred Brand	100100	
H5594	026	0	1	02	01	H5594_026_0	7	1	Preferred Generic	001010	
H5594	026	0	1	02	01	H5594_026_0	7	3	Non-Preferred Brand	100100	
H5594	026	0	1	02	01	H5594_026_0	7	2	Preferred Brand	000101	
H5594	026	0	1	02	01	H5594_026_0	7	4	Specialty Tier	100100	
H5594	027	0	1	02	01	H5594_027_0	5	1	Preferred Generic	001010	
H5594	027	0	1	02	01	H5594_027_0	5	1	Preferred Generic	001010	1
H5594	027	0	1	02	01	H5594_027_0	5	4	Specialty Tier	100100	
H5594	027	0	1	02	01	H5594_027_0	5	3	Non-Preferred Brand	100100	
H5594	027	0	1	02	01	H5594_027_0	5	2	Preferred Brand	000101	
H5594	028	0	1	02	01	H5594_028_0	6	1	Preferred Generic	001010	
H5594	028	0	1	02	01	H5594_028_0	6	2	Preferred Brand	000101	
H5594	028	0	1	02	01	H5594_028_0	6	3	Non-Preferred Brand	100100	
H5594	028	0	1	02	01	H5594_028_0	6	4	Specialty Tier	100100	
H5594	028	0	1	02	01	H5594_028_0	6	1	Preferred Generic	001010	1
H5594	029	0	1	02	01	H5594_029_0	7	4	Specialty Tier	100100	
H5594	029	0	1	02	01	H5594_029_0	7	3	Non-Preferred Brand	100100	
H5594	029	0	1	02	01	H5594_029_0	7	2	Preferred Brand	000101	
H5594	029	0	1	02	01	H5594_029_0	7	1	Preferred Generic	001010	
H5594	029	0	1	02	01	H5594_029_0	7	1	Preferred Generic	001010	1
H5594	030	0	1	02	01	H5594_030_0	7	1	Preferred Generic	001010	1
H5594	030	0	1	02	01	H5594_030_0	7	1	Preferred Generic	001010	
H5594	030	0	1	02	01	H5594_030_0	7	2	Preferred Brand	000101	
H5594	030	0	1	02	01	H5594_030_0	7	3	Non-Preferred Brand	100100	
H5594	030	0	1	02	01	H5594_030_0	7	4	Specialty Tier	100100	
H5594	031	0	1	02	01	H5594_031_0	8	2	Preferred Brand	000101	
H5594	031	0	1	02	01	H5594_031_0	8	1	Preferred Generic	001010	
H5594	031	0	1	02	01	H5594_031_0	8	3	Non-Preferred Brand	100100	
H5594	031	0	1	02	01	H5594_031_0	8	4	Specialty Tier	100100	
H5594	031	0	1	02	01	H5594_031_0	8	1	Preferred Generic	001010	1
H5594	032	0	1	02	01	H5594_032_0	4	2	Preferred Brand	000101	
H5594	032	0	1	02	01	H5594_032_0	4	1	Preferred Generic	001010	
H5594	032	0	1	02	01	H5594_032_0	4	3	Non-Preferred Brand	100100	
H5594	032	0	1	02	01	H5594_032_0	4	1	Preferred Generic	001010	1
H5594	032	0	1	02	01	H5594_032_0	4	4	Specialty Tier	100100	
H5594	033	0	1	02	01	H5594_033_0	4	1	Preferred Generic	001010	
H5594	033	0	1	02	01	H5594_033_0	4	2	Preferred Brand	000101	
H5594	033	0	1	02	01	H5594_033_0	4	4	Specialty Tier	100100	
H5594	033	0	1	02	01	H5594_033_0	4	3	Non-Preferred Brand	100100	
H5594	033	0	1	02	01	H5594_033_0	4	1	Preferred Generic	001010	1
H5608	002	0	1	01	01	H5608_002_0	6	4	Non-Preferred Brand	100000	
H5608	002	0	1	01	01	H5608_002_0	6	3	Preferred Brand	000001	
H5608	002	0	1	01	01	H5608_002_0	6	2	Non-Preferred Generic	000100	
H5608	002	0	1	01	01	H5608_002_0	6	1	Preferred Generic	001000	
H5609	001	0	1	01	01	H5609_001_0	4	1	Preferred Generic	001000	1
H5609	001	0	1	01	01	H5609_001_0	4	3	Preferred Brand	000001	
H5609	001	0	1	01	01	H5609_001_0	4	5	Specialty Tier	010010	
H5609	001	0	1	01	01	H5609_001_0	4	4	Non-Preferred Brand	100000	
H5609	001	0	1	01	01	H5609_001_0	4	1	Preferred Generic	001000	
H5609	001	0	1	01	01	H5609_001_0	4	2	Non-Preferred Generic	000100	
H5609	004	0	1	01	01	H5609_004_0	5	1	Preferred Generic	001000	1
H5609	004	0	1	01	01	H5609_004_0	5	5	Specialty Tier	010010	
H5609	004	0	1	01	01	H5609_004_0	5	4	Non-Preferred Brand	100000	
H5609	004	0	1	01	01	H5609_004_0	5	3	Preferred Brand	000001	
H5609	004	0	1	01	01	H5609_004_0	5	1	Preferred Generic	001000	
H5609	004	0	1	01	01	H5609_004_0	5	2	Non-Preferred Generic	000100	
H5609	005	0	1	01	01	H5609_005_0	5	2	Non-Preferred Generic	000100	
H5609	005	0	1	01	01	H5609_005_0	5	3	Preferred Brand	000001	
H5609	005	0	1	01	01	H5609_005_0	5	1	Preferred Generic	001000	1
H5609	005	0	1	01	01	H5609_005_0	5	5	Specialty Tier	010010	
H5609	005	0	1	01	01	H5609_005_0	5	4	Non-Preferred Brand	100000	
H5609	005	0	1	01	01	H5609_005_0	5	1	Preferred Generic	001000	
H5619	001	0	1	01	01	H5619_001_0	4	5	Specialty Tier	010010	2
H5619	001	0	1	01	01	H5619_001_0	4	4	Non-Preferred Brand	110000	
H5619	001	0	1	01	01	H5619_001_0	4	3	Preferred Brand	000101	2
H5619	001	0	1	01	01	H5619_001_0	4	2	Non-Preferred Generic	000101	2
H5619	001	0	1	01	01	H5619_001_0	4	1	Preferred Generic	001010	2
H5619	001	0	1	01	01	H5619_001_0	4	5	Specialty Tier	010010	
H5619	001	0	1	01	01	H5619_001_0	4	4	Non-Preferred Brand	110000	2
H5619	001	0	1	01	01	H5619_001_0	4	3	Preferred Brand	000101	
H5619	001	0	1	01	01	H5619_001_0	4	2	Non-Preferred Generic	000101	
H5619	001	0	1	01	01	H5619_001_0	4	1	Preferred Generic	001010	
H5619	003	0	1	01	01	H5619_003_0	5	1	Preferred Generic	001010	
H5619	003	0	1	01	01	H5619_003_0	5	2	Non-Preferred Generic	000101	
H5619	003	0	1	01	01	H5619_003_0	5	3	Preferred Brand	000101	
H5619	003	0	1	01	01	H5619_003_0	5	4	Non-Preferred Brand	110000	
H5619	003	0	1	01	01	H5619_003_0	5	5	Specialty Tier	010010	
H5619	007	0	1	01	01	H5619_007_0	4	5	Specialty Tier	010010	2
H5619	007	0	1	01	01	H5619_007_0	4	4	Non-Preferred Brand	110000	2
H5619	007	0	1	01	01	H5619_007_0	4	3	Preferred Brand	000101	2
H5619	007	0	1	01	01	H5619_007_0	4	2	Non-Preferred Generic	000101	2
H5619	007	0	1	01	01	H5619_007_0	4	4	Non-Preferred Brand	110000	
H5619	007	0	1	01	01	H5619_007_0	4	5	Specialty Tier	010010	
H5619	007	0	1	01	01	H5619_007_0	4	1	Preferred Generic	001010	2
H5619	007	0	1	01	01	H5619_007_0	4	3	Preferred Brand	000101	
H5619	007	0	1	01	01	H5619_007_0	4	2	Non-Preferred Generic	000101	
H5619	007	0	1	01	01	H5619_007_0	4	1	Preferred Generic	001010	
H5619	009	0	1	01	01	H5619_009_0	4	1	Preferred Generic	001010	
H5619	009	0	1	01	01	H5619_009_0	4	2	Non-Preferred Generic	000101	
H5619	009	0	1	01	01	H5619_009_0	4	3	Preferred Brand	000101	
H5619	009	0	1	01	01	H5619_009_0	4	4	Non-Preferred Brand	110000	
H5619	009	0	1	01	01	H5619_009_0	4	5	Specialty Tier	010010	
H5628	001	0	1	01	01	H5628_001_0	10	1	Generic	010000	
H5628	001	0	1	01	01	H5628_001_0	10	4	Specialty Tier	010010	
H5628	001	0	1	01	01	H5628_001_0	10	3	Non-Preferred Brand	100000	
H5628	001	0	1	01	01	H5628_001_0	10	2	Preferred Brand	000001	
H5649	001	0	1	01	01	H5649_001_0	7	2	Non-Preferred Generic	000100	
H5649	001	0	1	01	01	H5649_001_0	7	1	Preferred Generic	001000	
H5649	001	0	1	01	01	H5649_001_0	7	3	Preferred Brand	000001	
H5649	001	0	1	01	01	H5649_001_0	7	4	Non-Preferred Brand	100000	
H5649	001	0	1	01	01	H5649_001_0	7	5	Specialty Tier	010010	
H5649	001	0	1	01	01	H5649_001_0	7	1	Preferred Generic	001000	1
H5649	001	0	1	01	01	H5649_001_0	7	2	Non-Preferred Generic	000100	1
H5649	002	0	1	01	01	H5649_002_0	6	2	Non-Preferred Generic	000100	
H5649	002	0	1	01	01	H5649_002_0	6	1	Preferred Generic	001000	
H5649	002	0	1	01	01	H5649_002_0	6	3	Preferred Brand	000001	
H5649	002	0	1	01	01	H5649_002_0	6	1	Preferred Generic	001000	1
H5649	002	0	1	01	01	H5649_002_0	6	5	Specialty Tier	010010	
H5649	002	0	1	01	01	H5649_002_0	6	4	Non-Preferred Brand	100000	
H5649	004	0	1	01	01	H5649_004_0	6	1	Preferred Generic	001000	
H5649	004	0	1	01	01	H5649_004_0	6	2	Non-Preferred Generic	000100	
H5649	004	0	1	01	01	H5649_004_0	6	5	Specialty Tier	010010	
H5649	004	0	1	01	01	H5649_004_0	6	4	Non-Preferred Brand	100000	
H5649	004	0	1	01	01	H5649_004_0	6	3	Preferred Brand	000001	
H5649	004	0	1	01	01	H5649_004_0	6	1	Preferred Generic	001000	1
H5652	001	0	1	02	01	H5652_001_0	5	5	Specialty Tier	010010	
H5652	001	0	1	02	01	H5652_001_0	5	4	Non-Preferred Brand	100100	
H5652	001	0	1	02	01	H5652_001_0	5	3	Preferred Brand	010001	
H5652	001	0	1	02	01	H5652_001_0	5	2	Non-Preferred Generic	000100	
H5652	001	0	1	02	01	H5652_001_0	5	1	Preferred Generic	001000	
H5652	003	0	1	02	01	H5652_003_0	5	5	Specialty Tier	010010	
H5652	003	0	1	02	01	H5652_003_0	5	4	Non-Preferred Brand	100100	
H5652	003	0	1	02	01	H5652_003_0	5	3	Preferred Brand	010001	
H5652	003	0	1	02	01	H5652_003_0	5	2	Non-Preferred Generic	000100	
H5652	003	0	1	02	01	H5652_003_0	5	1	Preferred Generic	001000	
H5652	004	0	1	02	01	H5652_004_0	5	1	Preferred Generic	001000	
H5652	004	0	1	02	01	H5652_004_0	5	4	Non-Preferred Brand	100100	
H5652	004	0	1	02	01	H5652_004_0	5	3	Preferred Brand	010001	
H5652	004	0	1	02	01	H5652_004_0	5	2	Non-Preferred Generic	000100	
H5652	004	0	1	02	01	H5652_004_0	5	5	Specialty Tier	010010	
H5652	006	0	1	02	01	H5652_006_0	4	5	Specialty Tier	010010	
H5652	006	0	1	02	01	H5652_006_0	4	4	Non-Preferred Brand	100100	
H5652	006	0	1	02	01	H5652_006_0	4	2	Non-Preferred Generic	000100	
H5652	006	0	1	02	01	H5652_006_0	4	3	Preferred Brand	010001	
H5652	006	0	1	02	01	H5652_006_0	4	1	Preferred Generic	001000	
H5656	001	0	1	01	01	H5656_001_0	8	1	Preferred Generic	001000	
H5656	001	0	1	01	01	H5656_001_0	8	2	Non-Preferred Generic	000100	
H5656	001	0	1	01	01	H5656_001_0	8	3	Preferred Brand	000101	
H5656	001	0	1	01	01	H5656_001_0	8	4	Non-Preferred Brand	100100	
H5656	001	0	1	01	01	H5656_001_0	8	5	Specialty Tier	010010	
H5656	001	0	1	01	01	H5656_001_0	8	1	Preferred Generic	001000	1
H5656	001	0	1	01	01	H5656_001_0	8	2	Non-Preferred Generic	000100	1
H5656	001	0	1	01	01	H5656_001_0	8	3	Preferred Brand	000101	2
H5656	017	0	1	02	01	H5656_017_0	9	1	Preferred Generic	001000	
H5656	017	0	1	02	01	H5656_017_0	9	2	Non-Preferred Generic	000100	
H5656	017	0	1	02	01	H5656_017_0	9	3	Preferred Brand	000101	
H5656	017	0	1	02	01	H5656_017_0	9	4	Non-Preferred Brand	100100	
H5656	017	0	1	02	01	H5656_017_0	9	5	Specialty Tier	010010	
H5685	001	0	1	01	01	H5685_001_0	6	2	Brand	000010	
H5685	001	0	1	01	01	H5685_001_0	6	1	Generic	010000	
H5696	002	0	1	01	01	H5696_002_0	3	3	Non-Preferred Brand	110000	
H5696	002	0	1	01	01	H5696_002_0	3	2	Preferred Brand	000001	
H5696	002	0	1	01	01	H5696_002_0	3	1	Generic	010010	
H5696	002	0	1	01	01	H5696_002_0	3	4	Specialty Tier	010010	
H5696	004	0	1	01	01	H5696_004_0	4	1	Generic	010010	
H5696	004	0	1	01	01	H5696_004_0	4	2	Preferred Brand	000001	
H5696	004	0	1	01	01	H5696_004_0	4	3	Non-Preferred Brand	110000	
H5696	004	0	1	01	01	H5696_004_0	4	4	Specialty Tier	010010	
H5696	021	0	1	01	01	H5696_021_0	6	3	Non-Preferred Brand	110000	
H5696	021	0	1	01	01	H5696_021_0	6	2	Preferred Brand	000001	
H5696	021	0	1	01	01	H5696_021_0	6	1	Generic	010010	
H5696	021	0	1	01	01	H5696_021_0	6	4	Specialty Tier	010010	
H5696	024	0	1	01	01	H5696_024_0	4	1	Generic	010010	
H5696	024	0	1	01	01	H5696_024_0	4	2	Preferred Brand	000001	
H5696	024	0	1	01	01	H5696_024_0	4	3	Non-Preferred Brand	110000	
H5696	024	0	1	01	01	H5696_024_0	4	4	Specialty Tier	010010	
H5696	028	0	1	01	01	H5696_028_0	5	1	Generic	010010	
H5696	028	0	1	01	01	H5696_028_0	5	2	Preferred Brand	000001	
H5696	028	0	1	01	01	H5696_028_0	5	4	Specialty Tier	010010	
H5696	028	0	1	01	01	H5696_028_0	5	3	Non-Preferred Brand	110000	
H5696	030	0	1	01	01	H5696_030_0	4	1	Generic	010010	
H5696	030	0	1	01	01	H5696_030_0	4	3	Non-Preferred Brand	110000	
H5696	030	0	1	01	01	H5696_030_0	4	2	Preferred Brand	000001	
H5696	030	0	1	01	01	H5696_030_0	4	4	Specialty Tier	010010	
H5696	033	0	1	01	01	H5696_033_0	4	1	Generic	010010	1
H5696	033	0	1	01	01	H5696_033_0	4	1	Generic	010010	
H5696	033	0	1	01	01	H5696_033_0	4	2	Preferred Brand	000001	
H5696	033	0	1	01	01	H5696_033_0	4	3	Non-Preferred Brand	110000	
H5696	033	0	1	01	01	H5696_033_0	4	4	Specialty Tier	010010	
H5696	034	0	1	01	01	H5696_034_0	4	4	Specialty Tier	010010	
H5696	034	0	1	01	01	H5696_034_0	4	1	Generic	010010	
H5696	034	0	1	01	01	H5696_034_0	4	2	Preferred Brand	000001	
H5696	034	0	1	01	01	H5696_034_0	4	3	Non-Preferred Brand	110000	
H5696	035	0	1	01	01	H5696_035_0	4	4	Specialty Tier	010010	
H5696	035	0	1	01	01	H5696_035_0	4	3	Non-Preferred Brand	110000	
H5696	035	0	1	01	01	H5696_035_0	4	2	Preferred Brand	000001	
H5696	035	0	1	01	01	H5696_035_0	4	1	Generic	010010	
H5696	035	0	1	01	01	H5696_035_0	4	1	Generic	010010	1
H5696	037	0	1	01	01	H5696_037_0	5	1	Generic	010010	
H5696	037	0	1	01	01	H5696_037_0	5	2	Preferred Brand	000001	
H5696	037	0	1	01	01	H5696_037_0	5	3	Non-Preferred Brand	110000	
H5696	037	0	1	01	01	H5696_037_0	5	4	Specialty Tier	010010	
H5696	037	0	1	01	01	H5696_037_0	5	1	Generic	010010	1
H5696	038	0	1	01	01	H5696_038_0	5	1	Generic	010010	
H5696	038	0	1	01	01	H5696_038_0	5	2	Preferred Brand	000001	
H5696	038	0	1	01	01	H5696_038_0	5	3	Non-Preferred Brand	110000	
H5696	038	0	1	01	01	H5696_038_0	5	4	Specialty Tier	010010	
H5696	039	0	1	01	01	H5696_039_0	4	3	Non-Preferred Brand	110000	
H5696	039	0	1	01	01	H5696_039_0	4	2	Preferred Brand	000001	
H5696	039	0	1	01	01	H5696_039_0	4	1	Generic	010010	
H5696	039	0	1	01	01	H5696_039_0	4	4	Specialty Tier	010010	
H5696	039	0	1	01	01	H5696_039_0	4	1	Generic	010010	1
H5696	040	0	1	01	01	H5696_040_0	4	4	Specialty Tier	010010	
H5696	040	0	1	01	01	H5696_040_0	4	3	Non-Preferred Brand	110000	
H5696	040	0	1	01	01	H5696_040_0	4	2	Preferred Brand	000001	
H5696	040	0	1	01	01	H5696_040_0	4	1	Generic	010010	
H5696	041	0	1	01	01	H5696_041_0	4	4	Specialty Tier	010010	
H5696	041	0	1	01	01	H5696_041_0	4	3	Non-Preferred Brand	110000	
H5696	041	0	1	01	01	H5696_041_0	4	2	Preferred Brand	000001	
H5696	041	0	1	01	01	H5696_041_0	4	1	Generic	010010	1
H5696	041	0	1	01	01	H5696_041_0	4	1	Generic	010010	
H5696	043	0	1	01	01	H5696_043_0	4	1	Generic	010010	
H5696	043	0	1	01	01	H5696_043_0	4	1	Generic	010010	1
H5696	043	0	1	01	01	H5696_043_0	4	4	Specialty Tier	010010	
H5696	043	0	1	01	01	H5696_043_0	4	3	Non-Preferred Brand	110000	
H5696	043	0	1	01	01	H5696_043_0	4	2	Preferred Brand	000001	
H5696	046	0	1	01	01	H5696_046_0	6	1	Generic	010010	
H5696	046	0	1	01	01	H5696_046_0	6	1	Generic	010010	1
H5696	046	0	1	01	01	H5696_046_0	6	4	Specialty Tier	010010	
H5696	046	0	1	01	01	H5696_046_0	6	3	Non-Preferred Brand	110000	
H5696	046	0	1	01	01	H5696_046_0	6	2	Preferred Brand	000001	
H5696	046	0	1	01	01	H5696_046_0	6	2	Preferred Brand	000001	1
H5698	028	0	1	01	01	H5698_028_0	5	1	Preferred Generic	001000	
H5698	028	0	1	01	01	H5698_028_0	5	2	Non-Preferred Generic	000100	
H5698	028	0	1	01	01	H5698_028_0	5	1	Preferred Generic	001000	1
H5698	028	0	1	01	01	H5698_028_0	5	4	Non-Preferred Brand	100000	
H5698	028	0	1	01	01	H5698_028_0	5	5	Specialty Tier	010010	
H5698	028	0	1	01	01	H5698_028_0	5	3	Preferred Brand	000001	
H5698	062	0	1	01	01	H5698_062_0	7	3	Preferred Brand	000001	
H5698	062	0	1	01	01	H5698_062_0	7	4	Non-Preferred Brand	100000	
H5698	062	0	1	01	01	H5698_062_0	7	5	Specialty Tier	010010	
H5698	062	0	1	01	01	H5698_062_0	7	1	Preferred Generic	001000	1
H5698	062	0	1	01	01	H5698_062_0	7	1	Preferred Generic	001000	
H5698	062	0	1	01	01	H5698_062_0	7	2	Non-Preferred Generic	000100	
H5698	063	0	1	01	01	H5698_063_0	5	1	Preferred Generic	001000	
H5698	063	0	1	01	01	H5698_063_0	5	2	Non-Preferred Generic	000100	
H5698	063	0	1	01	01	H5698_063_0	5	3	Preferred Brand	000001	
H5698	063	0	1	01	01	H5698_063_0	5	4	Non-Preferred Brand	100000	
H5698	063	0	1	01	01	H5698_063_0	5	5	Specialty Tier	010010	
H5698	063	0	1	01	01	H5698_063_0	5	1	Preferred Generic	001000	1
H5698	159	0	1	01	01	H5698_159_0	5	1	Preferred Generic	001000	
H5698	159	0	1	01	01	H5698_159_0	5	2	Non-Preferred Generic	000100	
H5698	159	0	1	01	01	H5698_159_0	5	3	Preferred Brand	000001	
H5698	159	0	1	01	01	H5698_159_0	5	4	Non-Preferred Brand	100000	
H5698	159	0	1	01	01	H5698_159_0	5	5	Specialty Tier	010010	
H5698	159	0	1	01	01	H5698_159_0	5	1	Preferred Generic	001000	1
H5732	001	0	1	01	01	H5732_001_0	15	1	Preferred Generic	001000	
H5732	001	0	1	01	01	H5732_001_0	15	2	Non-Preferred Generic	000100	
H5732	001	0	1	01	01	H5732_001_0	15	3	Preferred Brand	000001	
H5732	001	0	1	01	01	H5732_001_0	15	4	Non-Preferred Brand	100000	
H5732	001	0	1	01	01	H5732_001_0	15	5	Specialty Tier	100100	
H5732	001	0	1	01	01	H5732_001_0	15	1	Preferred Generic	001000	1
H5732	001	0	1	01	01	H5732_001_0	15	2	Non-Preferred Generic	000100	1
H5746	006	0	1	01	01	H5746_006_0	6	1	Preferred Generic	001000	
H5746	006	0	1	01	01	H5746_006_0	6	2	Non-Preferred Generic	000100	1
H5746	006	0	1	01	01	H5746_006_0	6	1	Preferred Generic	001000	1
H5746	006	0	1	01	01	H5746_006_0	6	5	Specialty Tier	010010	
H5746	006	0	1	01	01	H5746_006_0	6	4	Non-Preferred Brand	100000	
H5746	006	0	1	01	01	H5746_006_0	6	3	Preferred Brand	000001	
H5746	006	0	1	01	01	H5746_006_0	6	2	Non-Preferred Generic	000100	
H5746	012	0	1	01	01	H5746_012_0	6	1	Preferred Generic	001000	
H5746	012	0	1	01	01	H5746_012_0	6	2	Non-Preferred Generic	000100	
H5746	012	0	1	01	01	H5746_012_0	6	3	Preferred Brand	000001	
H5746	012	0	1	01	01	H5746_012_0	6	4	Non-Preferred Brand	100000	
H5746	012	0	1	01	01	H5746_012_0	6	5	Specialty Tier	010010	
H5746	012	0	1	01	01	H5746_012_0	6	1	Preferred Generic	001000	1
H5749	001	0	1	02	01	H5749_001_0	5	5	Specialty Tier	010010	
H5749	001	0	1	02	01	H5749_001_0	5	4	Non-Preferred Brand	100100	
H5749	001	0	1	02	01	H5749_001_0	5	3	Preferred Brand	010001	
H5749	001	0	1	02	01	H5749_001_0	5	2	Non-Preferred Generic	000100	
H5749	001	0	1	02	01	H5749_001_0	5	1	Preferred Generic	001000	
H5765	001	0	1	01	01	H5765_001_0	7	2	Non-Preferred Generic	000100	
H5765	001	0	1	01	01	H5765_001_0	7	3	Preferred Brand	000001	
H5765	001	0	1	01	01	H5765_001_0	7	4	Non-Preferred Brand	100000	
H5765	001	0	1	01	01	H5765_001_0	7	5	Specialty Tier	010010	
H5765	001	0	1	01	01	H5765_001_0	7	1	Preferred Generic	001000	
H5774	005	0	1	01	01	H5774_005_0	13	4	Non-Preferred Brand	100000	
H5774	005	0	1	01	01	H5774_005_0	13	3	Preferred Brand	000001	
H5774	005	0	1	01	01	H5774_005_0	13	2	Non-Preferred Generic	000100	
H5774	005	0	1	01	01	H5774_005_0	13	5	Specialty Tier	100100	
H5774	005	0	1	01	01	H5774_005_0	13	1	Preferred Generic	001000	1
H5774	005	0	1	01	01	H5774_005_0	13	2	Non-Preferred Generic	000100	1
H5774	005	0	1	01	01	H5774_005_0	13	1	Preferred Generic	001000	
H5774	008	0	1	01	01	H5774_008_0	16	5	Specialty Tier	100100	
H5774	008	0	1	01	01	H5774_008_0	16	1	Preferred Generic	001000	1
H5774	008	0	1	01	01	H5774_008_0	16	2	Non-Preferred Generic	000100	1
H5774	008	0	1	01	01	H5774_008_0	16	4	Non-Preferred Brand	100000	
H5774	008	0	1	01	01	H5774_008_0	16	1	Preferred Generic	001000	
H5774	008	0	1	01	01	H5774_008_0	16	2	Non-Preferred Generic	000100	
H5774	008	0	1	01	01	H5774_008_0	16	3	Preferred Brand	000001	
H5774	009	0	1	01	01	H5774_009_0	16	2	Non-Preferred Generic	000100	
H5774	009	0	1	01	01	H5774_009_0	16	3	Preferred Brand	000001	
H5774	009	0	1	01	01	H5774_009_0	16	4	Non-Preferred Brand	100000	
H5774	009	0	1	01	01	H5774_009_0	16	2	Non-Preferred Generic	000100	1
H5774	009	0	1	01	01	H5774_009_0	16	1	Preferred Generic	001000	1
H5774	009	0	1	01	01	H5774_009_0	16	5	Specialty Tier	100100	
H5774	009	0	1	01	01	H5774_009_0	16	1	Preferred Generic	001000	
H5774	014	0	1	02	01	H5774_014_0	17	1	Preferred Generic	001000	1
H5774	014	0	1	02	01	H5774_014_0	17	2	Non-Preferred Generic	000100	1
H5774	014	0	1	02	01	H5774_014_0	17	5	Specialty Tier	100100	
H5774	014	0	1	02	01	H5774_014_0	17	4	Non-Preferred Brand	100000	
H5774	014	0	1	02	01	H5774_014_0	17	3	Preferred Brand	000001	
H5774	014	0	1	02	01	H5774_014_0	17	2	Non-Preferred Generic	000100	
H5774	014	0	1	02	01	H5774_014_0	17	1	Preferred Generic	001000	
H5779	002	0	1	01	01	H5779_002_0	7	5	Specialty Tier	100000	
H5779	002	0	1	01	01	H5779_002_0	7	3	Preferred Brand	000001	
H5779	002	0	1	01	01	H5779_002_0	7	2	Non-Preferred Generic	000100	
H5779	002	0	1	01	01	H5779_002_0	7	1	Preferred Generic	001000	
H5779	002	0	1	01	01	H5779_002_0	7	4	Non-Preferred Brand	100000	
H5782	001	0	1	01	01	H5782_001_0	7	1	Generic	010000	
H5782	001	0	1	01	01	H5782_001_0	7	2	Brand	000010	
H5786	002	0	1	01	01	H5786_002_0	7	1	Preferred Generic	001000	
H5786	002	0	1	01	01	H5786_002_0	7	2	Non-Preferred Generic	000100	
H5786	002	0	1	01	01	H5786_002_0	7	3	Preferred Brand	000001	
H5786	002	0	1	01	01	H5786_002_0	7	4	Non-Preferred Brand	100000	
H5786	002	0	1	01	01	H5786_002_0	7	5	Specialty Tier	100000	
H5793	001	0	1	01	01	H5793_001_0	5	1	Generic	010000	
H5793	001	0	1	01	01	H5793_001_0	5	2	Preferred Brand	010001	
H5793	001	0	1	01	01	H5793_001_0	5	3	Non-Preferred Brand	110000	
H5793	001	0	1	01	01	H5793_001_0	5	5	Select Care Drugs	010000	
H5793	001	0	1	01	01	H5793_001_0	5	4	Specialty Tier	010010	
H5793	001	0	1	01	01	H5793_001_0	5	5	Select Care Drugs	010000	1
H5793	008	0	1	01	01	H5793_008_0	6	1	Generic	010000	
H5793	008	0	1	01	01	H5793_008_0	6	2	Preferred Brand	010001	
H5793	008	0	1	01	01	H5793_008_0	6	3	Non-Preferred Brand	110000	
H5793	008	0	1	01	01	H5793_008_0	6	5	Select Care Drugs	010000	1
H5793	008	0	1	01	01	H5793_008_0	6	5	Select Care Drugs	010000	
H5793	008	0	1	01	01	H5793_008_0	6	4	Specialty Tier	010010	
H5810	001	0	1	01	01	H5810_001_0	10	4	Specialty Tier	010010	
H5810	001	0	1	01	01	H5810_001_0	10	3	Non-Preferred Brand	100000	
H5810	001	0	1	01	01	H5810_001_0	10	2	Preferred Brand	000001	
H5810	001	0	1	01	01	H5810_001_0	10	1	Generic	010000	
H5811	001	0	1	01	01	H5811_001_0	5	6	Select Care Drugs	000010	
H5811	001	0	1	01	01	H5811_001_0	5	1	Preferred Generic	001000	1
H5811	001	0	1	01	01	H5811_001_0	5	2	Non-Preferred Generic	000100	1
H5811	001	0	1	01	01	H5811_001_0	5	5	Specialty Tier	010010	
H5811	001	0	1	01	01	H5811_001_0	5	4	Non-Preferred Brand	100000	
H5811	001	0	1	01	01	H5811_001_0	5	3	Preferred Brand	000001	
H5811	001	0	1	01	01	H5811_001_0	5	1	Preferred Generic	001000	
H5811	001	0	1	01	01	H5811_001_0	5	2	Non-Preferred Generic	000100	
H5811	005	0	1	01	01	H5811_005_0	4	1	Preferred Generic	001000	
H5811	005	0	1	01	01	H5811_005_0	4	2	Non-Preferred Generic	000100	
H5811	005	0	1	01	01	H5811_005_0	4	3	Preferred Brand	000001	
H5811	005	0	1	01	01	H5811_005_0	4	5	Specialty Tier	010010	
H5811	005	0	1	01	01	H5811_005_0	4	6	Select Care Drugs	000010	
H5811	005	0	1	01	01	H5811_005_0	4	4	Non-Preferred Brand	100000	
H5813	003	0	1	01	01	H5813_003_0	5	1	Generic	010000	
H5813	003	0	1	01	01	H5813_003_0	5	2	Preferred Brand	010001	
H5813	003	0	1	01	01	H5813_003_0	5	4	Specialty Tier	010010	
H5813	003	0	1	01	01	H5813_003_0	5	5	Select Care Drugs	010000	
H5813	003	0	1	01	01	H5813_003_0	5	5	Select Care Drugs	010000	1
H5813	003	0	1	01	01	H5813_003_0	5	3	Non-Preferred Brand	110000	
H5813	006	0	1	01	01	H5813_006_0	5	5	Select Care Drugs	010000	
H5813	006	0	1	01	01	H5813_006_0	5	5	Select Care Drugs	010000	1
H5813	006	0	1	01	01	H5813_006_0	5	4	Specialty Tier	010010	
H5813	006	0	1	01	01	H5813_006_0	5	3	Non-Preferred Brand	110000	
H5813	006	0	1	01	01	H5813_006_0	5	2	Preferred Brand	010001	
H5813	006	0	1	01	01	H5813_006_0	5	1	Generic	010000	
H5817	009	0	1	01	01	H5817_009_0	13	1	Preferred Generic	001000	1
H5817	009	0	1	01	01	H5817_009_0	13	5	Specialty Tier	010010	
H5817	009	0	1	01	01	H5817_009_0	13	4	Non-Preferred Brand	100000	
H5817	009	0	1	01	01	H5817_009_0	13	3	Preferred Brand	000001	
H5817	009	0	1	01	01	H5817_009_0	13	2	Non-Preferred Generic	000100	
H5817	009	0	1	01	01	H5817_009_0	13	1	Preferred Generic	001000	
H5817	009	0	1	01	01	H5817_009_0	13	2	Non-Preferred Generic	000100	1
H5817	010	0	1	01	01	H5817_010_0	13	1	Preferred Generic	001000	
H5817	010	0	1	01	01	H5817_010_0	13	2	Non-Preferred Generic	000100	
H5817	010	0	1	01	01	H5817_010_0	13	3	Preferred Brand	000001	
H5817	010	0	1	01	01	H5817_010_0	13	5	Specialty Tier	010010	
H5817	010	0	1	01	01	H5817_010_0	13	4	Non-Preferred Brand	100000	
H5826	008	0	1	01	01	H5826_008_0	7	1	Preferred Generic	001000	
H5826	008	0	1	01	01	H5826_008_0	7	2	Preferred Brand	000001	
H5826	008	0	1	01	01	H5826_008_0	7	3	Specialty Tier	010010	
H5826	009	0	1	01	01	H5826_009_0	7	1	Preferred Generic	001000	
H5826	009	0	1	01	01	H5826_009_0	7	2	Preferred Brand	000001	
H5826	009	0	1	01	01	H5826_009_0	7	3	Specialty Tier	010010	
H5826	010	0	1	01	01	H5826_010_0	7	1	Preferred Generic	001000	
H5826	010	0	1	01	01	H5826_010_0	7	2	Preferred Brand	000001	
H5826	010	0	1	01	01	H5826_010_0	7	3	Specialty Tier	010000	
H5832	001	0	1	01	01	H5832_001_0	7	1	Generic	010000	
H5832	001	0	1	01	01	H5832_001_0	7	2	Preferred Brand	010001	
H5832	001	0	1	01	01	H5832_001_0	7	5	Select Care Drugs	010000	1
H5832	001	0	1	01	01	H5832_001_0	7	4	Specialty Tier	010010	
H5832	001	0	1	01	01	H5832_001_0	7	5	Select Care Drugs	010000	
H5832	001	0	1	01	01	H5832_001_0	7	3	Non-Preferred Brand	110000	
H5850	002	0	1	01	01	H5850_002_0	14	4	Specialty Tier	010010	
H5850	002	0	1	01	01	H5850_002_0	14	3	Non-Preferred Brand	100100	
H5850	002	0	1	01	01	H5850_002_0	14	2	Preferred Brand	000001	
H5850	002	0	1	01	01	H5850_002_0	14	1	Preferred Generic	001010	
H5850	002	0	1	01	01	H5850_002_0	14	1	Preferred Generic	001010	1
H5850	003	0	1	01	01	H5850_003_0	8	2	Preferred Brand	000001	
H5850	003	0	1	01	01	H5850_003_0	8	3	Non-Preferred Brand	100100	
H5850	003	0	1	01	01	H5850_003_0	8	4	Specialty Tier	010010	
H5850	003	0	1	01	01	H5850_003_0	8	1	Preferred Generic	001010	1
H5850	003	0	1	01	01	H5850_003_0	8	1	Preferred Generic	001010	
H5850	004	0	1	01	01	H5850_004_0	8	4	Specialty Tier	010010	
H5850	004	0	1	01	01	H5850_004_0	8	1	Preferred Generic	001010	1
H5850	004	0	1	01	01	H5850_004_0	8	3	Non-Preferred Brand	100100	
H5850	004	0	1	01	01	H5850_004_0	8	2	Preferred Brand	000001	
H5850	004	0	1	01	01	H5850_004_0	8	1	Preferred Generic	001010	
H5850	006	0	1	01	01	H5850_006_0	8	1	Preferred Generic	001010	1
H5850	006	0	1	01	01	H5850_006_0	8	4	Specialty Tier	010010	
H5850	006	0	1	01	01	H5850_006_0	8	3	Non-Preferred Brand	100100	
H5850	006	0	1	01	01	H5850_006_0	8	2	Preferred Brand	000001	
H5850	006	0	1	01	01	H5850_006_0	8	1	Preferred Generic	001010	
H5850	007	0	1	01	01	H5850_007_0	8	4	Specialty Tier	010010	
H5850	007	0	1	01	01	H5850_007_0	8	1	Preferred Generic	001010	1
H5850	007	0	1	01	01	H5850_007_0	8	3	Non-Preferred Brand	100100	
H5850	007	0	1	01	01	H5850_007_0	8	2	Preferred Brand	000001	
H5850	007	0	1	01	01	H5850_007_0	8	1	Preferred Generic	001010	
H5850	012	0	1	01	01	H5850_012_0	9	1	Preferred Generic	001010	
H5850	012	0	1	01	01	H5850_012_0	9	1	Preferred Generic	001010	1
H5850	012	0	1	01	01	H5850_012_0	9	4	Specialty Tier	010010	
H5850	012	0	1	01	01	H5850_012_0	9	3	Non-Preferred Brand	100100	
H5850	012	0	1	01	01	H5850_012_0	9	2	Preferred Brand	000001	
H5850	022	0	1	01	01	H5850_022_0	8	4	Specialty Tier	010010	
H5850	022	0	1	01	01	H5850_022_0	8	2	Preferred Brand	000001	
H5850	022	0	1	01	01	H5850_022_0	8	3	Non-Preferred Brand	100100	
H5850	022	0	1	01	01	H5850_022_0	8	1	Preferred Generic	001010	
H5850	023	0	1	01	01	H5850_023_0	7	1	Preferred Generic	001010	
H5850	023	0	1	01	01	H5850_023_0	7	2	Preferred Brand	000001	
H5850	023	0	1	01	01	H5850_023_0	7	3	Non-Preferred Brand	100100	
H5850	023	0	1	01	01	H5850_023_0	7	4	Specialty Tier	010010	
H5850	025	0	1	01	01	H5850_025_0	7	1	Preferred Generic	001010	
H5850	025	0	1	01	01	H5850_025_0	7	2	Preferred Brand	000001	
H5850	025	0	1	01	01	H5850_025_0	7	3	Non-Preferred Brand	100100	
H5850	025	0	1	01	01	H5850_025_0	7	4	Specialty Tier	010010	
H5850	025	0	1	01	01	H5850_025_0	7	1	Preferred Generic	001010	1
H5850	027	0	1	01	01	H5850_027_0	7	4	Specialty Tier	010010	
H5850	027	0	1	01	01	H5850_027_0	7	3	Non-Preferred Brand	100100	
H5850	027	0	1	01	01	H5850_027_0	7	2	Preferred Brand	000001	
H5850	027	0	1	01	01	H5850_027_0	7	1	Preferred Generic	001010	
H5852	001	0	1	01	01	H5852_001_0	4	3	Non-Preferred Brand	100000	
H5852	001	0	1	01	01	H5852_001_0	4	1	Preferred Generic	001001	
H5852	001	0	1	01	01	H5852_001_0	4	2	Preferred Brand	010001	
H5854	005	0	1	01	01	H5854_005_0	6	3	Preferred Brand	000101	
H5854	005	0	1	01	01	H5854_005_0	6	6	Specialty Tier	010010	
H5854	005	0	1	01	01	H5854_005_0	6	5	Injectable Drugs	010010	
H5854	005	0	1	01	01	H5854_005_0	6	4	Non-Preferred Brand	100100	
H5854	005	0	1	01	01	H5854_005_0	6	2	Non-Preferred Generic	000100	
H5854	005	0	1	01	01	H5854_005_0	6	1	Preferred Generic	001000	
H5859	001	0	1	02	01	H5859_001_0	12	1	Preferred Generic	001001	
H5859	001	0	1	02	01	H5859_001_0	12	2	Preferred Brand	000101	
H5859	001	0	1	02	01	H5859_001_0	12	3	Non-Preferred Brand	100100	
H5859	001	0	1	02	01	H5859_001_0	12	1	Preferred Generic	001001	1
H5859	003	0	1	02	01	H5859_003_0	11	1	Preferred Generic	001001	
H5859	003	0	1	02	01	H5859_003_0	11	3	Non-Preferred Brand	100100	
H5859	003	0	1	02	01	H5859_003_0	11	2	Preferred Brand	000101	
H5868	001	0	1	04	01	H5868_001_0	7	5	Specialty Tier	010010	
H5868	001	0	1	04	01	H5868_001_0	7	4	Non-Preferred Brand	110000	
H5868	001	0	1	04	01	H5868_001_0	7	5	Specialty Tier	010010	2
H5868	001	0	1	04	01	H5868_001_0	7	4	Non-Preferred Brand	110000	2
H5868	001	0	1	04	01	H5868_001_0	7	3	Preferred Brand	000101	2
H5868	001	0	1	04	01	H5868_001_0	7	2	Non-Preferred Generic	000101	2
H5868	001	0	1	04	01	H5868_001_0	7	1	Preferred Generic	001010	2
H5868	001	0	1	04	01	H5868_001_0	7	1	Preferred Generic	001010	
H5868	001	0	1	04	01	H5868_001_0	7	2	Non-Preferred Generic	000101	
H5868	001	0	1	04	01	H5868_001_0	7	3	Preferred Brand	000101	
H5868	009	0	1	04	01	H5868_009_0	5	2	Non-Preferred Generic	000101	
H5868	009	0	1	04	01	H5868_009_0	5	1	Preferred Generic	001010	
H5868	009	0	1	04	01	H5868_009_0	5	2	Non-Preferred Generic	000101	2
H5868	009	0	1	04	01	H5868_009_0	5	3	Preferred Brand	000101	2
H5868	009	0	1	04	01	H5868_009_0	5	1	Preferred Generic	001010	2
H5868	009	0	1	04	01	H5868_009_0	5	5	Specialty Tier	010010	2
H5868	009	0	1	04	01	H5868_009_0	5	5	Specialty Tier	010010	
H5868	009	0	1	04	01	H5868_009_0	5	4	Non-Preferred Brand	110000	
H5868	009	0	1	04	01	H5868_009_0	5	3	Preferred Brand	000101	
H5868	009	0	1	04	01	H5868_009_0	5	4	Non-Preferred Brand	110000	2
H5868	010	0	1	04	01	H5868_010_0	5	5	Specialty Tier	010010	
H5868	010	0	1	04	01	H5868_010_0	5	4	Non-Preferred Brand	110000	
H5868	010	0	1	04	01	H5868_010_0	5	3	Preferred Brand	000101	
H5868	010	0	1	04	01	H5868_010_0	5	2	Non-Preferred Generic	000101	
H5868	010	0	1	04	01	H5868_010_0	5	1	Preferred Generic	001010	
H5868	010	0	1	04	01	H5868_010_0	5	2	Non-Preferred Generic	000101	2
H5868	010	0	1	04	01	H5868_010_0	5	3	Preferred Brand	000101	2
H5868	010	0	1	04	01	H5868_010_0	5	1	Preferred Generic	001010	2
H5868	010	0	1	04	01	H5868_010_0	5	5	Specialty Tier	010010	2
H5868	010	0	1	04	01	H5868_010_0	5	4	Non-Preferred Brand	110000	2
H5868	012	0	1	04	01	H5868_012_0	5	5	Specialty Tier	010010	2
H5868	012	0	1	04	01	H5868_012_0	5	4	Non-Preferred Brand	110000	2
H5868	012	0	1	04	01	H5868_012_0	5	3	Preferred Brand	000101	2
H5868	012	0	1	04	01	H5868_012_0	5	2	Non-Preferred Generic	000101	2
H5868	012	0	1	04	01	H5868_012_0	5	5	Specialty Tier	010010	
H5868	012	0	1	04	01	H5868_012_0	5	1	Preferred Generic	001010	
H5868	012	0	1	04	01	H5868_012_0	5	2	Non-Preferred Generic	000101	
H5868	012	0	1	04	01	H5868_012_0	5	3	Preferred Brand	000101	
H5868	012	0	1	04	01	H5868_012_0	5	4	Non-Preferred Brand	110000	
H5868	013	0	1	04	01	H5868_013_0	4	1	Preferred Generic	001010	
H5868	013	0	1	04	01	H5868_013_0	4	2	Non-Preferred Generic	000101	
H5868	013	0	1	04	01	H5868_013_0	4	3	Preferred Brand	000101	
H5868	013	0	1	04	01	H5868_013_0	4	4	Non-Preferred Brand	110000	
H5868	013	0	1	04	01	H5868_013_0	4	5	Specialty Tier	010010	
H5883	002	1	1	02	01	H5883_002_1	8	1	Preferred Generic	001000	
H5883	002	1	1	02	01	H5883_002_1	8	2	Non-Preferred Generic	000100	
H5883	002	1	1	02	01	H5883_002_1	8	3	Preferred Brand	000001	
H5883	002	1	1	02	01	H5883_002_1	8	4	Non-Preferred Brand	100000	
H5883	002	1	1	02	01	H5883_002_1	8	5	Specialty Tier	010010	
H5883	002	1	1	02	01	H5883_002_1	8	1	Preferred Generic	001000	1
H5883	002	2	1	02	01	H5883_002_2	8	2	Non-Preferred Generic	000100	
H5883	002	2	1	02	01	H5883_002_2	8	1	Preferred Generic	001000	
H5883	002	2	1	02	01	H5883_002_2	8	3	Preferred Brand	000001	
H5883	002	2	1	02	01	H5883_002_2	8	1	Preferred Generic	001000	1
H5883	002	2	1	02	01	H5883_002_2	8	5	Specialty Tier	010010	
H5883	002	2	1	02	01	H5883_002_2	8	4	Non-Preferred Brand	100000	
H5883	002	3	1	02	01	H5883_002_3	9	1	Preferred Generic	001000	
H5883	002	3	1	02	01	H5883_002_3	9	2	Non-Preferred Generic	000100	
H5883	002	3	1	02	01	H5883_002_3	9	5	Specialty Tier	010010	
H5883	002	3	1	02	01	H5883_002_3	9	4	Non-Preferred Brand	100000	
H5883	002	3	1	02	01	H5883_002_3	9	3	Preferred Brand	000001	
H5883	002	3	1	02	01	H5883_002_3	9	1	Preferred Generic	001000	1
H5883	002	4	1	02	01	H5883_002_4	8	2	Non-Preferred Generic	000100	
H5883	002	4	1	02	01	H5883_002_4	8	1	Preferred Generic	001000	
H5883	002	4	1	02	01	H5883_002_4	8	3	Preferred Brand	000001	
H5883	002	4	1	02	01	H5883_002_4	8	1	Preferred Generic	001000	1
H5883	002	4	1	02	01	H5883_002_4	8	5	Specialty Tier	010010	
H5883	002	4	1	02	01	H5883_002_4	8	4	Non-Preferred Brand	100000	
H5883	002	7	1	02	01	H5883_002_7	7	2	Non-Preferred Generic	000100	
H5883	002	7	1	02	01	H5883_002_7	7	1	Preferred Generic	001000	
H5883	002	7	1	02	01	H5883_002_7	7	3	Preferred Brand	000001	
H5883	002	7	1	02	01	H5883_002_7	7	4	Non-Preferred Brand	100000	
H5883	002	7	1	02	01	H5883_002_7	7	5	Specialty Tier	010010	
H5883	002	7	1	02	01	H5883_002_7	7	1	Preferred Generic	001000	1
H5883	003	1	1	02	01	H5883_003_1	7	2	Non-Preferred Generic	000100	
H5883	003	1	1	02	01	H5883_003_1	7	1	Preferred Generic	001000	
H5883	003	1	1	02	01	H5883_003_1	7	3	Preferred Brand	000001	
H5883	003	1	1	02	01	H5883_003_1	7	1	Preferred Generic	001000	1
H5883	003	1	1	02	01	H5883_003_1	7	5	Specialty Tier	010010	
H5883	003	1	1	02	01	H5883_003_1	7	4	Non-Preferred Brand	100000	
H5883	003	2	1	02	01	H5883_003_2	7	1	Preferred Generic	001000	
H5883	003	2	1	02	01	H5883_003_2	7	2	Non-Preferred Generic	000100	
H5883	003	2	1	02	01	H5883_003_2	7	3	Preferred Brand	000001	
H5883	003	2	1	02	01	H5883_003_2	7	4	Non-Preferred Brand	100000	
H5883	003	2	1	02	01	H5883_003_2	7	5	Specialty Tier	010010	
H5883	003	2	1	02	01	H5883_003_2	7	1	Preferred Generic	001000	1
H5883	003	3	1	02	01	H5883_003_3	7	1	Preferred Generic	001000	1
H5883	003	3	1	02	01	H5883_003_3	7	1	Preferred Generic	001000	
H5883	003	3	1	02	01	H5883_003_3	7	2	Non-Preferred Generic	000100	
H5883	003	3	1	02	01	H5883_003_3	7	3	Preferred Brand	000001	
H5883	003	3	1	02	01	H5883_003_3	7	4	Non-Preferred Brand	100000	
H5883	003	3	1	02	01	H5883_003_3	7	5	Specialty Tier	010010	
H5883	003	4	1	02	01	H5883_003_4	7	5	Specialty Tier	010010	
H5883	003	4	1	02	01	H5883_003_4	7	4	Non-Preferred Brand	100000	
H5883	003	4	1	02	01	H5883_003_4	7	3	Preferred Brand	000001	
H5883	003	4	1	02	01	H5883_003_4	7	2	Non-Preferred Generic	000100	
H5883	003	4	1	02	01	H5883_003_4	7	1	Preferred Generic	001000	
H5883	003	4	1	02	01	H5883_003_4	7	1	Preferred Generic	001000	1
H5883	003	5	1	02	01	H5883_003_5	7	5	Specialty Tier	010010	
H5883	003	5	1	02	01	H5883_003_5	7	4	Non-Preferred Brand	100000	
H5883	003	5	1	02	01	H5883_003_5	7	3	Preferred Brand	000001	
H5883	003	5	1	02	01	H5883_003_5	7	2	Non-Preferred Generic	000100	
H5883	003	5	1	02	01	H5883_003_5	7	1	Preferred Generic	001000	
H5883	003	5	1	02	01	H5883_003_5	7	1	Preferred Generic	001000	1
H5883	005	0	1	01	01	H5883_005_0	7	5	Specialty Tier	010010	
H5883	005	0	1	01	01	H5883_005_0	7	4	Non-Preferred Brand	100000	
H5883	005	0	1	01	01	H5883_005_0	7	3	Preferred Brand	000001	
H5883	005	0	1	01	01	H5883_005_0	7	2	Non-Preferred Generic	000100	
H5883	005	0	1	01	01	H5883_005_0	7	1	Preferred Generic	001000	
H5883	006	0	1	01	01	H5883_006_0	9	5	Specialty Tier	010010	
H5883	006	0	1	01	01	H5883_006_0	9	4	Non-Preferred Brand	100000	
H5883	006	0	1	01	01	H5883_006_0	9	3	Preferred Brand	000001	
H5883	006	0	1	01	01	H5883_006_0	9	2	Non-Preferred Generic	000100	
H5883	006	0	1	01	01	H5883_006_0	9	1	Preferred Generic	001000	1
H5883	006	0	1	01	01	H5883_006_0	9	1	Preferred Generic	001000	
H5887	001	0	1	01	01	H5887_001_0	12	3	Preferred Brand	000001	
H5887	001	0	1	01	01	H5887_001_0	12	4	Non-Preferred Brand	100000	
H5887	001	0	1	01	01	H5887_001_0	12	5	Specialty Tier	010010	
H5887	001	0	1	01	01	H5887_001_0	12	1	Preferred Generic	001000	1
H5887	001	0	1	01	01	H5887_001_0	12	2	Non-Preferred Generic	000100	1
H5887	001	0	1	01	01	H5887_001_0	12	1	Preferred Generic	001000	
H5887	001	0	1	01	01	H5887_001_0	12	2	Non-Preferred Generic	000100	
H5887	007	0	1	01	01	H5887_007_0	12	1	Preferred Generic	001000	
H5887	007	0	1	01	01	H5887_007_0	12	2	Non-Preferred Generic	000100	1
H5887	007	0	1	01	01	H5887_007_0	12	1	Preferred Generic	001000	1
H5887	007	0	1	01	01	H5887_007_0	12	5	Specialty Tier	010010	
H5887	007	0	1	01	01	H5887_007_0	12	4	Non-Preferred Brand	100000	
H5887	007	0	1	01	01	H5887_007_0	12	3	Preferred Brand	000001	
H5887	007	0	1	01	01	H5887_007_0	12	2	Non-Preferred Generic	000100	
H5887	012	0	1	01	01	H5887_012_0	12	1	Preferred Generic	001000	
H5887	012	0	1	01	01	H5887_012_0	12	2	Non-Preferred Generic	000100	
H5887	012	0	1	01	01	H5887_012_0	12	3	Preferred Brand	000001	
H5887	012	0	1	01	01	H5887_012_0	12	4	Non-Preferred Brand	100000	
H5887	012	0	1	01	01	H5887_012_0	12	5	Specialty Tier	010010	
H5887	012	0	1	01	01	H5887_012_0	12	1	Preferred Generic	001000	1
H5887	012	0	1	01	01	H5887_012_0	12	2	Non-Preferred Generic	000100	1
H5887	013	0	1	01	01	H5887_013_0	14	1	Preferred Generic	001000	1
H5887	013	0	1	01	01	H5887_013_0	14	2	Non-Preferred Generic	000100	1
H5887	013	0	1	01	01	H5887_013_0	14	5	Specialty Tier	010010	
H5887	013	0	1	01	01	H5887_013_0	14	4	Non-Preferred Brand	100000	
H5887	013	0	1	01	01	H5887_013_0	14	3	Preferred Brand	000001	
H5887	013	0	1	01	01	H5887_013_0	14	2	Non-Preferred Generic	000100	
H5887	013	0	1	01	01	H5887_013_0	14	1	Preferred Generic	001000	
H5896	007	0	1	01	01	H5896_007_0	6	1	Preferred Generic	001000	
H5896	007	0	1	01	01	H5896_007_0	6	2	Non-Preferred Generic	000100	
H5896	007	0	1	01	01	H5896_007_0	6	3	Preferred Brand	000001	
H5896	007	0	1	01	01	H5896_007_0	6	4	Non-Preferred Brand	100000	
H5896	007	0	1	01	01	H5896_007_0	6	5	Specialty Tier	010010	
H5896	007	0	1	01	01	H5896_007_0	6	1	Preferred Generic	001000	1
H5926	001	0	1	01	01	H5926_001_0	9	4	Specialty Tier	010010	
H5926	001	0	1	01	01	H5926_001_0	9	3	Non-Preferred Brand	100000	
H5926	001	0	1	01	01	H5926_001_0	9	2	Preferred Brand	000001	
H5926	001	0	1	01	01	H5926_001_0	9	1	Generic	010000	
H5928	001	0	1	01	01	H5928_001_0	5	4	Non-Preferred Brand	100100	
H5928	001	0	1	01	01	H5928_001_0	5	3	Preferred Brand	000001	
H5928	001	0	1	01	01	H5928_001_0	5	2	Non-Preferred Generic	000100	
H5928	001	0	1	01	01	H5928_001_0	5	1	Preferred Generic	001000	
H5928	001	0	1	01	01	H5928_001_0	5	5	Specialty Tier	010010	
H5928	001	0	1	01	01	H5928_001_0	5	1	Preferred Generic	001000	1
H5928	004	0	1	01	01	H5928_004_0	5	1	Preferred Generic	001000	
H5928	004	0	1	01	01	H5928_004_0	5	2	Non-Preferred Generic	000100	
H5928	004	0	1	01	01	H5928_004_0	5	3	Preferred Brand	000001	
H5928	004	0	1	01	01	H5928_004_0	5	4	Non-Preferred Brand	100100	
H5928	004	0	1	01	01	H5928_004_0	5	5	Specialty Tier	010010	
H5928	004	0	1	01	01	H5928_004_0	5	1	Preferred Generic	001000	1
H5928	004	0	1	01	01	H5928_004_0	5	2	Non-Preferred Generic	000100	1
H5928	005	0	1	01	01	H5928_005_0	8	1	Preferred Generic	001000	
H5928	005	0	1	01	01	H5928_005_0	8	2	Non-Preferred Generic	000100	
H5928	005	0	1	01	01	H5928_005_0	8	1	Preferred Generic	001000	1
H5928	005	0	1	01	01	H5928_005_0	8	5	Specialty Tier	010010	
H5928	005	0	1	01	01	H5928_005_0	8	4	Non-Preferred Brand	100100	
H5928	005	0	1	01	01	H5928_005_0	8	3	Preferred Brand	000001	
H5928	010	0	1	01	01	H5928_010_0	6	1	Preferred Generic	001000	
H5928	010	0	1	01	01	H5928_010_0	6	2	Non-Preferred Generic	000100	
H5928	010	0	1	01	01	H5928_010_0	6	3	Preferred Brand	000001	
H5928	010	0	1	01	01	H5928_010_0	6	4	Non-Preferred Brand	100100	
H5928	010	0	1	01	01	H5928_010_0	6	5	Specialty Tier	010010	
H5928	010	0	1	01	01	H5928_010_0	6	1	Preferred Generic	001000	1
H5928	010	0	1	01	01	H5928_010_0	6	2	Non-Preferred Generic	000100	1
H5928	012	0	1	01	01	H5928_012_0	7	1	Preferred Generic	001000	
H5928	012	0	1	01	01	H5928_012_0	7	2	Non-Preferred Generic	000100	
H5928	012	0	1	01	01	H5928_012_0	7	1	Preferred Generic	001000	1
H5928	012	0	1	01	01	H5928_012_0	7	5	Specialty Tier	010010	
H5928	012	0	1	01	01	H5928_012_0	7	4	Non-Preferred Brand	100100	
H5928	012	0	1	01	01	H5928_012_0	7	3	Preferred Brand	000001	
H5928	012	0	1	01	01	H5928_012_0	7	2	Non-Preferred Generic	000100	1
H5928	016	0	1	01	01	H5928_016_0	5	5	Specialty Tier	010010	
H5928	016	0	1	01	01	H5928_016_0	5	1	Preferred Generic	001000	1
H5928	016	0	1	01	01	H5928_016_0	5	2	Non-Preferred Generic	000100	1
H5928	016	0	1	01	01	H5928_016_0	5	1	Preferred Generic	001000	
H5928	016	0	1	01	01	H5928_016_0	5	2	Non-Preferred Generic	000100	
H5928	016	0	1	01	01	H5928_016_0	5	3	Preferred Brand	000001	
H5928	016	0	1	01	01	H5928_016_0	5	4	Non-Preferred Brand	100100	
H5928	020	0	1	01	01	H5928_020_0	5	3	Preferred Brand	000001	
H5928	020	0	1	01	01	H5928_020_0	5	4	Non-Preferred Brand	100100	
H5928	020	0	1	01	01	H5928_020_0	5	5	Specialty Tier	010010	
H5928	020	0	1	01	01	H5928_020_0	5	2	Non-Preferred Generic	000100	
H5928	020	0	1	01	01	H5928_020_0	5	1	Preferred Generic	001000	
H5928	020	0	1	01	01	H5928_020_0	5	1	Preferred Generic	001000	1
H5928	020	0	1	01	01	H5928_020_0	5	2	Non-Preferred Generic	000100	1
H5928	022	0	1	01	01	H5928_022_0	5	3	Preferred Brand	000001	
H5928	022	0	1	01	01	H5928_022_0	5	2	Non-Preferred Generic	000100	
H5928	022	0	1	01	01	H5928_022_0	5	1	Preferred Generic	001000	
H5928	022	0	1	01	01	H5928_022_0	5	4	Non-Preferred Brand	100100	
H5928	022	0	1	01	01	H5928_022_0	5	2	Non-Preferred Generic	000100	1
H5928	022	0	1	01	01	H5928_022_0	5	1	Preferred Generic	001000	1
H5928	022	0	1	01	01	H5928_022_0	5	5	Specialty Tier	010010	
H5928	024	0	1	01	01	H5928_024_0	5	1	Preferred Generic	001000	
H5928	024	0	1	01	01	H5928_024_0	5	2	Non-Preferred Generic	000100	
H5928	024	0	1	01	01	H5928_024_0	5	3	Preferred Brand	000001	
H5928	024	0	1	01	01	H5928_024_0	5	1	Preferred Generic	001000	1
H5928	024	0	1	01	01	H5928_024_0	5	5	Specialty Tier	010010	
H5928	024	0	1	01	01	H5928_024_0	5	4	Non-Preferred Brand	100100	
H5928	024	0	1	01	01	H5928_024_0	5	2	Non-Preferred Generic	000100	1
H5928	025	0	1	01	01	H5928_025_0	5	5	Specialty Tier	010010	
H5928	025	0	1	01	01	H5928_025_0	5	4	Non-Preferred Brand	100100	
H5928	025	0	1	01	01	H5928_025_0	5	3	Preferred Brand	000001	
H5928	025	0	1	01	01	H5928_025_0	5	2	Non-Preferred Generic	000100	
H5928	025	0	1	01	01	H5928_025_0	5	1	Preferred Generic	001000	
H5928	025	0	1	01	01	H5928_025_0	5	1	Preferred Generic	001000	1
H5928	036	0	1	01	01	H5928_036_0	5	1	Preferred Generic	001000	
H5928	036	0	1	01	01	H5928_036_0	5	2	Non-Preferred Generic	000100	
H5928	036	0	1	01	01	H5928_036_0	5	3	Preferred Brand	000001	
H5928	036	0	1	01	01	H5928_036_0	5	4	Non-Preferred Brand	100000	
H5928	036	0	1	01	01	H5928_036_0	5	5	Specialty Tier	010010	
H5928	036	0	1	01	01	H5928_036_0	5	1	Preferred Generic	001000	1
H5928	036	0	1	01	01	H5928_036_0	5	2	Non-Preferred Generic	000100	1
H5928	037	0	1	01	01	H5928_037_0	5	1	Preferred Generic	001000	
H5928	037	0	1	01	01	H5928_037_0	5	2	Non-Preferred Generic	000100	
H5928	037	0	1	01	01	H5928_037_0	5	3	Preferred Brand	000001	
H5928	037	0	1	01	01	H5928_037_0	5	4	Non-Preferred Brand	100100	
H5928	037	0	1	01	01	H5928_037_0	5	5	Specialty Tier	010010	
H5928	037	0	1	01	01	H5928_037_0	5	1	Preferred Generic	001000	1
H5928	038	0	1	01	01	H5928_038_0	5	1	Preferred Generic	001000	
H5928	038	0	1	01	01	H5928_038_0	5	2	Non-Preferred Generic	000100	1
H5928	038	0	1	01	01	H5928_038_0	5	1	Preferred Generic	001000	1
H5928	038	0	1	01	01	H5928_038_0	5	5	Specialty Tier	010010	
H5928	038	0	1	01	01	H5928_038_0	5	4	Non-Preferred Brand	100100	
H5928	038	0	1	01	01	H5928_038_0	5	3	Preferred Brand	000001	
H5928	038	0	1	01	01	H5928_038_0	5	2	Non-Preferred Generic	000100	
H5928	040	0	1	01	01	H5928_040_0	5	1	Preferred Generic	001000	1
H5928	040	0	1	01	01	H5928_040_0	5	5	Specialty Tier	010010	
H5928	040	0	1	01	01	H5928_040_0	5	4	Non-Preferred Brand	100100	
H5928	040	0	1	01	01	H5928_040_0	5	3	Preferred Brand	000001	
H5928	040	0	1	01	01	H5928_040_0	5	2	Non-Preferred Generic	000100	
H5928	040	0	1	01	01	H5928_040_0	5	1	Preferred Generic	001000	
H5928	040	0	1	01	01	H5928_040_0	5	2	Non-Preferred Generic	000100	1
H5932	007	0	1	01	01	H5932_007_0	4	5	Specialty Tier	010010	
H5932	007	0	1	01	01	H5932_007_0	4	4	Non-Preferred Brand	100000	
H5932	007	0	1	01	01	H5932_007_0	4	3	Preferred Brand	000001	
H5932	007	0	1	01	01	H5932_007_0	4	2	Non-Preferred Generic	000100	
H5932	007	0	1	01	01	H5932_007_0	4	1	Preferred Generic	001000	
H5932	007	0	1	01	01	H5932_007_0	4	6	Select Care Drugs	000010	
H5932	008	0	1	01	01	H5932_008_0	4	5	Specialty Tier	010010	
H5932	008	0	1	01	01	H5932_008_0	4	4	Non-Preferred Brand	100000	
H5932	008	0	1	01	01	H5932_008_0	4	3	Preferred Brand	000001	
H5932	008	0	1	01	01	H5932_008_0	4	2	Non-Preferred Generic	000100	
H5932	008	0	1	01	01	H5932_008_0	4	1	Preferred Generic	001000	
H5932	008	0	1	01	01	H5932_008_0	4	6	Select Care Drugs	000010	
H5938	001	0	1	01	01	H5938_001_0	11	1	Preferred Generic	001000	
H5938	001	0	1	01	01	H5938_001_0	11	5	Specialty Tier	010010	
H5938	001	0	1	01	01	H5938_001_0	11	4	Non-Preferred Brand	110000	
H5938	001	0	1	01	01	H5938_001_0	11	3	Preferred Brand	000001	
H5938	001	0	1	01	01	H5938_001_0	11	2	Non-Preferred Generic	000100	
H5938	006	0	1	01	01	H5938_006_0	9	1	Preferred Generic	001000	1
H5938	006	0	1	01	01	H5938_006_0	9	5	Specialty Tier	010010	
H5938	006	0	1	01	01	H5938_006_0	9	4	Non-Preferred Brand	110000	
H5938	006	0	1	01	01	H5938_006_0	9	3	Preferred Brand	000001	
H5938	006	0	1	01	01	H5938_006_0	9	2	Non-Preferred Generic	000100	
H5938	006	0	1	01	01	H5938_006_0	9	2	Non-Preferred Generic	000100	1
H5938	006	0	1	01	01	H5938_006_0	9	1	Preferred Generic	001000	
H5950	001	0	1	01	01	H5950_001_0	6	1	Generic	010000	
H5950	001	0	1	01	01	H5950_001_0	6	2	Preferred Brand	010001	
H5950	001	0	1	01	01	H5950_001_0	6	5	Select Care Drugs	010000	1
H5950	001	0	1	01	01	H5950_001_0	6	4	Specialty Tier	010010	
H5950	001	0	1	01	01	H5950_001_0	6	5	Select Care Drugs	010000	
H5950	001	0	1	01	01	H5950_001_0	6	3	Non-Preferred Brand	110000	
H5969	001	0	1	01	01	H5969_001_0	13	4	Non-Preferred Brand	100000	
H5969	001	0	1	01	01	H5969_001_0	13	5	Specialty Tier	100001	
H5969	001	0	1	01	01	H5969_001_0	13	1	Preferred Generic	001000	
H5969	001	0	1	01	01	H5969_001_0	13	2	Non-Preferred Generic	000100	
H5969	001	0	1	01	01	H5969_001_0	13	3	Preferred Brand	000001	
H5970	001	0	1	04	01	H5970_001_0	6	4	Non-Preferred Brand	110000	2
H5970	001	0	1	04	01	H5970_001_0	6	3	Preferred Brand	000101	2
H5970	001	0	1	04	01	H5970_001_0	6	2	Non-Preferred Generic	000101	2
H5970	001	0	1	04	01	H5970_001_0	6	1	Preferred Generic	001010	2
H5970	001	0	1	04	01	H5970_001_0	6	5	Specialty Tier	010010	2
H5970	001	0	1	04	01	H5970_001_0	6	4	Non-Preferred Brand	110000	
H5970	001	0	1	04	01	H5970_001_0	6	3	Preferred Brand	000101	
H5970	001	0	1	04	01	H5970_001_0	6	2	Non-Preferred Generic	000101	
H5970	001	0	1	04	01	H5970_001_0	6	1	Preferred Generic	001010	
H5970	001	0	1	04	01	H5970_001_0	6	5	Specialty Tier	010010	
H5970	002	0	1	04	01	H5970_002_0	6	1	Preferred Generic	001010	
H5970	002	0	1	04	01	H5970_002_0	6	2	Non-Preferred Generic	000101	
H5970	002	0	1	04	01	H5970_002_0	6	3	Preferred Brand	000101	
H5970	002	0	1	04	01	H5970_002_0	6	4	Non-Preferred Brand	110000	
H5970	002	0	1	04	01	H5970_002_0	6	5	Specialty Tier	010010	
H5970	002	0	1	04	01	H5970_002_0	6	1	Preferred Generic	001010	2
H5970	002	0	1	04	01	H5970_002_0	6	2	Non-Preferred Generic	000101	2
H5970	002	0	1	04	01	H5970_002_0	6	3	Preferred Brand	000101	2
H5970	002	0	1	04	01	H5970_002_0	6	4	Non-Preferred Brand	110000	2
H5970	002	0	1	04	01	H5970_002_0	6	5	Specialty Tier	010010	2
H5970	004	0	1	04	01	H5970_004_0	6	5	Specialty Tier	010010	2
H5970	004	0	1	04	01	H5970_004_0	6	4	Non-Preferred Brand	110000	2
H5970	004	0	1	04	01	H5970_004_0	6	3	Preferred Brand	000101	2
H5970	004	0	1	04	01	H5970_004_0	6	2	Non-Preferred Generic	000101	2
H5970	004	0	1	04	01	H5970_004_0	6	1	Preferred Generic	001010	2
H5970	004	0	1	04	01	H5970_004_0	6	5	Specialty Tier	010010	
H5970	004	0	1	04	01	H5970_004_0	6	4	Non-Preferred Brand	110000	
H5970	004	0	1	04	01	H5970_004_0	6	1	Preferred Generic	001010	
H5970	004	0	1	04	01	H5970_004_0	6	2	Non-Preferred Generic	000101	
H5970	004	0	1	04	01	H5970_004_0	6	3	Preferred Brand	000101	
H5970	006	0	1	04	01	H5970_006_0	5	4	Non-Preferred Brand	110000	2
H5970	006	0	1	04	01	H5970_006_0	5	3	Preferred Brand	000101	2
H5970	006	0	1	04	01	H5970_006_0	5	2	Non-Preferred Generic	000101	2
H5970	006	0	1	04	01	H5970_006_0	5	1	Preferred Generic	001010	2
H5970	006	0	1	04	01	H5970_006_0	5	1	Preferred Generic	001010	
H5970	006	0	1	04	01	H5970_006_0	5	5	Specialty Tier	010010	
H5970	006	0	1	04	01	H5970_006_0	5	4	Non-Preferred Brand	110000	
H5970	006	0	1	04	01	H5970_006_0	5	3	Preferred Brand	000101	
H5970	006	0	1	04	01	H5970_006_0	5	2	Non-Preferred Generic	000101	
H5970	006	0	1	04	01	H5970_006_0	5	5	Specialty Tier	010010	2
H5970	008	0	1	04	01	H5970_008_0	6	1	Preferred Generic	001010	
H5970	008	0	1	04	01	H5970_008_0	6	2	Non-Preferred Generic	000101	
H5970	008	0	1	04	01	H5970_008_0	6	3	Preferred Brand	000101	
H5970	008	0	1	04	01	H5970_008_0	6	4	Non-Preferred Brand	110000	
H5970	008	0	1	04	01	H5970_008_0	6	1	Preferred Generic	001010	2
H5970	008	0	1	04	01	H5970_008_0	6	2	Non-Preferred Generic	000101	2
H5970	008	0	1	04	01	H5970_008_0	6	3	Preferred Brand	000101	2
H5970	008	0	1	04	01	H5970_008_0	6	4	Non-Preferred Brand	110000	2
H5970	008	0	1	04	01	H5970_008_0	6	5	Specialty Tier	010010	2
H5970	008	0	1	04	01	H5970_008_0	6	5	Specialty Tier	010010	
H5970	010	0	1	04	01	H5970_010_0	6	5	Specialty Tier	010010	2
H5970	010	0	1	04	01	H5970_010_0	6	4	Non-Preferred Brand	110000	2
H5970	010	0	1	04	01	H5970_010_0	6	3	Preferred Brand	000101	2
H5970	010	0	1	04	01	H5970_010_0	6	2	Non-Preferred Generic	000101	2
H5970	010	0	1	04	01	H5970_010_0	6	1	Preferred Generic	001010	
H5970	010	0	1	04	01	H5970_010_0	6	5	Specialty Tier	010010	
H5970	010	0	1	04	01	H5970_010_0	6	4	Non-Preferred Brand	110000	
H5970	010	0	1	04	01	H5970_010_0	6	3	Preferred Brand	000101	
H5970	010	0	1	04	01	H5970_010_0	6	2	Non-Preferred Generic	000101	
H5970	010	0	1	04	01	H5970_010_0	6	1	Preferred Generic	001010	2
H5985	001	0	1	01	01	H5985_001_0	10	3	Preferred Brand	000001	
H5985	001	0	1	01	01	H5985_001_0	10	2	Non-Preferred Generic	000100	
H5985	001	0	1	01	01	H5985_001_0	10	1	Preferred Generic	001000	
H5985	001	0	1	01	01	H5985_001_0	10	4	Specialty Tier	000101	
H5985	005	0	1	01	01	H5985_005_0	8	4	Specialty Tier	000101	
H5985	005	0	1	01	01	H5985_005_0	8	3	Preferred Brand	000001	
H5985	005	0	1	01	01	H5985_005_0	8	2	Non-Preferred Generic	000100	
H5985	005	0	1	01	01	H5985_005_0	8	1	Preferred Generic	001000	
H5989	002	0	1	01	01	H5989_002_0	6	4	Specialty Tier	010010	
H5989	002	0	1	01	01	H5989_002_0	6	3	Preferred Brand	100001	
H5989	002	0	1	01	01	H5989_002_0	6	1	Preferred Generic	001000	
H5989	002	0	1	01	01	H5989_002_0	6	2	Non-Preferred Generic	000100	
H5989	008	0	1	01	01	H5989_008_0	5	3	Preferred Brand	100001	
H5989	008	0	1	01	01	H5989_008_0	5	2	Non-Preferred Generic	000100	
H5989	008	0	1	01	01	H5989_008_0	5	1	Preferred Generic	001000	
H5989	008	0	1	01	01	H5989_008_0	5	4	Specialty Tier	010010	
H5991	001	0	1	01	01	H5991_001_0	8	5	Specialty Tier	100000	
H5991	001	0	1	01	01	H5991_001_0	8	4	Non-Preferred Brand	100000	
H5991	001	0	1	01	01	H5991_001_0	8	3	Preferred Brand	000001	
H5991	001	0	1	01	01	H5991_001_0	8	2	Non-Preferred Generic	000100	
H5991	001	0	1	01	01	H5991_001_0	8	1	Preferred Generic	001000	
H5991	002	0	1	01	01	H5991_002_0	6	4	Non-Preferred Brand	100000	
H5991	002	0	1	01	01	H5991_002_0	6	5	Specialty Tier	100000	
H5991	002	0	1	01	01	H5991_002_0	6	3	Preferred Brand	000001	
H5991	002	0	1	01	01	H5991_002_0	6	2	Non-Preferred Generic	000100	
H5991	002	0	1	01	01	H5991_002_0	6	1	Preferred Generic	001000	
H5992	006	0	1	01	01	H5992_006_0	10	3	Specialty Tier	001001	
H5992	006	0	1	01	01	H5992_006_0	10	2	Preferred Brand	000001	
H5992	006	0	1	01	01	H5992_006_0	10	1	Preferred Generic	001000	
H5992	006	0	1	01	01	H5992_006_0	10	1	Preferred Generic	001000	2
H5992	007	0	1	01	01	H5992_007_0	8	1	Preferred Generic	001000	
H5992	007	0	1	01	01	H5992_007_0	8	1	Preferred Generic	001000	2
H5992	007	0	1	01	01	H5992_007_0	8	3	Specialty Tier	001001	
H5992	007	0	1	01	01	H5992_007_0	8	2	Preferred Brand	000001	
H6080	001	0	1	48	05	H6080_001_0	4	1	Generic Drugs	010000	
H6080	001	0	1	48	05	H6080_001_0	4	3	Non-Medicare Rx/OTC Drugs	010010	
H6080	001	0	1	48	05	H6080_001_0	4	2	Brand Drugs	000010	
H6169	021	0	1	09	04	H6169_021_0	7	5	Specialty Tier	010010	
H6169	021	0	1	09	04	H6169_021_0	7	1	Preferred Generic	001000	
H6169	021	0	1	09	04	H6169_021_0	7	3	Preferred Brand	000101	
H6169	021	0	1	09	04	H6169_021_0	7	4	Non-Preferred Brand	100100	
H6169	021	0	1	09	04	H6169_021_0	7	2	Non-Preferred Generic	000100	
H6169	024	0	1	09	04	H6169_024_0	7	3	Preferred Brand	000101	
H6169	024	0	1	09	04	H6169_024_0	7	2	Non-Preferred Generic	000100	
H6169	024	0	1	09	04	H6169_024_0	7	1	Preferred Generic	001000	
H6169	024	0	1	09	04	H6169_024_0	7	4	Non-Preferred Brand	100100	
H6169	024	0	1	09	04	H6169_024_0	7	5	Specialty Tier	010010	
H6169	031	0	1	09	04	H6169_031_0	6	5	Specialty Tier	010010	
H6169	031	0	1	09	04	H6169_031_0	6	3	Preferred Brand	000101	
H6169	031	0	1	09	04	H6169_031_0	6	4	Non-Preferred Brand	100100	
H6169	031	0	1	09	04	H6169_031_0	6	1	Preferred Generic	001000	
H6169	031	0	1	09	04	H6169_031_0	6	2	Non-Preferred Generic	000100	
H6169	032	0	1	09	04	H6169_032_0	6	3	Preferred Brand	000101	
H6169	032	0	1	09	04	H6169_032_0	6	1	Preferred Generic	001000	
H6169	032	0	1	09	04	H6169_032_0	6	2	Non-Preferred Generic	000100	
H6169	032	0	1	09	04	H6169_032_0	6	5	Specialty Tier	010010	
H6169	032	0	1	09	04	H6169_032_0	6	4	Non-Preferred Brand	100100	
H6169	033	0	1	09	04	H6169_033_0	6	1	Preferred Generic	001000	
H6169	033	0	1	09	04	H6169_033_0	6	2	Non-Preferred Generic	000100	
H6169	033	0	1	09	04	H6169_033_0	6	5	Specialty Tier	010010	
H6169	033	0	1	09	04	H6169_033_0	6	4	Non-Preferred Brand	100100	
H6169	033	0	1	09	04	H6169_033_0	6	3	Preferred Brand	000101	
H6169	036	0	1	09	04	H6169_036_0	6	5	Specialty Tier	010010	
H6169	036	0	1	09	04	H6169_036_0	6	4	Non-Preferred Brand	100100	
H6169	036	0	1	09	04	H6169_036_0	6	3	Preferred Brand	000101	
H6169	036	0	1	09	04	H6169_036_0	6	1	Preferred Generic	001000	
H6169	036	0	1	09	04	H6169_036_0	6	2	Non-Preferred Generic	000100	
H6178	001	0	1	01	01	H6178_001_0	6	4	Specialty Tier	010010	
H6178	001	0	1	01	01	H6178_001_0	6	3	Non-Preferred Brand	100100	
H6178	001	0	1	01	01	H6178_001_0	6	2	Preferred Brand	000001	
H6178	001	0	1	01	01	H6178_001_0	6	1	Generic	010000	
H6181	009	0	1	01	01	H6181_009_0	5	4	Non-Preferred Brand	100000	
H6181	009	0	1	01	01	H6181_009_0	5	3	Preferred Brand	000001	
H6181	009	0	1	01	01	H6181_009_0	5	2	Non-Preferred Generic	000100	
H6181	009	0	1	01	01	H6181_009_0	5	5	Specialty Tier	010010	
H6181	009	0	1	01	01	H6181_009_0	5	1	Preferred Generic	001000	
H6229	005	0	1	48	05	H6229_005_0	1	1	Generic Drugs	001001	
H6229	005	0	1	48	05	H6229_005_0	1	2	Brand Drugs	100100	
H6229	005	0	1	48	05	H6229_005_0	1	3	Non-Medicare Rx Generic Drugs	010000	
H6229	005	0	1	48	05	H6229_005_0	1	4	Non-Medicare Rx Brand Drugs	000010	
H6229	005	0	1	48	05	H6229_005_0	1	5	Non-Medicare OTC Generic Drugs	010000	
H6237	002	0	1	01	01	H6237_002_0	8	1	Preferred Generic	001000	
H6237	002	0	1	01	01	H6237_002_0	8	2	Non-Preferred Generic	000100	
H6237	002	0	1	01	01	H6237_002_0	8	3	Preferred Brand	000001	
H6237	002	0	1	01	01	H6237_002_0	8	4	Non-Preferred Brand	100000	
H6237	002	0	1	01	01	H6237_002_0	8	5	Specialty Tier	010010	
H6306	002	0	1	01	01	H6306_002_0	4	4	Non-Preferred Brand	100000	
H6306	002	0	1	01	01	H6306_002_0	4	5	Specialty Tier	010010	
H6306	002	0	1	01	01	H6306_002_0	4	1	Preferred Generic	001000	1
H6306	002	0	1	01	01	H6306_002_0	4	1	Preferred Generic	001000	
H6306	002	0	1	01	01	H6306_002_0	4	2	Non-Preferred Generic	000100	
H6306	002	0	1	01	01	H6306_002_0	4	3	Preferred Brand	000001	
H6328	001	0	1	04	01	H6328_001_0	7	1	Preferred Generic	001000	1
H6328	001	0	1	04	01	H6328_001_0	7	5	Specialty Tier	010010	
H6328	001	0	1	04	01	H6328_001_0	7	4	Non-Preferred Brand	100000	
H6328	001	0	1	04	01	H6328_001_0	7	3	Preferred Brand	000001	
H6328	001	0	1	04	01	H6328_001_0	7	1	Preferred Generic	001000	
H6328	001	0	1	04	01	H6328_001_0	7	2	Non-Preferred Generic	000100	
H6328	002	0	1	04	01	H6328_002_0	7	5	Specialty Tier	010010	
H6328	002	0	1	04	01	H6328_002_0	7	4	Non-Preferred Brand	100000	
H6328	002	0	1	04	01	H6328_002_0	7	3	Preferred Brand	000001	
H6328	002	0	1	04	01	H6328_002_0	7	2	Non-Preferred Generic	000100	
H6328	002	0	1	04	01	H6328_002_0	7	1	Preferred Generic	001000	
H6328	002	0	1	04	01	H6328_002_0	7	1	Preferred Generic	001000	1
H6328	003	0	1	04	01	H6328_003_0	7	1	Preferred Generic	001000	1
H6328	003	0	1	04	01	H6328_003_0	7	5	Specialty Tier	010010	
H6328	003	0	1	04	01	H6328_003_0	7	4	Non-Preferred Brand	100000	
H6328	003	0	1	04	01	H6328_003_0	7	3	Preferred Brand	000001	
H6328	003	0	1	04	01	H6328_003_0	7	1	Preferred Generic	001000	
H6328	003	0	1	04	01	H6328_003_0	7	2	Non-Preferred Generic	000100	
H6360	001	0	1	18	06	H6360_001_0	3	1	Preferred Generic	001000	1
H6360	001	0	1	18	06	H6360_001_0	3	6	Vaccines	000001	
H6360	001	0	1	18	06	H6360_001_0	3	6	Vaccines	000001	1
H6360	001	0	1	18	06	H6360_001_0	3	2	Non-Preferred Generic	000100	1
H6360	001	0	1	18	06	H6360_001_0	3	1	Preferred Generic	001000	
H6360	001	0	1	18	06	H6360_001_0	3	2	Non-Preferred Generic	000100	
H6360	001	0	1	18	06	H6360_001_0	3	3	Preferred Brand	000001	
H6360	001	0	1	18	06	H6360_001_0	3	4	Non-Preferred Brand	100000	
H6360	001	0	1	18	06	H6360_001_0	3	5	Specialty Tier	100001	
H6360	002	0	1	18	06	H6360_002_0	3	1	Preferred Generic	001000	1
H6360	002	0	1	18	06	H6360_002_0	3	1	Preferred Generic	001000	
H6360	002	0	1	18	06	H6360_002_0	3	6	Vaccines	000001	1
H6360	002	0	1	18	06	H6360_002_0	3	2	Non-Preferred Generic	000100	1
H6360	002	0	1	18	06	H6360_002_0	3	2	Non-Preferred Generic	000100	
H6360	002	0	1	18	06	H6360_002_0	3	3	Preferred Brand	000001	
H6360	002	0	1	18	06	H6360_002_0	3	4	Non-Preferred Brand	100000	
H6360	002	0	1	18	06	H6360_002_0	3	5	Specialty Tier	100001	
H6360	002	0	1	18	06	H6360_002_0	3	6	Vaccines	000001	
H6360	006	0	1	18	06	H6360_006_0	3	6	Vaccines	000001	
H6360	006	0	1	18	06	H6360_006_0	3	5	Specialty Tier	100001	
H6360	006	0	1	18	06	H6360_006_0	3	4	Non-Preferred Brand	100000	
H6360	006	0	1	18	06	H6360_006_0	3	3	Preferred Brand	000001	
H6360	006	0	1	18	06	H6360_006_0	3	2	Non-Preferred Generic	000100	
H6360	006	0	1	18	06	H6360_006_0	3	1	Preferred Generic	001000	
H6360	009	0	2	18	06	H6360_009_0	3	2	Non-Preferred Generic	000100	1
H6360	009	0	2	18	06	H6360_009_0	3	6	Vaccines	000001	1
H6360	009	0	2	18	06	H6360_009_0	3	1	Preferred Generic	001000	1
H6360	009	0	2	18	06	H6360_009_0	3	6	Vaccines	000001	
H6360	009	0	2	18	06	H6360_009_0	3	5	Specialty Tier	100001	
H6360	009	0	2	18	06	H6360_009_0	3	4	Non-Preferred Brand	100000	
H6360	009	0	2	18	06	H6360_009_0	3	3	Preferred Brand	000001	
H6360	009	0	2	18	06	H6360_009_0	3	1	Preferred Generic	001000	
H6360	009	0	2	18	06	H6360_009_0	3	2	Non-Preferred Generic	000100	
H6360	010	0	1	18	06	H6360_010_0	5	5	Specialty Tier	100001	
H6360	010	0	1	18	06	H6360_010_0	5	4	Non-Preferred Brand	100000	
H6360	010	0	1	18	06	H6360_010_0	5	3	Preferred Brand	000001	
H6360	010	0	1	18	06	H6360_010_0	5	2	Non-Preferred Generic	000100	
H6360	010	0	1	18	06	H6360_010_0	5	1	Preferred Generic	001000	
H6360	010	0	1	18	06	H6360_010_0	5	6	Vaccines	000001	
H6411	002	0	1	04	01	H6411_002_0	7	1	Preferred Generic	001010	
H6411	002	0	1	04	01	H6411_002_0	7	2	Non-Preferred Generic	000101	
H6411	002	0	1	04	01	H6411_002_0	7	5	Specialty Tier	010010	2
H6411	002	0	1	04	01	H6411_002_0	7	4	Non-Preferred Brand	110000	2
H6411	002	0	1	04	01	H6411_002_0	7	3	Preferred Brand	000101	2
H6411	002	0	1	04	01	H6411_002_0	7	2	Non-Preferred Generic	000101	2
H6411	002	0	1	04	01	H6411_002_0	7	1	Preferred Generic	001010	2
H6411	002	0	1	04	01	H6411_002_0	7	5	Specialty Tier	010010	
H6411	002	0	1	04	01	H6411_002_0	7	4	Non-Preferred Brand	110000	
H6411	002	0	1	04	01	H6411_002_0	7	3	Preferred Brand	000101	
H6411	007	0	1	04	01	H6411_007_0	6	1	Preferred Generic	001010	
H6411	007	0	1	04	01	H6411_007_0	6	4	Non-Preferred Brand	110000	2
H6411	007	0	1	04	01	H6411_007_0	6	3	Preferred Brand	000101	2
H6411	007	0	1	04	01	H6411_007_0	6	2	Non-Preferred Generic	000101	2
H6411	007	0	1	04	01	H6411_007_0	6	5	Specialty Tier	010010	2
H6411	007	0	1	04	01	H6411_007_0	6	5	Specialty Tier	010010	
H6411	007	0	1	04	01	H6411_007_0	6	4	Non-Preferred Brand	110000	
H6411	007	0	1	04	01	H6411_007_0	6	3	Preferred Brand	000101	
H6411	007	0	1	04	01	H6411_007_0	6	2	Non-Preferred Generic	000101	
H6411	007	0	1	04	01	H6411_007_0	6	1	Preferred Generic	001010	2
H6528	006	0	1	04	01	H6528_006_0	6	4	Non-Preferred Brand	100100	
H6528	006	0	1	04	01	H6528_006_0	6	1	Preferred Generic	001000	
H6528	006	0	1	04	01	H6528_006_0	6	2	Non-Preferred Generic	000100	
H6528	006	0	1	04	01	H6528_006_0	6	3	Preferred Brand	010001	
H6528	006	0	1	04	01	H6528_006_0	6	5	Specialty Tier	010010	
H6528	016	0	1	04	01	H6528_016_0	6	1	Preferred Generic	001000	
H6528	016	0	1	04	01	H6528_016_0	6	2	Non-Preferred Generic	000100	
H6528	016	0	1	04	01	H6528_016_0	6	3	Preferred Brand	010001	
H6528	016	0	1	04	01	H6528_016_0	6	4	Non-Preferred Brand	100100	
H6528	016	0	1	04	01	H6528_016_0	6	5	Specialty Tier	010010	
H6528	029	0	1	04	01	H6528_029_0	5	5	Specialty Tier	010010	
H6528	029	0	1	04	01	H6528_029_0	5	4	Non-Preferred Brand	100100	
H6528	029	0	1	04	01	H6528_029_0	5	3	Preferred Brand	010001	
H6528	029	0	1	04	01	H6528_029_0	5	2	Non-Preferred Generic	000100	
H6528	029	0	1	04	01	H6528_029_0	5	1	Preferred Generic	001000	
H6528	030	0	1	04	01	H6528_030_0	5	4	Non-Preferred Brand	100100	
H6528	030	0	1	04	01	H6528_030_0	5	3	Preferred Brand	010001	
H6528	030	0	1	04	01	H6528_030_0	5	2	Non-Preferred Generic	000100	
H6528	030	0	1	04	01	H6528_030_0	5	1	Preferred Generic	001000	
H6528	030	0	1	04	01	H6528_030_0	5	5	Specialty Tier	010010	
H6609	001	0	1	04	01	H6609_001_0	5	2	Non-Preferred Generic	000101	
H6609	001	0	1	04	01	H6609_001_0	5	3	Preferred Brand	000101	
H6609	001	0	1	04	01	H6609_001_0	5	4	Non-Preferred Brand	110000	
H6609	001	0	1	04	01	H6609_001_0	5	5	Specialty Tier	010010	
H6609	001	0	1	04	01	H6609_001_0	5	1	Preferred Generic	001010	
H6609	003	0	1	04	01	H6609_003_0	5	3	Preferred Brand	000101	
H6609	003	0	1	04	01	H6609_003_0	5	4	Non-Preferred Brand	110000	
H6609	003	0	1	04	01	H6609_003_0	5	5	Specialty Tier	010010	
H6609	003	0	1	04	01	H6609_003_0	5	1	Preferred Generic	001010	
H6609	003	0	1	04	01	H6609_003_0	5	2	Non-Preferred Generic	000101	
H6609	005	0	1	04	01	H6609_005_0	5	1	Preferred Generic	001010	
H6609	005	0	1	04	01	H6609_005_0	5	3	Preferred Brand	000101	
H6609	005	0	1	04	01	H6609_005_0	5	4	Non-Preferred Brand	110000	
H6609	005	0	1	04	01	H6609_005_0	5	5	Specialty Tier	010010	
H6609	005	0	1	04	01	H6609_005_0	5	1	Preferred Generic	001010	2
H6609	005	0	1	04	01	H6609_005_0	5	2	Non-Preferred Generic	000101	2
H6609	005	0	1	04	01	H6609_005_0	5	3	Preferred Brand	000101	2
H6609	005	0	1	04	01	H6609_005_0	5	4	Non-Preferred Brand	110000	2
H6609	005	0	1	04	01	H6609_005_0	5	2	Non-Preferred Generic	000101	
H6609	005	0	1	04	01	H6609_005_0	5	5	Specialty Tier	010010	2
H6609	009	0	1	04	01	H6609_009_0	4	1	Preferred Generic	001010	
H6609	009	0	1	04	01	H6609_009_0	4	5	Specialty Tier	010010	2
H6609	009	0	1	04	01	H6609_009_0	4	4	Non-Preferred Brand	110000	2
H6609	009	0	1	04	01	H6609_009_0	4	3	Preferred Brand	000101	2
H6609	009	0	1	04	01	H6609_009_0	4	2	Non-Preferred Generic	000101	2
H6609	009	0	1	04	01	H6609_009_0	4	1	Preferred Generic	001010	2
H6609	009	0	1	04	01	H6609_009_0	4	5	Specialty Tier	010010	
H6609	009	0	1	04	01	H6609_009_0	4	2	Non-Preferred Generic	000101	
H6609	009	0	1	04	01	H6609_009_0	4	3	Preferred Brand	000101	
H6609	009	0	1	04	01	H6609_009_0	4	4	Non-Preferred Brand	110000	
H6609	011	0	1	04	01	H6609_011_0	4	2	Non-Preferred Generic	000101	2
H6609	011	0	1	04	01	H6609_011_0	4	1	Preferred Generic	001010	2
H6609	011	0	1	04	01	H6609_011_0	4	5	Specialty Tier	010010	
H6609	011	0	1	04	01	H6609_011_0	4	4	Non-Preferred Brand	110000	
H6609	011	0	1	04	01	H6609_011_0	4	5	Specialty Tier	010010	2
H6609	011	0	1	04	01	H6609_011_0	4	2	Non-Preferred Generic	000101	
H6609	011	0	1	04	01	H6609_011_0	4	1	Preferred Generic	001010	
H6609	011	0	1	04	01	H6609_011_0	4	3	Preferred Brand	000101	2
H6609	011	0	1	04	01	H6609_011_0	4	4	Non-Preferred Brand	110000	2
H6609	011	0	1	04	01	H6609_011_0	4	3	Preferred Brand	000101	
H6609	013	0	1	04	01	H6609_013_0	4	2	Non-Preferred Generic	000101	2
H6609	013	0	1	04	01	H6609_013_0	4	1	Preferred Generic	001010	2
H6609	013	0	1	04	01	H6609_013_0	4	5	Specialty Tier	010010	
H6609	013	0	1	04	01	H6609_013_0	4	4	Non-Preferred Brand	110000	
H6609	013	0	1	04	01	H6609_013_0	4	3	Preferred Brand	000101	
H6609	013	0	1	04	01	H6609_013_0	4	2	Non-Preferred Generic	000101	
H6609	013	0	1	04	01	H6609_013_0	4	1	Preferred Generic	001010	
H6609	013	0	1	04	01	H6609_013_0	4	3	Preferred Brand	000101	2
H6609	013	0	1	04	01	H6609_013_0	4	5	Specialty Tier	010010	2
H6609	013	0	1	04	01	H6609_013_0	4	4	Non-Preferred Brand	110000	2
H6609	017	0	1	04	01	H6609_017_0	5	4	Non-Preferred Brand	110000	
H6609	017	0	1	04	01	H6609_017_0	5	3	Preferred Brand	000101	
H6609	017	0	1	04	01	H6609_017_0	5	2	Non-Preferred Generic	000101	
H6609	017	0	1	04	01	H6609_017_0	5	1	Preferred Generic	001010	
H6609	017	0	1	04	01	H6609_017_0	5	5	Specialty Tier	010010	
H6609	019	0	1	04	01	H6609_019_0	5	1	Preferred Generic	001010	2
H6609	019	0	1	04	01	H6609_019_0	5	2	Non-Preferred Generic	000101	2
H6609	019	0	1	04	01	H6609_019_0	5	4	Non-Preferred Brand	110000	2
H6609	019	0	1	04	01	H6609_019_0	5	3	Preferred Brand	000101	2
H6609	019	0	1	04	01	H6609_019_0	5	5	Specialty Tier	010010	
H6609	019	0	1	04	01	H6609_019_0	5	4	Non-Preferred Brand	110000	
H6609	019	0	1	04	01	H6609_019_0	5	5	Specialty Tier	010010	2
H6609	019	0	1	04	01	H6609_019_0	5	2	Non-Preferred Generic	000101	
H6609	019	0	1	04	01	H6609_019_0	5	1	Preferred Generic	001010	
H6609	019	0	1	04	01	H6609_019_0	5	3	Preferred Brand	000101	
H6609	029	0	1	04	01	H6609_029_0	6	1	Preferred Generic	001010	2
H6609	029	0	1	04	01	H6609_029_0	6	2	Non-Preferred Generic	000101	2
H6609	029	0	1	04	01	H6609_029_0	6	3	Preferred Brand	000101	2
H6609	029	0	1	04	01	H6609_029_0	6	4	Non-Preferred Brand	110000	2
H6609	029	0	1	04	01	H6609_029_0	6	5	Specialty Tier	010010	
H6609	029	0	1	04	01	H6609_029_0	6	1	Preferred Generic	001010	
H6609	029	0	1	04	01	H6609_029_0	6	2	Non-Preferred Generic	000101	
H6609	029	0	1	04	01	H6609_029_0	6	3	Preferred Brand	000101	
H6609	029	0	1	04	01	H6609_029_0	6	4	Non-Preferred Brand	110000	
H6609	029	0	1	04	01	H6609_029_0	6	5	Specialty Tier	010010	2
H6609	060	0	1	04	01	H6609_060_0	5	1	Preferred Generic	001010	
H6609	060	0	1	04	01	H6609_060_0	5	2	Non-Preferred Generic	000101	
H6609	060	0	1	04	01	H6609_060_0	5	5	Specialty Tier	010010	2
H6609	060	0	1	04	01	H6609_060_0	5	4	Non-Preferred Brand	110000	2
H6609	060	0	1	04	01	H6609_060_0	5	3	Preferred Brand	000101	2
H6609	060	0	1	04	01	H6609_060_0	5	2	Non-Preferred Generic	000101	2
H6609	060	0	1	04	01	H6609_060_0	5	1	Preferred Generic	001010	2
H6609	060	0	1	04	01	H6609_060_0	5	5	Specialty Tier	010010	
H6609	060	0	1	04	01	H6609_060_0	5	4	Non-Preferred Brand	110000	
H6609	060	0	1	04	01	H6609_060_0	5	3	Preferred Brand	000101	
H6609	062	0	1	04	01	H6609_062_0	4	1	Preferred Generic	001010	
H6609	062	0	1	04	01	H6609_062_0	4	4	Non-Preferred Brand	110000	2
H6609	062	0	1	04	01	H6609_062_0	4	3	Preferred Brand	000101	2
H6609	062	0	1	04	01	H6609_062_0	4	2	Non-Preferred Generic	000101	2
H6609	062	0	1	04	01	H6609_062_0	4	5	Specialty Tier	010010	2
H6609	062	0	1	04	01	H6609_062_0	4	5	Specialty Tier	010010	
H6609	062	0	1	04	01	H6609_062_0	4	4	Non-Preferred Brand	110000	
H6609	062	0	1	04	01	H6609_062_0	4	3	Preferred Brand	000101	
H6609	062	0	1	04	01	H6609_062_0	4	2	Non-Preferred Generic	000101	
H6609	062	0	1	04	01	H6609_062_0	4	1	Preferred Generic	001010	2
H6609	065	0	1	04	01	H6609_065_0	4	1	Preferred Generic	001010	
H6609	065	0	1	04	01	H6609_065_0	4	2	Non-Preferred Generic	000101	
H6609	065	0	1	04	01	H6609_065_0	4	3	Preferred Brand	000101	
H6609	065	0	1	04	01	H6609_065_0	4	4	Non-Preferred Brand	110000	
H6609	065	0	1	04	01	H6609_065_0	4	5	Specialty Tier	010010	
H6609	065	0	1	04	01	H6609_065_0	4	1	Preferred Generic	001010	2
H6609	065	0	1	04	01	H6609_065_0	4	2	Non-Preferred Generic	000101	2
H6609	065	0	1	04	01	H6609_065_0	4	3	Preferred Brand	000101	2
H6609	065	0	1	04	01	H6609_065_0	4	4	Non-Preferred Brand	110000	2
H6609	065	0	1	04	01	H6609_065_0	4	5	Specialty Tier	010010	2
H6609	066	0	1	04	01	H6609_066_0	4	3	Preferred Brand	000101	
H6609	066	0	1	04	01	H6609_066_0	4	4	Non-Preferred Brand	110000	
H6609	066	0	1	04	01	H6609_066_0	4	5	Specialty Tier	010010	
H6609	066	0	1	04	01	H6609_066_0	4	1	Preferred Generic	001010	2
H6609	066	0	1	04	01	H6609_066_0	4	1	Preferred Generic	001010	
H6609	066	0	1	04	01	H6609_066_0	4	3	Preferred Brand	000101	2
H6609	066	0	1	04	01	H6609_066_0	4	5	Specialty Tier	010010	2
H6609	066	0	1	04	01	H6609_066_0	4	4	Non-Preferred Brand	110000	2
H6609	066	0	1	04	01	H6609_066_0	4	2	Non-Preferred Generic	000101	
H6609	066	0	1	04	01	H6609_066_0	4	2	Non-Preferred Generic	000101	2
H6609	074	0	1	04	01	H6609_074_0	4	2	Non-Preferred Generic	000101	
H6609	074	0	1	04	01	H6609_074_0	4	5	Specialty Tier	010010	
H6609	074	0	1	04	01	H6609_074_0	4	4	Non-Preferred Brand	110000	
H6609	074	0	1	04	01	H6609_074_0	4	3	Preferred Brand	000101	
H6609	074	0	1	04	01	H6609_074_0	4	1	Preferred Generic	001010	
H6609	075	0	1	04	01	H6609_075_0	4	5	Specialty Tier	010010	2
H6609	075	0	1	04	01	H6609_075_0	4	4	Non-Preferred Brand	110000	2
H6609	075	0	1	04	01	H6609_075_0	4	3	Preferred Brand	000101	2
H6609	075	0	1	04	01	H6609_075_0	4	2	Non-Preferred Generic	000101	2
H6609	075	0	1	04	01	H6609_075_0	4	1	Preferred Generic	001010	2
H6609	075	0	1	04	01	H6609_075_0	4	5	Specialty Tier	010010	
H6609	075	0	1	04	01	H6609_075_0	4	4	Non-Preferred Brand	110000	
H6609	075	0	1	04	01	H6609_075_0	4	3	Preferred Brand	000101	
H6609	075	0	1	04	01	H6609_075_0	4	2	Non-Preferred Generic	000101	
H6609	075	0	1	04	01	H6609_075_0	4	1	Preferred Generic	001010	
H6609	076	0	1	04	01	H6609_076_0	4	3	Preferred Brand	000101	2
H6609	076	0	1	04	01	H6609_076_0	4	2	Non-Preferred Generic	000101	2
H6609	076	0	1	04	01	H6609_076_0	4	1	Preferred Generic	001010	2
H6609	076	0	1	04	01	H6609_076_0	4	5	Specialty Tier	010010	2
H6609	076	0	1	04	01	H6609_076_0	4	5	Specialty Tier	010010	
H6609	076	0	1	04	01	H6609_076_0	4	2	Non-Preferred Generic	000101	
H6609	076	0	1	04	01	H6609_076_0	4	1	Preferred Generic	001010	
H6609	076	0	1	04	01	H6609_076_0	4	4	Non-Preferred Brand	110000	
H6609	076	0	1	04	01	H6609_076_0	4	4	Non-Preferred Brand	110000	2
H6609	076	0	1	04	01	H6609_076_0	4	3	Preferred Brand	000101	
H6609	077	0	1	04	01	H6609_077_0	4	1	Preferred Generic	001010	
H6609	077	0	1	04	01	H6609_077_0	4	2	Non-Preferred Generic	000101	
H6609	077	0	1	04	01	H6609_077_0	4	3	Preferred Brand	000101	
H6609	077	0	1	04	01	H6609_077_0	4	4	Non-Preferred Brand	110000	
H6609	077	0	1	04	01	H6609_077_0	4	5	Specialty Tier	010010	
H6609	077	0	1	04	01	H6609_077_0	4	1	Preferred Generic	001010	2
H6609	077	0	1	04	01	H6609_077_0	4	2	Non-Preferred Generic	000101	2
H6609	077	0	1	04	01	H6609_077_0	4	3	Preferred Brand	000101	2
H6609	077	0	1	04	01	H6609_077_0	4	4	Non-Preferred Brand	110000	2
H6609	077	0	1	04	01	H6609_077_0	4	5	Specialty Tier	010010	2
H6609	078	0	1	04	01	H6609_078_0	4	1	Preferred Generic	001010	
H6609	078	0	1	04	01	H6609_078_0	4	2	Non-Preferred Generic	000101	
H6609	078	0	1	04	01	H6609_078_0	4	5	Specialty Tier	010010	2
H6609	078	0	1	04	01	H6609_078_0	4	4	Non-Preferred Brand	110000	2
H6609	078	0	1	04	01	H6609_078_0	4	3	Preferred Brand	000101	2
H6609	078	0	1	04	01	H6609_078_0	4	2	Non-Preferred Generic	000101	2
H6609	078	0	1	04	01	H6609_078_0	4	1	Preferred Generic	001010	2
H6609	078	0	1	04	01	H6609_078_0	4	5	Specialty Tier	010010	
H6609	078	0	1	04	01	H6609_078_0	4	4	Non-Preferred Brand	110000	
H6609	078	0	1	04	01	H6609_078_0	4	3	Preferred Brand	000101	
H6609	079	0	1	04	01	H6609_079_0	4	1	Preferred Generic	001010	
H6609	079	0	1	04	01	H6609_079_0	4	4	Non-Preferred Brand	110000	2
H6609	079	0	1	04	01	H6609_079_0	4	3	Preferred Brand	000101	2
H6609	079	0	1	04	01	H6609_079_0	4	2	Non-Preferred Generic	000101	2
H6609	079	0	1	04	01	H6609_079_0	4	5	Specialty Tier	010010	2
H6609	079	0	1	04	01	H6609_079_0	4	5	Specialty Tier	010010	
H6609	079	0	1	04	01	H6609_079_0	4	4	Non-Preferred Brand	110000	
H6609	079	0	1	04	01	H6609_079_0	4	3	Preferred Brand	000101	
H6609	079	0	1	04	01	H6609_079_0	4	2	Non-Preferred Generic	000101	
H6609	079	0	1	04	01	H6609_079_0	4	1	Preferred Generic	001010	2
H6609	080	0	1	04	01	H6609_080_0	5	3	Preferred Brand	000101	2
H6609	080	0	1	04	01	H6609_080_0	5	1	Preferred Generic	001010	
H6609	080	0	1	04	01	H6609_080_0	5	2	Non-Preferred Generic	000101	
H6609	080	0	1	04	01	H6609_080_0	5	3	Preferred Brand	000101	
H6609	080	0	1	04	01	H6609_080_0	5	5	Specialty Tier	010010	
H6609	080	0	1	04	01	H6609_080_0	5	5	Specialty Tier	010010	2
H6609	080	0	1	04	01	H6609_080_0	5	4	Non-Preferred Brand	110000	2
H6609	080	0	1	04	01	H6609_080_0	5	2	Non-Preferred Generic	000101	2
H6609	080	0	1	04	01	H6609_080_0	5	1	Preferred Generic	001010	2
H6609	080	0	1	04	01	H6609_080_0	5	4	Non-Preferred Brand	110000	
H6609	081	0	1	04	01	H6609_081_0	4	3	Preferred Brand	000101	
H6609	081	0	1	04	01	H6609_081_0	4	4	Non-Preferred Brand	110000	
H6609	081	0	1	04	01	H6609_081_0	4	5	Specialty Tier	010010	
H6609	081	0	1	04	01	H6609_081_0	4	2	Non-Preferred Generic	000101	
H6609	081	0	1	04	01	H6609_081_0	4	2	Non-Preferred Generic	000101	2
H6609	081	0	1	04	01	H6609_081_0	4	1	Preferred Generic	001010	2
H6609	081	0	1	04	01	H6609_081_0	4	1	Preferred Generic	001010	
H6609	081	0	1	04	01	H6609_081_0	4	3	Preferred Brand	000101	2
H6609	081	0	1	04	01	H6609_081_0	4	4	Non-Preferred Brand	110000	2
H6609	081	0	1	04	01	H6609_081_0	4	5	Specialty Tier	010010	2
H6609	082	0	1	04	01	H6609_082_0	4	2	Non-Preferred Generic	000101	
H6609	082	0	1	04	01	H6609_082_0	4	1	Preferred Generic	001010	
H6609	082	0	1	04	01	H6609_082_0	4	3	Preferred Brand	000101	2
H6609	082	0	1	04	01	H6609_082_0	4	4	Non-Preferred Brand	110000	2
H6609	082	0	1	04	01	H6609_082_0	4	2	Non-Preferred Generic	000101	2
H6609	082	0	1	04	01	H6609_082_0	4	3	Preferred Brand	000101	
H6609	082	0	1	04	01	H6609_082_0	4	4	Non-Preferred Brand	110000	
H6609	082	0	1	04	01	H6609_082_0	4	5	Specialty Tier	010010	
H6609	082	0	1	04	01	H6609_082_0	4	1	Preferred Generic	001010	2
H6609	082	0	1	04	01	H6609_082_0	4	5	Specialty Tier	010010	2
H6609	083	0	1	04	01	H6609_083_0	4	5	Specialty Tier	010010	2
H6609	083	0	1	04	01	H6609_083_0	4	4	Non-Preferred Brand	110000	2
H6609	083	0	1	04	01	H6609_083_0	4	3	Preferred Brand	000101	2
H6609	083	0	1	04	01	H6609_083_0	4	5	Specialty Tier	010010	
H6609	083	0	1	04	01	H6609_083_0	4	1	Preferred Generic	001010	2
H6609	083	0	1	04	01	H6609_083_0	4	2	Non-Preferred Generic	000101	2
H6609	083	0	1	04	01	H6609_083_0	4	4	Non-Preferred Brand	110000	
H6609	083	0	1	04	01	H6609_083_0	4	3	Preferred Brand	000101	
H6609	083	0	1	04	01	H6609_083_0	4	2	Non-Preferred Generic	000101	
H6609	083	0	1	04	01	H6609_083_0	4	1	Preferred Generic	001010	
H6609	084	0	1	04	01	H6609_084_0	4	2	Non-Preferred Generic	000101	2
H6609	084	0	1	04	01	H6609_084_0	4	3	Preferred Brand	000101	2
H6609	084	0	1	04	01	H6609_084_0	4	4	Non-Preferred Brand	110000	2
H6609	084	0	1	04	01	H6609_084_0	4	5	Specialty Tier	010010	2
H6609	084	0	1	04	01	H6609_084_0	4	1	Preferred Generic	001010	2
H6609	084	0	1	04	01	H6609_084_0	4	2	Non-Preferred Generic	000101	
H6609	084	0	1	04	01	H6609_084_0	4	3	Preferred Brand	000101	
H6609	084	0	1	04	01	H6609_084_0	4	4	Non-Preferred Brand	110000	
H6609	084	0	1	04	01	H6609_084_0	4	5	Specialty Tier	010010	
H6609	084	0	1	04	01	H6609_084_0	4	1	Preferred Generic	001010	
H6609	085	0	1	04	01	H6609_085_0	4	4	Non-Preferred Brand	110000	2
H6609	085	0	1	04	01	H6609_085_0	4	3	Preferred Brand	000101	2
H6609	085	0	1	04	01	H6609_085_0	4	2	Non-Preferred Generic	000101	2
H6609	085	0	1	04	01	H6609_085_0	4	1	Preferred Generic	001010	2
H6609	085	0	1	04	01	H6609_085_0	4	1	Preferred Generic	001010	
H6609	085	0	1	04	01	H6609_085_0	4	2	Non-Preferred Generic	000101	
H6609	085	0	1	04	01	H6609_085_0	4	3	Preferred Brand	000101	
H6609	085	0	1	04	01	H6609_085_0	4	5	Specialty Tier	010010	2
H6609	085	0	1	04	01	H6609_085_0	4	5	Specialty Tier	010010	
H6609	085	0	1	04	01	H6609_085_0	4	4	Non-Preferred Brand	110000	
H6609	086	0	1	04	01	H6609_086_0	4	1	Preferred Generic	001010	
H6609	086	0	1	04	01	H6609_086_0	4	2	Non-Preferred Generic	000101	
H6609	086	0	1	04	01	H6609_086_0	4	3	Preferred Brand	000101	
H6609	086	0	1	04	01	H6609_086_0	4	4	Non-Preferred Brand	110000	
H6609	086	0	1	04	01	H6609_086_0	4	5	Specialty Tier	010010	
H6609	086	0	1	04	01	H6609_086_0	4	1	Preferred Generic	001010	2
H6609	086	0	1	04	01	H6609_086_0	4	2	Non-Preferred Generic	000101	2
H6609	086	0	1	04	01	H6609_086_0	4	3	Preferred Brand	000101	2
H6609	086	0	1	04	01	H6609_086_0	4	4	Non-Preferred Brand	110000	2
H6609	086	0	1	04	01	H6609_086_0	4	5	Specialty Tier	010010	2
H6609	087	0	1	04	01	H6609_087_0	4	2	Non-Preferred Generic	000101	
H6609	087	0	1	04	01	H6609_087_0	4	3	Preferred Brand	000101	
H6609	087	0	1	04	01	H6609_087_0	4	4	Non-Preferred Brand	110000	
H6609	087	0	1	04	01	H6609_087_0	4	5	Specialty Tier	010010	
H6609	087	0	1	04	01	H6609_087_0	4	5	Specialty Tier	010010	2
H6609	087	0	1	04	01	H6609_087_0	4	2	Non-Preferred Generic	000101	2
H6609	087	0	1	04	01	H6609_087_0	4	3	Preferred Brand	000101	2
H6609	087	0	1	04	01	H6609_087_0	4	4	Non-Preferred Brand	110000	2
H6609	087	0	1	04	01	H6609_087_0	4	1	Preferred Generic	001010	
H6609	087	0	1	04	01	H6609_087_0	4	1	Preferred Generic	001010	2
H6622	001	0	1	01	01	H6622_001_0	5	5	Specialty Tier	010010	2
H6622	001	0	1	01	01	H6622_001_0	5	4	Non-Preferred Brand	110000	2
H6622	001	0	1	01	01	H6622_001_0	5	3	Preferred Brand	000101	2
H6622	001	0	1	01	01	H6622_001_0	5	2	Non-Preferred Generic	000101	2
H6622	001	0	1	01	01	H6622_001_0	5	1	Preferred Generic	001010	2
H6622	001	0	1	01	01	H6622_001_0	5	5	Specialty Tier	010010	
H6622	001	0	1	01	01	H6622_001_0	5	4	Non-Preferred Brand	110000	
H6622	001	0	1	01	01	H6622_001_0	5	2	Non-Preferred Generic	000101	
H6622	001	0	1	01	01	H6622_001_0	5	3	Preferred Brand	000101	
H6622	001	0	1	01	01	H6622_001_0	5	1	Preferred Generic	001010	
H6622	002	0	1	01	01	H6622_002_0	5	5	Specialty Tier	010010	2
H6622	002	0	1	01	01	H6622_002_0	5	2	Non-Preferred Generic	000101	
H6622	002	0	1	01	01	H6622_002_0	5	3	Preferred Brand	000101	
H6622	002	0	1	01	01	H6622_002_0	5	4	Non-Preferred Brand	110000	
H6622	002	0	1	01	01	H6622_002_0	5	4	Non-Preferred Brand	110000	2
H6622	002	0	1	01	01	H6622_002_0	5	1	Preferred Generic	001010	2
H6622	002	0	1	01	01	H6622_002_0	5	2	Non-Preferred Generic	000101	2
H6622	002	0	1	01	01	H6622_002_0	5	3	Preferred Brand	000101	2
H6622	002	0	1	01	01	H6622_002_0	5	1	Preferred Generic	001010	
H6622	002	0	1	01	01	H6622_002_0	5	5	Specialty Tier	010010	
H6622	003	0	1	01	01	H6622_003_0	6	5	Specialty Tier	010010	2
H6622	003	0	1	01	01	H6622_003_0	6	4	Non-Preferred Brand	110000	2
H6622	003	0	1	01	01	H6622_003_0	6	3	Preferred Brand	000101	2
H6622	003	0	1	01	01	H6622_003_0	6	2	Non-Preferred Generic	000101	2
H6622	003	0	1	01	01	H6622_003_0	6	1	Preferred Generic	001010	2
H6622	003	0	1	01	01	H6622_003_0	6	5	Specialty Tier	010010	
H6622	003	0	1	01	01	H6622_003_0	6	4	Non-Preferred Brand	110000	
H6622	003	0	1	01	01	H6622_003_0	6	3	Preferred Brand	000101	
H6622	003	0	1	01	01	H6622_003_0	6	1	Preferred Generic	001010	
H6622	003	0	1	01	01	H6622_003_0	6	2	Non-Preferred Generic	000101	
H6743	001	0	1	04	01	H6743_001_0	8	1	Preferred Generic	001000	
H6743	001	0	1	04	01	H6743_001_0	8	2	Non-Preferred Generic	000100	
H6743	001	0	1	04	01	H6743_001_0	8	5	Specialty Tier	100100	
H6743	001	0	1	04	01	H6743_001_0	8	4	Non-Preferred Brand	100000	
H6743	001	0	1	04	01	H6743_001_0	8	3	Preferred Brand	000001	
H6743	003	0	1	04	01	H6743_003_0	7	1	Preferred Generic	001000	
H6743	003	0	1	04	01	H6743_003_0	7	2	Non-Preferred Generic	000100	
H6743	003	0	1	04	01	H6743_003_0	7	3	Preferred Brand	000001	
H6743	003	0	1	04	01	H6743_003_0	7	4	Non-Preferred Brand	100000	
H6743	003	0	1	04	01	H6743_003_0	7	5	Specialty Tier	100100	
H6743	004	0	1	04	01	H6743_004_0	7	1	Preferred Generic	001000	
H6743	004	0	1	04	01	H6743_004_0	7	3	Preferred Brand	000001	
H6743	004	0	1	04	01	H6743_004_0	7	4	Non-Preferred Brand	100000	
H6743	004	0	1	04	01	H6743_004_0	7	2	Non-Preferred Generic	000100	
H6743	004	0	1	04	01	H6743_004_0	7	5	Specialty Tier	100100	
H6743	005	0	1	04	01	H6743_005_0	8	1	Preferred Generic	001000	
H6743	005	0	1	04	01	H6743_005_0	8	3	Preferred Brand	000001	
H6743	005	0	1	04	01	H6743_005_0	8	4	Non-Preferred Brand	100000	
H6743	005	0	1	04	01	H6743_005_0	8	2	Non-Preferred Generic	000100	
H6743	005	0	1	04	01	H6743_005_0	8	5	Specialty Tier	100100	
H6743	007	0	1	04	01	H6743_007_0	7	1	Preferred Generic	001000	
H6743	007	0	1	04	01	H6743_007_0	7	5	Specialty Tier	100100	
H6743	007	0	1	04	01	H6743_007_0	7	2	Non-Preferred Generic	000100	
H6743	007	0	1	04	01	H6743_007_0	7	4	Non-Preferred Brand	100000	
H6743	007	0	1	04	01	H6743_007_0	7	3	Preferred Brand	000001	
H6745	001	0	1	01	01	H6745_001_0	8	3	Specialty Tier	010010	
H6745	001	0	1	01	01	H6745_001_0	8	1	Generic	010000	
H6745	001	0	1	01	01	H6745_001_0	8	2	Brand	000010	
H6750	001	0	1	01	01	H6750_001_0	10	1	Preferred Generic	001000	
H6750	001	0	1	01	01	H6750_001_0	10	2	Non-Preferred Generic	000100	1
H6750	001	0	1	01	01	H6750_001_0	10	1	Preferred Generic	001000	1
H6750	001	0	1	01	01	H6750_001_0	10	4	Non-Preferred Brand	100000	
H6750	001	0	1	01	01	H6750_001_0	10	3	Preferred Brand	000001	
H6750	001	0	1	01	01	H6750_001_0	10	2	Non-Preferred Generic	000100	
H6751	001	0	1	48	05	H6751_001_0	7	2	Brand Drugs	000010	
H6751	001	0	1	48	05	H6751_001_0	7	1	Generic Drugs	010000	
H6786	001	0	1	04	01	H6786_001_0	7	6	Specialty Tier	010010	
H6786	001	0	1	04	01	H6786_001_0	7	5	Injectable Drugs	010010	
H6786	001	0	1	04	01	H6786_001_0	7	4	Non-Preferred Brand	100100	
H6786	001	0	1	04	01	H6786_001_0	7	3	Preferred Brand	000101	
H6786	001	0	1	04	01	H6786_001_0	7	2	Non-Preferred Generic	000100	
H6786	001	0	1	04	01	H6786_001_0	7	1	Preferred Generic	001000	
H6801	002	0	1	01	01	H6801_002_0	10	1	Preferred Generic	001000	
H6801	002	0	1	01	01	H6801_002_0	10	2	Non-Preferred Generic	000100	
H6801	002	0	1	01	01	H6801_002_0	10	3	Preferred Brand	000001	
H6801	002	0	1	01	01	H6801_002_0	10	2	Non-Preferred Generic	000100	1
H6801	002	0	1	01	01	H6801_002_0	10	5	Specialty Tier	000010	
H6801	002	0	1	01	01	H6801_002_0	10	1	Preferred Generic	001000	1
H6801	002	0	1	01	01	H6801_002_0	10	4	Non-Preferred Brand	100000	
H6815	001	0	1	01	01	H6815_001_0	4	1	Preferred Generic	001000	
H6815	001	0	1	01	01	H6815_001_0	4	2	Non-Preferred Generic	000100	
H6815	001	0	1	01	01	H6815_001_0	4	3	Preferred Brand	000001	
H6815	001	0	1	01	01	H6815_001_0	4	4	Non-Preferred Brand	100000	
H6815	001	0	1	01	01	H6815_001_0	4	5	Specialty Tier	010010	
H6815	001	0	1	01	01	H6815_001_0	4	6	Select Care Drugs	010010	
H6815	002	0	1	01	01	H6815_002_0	4	1	Preferred Generic	001000	
H6815	002	0	1	01	01	H6815_002_0	4	2	Non-Preferred Generic	000100	
H6815	002	0	1	01	01	H6815_002_0	4	3	Preferred Brand	000001	
H6815	002	0	1	01	01	H6815_002_0	4	4	Non-Preferred Brand	100000	
H6815	002	0	1	01	01	H6815_002_0	4	5	Specialty Tier	010010	
H6815	002	0	1	01	01	H6815_002_0	4	6	Select Care Drugs	010010	
H6859	001	0	1	01	01	H6859_001_0	5	4	Non-Preferred Brand	110000	
H6859	001	0	1	01	01	H6859_001_0	5	3	Preferred Brand	000101	
H6859	001	0	1	01	01	H6859_001_0	5	5	Specialty Tier	010010	2
H6859	001	0	1	01	01	H6859_001_0	5	4	Non-Preferred Brand	110000	2
H6859	001	0	1	01	01	H6859_001_0	5	3	Preferred Brand	000101	2
H6859	001	0	1	01	01	H6859_001_0	5	2	Non-Preferred Generic	000101	2
H6859	001	0	1	01	01	H6859_001_0	5	1	Preferred Generic	001010	2
H6859	001	0	1	01	01	H6859_001_0	5	5	Specialty Tier	010010	
H6859	001	0	1	01	01	H6859_001_0	5	1	Preferred Generic	001010	
H6859	001	0	1	01	01	H6859_001_0	5	2	Non-Preferred Generic	000101	
H6859	002	0	1	01	01	H6859_002_0	4	1	Preferred Generic	001010	
H6859	002	0	1	01	01	H6859_002_0	4	4	Non-Preferred Brand	110000	2
H6859	002	0	1	01	01	H6859_002_0	4	3	Preferred Brand	000101	2
H6859	002	0	1	01	01	H6859_002_0	4	2	Non-Preferred Generic	000101	2
H6859	002	0	1	01	01	H6859_002_0	4	5	Specialty Tier	010010	2
H6859	002	0	1	01	01	H6859_002_0	4	5	Specialty Tier	010010	
H6859	002	0	1	01	01	H6859_002_0	4	4	Non-Preferred Brand	110000	
H6859	002	0	1	01	01	H6859_002_0	4	3	Preferred Brand	000101	
H6859	002	0	1	01	01	H6859_002_0	4	2	Non-Preferred Generic	000101	
H6859	002	0	1	01	01	H6859_002_0	4	1	Preferred Generic	001010	2
H6859	003	0	1	01	01	H6859_003_0	5	4	Non-Preferred Brand	110000	
H6859	003	0	1	01	01	H6859_003_0	5	3	Preferred Brand	000101	
H6859	003	0	1	01	01	H6859_003_0	5	2	Non-Preferred Generic	000101	
H6859	003	0	1	01	01	H6859_003_0	5	1	Preferred Generic	001010	
H6859	003	0	1	01	01	H6859_003_0	5	5	Specialty Tier	010010	
H6859	003	0	1	01	01	H6859_003_0	5	5	Specialty Tier	010010	2
H6859	003	0	1	01	01	H6859_003_0	5	4	Non-Preferred Brand	110000	2
H6859	003	0	1	01	01	H6859_003_0	5	3	Preferred Brand	000101	2
H6859	003	0	1	01	01	H6859_003_0	5	2	Non-Preferred Generic	000101	2
H6859	003	0	1	01	01	H6859_003_0	5	1	Preferred Generic	001010	2
H6859	004	0	1	01	01	H6859_004_0	5	1	Preferred Generic	001010	
H6859	004	0	1	01	01	H6859_004_0	5	2	Non-Preferred Generic	000101	
H6859	004	0	1	01	01	H6859_004_0	5	5	Specialty Tier	010010	2
H6859	004	0	1	01	01	H6859_004_0	5	4	Non-Preferred Brand	110000	2
H6859	004	0	1	01	01	H6859_004_0	5	3	Preferred Brand	000101	2
H6859	004	0	1	01	01	H6859_004_0	5	2	Non-Preferred Generic	000101	2
H6859	004	0	1	01	01	H6859_004_0	5	1	Preferred Generic	001010	2
H6859	004	0	1	01	01	H6859_004_0	5	5	Specialty Tier	010010	
H6859	004	0	1	01	01	H6859_004_0	5	4	Non-Preferred Brand	110000	
H6859	004	0	1	01	01	H6859_004_0	5	3	Preferred Brand	000101	
H6859	005	0	1	01	01	H6859_005_0	4	1	Preferred Generic	001010	
H6859	005	0	1	01	01	H6859_005_0	4	5	Specialty Tier	010010	
H6859	005	0	1	01	01	H6859_005_0	4	1	Preferred Generic	001010	2
H6859	005	0	1	01	01	H6859_005_0	4	2	Non-Preferred Generic	000101	2
H6859	005	0	1	01	01	H6859_005_0	4	5	Specialty Tier	010010	2
H6859	005	0	1	01	01	H6859_005_0	4	4	Non-Preferred Brand	110000	2
H6859	005	0	1	01	01	H6859_005_0	4	4	Non-Preferred Brand	110000	
H6859	005	0	1	01	01	H6859_005_0	4	3	Preferred Brand	000101	
H6859	005	0	1	01	01	H6859_005_0	4	2	Non-Preferred Generic	000101	
H6859	005	0	1	01	01	H6859_005_0	4	3	Preferred Brand	000101	2
H6881	002	0	1	04	01	H6881_002_0	5	3	Non-Preferred Brand	100100	
H6881	002	0	1	04	01	H6881_002_0	5	4	Specialty Tier	100100	
H6881	002	0	1	04	01	H6881_002_0	5	1	Preferred Generic	001010	
H6881	002	0	1	04	01	H6881_002_0	5	2	Preferred Brand	000101	
H6923	001	0	1	01	01	H6923_001_0	5	5	Select Care Drugs	010000	1
H6923	001	0	1	01	01	H6923_001_0	5	3	Non-Preferred Brand	110000	
H6923	001	0	1	01	01	H6923_001_0	5	2	Preferred Brand	010001	
H6923	001	0	1	01	01	H6923_001_0	5	1	Generic	010000	
H6923	001	0	1	01	01	H6923_001_0	5	5	Select Care Drugs	010000	
H6923	001	0	1	01	01	H6923_001_0	5	4	Specialty Tier	010010	
H6923	005	0	1	01	01	H6923_005_0	6	5	Select Care Drugs	010000	1
H6923	005	0	1	01	01	H6923_005_0	6	5	Select Care Drugs	010000	
H6923	005	0	1	01	01	H6923_005_0	6	1	Generic	010000	
H6923	005	0	1	01	01	H6923_005_0	6	2	Preferred Brand	010001	
H6923	005	0	1	01	01	H6923_005_0	6	4	Specialty Tier	010010	
H6923	005	0	1	01	01	H6923_005_0	6	3	Non-Preferred Brand	110000	
H6951	002	0	1	04	01	H6951_002_0	5	1	Preferred Generic	001000	
H6951	002	0	1	04	01	H6951_002_0	5	5	Specialty Tier	010010	
H6951	002	0	1	04	01	H6951_002_0	5	4	Non-Preferred Brand	100000	
H6951	002	0	1	04	01	H6951_002_0	5	3	Preferred Brand	000001	
H6951	002	0	1	04	01	H6951_002_0	5	2	Non-Preferred Generic	000100	
H6951	003	0	1	04	01	H6951_003_0	7	5	Specialty Tier	010010	
H6951	003	0	1	04	01	H6951_003_0	7	4	Non-Preferred Brand	100000	
H6951	003	0	1	04	01	H6951_003_0	7	3	Preferred Brand	000001	
H6951	003	0	1	04	01	H6951_003_0	7	1	Preferred Generic	001000	
H6951	003	0	1	04	01	H6951_003_0	7	2	Non-Preferred Generic	000100	
H6972	001	0	1	01	01	H6972_001_0	3	4	Non-Preferred Brand	100100	
H6972	001	0	1	01	01	H6972_001_0	3	3	Preferred Brand	000001	
H6972	001	0	1	01	01	H6972_001_0	3	2	Non-Preferred Generic	000100	
H6972	001	0	1	01	01	H6972_001_0	3	1	Preferred Generic	001000	
H6972	001	0	1	01	01	H6972_001_0	3	5	Specialty Tier	010010	
H7002	002	0	1	04	01	H7002_002_0	3	4	Non-Preferred Brand	110000	2
H7002	002	0	1	04	01	H7002_002_0	3	3	Preferred Brand	000101	
H7002	002	0	1	04	01	H7002_002_0	3	2	Non-Preferred Generic	000101	2
H7002	002	0	1	04	01	H7002_002_0	3	1	Preferred Generic	001010	2
H7002	002	0	1	04	01	H7002_002_0	3	5	Specialty Tier	010010	
H7002	002	0	1	04	01	H7002_002_0	3	4	Non-Preferred Brand	110000	
H7002	002	0	1	04	01	H7002_002_0	3	5	Specialty Tier	010010	2
H7002	002	0	1	04	01	H7002_002_0	3	3	Preferred Brand	000101	2
H7002	002	0	1	04	01	H7002_002_0	3	2	Non-Preferred Generic	000101	
H7002	002	0	1	04	01	H7002_002_0	3	1	Preferred Generic	001010	
H7006	001	0	1	04	01	H7006_001_0	6	1	Preferred Generic	001000	
H7006	001	0	1	04	01	H7006_001_0	6	5	Specialty Tier	100100	
H7006	001	0	1	04	01	H7006_001_0	6	4	Non-Preferred Brand	100000	
H7006	001	0	1	04	01	H7006_001_0	6	3	Preferred Brand	000001	
H7006	001	0	1	04	01	H7006_001_0	6	2	Non-Preferred Generic	000100	
H7006	003	0	1	04	01	H7006_003_0	5	5	Specialty Tier	100100	
H7006	003	0	1	04	01	H7006_003_0	5	3	Preferred Brand	000001	
H7006	003	0	1	04	01	H7006_003_0	5	2	Non-Preferred Generic	000100	
H7006	003	0	1	04	01	H7006_003_0	5	4	Non-Preferred Brand	100000	
H7006	003	0	1	04	01	H7006_003_0	5	1	Preferred Generic	001000	
H7006	005	0	1	04	01	H7006_005_0	6	1	Preferred Generic	001000	
H7006	005	0	1	04	01	H7006_005_0	6	2	Non-Preferred Generic	000100	
H7006	005	0	1	04	01	H7006_005_0	6	3	Preferred Brand	000001	
H7006	005	0	1	04	01	H7006_005_0	6	4	Non-Preferred Brand	100000	
H7006	005	0	1	04	01	H7006_005_0	6	5	Specialty Tier	100100	
H7020	001	0	1	01	01	H7020_001_0	6	2	Non-Preferred Generic	000100	1
H7020	001	0	1	01	01	H7020_001_0	6	1	Preferred Generic	001000	1
H7020	001	0	1	01	01	H7020_001_0	6	5	Specialty Tier	010010	
H7020	001	0	1	01	01	H7020_001_0	6	4	Non-Preferred Brand	100100	
H7020	001	0	1	01	01	H7020_001_0	6	3	Preferred Brand	000001	
H7020	001	0	1	01	01	H7020_001_0	6	1	Preferred Generic	001000	
H7020	001	0	1	01	01	H7020_001_0	6	2	Non-Preferred Generic	000100	
H7086	001	0	1	01	01	H7086_001_0	5	1	Generic	010000	
H7086	001	0	1	01	01	H7086_001_0	5	2	Brand	000010	
H7149	001	0	1	01	01	H7149_001_0	7	1	Preferred Generic	001000	
H7149	001	0	1	01	01	H7149_001_0	7	4	Non-Preferred Brand	100100	
H7149	001	0	1	01	01	H7149_001_0	7	3	Preferred Brand	000001	
H7149	001	0	1	01	01	H7149_001_0	7	2	Non-Preferred Generic	000100	
H7149	001	0	1	01	01	H7149_001_0	7	5	Specialty Tier	010010	
H7149	004	0	1	01	01	H7149_004_0	6	1	Preferred Generic	001000	
H7149	004	0	1	01	01	H7149_004_0	6	2	Non-Preferred Generic	000100	
H7149	004	0	1	01	01	H7149_004_0	6	3	Preferred Brand	000001	
H7149	004	0	1	01	01	H7149_004_0	6	4	Non-Preferred Brand	100100	
H7149	004	0	1	01	01	H7149_004_0	6	5	Specialty Tier	010010	
H7172	001	0	1	48	05	H7172_001_0	3	1	Generic Drugs	010000	
H7172	001	0	1	48	05	H7172_001_0	3	2	Brand Drugs	000010	
H7172	001	0	1	48	05	H7172_001_0	3	4	Non-Medicare Rx Brand Drugs	000010	
H7172	001	0	1	48	05	H7172_001_0	3	3	Non-Medicare Rx Generic Drugs	010000	
H7172	001	0	1	48	05	H7172_001_0	3	5	Non-Medicare OTC Drugs	010010	
H7173	001	0	1	01	01	H7173_001_0	7	4	Injectable Drugs	000001	
H7173	001	0	1	01	01	H7173_001_0	7	3	Non-Preferred Brand	100000	
H7173	001	0	1	01	01	H7173_001_0	7	2	Preferred Brand	000001	
H7173	001	0	1	01	01	H7173_001_0	7	1	Generic	010000	
H7187	003	0	1	01	01	H7187_003_0	4	1	Preferred Generic	001000	
H7187	003	0	1	01	01	H7187_003_0	4	5	Specialty Tier	010010	
H7187	003	0	1	01	01	H7187_003_0	4	4	Non-Preferred Brand	100100	
H7187	003	0	1	01	01	H7187_003_0	4	3	Preferred Brand	010001	
H7187	003	0	1	01	01	H7187_003_0	4	2	Non-Preferred Generic	000100	
H7187	009	0	1	01	01	H7187_009_0	4	5	Specialty Tier	010010	
H7187	009	0	1	01	01	H7187_009_0	4	1	Preferred Generic	001000	
H7187	009	0	1	01	01	H7187_009_0	4	2	Non-Preferred Generic	000100	
H7187	009	0	1	01	01	H7187_009_0	4	3	Preferred Brand	010001	
H7187	009	0	1	01	01	H7187_009_0	4	4	Non-Preferred Brand	100100	
H7188	003	0	1	04	01	H7188_003_0	5	3	Preferred Brand	000101	
H7188	003	0	1	04	01	H7188_003_0	5	2	Non-Preferred Generic	000101	
H7188	003	0	1	04	01	H7188_003_0	5	1	Preferred Generic	001010	
H7188	003	0	1	04	01	H7188_003_0	5	5	Specialty Tier	010010	2
H7188	003	0	1	04	01	H7188_003_0	5	4	Non-Preferred Brand	110000	
H7188	003	0	1	04	01	H7188_003_0	5	4	Non-Preferred Brand	110000	2
H7188	003	0	1	04	01	H7188_003_0	5	2	Non-Preferred Generic	000101	2
H7188	003	0	1	04	01	H7188_003_0	5	1	Preferred Generic	001010	2
H7188	003	0	1	04	01	H7188_003_0	5	5	Specialty Tier	010010	
H7188	003	0	1	04	01	H7188_003_0	5	3	Preferred Brand	000101	2
H7188	006	0	1	04	01	H7188_006_0	6	4	Non-Preferred Brand	110000	2
H7188	006	0	1	04	01	H7188_006_0	6	3	Preferred Brand	000101	2
H7188	006	0	1	04	01	H7188_006_0	6	2	Non-Preferred Generic	000101	2
H7188	006	0	1	04	01	H7188_006_0	6	5	Specialty Tier	010010	
H7188	006	0	1	04	01	H7188_006_0	6	1	Preferred Generic	001010	
H7188	006	0	1	04	01	H7188_006_0	6	5	Specialty Tier	010010	2
H7188	006	0	1	04	01	H7188_006_0	6	3	Preferred Brand	000101	
H7188	006	0	1	04	01	H7188_006_0	6	4	Non-Preferred Brand	110000	
H7188	006	0	1	04	01	H7188_006_0	6	2	Non-Preferred Generic	000101	
H7200	007	0	1	01	01	H7200_007_0	5	1	Preferred Generic	001000	
H7200	007	0	1	01	01	H7200_007_0	5	2	Non-Preferred Generic	000100	
H7200	007	0	1	01	01	H7200_007_0	5	3	Preferred Brand	000001	
H7200	007	0	1	01	01	H7200_007_0	5	4	Non-Preferred Brand	100000	
H7200	007	0	1	01	01	H7200_007_0	5	5	Specialty Tier	010010	
H7220	003	0	1	01	01	H7220_003_0	6	5	Specialty Tier	100000	
H7220	003	0	1	01	01	H7220_003_0	6	4	Non-Preferred Brand	100000	
H7220	003	0	1	01	01	H7220_003_0	6	3	Preferred Brand	000001	
H7220	003	0	1	01	01	H7220_003_0	6	1	Preferred Generic	001000	
H7220	003	0	1	01	01	H7220_003_0	6	2	Non-Preferred Generic	000100	
H7220	004	0	1	02	01	H7220_004_0	7	4	Non-Preferred Brand	100000	
H7220	004	0	1	02	01	H7220_004_0	7	3	Preferred Brand	000001	
H7220	004	0	1	02	01	H7220_004_0	7	2	Non-Preferred Generic	000100	
H7220	004	0	1	02	01	H7220_004_0	7	1	Preferred Generic	001000	
H7220	004	0	1	02	01	H7220_004_0	7	1	Preferred Generic	001000	1
H7220	004	0	1	02	01	H7220_004_0	7	5	Specialty Tier	100000	
H7245	001	0	1	01	01	H7245_001_0	10	6	Specialty Tier	010010	
H7245	001	0	1	01	01	H7245_001_0	10	5	Injectable Drugs	010010	
H7245	001	0	1	01	01	H7245_001_0	10	4	Non-Preferred Brand	100000	
H7245	001	0	1	01	01	H7245_001_0	10	3	Preferred Brand	000001	
H7245	001	0	1	01	01	H7245_001_0	10	2	Non-Preferred Generic	000100	
H7245	001	0	1	01	01	H7245_001_0	10	1	Preferred Generic	001000	
H7245	002	0	1	02	01	H7245_002_0	10	4	Non-Preferred Brand	100000	
H7245	002	0	1	02	01	H7245_002_0	10	3	Preferred Brand	000001	
H7245	002	0	1	02	01	H7245_002_0	10	2	Non-Preferred Generic	000100	
H7245	002	0	1	02	01	H7245_002_0	10	1	Preferred Generic	001000	
H7245	002	0	1	02	01	H7245_002_0	10	6	Specialty Tier	010010	
H7245	002	0	1	02	01	H7245_002_0	10	5	Injectable Drugs	010010	
H7245	003	0	1	01	01	H7245_003_0	10	6	Specialty Tier	010010	
H7245	003	0	1	01	01	H7245_003_0	10	5	Injectable Drugs	010010	
H7245	003	0	1	01	01	H7245_003_0	10	4	Non-Preferred Brand	100000	
H7245	003	0	1	01	01	H7245_003_0	10	3	Preferred Brand	000001	
H7245	003	0	1	01	01	H7245_003_0	10	2	Non-Preferred Generic	000100	
H7245	003	0	1	01	01	H7245_003_0	10	1	Preferred Generic	001000	
H7245	004	0	1	02	01	H7245_004_0	10	6	Specialty Tier	010010	
H7245	004	0	1	02	01	H7245_004_0	10	4	Non-Preferred Brand	100000	
H7245	004	0	1	02	01	H7245_004_0	10	3	Preferred Brand	000001	
H7245	004	0	1	02	01	H7245_004_0	10	2	Non-Preferred Generic	000100	
H7245	004	0	1	02	01	H7245_004_0	10	1	Preferred Generic	001000	
H7245	004	0	1	02	01	H7245_004_0	10	5	Injectable Drugs	010010	
H7301	002	0	1	04	01	H7301_002_0	10	2	Non-Preferred Generic	000100	
H7301	002	0	1	04	01	H7301_002_0	10	3	Preferred Brand	000001	
H7301	002	0	1	04	01	H7301_002_0	10	4	Non-Preferred Brand	100100	
H7301	002	0	1	04	01	H7301_002_0	10	5	Specialty Tier	010010	
H7301	002	0	1	04	01	H7301_002_0	10	1	Preferred Generic	001000	
H7306	001	0	1	04	01	H7306_001_0	7	1	Preferred Generic	001000	
H7306	001	0	1	04	01	H7306_001_0	7	2	Non-Preferred Generic	000100	
H7306	001	0	1	04	01	H7306_001_0	7	5	Specialty Tier	010010	
H7306	001	0	1	04	01	H7306_001_0	7	4	Non-Preferred Brand	100100	
H7306	001	0	1	04	01	H7306_001_0	7	3	Preferred Brand	000001	
H7419	001	0	1	48	05	H7419_001_0	4	1	Generic Drugs	010000	
H7419	001	0	1	48	05	H7419_001_0	4	3	Non-Medicare Rx/OTC Drugs	010010	
H7419	001	0	1	48	05	H7419_001_0	4	2	Brand Drugs	000010	
H7678	001	0	1	01	01	H7678_001_0	8	1	Generic	010000	
H7678	001	0	1	01	01	H7678_001_0	8	2	Preferred Brand	000001	
H7678	001	0	1	01	01	H7678_001_0	8	1	Generic	010000	1
H7678	001	0	1	01	01	H7678_001_0	8	4	Specialty Tier	010010	
H7678	001	0	1	01	01	H7678_001_0	8	3	Non-Preferred Brand	100000	
H7728	001	0	1	04	01	H7728_001_0	5	1	Preferred Generic	001000	
H7728	001	0	1	04	01	H7728_001_0	5	5	Injectable Drugs	010010	
H7728	001	0	1	04	01	H7728_001_0	5	4	Non-Preferred Brand	100100	
H7728	001	0	1	04	01	H7728_001_0	5	3	Preferred Brand	000101	
H7728	001	0	1	04	01	H7728_001_0	5	2	Non-Preferred Generic	000100	
H7728	001	0	1	04	01	H7728_001_0	5	6	Specialty Tier	010010	
H7787	001	0	1	04	01	H7787_001_0	5	5	Specialty Tier	010010	
H7787	001	0	1	04	01	H7787_001_0	5	4	Non-Preferred Brand	100100	
H7787	001	0	1	04	01	H7787_001_0	5	3	Preferred Brand	000001	
H7787	001	0	1	04	01	H7787_001_0	5	2	Non-Preferred Generic	000100	
H7787	001	0	1	04	01	H7787_001_0	5	1	Preferred Generic	001000	
H7811	001	0	1	01	01	H7811_001_0	3	3	Preferred Brand	000001	
H7811	001	0	1	01	01	H7811_001_0	3	2	Non-Preferred Generic	000100	
H7811	001	0	1	01	01	H7811_001_0	3	1	Preferred Generic	001000	
H7811	001	0	1	01	01	H7811_001_0	3	4	Non-Preferred Brand	100100	
H7811	001	0	1	01	01	H7811_001_0	3	5	Specialty Tier	010010	
H7811	002	0	1	01	01	H7811_002_0	4	3	Preferred Brand	000001	
H7811	002	0	1	01	01	H7811_002_0	4	2	Non-Preferred Generic	000100	
H7811	002	0	1	01	01	H7811_002_0	4	1	Preferred Generic	001000	
H7811	002	0	1	01	01	H7811_002_0	4	4	Non-Preferred Brand	100100	
H7811	002	0	1	01	01	H7811_002_0	4	5	Specialty Tier	010010	
H7885	001	0	1	48	05	H7885_001_0	4	2	Brand Drugs	000010	
H7885	001	0	1	48	05	H7885_001_0	4	1	Generic Drugs	010000	
H7890	001	0	1	48	05	H7890_001_0	5	1	Generic Drugs	010000	
H7890	001	0	1	48	05	H7890_001_0	5	2	Brand Drugs	000010	
H7890	001	0	1	48	05	H7890_001_0	5	3	Non-Medicare Rx Generic Drugs	001000	
H7890	001	0	1	48	05	H7890_001_0	5	4	Non-Medicare Rx Brand Drugs	000001	
H7890	001	0	1	48	05	H7890_001_0	5	5	Non-Medicare OTC Drugs	100000	
H7908	001	0	1	01	01	H7908_001_0	5	2	Preferred Brand	010001	
H7908	001	0	1	01	01	H7908_001_0	5	3	Non-Preferred Brand	110000	
H7908	001	0	1	01	01	H7908_001_0	5	4	Specialty Tier	010010	
H7908	001	0	1	01	01	H7908_001_0	5	5	Select Care Drugs	010000	
H7908	001	0	1	01	01	H7908_001_0	5	5	Select Care Drugs	010000	1
H7908	001	0	1	01	01	H7908_001_0	5	1	Generic	010000	
H7917	008	0	1	04	01	H7917_008_0	6	1	Generic	010000	
H7917	008	0	1	04	01	H7917_008_0	6	2	Preferred Brand	010001	
H7917	008	0	1	04	01	H7917_008_0	6	3	Non-Preferred Brand	100000	
H7917	008	0	1	04	01	H7917_008_0	6	4	Specialty Tier	010010	
H7917	009	0	1	04	01	H7917_009_0	6	1	Generic	010000	
H7917	009	0	1	04	01	H7917_009_0	6	3	Non-Preferred Brand	100000	
H7917	009	0	1	04	01	H7917_009_0	6	2	Preferred Brand	010001	
H7917	009	0	1	04	01	H7917_009_0	6	4	Specialty Tier	010010	
H7917	010	0	1	04	01	H7917_010_0	6	4	Specialty Tier	010010	
H7917	010	0	1	04	01	H7917_010_0	6	3	Non-Preferred Brand	100000	
H7917	010	0	1	04	01	H7917_010_0	6	2	Preferred Brand	010001	
H7917	010	0	1	04	01	H7917_010_0	6	1	Generic	010000	
H7917	011	0	1	04	01	H7917_011_0	6	4	Specialty Tier	010010	
H7917	011	0	1	04	01	H7917_011_0	6	1	Generic	010000	
H7917	011	0	1	04	01	H7917_011_0	6	2	Preferred Brand	010001	
H7917	011	0	1	04	01	H7917_011_0	6	3	Non-Preferred Brand	100000	
H7917	012	0	1	04	01	H7917_012_0	6	3	Non-Preferred Brand	100000	
H7917	012	0	1	04	01	H7917_012_0	6	4	Specialty Tier	010010	
H7917	012	0	1	04	01	H7917_012_0	6	1	Generic	010000	
H7917	012	0	1	04	01	H7917_012_0	6	2	Preferred Brand	010001	
H7917	013	0	1	04	01	H7917_013_0	6	2	Preferred Brand	010001	
H7917	013	0	1	04	01	H7917_013_0	6	3	Non-Preferred Brand	100000	
H7917	013	0	1	04	01	H7917_013_0	6	4	Specialty Tier	010010	
H7917	013	0	1	04	01	H7917_013_0	6	1	Generic	010000	
H7917	014	0	1	04	01	H7917_014_0	6	4	Specialty Tier	010010	
H7917	014	0	1	04	01	H7917_014_0	6	1	Generic	010000	
H7917	014	0	1	04	01	H7917_014_0	6	2	Preferred Brand	010001	
H7917	014	0	1	04	01	H7917_014_0	6	3	Non-Preferred Brand	100000	
H7917	015	0	1	04	01	H7917_015_0	6	3	Non-Preferred Brand	100000	
H7917	015	0	1	04	01	H7917_015_0	6	4	Specialty Tier	010010	
H7917	015	0	1	04	01	H7917_015_0	6	1	Generic	010000	
H7917	015	0	1	04	01	H7917_015_0	6	2	Preferred Brand	010001	
H7917	030	0	1	04	01	H7917_030_0	8	3	Preferred Brand	010001	
H7917	030	0	1	04	01	H7917_030_0	8	2	Non-Preferred Generic	000100	
H7917	030	0	1	04	01	H7917_030_0	8	1	Preferred Generic	001000	
H7917	030	0	1	04	01	H7917_030_0	8	4	Non-Preferred Brand	100000	
H7917	030	0	1	04	01	H7917_030_0	8	5	Specialty Tier	010010	
H7917	030	0	1	04	01	H7917_030_0	8	1	Preferred Generic	001000	1
H7917	031	0	1	04	01	H7917_031_0	8	1	Preferred Generic	001000	1
H7917	031	0	1	04	01	H7917_031_0	8	5	Specialty Tier	010010	
H7917	031	0	1	04	01	H7917_031_0	8	3	Preferred Brand	010001	
H7917	031	0	1	04	01	H7917_031_0	8	2	Non-Preferred Generic	000100	
H7917	031	0	1	04	01	H7917_031_0	8	1	Preferred Generic	001000	
H7917	031	0	1	04	01	H7917_031_0	8	4	Non-Preferred Brand	100000	
H7917	032	0	1	04	01	H7917_032_0	8	1	Preferred Generic	001000	
H7917	032	0	1	04	01	H7917_032_0	8	2	Non-Preferred Generic	000100	
H7917	032	0	1	04	01	H7917_032_0	8	3	Preferred Brand	010001	
H7917	032	0	1	04	01	H7917_032_0	8	4	Non-Preferred Brand	100000	
H7917	032	0	1	04	01	H7917_032_0	8	5	Specialty Tier	010010	
H7917	032	0	1	04	01	H7917_032_0	8	1	Preferred Generic	001000	1
H7917	033	0	1	04	01	H7917_033_0	8	1	Preferred Generic	001000	
H7917	033	0	1	04	01	H7917_033_0	8	2	Non-Preferred Generic	000100	
H7917	033	0	1	04	01	H7917_033_0	8	3	Preferred Brand	010001	
H7917	033	0	1	04	01	H7917_033_0	8	4	Non-Preferred Brand	100000	
H7917	033	0	1	04	01	H7917_033_0	8	5	Specialty Tier	010010	
H7917	033	0	1	04	01	H7917_033_0	8	1	Preferred Generic	001000	1
H7949	001	0	1	01	01	H7949_001_0	8	1	Preferred Generic	001000	1
H7949	001	0	1	01	01	H7949_001_0	8	5	Specialty Tier	010010	
H7949	001	0	1	01	01	H7949_001_0	8	4	Non-Preferred Brand	100100	
H7949	001	0	1	01	01	H7949_001_0	8	3	Preferred Brand	010001	
H7949	001	0	1	01	01	H7949_001_0	8	2	Non-Preferred Generic	000100	
H7949	001	0	1	01	01	H7949_001_0	8	1	Preferred Generic	001000	
H7949	001	0	1	01	01	H7949_001_0	8	2	Non-Preferred Generic	000100	1
H8016	001	0	1	48	05	H8016_001_0	4	3	Non-Medicare Rx/OTC Drugs	010010	
H8016	001	0	1	48	05	H8016_001_0	4	2	Brand Drugs	000010	
H8016	001	0	1	48	05	H8016_001_0	4	1	Generic Drugs	010000	
H8046	001	0	1	48	05	H8046_001_0	6	5	Non-Medicare OTC Drugs	010010	
H8046	001	0	1	48	05	H8046_001_0	6	4	Non-Medicare Rx Brand Drugs	000010	
H8046	001	0	1	48	05	H8046_001_0	6	3	Non-Medicare Rx Generic Drugs	010000	
H8046	001	0	1	48	05	H8046_001_0	6	2	Brand Drugs	000010	
H8046	001	0	1	48	05	H8046_001_0	6	1	Generic Drugs	010000	
H8064	002	0	1	04	01	H8064_002_0	6	5	Specialty Tier	010010	
H8064	002	0	1	04	01	H8064_002_0	6	1	Preferred Generic	001000	1
H8064	002	0	1	04	01	H8064_002_0	6	4	Non-Preferred Brand	100000	
H8064	002	0	1	04	01	H8064_002_0	6	3	Preferred Brand	000001	
H8064	002	0	1	04	01	H8064_002_0	6	2	Non-Preferred Generic	000100	
H8064	002	0	1	04	01	H8064_002_0	6	1	Preferred Generic	001000	
H8091	002	0	1	04	01	H8091_002_0	17	4	Non-Preferred Brand	110000	
H8091	002	0	1	04	01	H8091_002_0	17	3	Preferred Brand	000001	
H8091	002	0	1	04	01	H8091_002_0	17	2	Non-Preferred Generic	000100	
H8091	002	0	1	04	01	H8091_002_0	17	1	Preferred Generic	001000	
H8091	002	0	1	04	01	H8091_002_0	17	5	Specialty Tier	010010	
H8091	004	0	1	04	01	H8091_004_0	18	1	Preferred Generic	001000	
H8091	004	0	1	04	01	H8091_004_0	18	2	Non-Preferred Generic	000100	
H8091	004	0	1	04	01	H8091_004_0	18	3	Preferred Brand	000001	
H8091	004	0	1	04	01	H8091_004_0	18	5	Specialty Tier	010010	
H8091	004	0	1	04	01	H8091_004_0	18	4	Non-Preferred Brand	110000	
H8130	001	0	1	01	01	H8130_001_0	10	1	Generic	010000	
H8130	001	0	1	01	01	H8130_001_0	10	2	Preferred Brand	000001	
H8130	001	0	1	01	01	H8130_001_0	10	1	Generic	010000	1
H8130	001	0	1	01	01	H8130_001_0	10	4	Specialty Tier	010010	
H8130	001	0	1	01	01	H8130_001_0	10	3	Non-Preferred Brand	100000	
H8145	001	0	1	09	04	H8145_001_0	7	4	Non-Preferred Brand	110000	
H8145	001	0	1	09	04	H8145_001_0	7	5	Specialty Tier	010010	
H8145	001	0	1	09	04	H8145_001_0	7	1	Preferred Generic	001010	
H8145	001	0	1	09	04	H8145_001_0	7	2	Non-Preferred Generic	000101	
H8145	001	0	1	09	04	H8145_001_0	7	3	Preferred Brand	000101	
H8145	003	0	1	09	04	H8145_003_0	6	1	Preferred Generic	001010	2
H8145	003	0	1	09	04	H8145_003_0	6	2	Non-Preferred Generic	000101	2
H8145	003	0	1	09	04	H8145_003_0	6	3	Preferred Brand	000101	2
H8145	003	0	1	09	04	H8145_003_0	6	4	Non-Preferred Brand	110000	2
H8145	003	0	1	09	04	H8145_003_0	6	5	Specialty Tier	010010	
H8145	003	0	1	09	04	H8145_003_0	6	4	Non-Preferred Brand	110000	
H8145	003	0	1	09	04	H8145_003_0	6	3	Preferred Brand	000101	
H8145	003	0	1	09	04	H8145_003_0	6	5	Specialty Tier	010010	2
H8145	003	0	1	09	04	H8145_003_0	6	2	Non-Preferred Generic	000101	
H8145	003	0	1	09	04	H8145_003_0	6	1	Preferred Generic	001010	
H8145	004	0	1	09	04	H8145_004_0	6	2	Non-Preferred Generic	000101	2
H8145	004	0	1	09	04	H8145_004_0	6	1	Preferred Generic	001010	2
H8145	004	0	1	09	04	H8145_004_0	6	5	Specialty Tier	010010	
H8145	004	0	1	09	04	H8145_004_0	6	4	Non-Preferred Brand	110000	
H8145	004	0	1	09	04	H8145_004_0	6	3	Preferred Brand	000101	
H8145	004	0	1	09	04	H8145_004_0	6	2	Non-Preferred Generic	000101	
H8145	004	0	1	09	04	H8145_004_0	6	1	Preferred Generic	001010	
H8145	004	0	1	09	04	H8145_004_0	6	3	Preferred Brand	000101	2
H8145	004	0	1	09	04	H8145_004_0	6	5	Specialty Tier	010010	2
H8145	004	0	1	09	04	H8145_004_0	6	4	Non-Preferred Brand	110000	2
H8145	005	0	1	09	04	H8145_005_0	5	1	Preferred Generic	001010	
H8145	005	0	1	09	04	H8145_005_0	5	2	Non-Preferred Generic	000101	
H8145	005	0	1	09	04	H8145_005_0	5	5	Specialty Tier	010010	2
H8145	005	0	1	09	04	H8145_005_0	5	4	Non-Preferred Brand	110000	2
H8145	005	0	1	09	04	H8145_005_0	5	3	Preferred Brand	000101	2
H8145	005	0	1	09	04	H8145_005_0	5	2	Non-Preferred Generic	000101	2
H8145	005	0	1	09	04	H8145_005_0	5	1	Preferred Generic	001010	2
H8145	005	0	1	09	04	H8145_005_0	5	5	Specialty Tier	010010	
H8145	005	0	1	09	04	H8145_005_0	5	4	Non-Preferred Brand	110000	
H8145	005	0	1	09	04	H8145_005_0	5	3	Preferred Brand	000101	
H8145	006	0	1	09	04	H8145_006_0	6	1	Preferred Generic	001010	
H8145	006	0	1	09	04	H8145_006_0	6	3	Preferred Brand	000101	2
H8145	006	0	1	09	04	H8145_006_0	6	4	Non-Preferred Brand	110000	2
H8145	006	0	1	09	04	H8145_006_0	6	2	Non-Preferred Generic	000101	2
H8145	006	0	1	09	04	H8145_006_0	6	5	Specialty Tier	010010	2
H8145	006	0	1	09	04	H8145_006_0	6	5	Specialty Tier	010010	
H8145	006	0	1	09	04	H8145_006_0	6	4	Non-Preferred Brand	110000	
H8145	006	0	1	09	04	H8145_006_0	6	3	Preferred Brand	000101	
H8145	006	0	1	09	04	H8145_006_0	6	2	Non-Preferred Generic	000101	
H8145	006	0	1	09	04	H8145_006_0	6	1	Preferred Generic	001010	2
H8145	007	0	1	09	04	H8145_007_0	5	2	Non-Preferred Generic	000101	2
H8145	007	0	1	09	04	H8145_007_0	5	3	Preferred Brand	000101	2
H8145	007	0	1	09	04	H8145_007_0	5	4	Non-Preferred Brand	110000	2
H8145	007	0	1	09	04	H8145_007_0	5	5	Specialty Tier	010010	2
H8145	007	0	1	09	04	H8145_007_0	5	1	Preferred Generic	001010	
H8145	007	0	1	09	04	H8145_007_0	5	2	Non-Preferred Generic	000101	
H8145	007	0	1	09	04	H8145_007_0	5	3	Preferred Brand	000101	
H8145	007	0	1	09	04	H8145_007_0	5	4	Non-Preferred Brand	110000	
H8145	007	0	1	09	04	H8145_007_0	5	5	Specialty Tier	010010	
H8145	007	0	1	09	04	H8145_007_0	5	1	Preferred Generic	001010	2
H8145	008	0	1	09	04	H8145_008_0	5	1	Preferred Generic	001010	
H8145	008	0	1	09	04	H8145_008_0	5	2	Non-Preferred Generic	000101	
H8145	008	0	1	09	04	H8145_008_0	5	3	Preferred Brand	000101	
H8145	008	0	1	09	04	H8145_008_0	5	4	Non-Preferred Brand	110000	
H8145	008	0	1	09	04	H8145_008_0	5	5	Specialty Tier	010010	2
H8145	008	0	1	09	04	H8145_008_0	5	1	Preferred Generic	001010	2
H8145	008	0	1	09	04	H8145_008_0	5	2	Non-Preferred Generic	000101	2
H8145	008	0	1	09	04	H8145_008_0	5	3	Preferred Brand	000101	2
H8145	008	0	1	09	04	H8145_008_0	5	4	Non-Preferred Brand	110000	2
H8145	008	0	1	09	04	H8145_008_0	5	5	Specialty Tier	010010	
H8145	011	0	1	09	04	H8145_011_0	3	1	Preferred Generic	001010	
H8145	011	0	1	09	04	H8145_011_0	3	2	Non-Preferred Generic	000101	
H8145	011	0	1	09	04	H8145_011_0	3	3	Preferred Brand	000101	
H8145	011	0	1	09	04	H8145_011_0	3	4	Non-Preferred Brand	110000	
H8145	011	0	1	09	04	H8145_011_0	3	5	Specialty Tier	010010	
H8145	011	0	1	09	04	H8145_011_0	3	1	Preferred Generic	001010	2
H8145	011	0	1	09	04	H8145_011_0	3	2	Non-Preferred Generic	000101	2
H8145	011	0	1	09	04	H8145_011_0	3	3	Preferred Brand	000101	2
H8145	011	0	1	09	04	H8145_011_0	3	4	Non-Preferred Brand	110000	2
H8145	011	0	1	09	04	H8145_011_0	3	5	Specialty Tier	010010	2
H8145	012	0	1	09	04	H8145_012_0	3	1	Preferred Generic	001010	
H8145	012	0	1	09	04	H8145_012_0	3	2	Non-Preferred Generic	000101	
H8145	012	0	1	09	04	H8145_012_0	3	3	Preferred Brand	000101	
H8145	012	0	1	09	04	H8145_012_0	3	4	Non-Preferred Brand	110000	
H8145	012	0	1	09	04	H8145_012_0	3	5	Specialty Tier	010010	2
H8145	012	0	1	09	04	H8145_012_0	3	1	Preferred Generic	001010	2
H8145	012	0	1	09	04	H8145_012_0	3	2	Non-Preferred Generic	000101	2
H8145	012	0	1	09	04	H8145_012_0	3	3	Preferred Brand	000101	2
H8145	012	0	1	09	04	H8145_012_0	3	4	Non-Preferred Brand	110000	2
H8145	012	0	1	09	04	H8145_012_0	3	5	Specialty Tier	010010	
H8145	020	0	1	09	04	H8145_020_0	4	1	Preferred Generic	001010	
H8145	020	0	1	09	04	H8145_020_0	4	4	Non-Preferred Brand	110000	2
H8145	020	0	1	09	04	H8145_020_0	4	3	Preferred Brand	000101	
H8145	020	0	1	09	04	H8145_020_0	4	5	Specialty Tier	010010	2
H8145	020	0	1	09	04	H8145_020_0	4	2	Non-Preferred Generic	000101	
H8145	020	0	1	09	04	H8145_020_0	4	3	Preferred Brand	000101	2
H8145	020	0	1	09	04	H8145_020_0	4	2	Non-Preferred Generic	000101	2
H8145	020	0	1	09	04	H8145_020_0	4	1	Preferred Generic	001010	2
H8145	020	0	1	09	04	H8145_020_0	4	5	Specialty Tier	010010	
H8145	020	0	1	09	04	H8145_020_0	4	4	Non-Preferred Brand	110000	
H8145	021	0	1	09	04	H8145_021_0	4	2	Non-Preferred Generic	000101	2
H8145	021	0	1	09	04	H8145_021_0	4	3	Preferred Brand	000101	2
H8145	021	0	1	09	04	H8145_021_0	4	4	Non-Preferred Brand	110000	2
H8145	021	0	1	09	04	H8145_021_0	4	5	Specialty Tier	010010	2
H8145	021	0	1	09	04	H8145_021_0	4	1	Preferred Generic	001010	
H8145	021	0	1	09	04	H8145_021_0	4	5	Specialty Tier	010010	
H8145	021	0	1	09	04	H8145_021_0	4	4	Non-Preferred Brand	110000	
H8145	021	0	1	09	04	H8145_021_0	4	3	Preferred Brand	000101	
H8145	021	0	1	09	04	H8145_021_0	4	2	Non-Preferred Generic	000101	
H8145	021	0	1	09	04	H8145_021_0	4	1	Preferred Generic	001010	2
H8145	032	0	1	09	04	H8145_032_0	5	1	Preferred Generic	001010	
H8145	032	0	1	09	04	H8145_032_0	5	2	Non-Preferred Generic	000101	
H8145	032	0	1	09	04	H8145_032_0	5	3	Preferred Brand	000101	
H8145	032	0	1	09	04	H8145_032_0	5	4	Non-Preferred Brand	110000	
H8145	032	0	1	09	04	H8145_032_0	5	5	Specialty Tier	010010	2
H8145	032	0	1	09	04	H8145_032_0	5	1	Preferred Generic	001010	2
H8145	032	0	1	09	04	H8145_032_0	5	2	Non-Preferred Generic	000101	2
H8145	032	0	1	09	04	H8145_032_0	5	3	Preferred Brand	000101	2
H8145	032	0	1	09	04	H8145_032_0	5	4	Non-Preferred Brand	110000	2
H8145	032	0	1	09	04	H8145_032_0	5	5	Specialty Tier	010010	
H8145	041	0	1	09	04	H8145_041_0	6	1	Preferred Generic	001010	
H8145	041	0	1	09	04	H8145_041_0	6	2	Non-Preferred Generic	000101	
H8145	041	0	1	09	04	H8145_041_0	6	5	Specialty Tier	010010	2
H8145	041	0	1	09	04	H8145_041_0	6	4	Non-Preferred Brand	110000	2
H8145	041	0	1	09	04	H8145_041_0	6	3	Preferred Brand	000101	2
H8145	041	0	1	09	04	H8145_041_0	6	2	Non-Preferred Generic	000101	2
H8145	041	0	1	09	04	H8145_041_0	6	1	Preferred Generic	001010	2
H8145	041	0	1	09	04	H8145_041_0	6	5	Specialty Tier	010010	
H8145	041	0	1	09	04	H8145_041_0	6	4	Non-Preferred Brand	110000	
H8145	041	0	1	09	04	H8145_041_0	6	3	Preferred Brand	000101	
H8145	049	0	1	09	04	H8145_049_0	4	1	Preferred Generic	001010	
H8145	049	0	1	09	04	H8145_049_0	4	4	Non-Preferred Brand	110000	2
H8145	049	0	1	09	04	H8145_049_0	4	3	Preferred Brand	000101	2
H8145	049	0	1	09	04	H8145_049_0	4	2	Non-Preferred Generic	000101	2
H8145	049	0	1	09	04	H8145_049_0	4	5	Specialty Tier	010010	2
H8145	049	0	1	09	04	H8145_049_0	4	5	Specialty Tier	010010	
H8145	049	0	1	09	04	H8145_049_0	4	4	Non-Preferred Brand	110000	
H8145	049	0	1	09	04	H8145_049_0	4	3	Preferred Brand	000101	
H8145	049	0	1	09	04	H8145_049_0	4	2	Non-Preferred Generic	000101	
H8145	049	0	1	09	04	H8145_049_0	4	1	Preferred Generic	001010	2
H8145	051	0	1	09	04	H8145_051_0	6	4	Non-Preferred Brand	110000	
H8145	051	0	1	09	04	H8145_051_0	6	3	Preferred Brand	000101	
H8145	051	0	1	09	04	H8145_051_0	6	2	Non-Preferred Generic	000101	
H8145	051	0	1	09	04	H8145_051_0	6	1	Preferred Generic	001010	
H8145	051	0	1	09	04	H8145_051_0	6	5	Specialty Tier	010010	
H8145	052	0	1	09	04	H8145_052_0	4	1	Preferred Generic	001010	2
H8145	052	0	1	09	04	H8145_052_0	4	2	Non-Preferred Generic	000101	2
H8145	052	0	1	09	04	H8145_052_0	4	3	Preferred Brand	000101	2
H8145	052	0	1	09	04	H8145_052_0	4	4	Non-Preferred Brand	110000	2
H8145	052	0	1	09	04	H8145_052_0	4	5	Specialty Tier	010010	
H8145	052	0	1	09	04	H8145_052_0	4	4	Non-Preferred Brand	110000	
H8145	052	0	1	09	04	H8145_052_0	4	5	Specialty Tier	010010	2
H8145	052	0	1	09	04	H8145_052_0	4	2	Non-Preferred Generic	000101	
H8145	052	0	1	09	04	H8145_052_0	4	1	Preferred Generic	001010	
H8145	052	0	1	09	04	H8145_052_0	4	3	Preferred Brand	000101	
H8145	053	0	1	09	04	H8145_053_0	4	1	Preferred Generic	001010	2
H8145	053	0	1	09	04	H8145_053_0	4	2	Non-Preferred Generic	000101	2
H8145	053	0	1	09	04	H8145_053_0	4	3	Preferred Brand	000101	2
H8145	053	0	1	09	04	H8145_053_0	4	3	Preferred Brand	000101	
H8145	053	0	1	09	04	H8145_053_0	4	4	Non-Preferred Brand	110000	
H8145	053	0	1	09	04	H8145_053_0	4	5	Specialty Tier	010010	
H8145	053	0	1	09	04	H8145_053_0	4	1	Preferred Generic	001010	
H8145	053	0	1	09	04	H8145_053_0	4	2	Non-Preferred Generic	000101	
H8145	053	0	1	09	04	H8145_053_0	4	4	Non-Preferred Brand	110000	2
H8145	053	0	1	09	04	H8145_053_0	4	5	Specialty Tier	010010	2
H8145	061	0	1	09	04	H8145_061_0	4	2	Non-Preferred Generic	000101	2
H8145	061	0	1	09	04	H8145_061_0	4	3	Preferred Brand	000101	2
H8145	061	0	1	09	04	H8145_061_0	4	1	Preferred Generic	001010	2
H8145	061	0	1	09	04	H8145_061_0	4	5	Specialty Tier	010010	
H8145	061	0	1	09	04	H8145_061_0	4	4	Non-Preferred Brand	110000	
H8145	061	0	1	09	04	H8145_061_0	4	3	Preferred Brand	000101	
H8145	061	0	1	09	04	H8145_061_0	4	2	Non-Preferred Generic	000101	
H8145	061	0	1	09	04	H8145_061_0	4	1	Preferred Generic	001010	
H8145	061	0	1	09	04	H8145_061_0	4	5	Specialty Tier	010010	2
H8145	061	0	1	09	04	H8145_061_0	4	4	Non-Preferred Brand	110000	2
H8145	063	0	1	09	04	H8145_063_0	9	2	Non-Preferred Generic	000101	2
H8145	063	0	1	09	04	H8145_063_0	9	5	Specialty Tier	010010	2
H8145	063	0	1	09	04	H8145_063_0	9	1	Preferred Generic	001010	
H8145	063	0	1	09	04	H8145_063_0	9	2	Non-Preferred Generic	000101	
H8145	063	0	1	09	04	H8145_063_0	9	3	Preferred Brand	000101	2
H8145	063	0	1	09	04	H8145_063_0	9	4	Non-Preferred Brand	110000	
H8145	063	0	1	09	04	H8145_063_0	9	5	Specialty Tier	010010	
H8145	063	0	1	09	04	H8145_063_0	9	1	Preferred Generic	001010	2
H8145	063	0	1	09	04	H8145_063_0	9	4	Non-Preferred Brand	110000	2
H8145	063	0	1	09	04	H8145_063_0	9	3	Preferred Brand	000101	
H8145	069	0	1	09	04	H8145_069_0	7	2	Non-Preferred Generic	000101	
H8145	069	0	1	09	04	H8145_069_0	7	3	Preferred Brand	000101	
H8145	069	0	1	09	04	H8145_069_0	7	1	Preferred Generic	001010	
H8145	069	0	1	09	04	H8145_069_0	7	5	Specialty Tier	010010	2
H8145	069	0	1	09	04	H8145_069_0	7	3	Preferred Brand	000101	2
H8145	069	0	1	09	04	H8145_069_0	7	2	Non-Preferred Generic	000101	2
H8145	069	0	1	09	04	H8145_069_0	7	1	Preferred Generic	001010	2
H8145	069	0	1	09	04	H8145_069_0	7	5	Specialty Tier	010010	
H8145	069	0	1	09	04	H8145_069_0	7	4	Non-Preferred Brand	110000	
H8145	069	0	1	09	04	H8145_069_0	7	4	Non-Preferred Brand	110000	2
H8145	071	0	1	09	04	H8145_071_0	5	3	Preferred Brand	000101	
H8145	071	0	1	09	04	H8145_071_0	5	2	Non-Preferred Generic	000101	
H8145	071	0	1	09	04	H8145_071_0	5	5	Specialty Tier	010010	2
H8145	071	0	1	09	04	H8145_071_0	5	4	Non-Preferred Brand	110000	2
H8145	071	0	1	09	04	H8145_071_0	5	3	Preferred Brand	000101	2
H8145	071	0	1	09	04	H8145_071_0	5	2	Non-Preferred Generic	000101	2
H8145	071	0	1	09	04	H8145_071_0	5	1	Preferred Generic	001010	2
H8145	071	0	1	09	04	H8145_071_0	5	5	Specialty Tier	010010	
H8145	071	0	1	09	04	H8145_071_0	5	4	Non-Preferred Brand	110000	
H8145	071	0	1	09	04	H8145_071_0	5	1	Preferred Generic	001010	
H8145	075	0	1	09	04	H8145_075_0	5	3	Preferred Brand	000101	
H8145	075	0	1	09	04	H8145_075_0	5	4	Non-Preferred Brand	110000	
H8145	075	0	1	09	04	H8145_075_0	5	1	Preferred Generic	001010	
H8145	075	0	1	09	04	H8145_075_0	5	2	Non-Preferred Generic	000101	
H8145	075	0	1	09	04	H8145_075_0	5	5	Specialty Tier	010010	
H8145	078	0	1	09	04	H8145_078_0	5	3	Preferred Brand	000101	
H8145	078	0	1	09	04	H8145_078_0	5	5	Specialty Tier	010010	2
H8145	078	0	1	09	04	H8145_078_0	5	5	Specialty Tier	010010	
H8145	078	0	1	09	04	H8145_078_0	5	1	Preferred Generic	001010	2
H8145	078	0	1	09	04	H8145_078_0	5	4	Non-Preferred Brand	110000	
H8145	078	0	1	09	04	H8145_078_0	5	3	Preferred Brand	000101	2
H8145	078	0	1	09	04	H8145_078_0	5	2	Non-Preferred Generic	000101	
H8145	078	0	1	09	04	H8145_078_0	5	1	Preferred Generic	001010	
H8145	078	0	1	09	04	H8145_078_0	5	4	Non-Preferred Brand	110000	2
H8145	078	0	1	09	04	H8145_078_0	5	2	Non-Preferred Generic	000101	2
H8145	079	0	1	09	04	H8145_079_0	4	4	Non-Preferred Brand	110000	2
H8145	079	0	1	09	04	H8145_079_0	4	3	Preferred Brand	000101	2
H8145	079	0	1	09	04	H8145_079_0	4	1	Preferred Generic	001010	
H8145	079	0	1	09	04	H8145_079_0	4	2	Non-Preferred Generic	000101	2
H8145	079	0	1	09	04	H8145_079_0	4	1	Preferred Generic	001010	2
H8145	079	0	1	09	04	H8145_079_0	4	5	Specialty Tier	010010	
H8145	079	0	1	09	04	H8145_079_0	4	4	Non-Preferred Brand	110000	
H8145	079	0	1	09	04	H8145_079_0	4	5	Specialty Tier	010010	2
H8145	079	0	1	09	04	H8145_079_0	4	2	Non-Preferred Generic	000101	
H8145	079	0	1	09	04	H8145_079_0	4	3	Preferred Brand	000101	
H8145	084	0	1	09	04	H8145_084_0	5	1	Preferred Generic	001010	2
H8145	084	0	1	09	04	H8145_084_0	5	5	Specialty Tier	010010	
H8145	084	0	1	09	04	H8145_084_0	5	3	Preferred Brand	000101	2
H8145	084	0	1	09	04	H8145_084_0	5	4	Non-Preferred Brand	110000	2
H8145	084	0	1	09	04	H8145_084_0	5	5	Specialty Tier	010010	2
H8145	084	0	1	09	04	H8145_084_0	5	2	Non-Preferred Generic	000101	2
H8145	084	0	1	09	04	H8145_084_0	5	4	Non-Preferred Brand	110000	
H8145	084	0	1	09	04	H8145_084_0	5	3	Preferred Brand	000101	
H8145	084	0	1	09	04	H8145_084_0	5	2	Non-Preferred Generic	000101	
H8145	084	0	1	09	04	H8145_084_0	5	1	Preferred Generic	001010	
H8145	087	0	1	09	04	H8145_087_0	5	2	Non-Preferred Generic	000101	
H8145	087	0	1	09	04	H8145_087_0	5	3	Preferred Brand	000101	
H8145	087	0	1	09	04	H8145_087_0	5	4	Non-Preferred Brand	110000	
H8145	087	0	1	09	04	H8145_087_0	5	5	Specialty Tier	010010	
H8145	087	0	1	09	04	H8145_087_0	5	1	Preferred Generic	001010	
H8145	089	0	1	09	04	H8145_089_0	4	2	Non-Preferred Generic	000101	2
H8145	089	0	1	09	04	H8145_089_0	4	3	Preferred Brand	000101	2
H8145	089	0	1	09	04	H8145_089_0	4	4	Non-Preferred Brand	110000	2
H8145	089	0	1	09	04	H8145_089_0	4	5	Specialty Tier	010010	2
H8145	089	0	1	09	04	H8145_089_0	4	1	Preferred Generic	001010	2
H8145	089	0	1	09	04	H8145_089_0	4	5	Specialty Tier	010010	
H8145	089	0	1	09	04	H8145_089_0	4	4	Non-Preferred Brand	110000	
H8145	089	0	1	09	04	H8145_089_0	4	3	Preferred Brand	000101	
H8145	089	0	1	09	04	H8145_089_0	4	1	Preferred Generic	001010	
H8145	089	0	1	09	04	H8145_089_0	4	2	Non-Preferred Generic	000101	
H8145	091	0	1	09	04	H8145_091_0	4	1	Preferred Generic	001010	
H8145	091	0	1	09	04	H8145_091_0	4	2	Non-Preferred Generic	000101	
H8145	091	0	1	09	04	H8145_091_0	4	5	Specialty Tier	010010	2
H8145	091	0	1	09	04	H8145_091_0	4	4	Non-Preferred Brand	110000	2
H8145	091	0	1	09	04	H8145_091_0	4	3	Preferred Brand	000101	2
H8145	091	0	1	09	04	H8145_091_0	4	2	Non-Preferred Generic	000101	2
H8145	091	0	1	09	04	H8145_091_0	4	1	Preferred Generic	001010	2
H8145	091	0	1	09	04	H8145_091_0	4	5	Specialty Tier	010010	
H8145	091	0	1	09	04	H8145_091_0	4	4	Non-Preferred Brand	110000	
H8145	091	0	1	09	04	H8145_091_0	4	3	Preferred Brand	000101	
H8145	093	0	1	09	04	H8145_093_0	6	1	Preferred Generic	001010	
H8145	093	0	1	09	04	H8145_093_0	6	4	Non-Preferred Brand	110000	2
H8145	093	0	1	09	04	H8145_093_0	6	3	Preferred Brand	000101	2
H8145	093	0	1	09	04	H8145_093_0	6	2	Non-Preferred Generic	000101	2
H8145	093	0	1	09	04	H8145_093_0	6	5	Specialty Tier	010010	2
H8145	093	0	1	09	04	H8145_093_0	6	5	Specialty Tier	010010	
H8145	093	0	1	09	04	H8145_093_0	6	4	Non-Preferred Brand	110000	
H8145	093	0	1	09	04	H8145_093_0	6	3	Preferred Brand	000101	
H8145	093	0	1	09	04	H8145_093_0	6	2	Non-Preferred Generic	000101	
H8145	093	0	1	09	04	H8145_093_0	6	1	Preferred Generic	001010	2
H8145	103	0	1	09	04	H8145_103_0	8	4	Non-Preferred Brand	110000	
H8145	103	0	1	09	04	H8145_103_0	8	3	Preferred Brand	000101	
H8145	103	0	1	09	04	H8145_103_0	8	2	Non-Preferred Generic	000101	
H8145	103	0	1	09	04	H8145_103_0	8	1	Preferred Generic	001010	
H8145	103	0	1	09	04	H8145_103_0	8	5	Specialty Tier	010010	2
H8145	103	0	1	09	04	H8145_103_0	8	1	Preferred Generic	001010	2
H8145	103	0	1	09	04	H8145_103_0	8	2	Non-Preferred Generic	000101	2
H8145	103	0	1	09	04	H8145_103_0	8	3	Preferred Brand	000101	2
H8145	103	0	1	09	04	H8145_103_0	8	4	Non-Preferred Brand	110000	2
H8145	103	0	1	09	04	H8145_103_0	8	5	Specialty Tier	010010	
H8145	104	0	1	09	04	H8145_104_0	6	5	Specialty Tier	010010	2
H8145	104	0	1	09	04	H8145_104_0	6	4	Non-Preferred Brand	110000	2
H8145	104	0	1	09	04	H8145_104_0	6	3	Preferred Brand	000101	2
H8145	104	0	1	09	04	H8145_104_0	6	2	Non-Preferred Generic	000101	2
H8145	104	0	1	09	04	H8145_104_0	6	5	Specialty Tier	010010	
H8145	104	0	1	09	04	H8145_104_0	6	1	Preferred Generic	001010	2
H8145	104	0	1	09	04	H8145_104_0	6	4	Non-Preferred Brand	110000	
H8145	104	0	1	09	04	H8145_104_0	6	3	Preferred Brand	000101	
H8145	104	0	1	09	04	H8145_104_0	6	2	Non-Preferred Generic	000101	
H8145	104	0	1	09	04	H8145_104_0	6	1	Preferred Generic	001010	
H8145	110	0	1	09	04	H8145_110_0	5	2	Non-Preferred Generic	000101	2
H8145	110	0	1	09	04	H8145_110_0	5	1	Preferred Generic	001010	
H8145	110	0	1	09	04	H8145_110_0	5	4	Non-Preferred Brand	110000	2
H8145	110	0	1	09	04	H8145_110_0	5	5	Specialty Tier	010010	2
H8145	110	0	1	09	04	H8145_110_0	5	3	Preferred Brand	000101	2
H8145	110	0	1	09	04	H8145_110_0	5	2	Non-Preferred Generic	000101	
H8145	110	0	1	09	04	H8145_110_0	5	3	Preferred Brand	000101	
H8145	110	0	1	09	04	H8145_110_0	5	4	Non-Preferred Brand	110000	
H8145	110	0	1	09	04	H8145_110_0	5	5	Specialty Tier	010010	
H8145	110	0	1	09	04	H8145_110_0	5	1	Preferred Generic	001010	2
H8145	122	0	1	09	04	H8145_122_0	4	2	Non-Preferred Generic	000101	2
H8145	122	0	1	09	04	H8145_122_0	4	1	Preferred Generic	001010	
H8145	122	0	1	09	04	H8145_122_0	4	4	Non-Preferred Brand	110000	2
H8145	122	0	1	09	04	H8145_122_0	4	5	Specialty Tier	010010	2
H8145	122	0	1	09	04	H8145_122_0	4	3	Preferred Brand	000101	2
H8145	122	0	1	09	04	H8145_122_0	4	2	Non-Preferred Generic	000101	
H8145	122	0	1	09	04	H8145_122_0	4	3	Preferred Brand	000101	
H8145	122	0	1	09	04	H8145_122_0	4	4	Non-Preferred Brand	110000	
H8145	122	0	1	09	04	H8145_122_0	4	5	Specialty Tier	010010	
H8145	122	0	1	09	04	H8145_122_0	4	1	Preferred Generic	001010	2
H8145	123	0	1	09	04	H8145_123_0	6	2	Non-Preferred Generic	000101	2
H8145	123	0	1	09	04	H8145_123_0	6	3	Preferred Brand	000101	2
H8145	123	0	1	09	04	H8145_123_0	6	4	Non-Preferred Brand	110000	2
H8145	123	0	1	09	04	H8145_123_0	6	5	Specialty Tier	010010	2
H8145	123	0	1	09	04	H8145_123_0	6	1	Preferred Generic	001010	
H8145	123	0	1	09	04	H8145_123_0	6	5	Specialty Tier	010010	
H8145	123	0	1	09	04	H8145_123_0	6	4	Non-Preferred Brand	110000	
H8145	123	0	1	09	04	H8145_123_0	6	3	Preferred Brand	000101	
H8145	123	0	1	09	04	H8145_123_0	6	2	Non-Preferred Generic	000101	
H8145	123	0	1	09	04	H8145_123_0	6	1	Preferred Generic	001010	2
H8145	124	0	1	09	04	H8145_124_0	4	1	Preferred Generic	001010	
H8145	124	0	1	09	04	H8145_124_0	4	2	Non-Preferred Generic	000101	
H8145	124	0	1	09	04	H8145_124_0	4	3	Preferred Brand	000101	
H8145	124	0	1	09	04	H8145_124_0	4	4	Non-Preferred Brand	110000	
H8145	124	0	1	09	04	H8145_124_0	4	5	Specialty Tier	010010	
H8145	124	0	1	09	04	H8145_124_0	4	1	Preferred Generic	001010	2
H8145	124	0	1	09	04	H8145_124_0	4	2	Non-Preferred Generic	000101	2
H8145	124	0	1	09	04	H8145_124_0	4	3	Preferred Brand	000101	2
H8145	124	0	1	09	04	H8145_124_0	4	4	Non-Preferred Brand	110000	2
H8145	124	0	1	09	04	H8145_124_0	4	5	Specialty Tier	010010	2
H8145	125	0	1	09	04	H8145_125_0	4	3	Preferred Brand	000101	
H8145	125	0	1	09	04	H8145_125_0	4	2	Non-Preferred Generic	000101	
H8145	125	0	1	09	04	H8145_125_0	4	1	Preferred Generic	001010	
H8145	125	0	1	09	04	H8145_125_0	4	4	Non-Preferred Brand	110000	
H8145	125	0	1	09	04	H8145_125_0	4	1	Preferred Generic	001010	2
H8145	125	0	1	09	04	H8145_125_0	4	5	Specialty Tier	010010	2
H8145	125	0	1	09	04	H8145_125_0	4	4	Non-Preferred Brand	110000	2
H8145	125	0	1	09	04	H8145_125_0	4	3	Preferred Brand	000101	2
H8145	125	0	1	09	04	H8145_125_0	4	2	Non-Preferred Generic	000101	2
H8145	125	0	1	09	04	H8145_125_0	4	5	Specialty Tier	010010	
H8145	138	0	1	09	04	H8145_138_0	4	5	Specialty Tier	010010	2
H8145	138	0	1	09	04	H8145_138_0	4	4	Non-Preferred Brand	110000	2
H8145	138	0	1	09	04	H8145_138_0	4	3	Preferred Brand	000101	2
H8145	138	0	1	09	04	H8145_138_0	4	2	Non-Preferred Generic	000101	2
H8145	138	0	1	09	04	H8145_138_0	4	5	Specialty Tier	010010	
H8145	138	0	1	09	04	H8145_138_0	4	1	Preferred Generic	001010	2
H8145	138	0	1	09	04	H8145_138_0	4	4	Non-Preferred Brand	110000	
H8145	138	0	1	09	04	H8145_138_0	4	3	Preferred Brand	000101	
H8145	138	0	1	09	04	H8145_138_0	4	2	Non-Preferred Generic	000101	
H8145	138	0	1	09	04	H8145_138_0	4	1	Preferred Generic	001010	
H8145	139	0	1	09	04	H8145_139_0	5	1	Preferred Generic	001010	
H8145	139	0	1	09	04	H8145_139_0	5	5	Specialty Tier	010010	
H8145	139	0	1	09	04	H8145_139_0	5	4	Non-Preferred Brand	110000	
H8145	139	0	1	09	04	H8145_139_0	5	3	Preferred Brand	000101	
H8145	139	0	1	09	04	H8145_139_0	5	2	Non-Preferred Generic	000101	
H8145	154	0	1	09	04	H8145_154_0	5	5	Specialty Tier	010010	
H8145	154	0	1	09	04	H8145_154_0	5	2	Non-Preferred Generic	000101	
H8145	154	0	1	09	04	H8145_154_0	5	4	Non-Preferred Brand	110000	2
H8145	154	0	1	09	04	H8145_154_0	5	3	Preferred Brand	000101	2
H8145	154	0	1	09	04	H8145_154_0	5	2	Non-Preferred Generic	000101	2
H8145	154	0	1	09	04	H8145_154_0	5	1	Preferred Generic	001010	2
H8145	154	0	1	09	04	H8145_154_0	5	4	Non-Preferred Brand	110000	
H8145	154	0	1	09	04	H8145_154_0	5	3	Preferred Brand	000101	
H8145	154	0	1	09	04	H8145_154_0	5	5	Specialty Tier	010010	2
H8145	154	0	1	09	04	H8145_154_0	5	1	Preferred Generic	001010	
H8146	001	0	1	01	01	H8146_001_0	6	1	Preferred Generic	001000	
H8146	001	0	1	01	01	H8146_001_0	6	5	Specialty Tier	010010	
H8146	001	0	1	01	01	H8146_001_0	6	4	Non-Preferred Brand	100000	
H8146	001	0	1	01	01	H8146_001_0	6	3	Preferred Brand	010001	
H8146	001	0	1	01	01	H8146_001_0	6	2	Non-Preferred Generic	000100	
H8146	001	0	1	01	01	H8146_001_0	6	1	Preferred Generic	001000	1
H8189	001	0	1	01	01	H8189_001_0	6	2	Preferred Brand	000001	
H8189	001	0	1	01	01	H8189_001_0	6	1	Generic	010000	
H8189	001	0	1	01	01	H8189_001_0	6	4	Injectable Drugs	000001	
H8189	001	0	1	01	01	H8189_001_0	6	3	Non-Preferred Brand	100000	
H8237	001	0	1	01	01	H8237_001_0	6	5	Specialty Tier	010010	
H8237	001	0	1	01	01	H8237_001_0	6	4	Non-Preferred Brand	100100	
H8237	001	0	1	01	01	H8237_001_0	6	3	Preferred Brand	000001	
H8237	001	0	1	01	01	H8237_001_0	6	2	Non-Preferred Generic	000100	
H8237	001	0	1	01	01	H8237_001_0	6	1	Preferred Generic	001000	
H8258	001	0	1	48	05	H8258_001_0	8	5	Non-Medicare OTC Drugs	010010	
H8258	001	0	1	48	05	H8258_001_0	8	4	Non-Medicare Rx Brand Drugs	000010	
H8258	001	0	1	48	05	H8258_001_0	8	1	Generic Drugs	010000	
H8258	001	0	1	48	05	H8258_001_0	8	2	Brand Drugs	000010	
H8258	001	0	1	48	05	H8258_001_0	8	3	Non-Medicare Rx Generic Drugs	010000	
H8266	001	0	1	01	01	H8266_001_0	6	2	Preferred Brand	000001	
H8266	001	0	1	01	01	H8266_001_0	6	3	Non-Preferred Brand	100000	
H8266	001	0	1	01	01	H8266_001_0	6	4	Specialty Tier	100000	
H8266	001	0	1	01	01	H8266_001_0	6	1	Generic	010000	1
H8266	001	0	1	01	01	H8266_001_0	6	1	Generic	010000	
H8393	001	0	1	04	01	H8393_001_0	7	1	Preferred Generic	001000	
H8393	001	0	1	04	01	H8393_001_0	7	2	Non-Preferred Generic	000100	
H8393	001	0	1	04	01	H8393_001_0	7	5	Specialty Tier	010010	
H8393	001	0	1	04	01	H8393_001_0	7	4	Non-Preferred Brand	100100	
H8393	001	0	1	04	01	H8393_001_0	7	3	Preferred Brand	000001	
H8432	001	0	1	01	01	H8432_001_0	7	5	Injectable Drugs	010010	
H8432	001	0	1	01	01	H8432_001_0	7	4	Non-Preferred Brand	100100	
H8432	001	0	1	01	01	H8432_001_0	7	3	Preferred Brand	000101	
H8432	001	0	1	01	01	H8432_001_0	7	2	Non-Preferred Generic	000100	
H8432	001	0	1	01	01	H8432_001_0	7	6	Specialty Tier	010010	
H8432	001	0	1	01	01	H8432_001_0	7	1	Preferred Generic	001000	
H8452	001	0	1	48	05	H8452_001_0	4	5	Non-Medicare OTC Drugs	010010	
H8452	001	0	1	48	05	H8452_001_0	4	4	Non-Medicare Rx Brand Drugs	010010	
H8452	001	0	1	48	05	H8452_001_0	4	3	Non-Medicare Rx Generic Drugs	010000	
H8452	001	0	1	48	05	H8452_001_0	4	1	Generic Drugs	010000	
H8452	001	0	1	48	05	H8452_001_0	4	2	Brand Drugs	000010	
H8491	002	0	1	01	01	H8491_002_0	10	1	Generic	010000	
H8491	002	0	1	01	01	H8491_002_0	10	2	Preferred Brand	000001	
H8491	002	0	1	01	01	H8491_002_0	10	3	Non-Preferred Brand	100000	
H8491	002	0	1	01	01	H8491_002_0	10	4	Specialty Tier	010010	
H8552	001	0	1	04	01	H8552_001_0	7	5	Injectable Drugs	010010	
H8552	001	0	1	04	01	H8552_001_0	7	4	Non-Preferred Brand	100100	
H8552	001	0	1	04	01	H8552_001_0	7	3	Preferred Brand	000101	
H8552	001	0	1	04	01	H8552_001_0	7	2	Non-Preferred Generic	000100	
H8552	001	0	1	04	01	H8552_001_0	7	1	Preferred Generic	001000	
H8552	001	0	1	04	01	H8552_001_0	7	6	Specialty Tier	010010	
H8552	002	0	1	04	01	H8552_002_0	7	1	Preferred Generic	001000	
H8552	002	0	1	04	01	H8552_002_0	7	2	Non-Preferred Generic	000100	
H8552	002	0	1	04	01	H8552_002_0	7	3	Preferred Brand	000101	
H8552	002	0	1	04	01	H8552_002_0	7	4	Non-Preferred Brand	100100	
H8552	002	0	1	04	01	H8552_002_0	7	5	Injectable Drugs	010010	
H8552	002	0	1	04	01	H8552_002_0	7	6	Specialty Tier	010010	
H8552	003	0	1	04	01	H8552_003_0	8	5	Injectable Drugs	010010	
H8552	003	0	1	04	01	H8552_003_0	8	4	Non-Preferred Brand	100100	
H8552	003	0	1	04	01	H8552_003_0	8	3	Preferred Brand	000101	
H8552	003	0	1	04	01	H8552_003_0	8	2	Non-Preferred Generic	000100	
H8552	003	0	1	04	01	H8552_003_0	8	1	Preferred Generic	001000	
H8552	003	0	1	04	01	H8552_003_0	8	6	Specialty Tier	010010	
H8552	006	0	1	04	01	H8552_006_0	6	2	Non-Preferred Generic	000100	
H8552	006	0	1	04	01	H8552_006_0	6	1	Preferred Generic	001000	
H8552	006	0	1	04	01	H8552_006_0	6	3	Preferred Brand	000101	
H8552	006	0	1	04	01	H8552_006_0	6	4	Non-Preferred Brand	100100	
H8552	006	0	1	04	01	H8552_006_0	6	5	Injectable Drugs	010010	
H8552	006	0	1	04	01	H8552_006_0	6	6	Specialty Tier	010010	
H8552	007	0	1	04	01	H8552_007_0	6	2	Non-Preferred Generic	000100	
H8552	007	0	1	04	01	H8552_007_0	6	1	Preferred Generic	001000	
H8552	007	0	1	04	01	H8552_007_0	6	3	Preferred Brand	000101	
H8552	007	0	1	04	01	H8552_007_0	6	6	Specialty Tier	010010	
H8552	007	0	1	04	01	H8552_007_0	6	5	Injectable Drugs	010010	
H8552	007	0	1	04	01	H8552_007_0	6	4	Non-Preferred Brand	100100	
H8552	008	0	1	04	01	H8552_008_0	7	1	Preferred Generic	001000	
H8552	008	0	1	04	01	H8552_008_0	7	2	Non-Preferred Generic	000100	
H8552	008	0	1	04	01	H8552_008_0	7	5	Injectable Drugs	010010	
H8552	008	0	1	04	01	H8552_008_0	7	4	Non-Preferred Brand	100100	
H8552	008	0	1	04	01	H8552_008_0	7	3	Preferred Brand	000101	
H8552	008	0	1	04	01	H8552_008_0	7	6	Specialty Tier	010010	
H8552	009	0	1	04	01	H8552_009_0	7	5	Injectable Drugs	010010	
H8552	009	0	1	04	01	H8552_009_0	7	6	Specialty Tier	010010	
H8552	009	0	1	04	01	H8552_009_0	7	1	Preferred Generic	001000	
H8552	009	0	1	04	01	H8552_009_0	7	2	Non-Preferred Generic	000100	
H8552	009	0	1	04	01	H8552_009_0	7	3	Preferred Brand	000101	
H8552	009	0	1	04	01	H8552_009_0	7	4	Non-Preferred Brand	100100	
H8552	015	0	1	04	01	H8552_015_0	6	2	Non-Preferred Generic	000100	
H8552	015	0	1	04	01	H8552_015_0	6	1	Preferred Generic	001000	
H8552	015	0	1	04	01	H8552_015_0	6	3	Preferred Brand	000101	
H8552	015	0	1	04	01	H8552_015_0	6	4	Non-Preferred Brand	100100	
H8552	015	0	1	04	01	H8552_015_0	6	5	Injectable Drugs	010010	
H8552	015	0	1	04	01	H8552_015_0	6	6	Specialty Tier	010010	
H8552	017	0	1	04	01	H8552_017_0	6	2	Non-Preferred Generic	000100	
H8552	017	0	1	04	01	H8552_017_0	6	1	Preferred Generic	001000	
H8552	017	0	1	04	01	H8552_017_0	6	3	Preferred Brand	000101	
H8552	017	0	1	04	01	H8552_017_0	6	6	Specialty Tier	010010	
H8552	017	0	1	04	01	H8552_017_0	6	5	Injectable Drugs	010010	
H8552	017	0	1	04	01	H8552_017_0	6	4	Non-Preferred Brand	100100	
H8552	018	0	1	04	01	H8552_018_0	7	1	Preferred Generic	001000	
H8552	018	0	1	04	01	H8552_018_0	7	2	Non-Preferred Generic	000100	
H8552	018	0	1	04	01	H8552_018_0	7	5	Injectable Drugs	010010	
H8552	018	0	1	04	01	H8552_018_0	7	4	Non-Preferred Brand	100100	
H8552	018	0	1	04	01	H8552_018_0	7	3	Preferred Brand	000101	
H8552	018	0	1	04	01	H8552_018_0	7	6	Specialty Tier	010010	
H8554	001	0	1	01	01	H8554_001_0	7	3	Preferred Brand	000001	
H8554	001	0	1	01	01	H8554_001_0	7	5	Specialty Tier	010010	
H8554	001	0	1	01	01	H8554_001_0	7	4	Non-Preferred Brand	100000	
H8554	001	0	1	01	01	H8554_001_0	7	2	Non-Preferred Generic	000100	
H8554	001	0	1	01	01	H8554_001_0	7	1	Preferred Generic	001000	
H8578	001	0	1	01	01	H8578_001_0	8	2	Preferred Brand	000001	
H8578	001	0	1	01	01	H8578_001_0	8	3	Non-Preferred Brand	100000	
H8578	001	0	1	01	01	H8578_001_0	8	1	Generic	010000	
H8578	001	0	1	01	01	H8578_001_0	8	4	Specialty Tier	110001	
H8578	001	0	1	01	01	H8578_001_0	8	1	Generic	010000	1
H8578	004	0	1	01	01	H8578_004_0	8	1	Generic	010000	
H8578	004	0	1	01	01	H8578_004_0	8	2	Preferred Brand	000001	
H8578	004	0	1	01	01	H8578_004_0	8	3	Non-Preferred Brand	100000	
H8578	004	0	1	01	01	H8578_004_0	8	4	Specialty Tier	110001	
H8578	004	0	1	01	01	H8578_004_0	8	1	Generic	010000	1
H8578	007	0	1	01	01	H8578_007_0	8	1	Generic	010000	
H8578	007	0	1	01	01	H8578_007_0	8	2	Preferred Brand	000001	
H8578	007	0	1	01	01	H8578_007_0	8	1	Generic	010000	1
H8578	007	0	1	01	01	H8578_007_0	8	4	Specialty Tier	110001	
H8578	007	0	1	01	01	H8578_007_0	8	3	Non-Preferred Brand	100000	
H8578	010	0	1	02	01	H8578_010_0	9	1	Generic	010000	1
H8578	010	0	1	02	01	H8578_010_0	9	3	Non-Preferred Brand	100000	
H8578	010	0	1	02	01	H8578_010_0	9	2	Preferred Brand	000001	
H8578	010	0	1	02	01	H8578_010_0	9	4	Specialty Tier	110001	
H8578	010	0	1	02	01	H8578_010_0	9	1	Generic	010000	
H8578	012	0	1	01	01	H8578_012_0	8	2	Preferred Brand	000001	
H8578	012	0	1	01	01	H8578_012_0	8	4	Specialty Tier	110001	
H8578	012	0	1	01	01	H8578_012_0	8	3	Non-Preferred Brand	100000	
H8578	012	0	1	01	01	H8578_012_0	8	1	Generic	010000	
H8604	001	0	1	04	01	H8604_001_0	9	2	Non-Preferred Generic	000100	
H8604	001	0	1	04	01	H8604_001_0	9	1	Preferred Generic	001000	
H8604	001	0	1	04	01	H8604_001_0	9	3	Preferred Brand	000001	
H8604	001	0	1	04	01	H8604_001_0	9	4	Specialty Tier	010010	
H8604	001	0	1	04	01	H8604_001_0	9	1	Preferred Generic	001000	1
H8604	001	0	1	04	01	H8604_001_0	9	2	Non-Preferred Generic	000100	1
H8604	003	0	1	04	01	H8604_003_0	8	2	Non-Preferred Generic	000100	
H8604	003	0	1	04	01	H8604_003_0	8	1	Preferred Generic	001000	
H8604	003	0	1	04	01	H8604_003_0	8	3	Preferred Brand	000001	
H8604	003	0	1	04	01	H8604_003_0	8	1	Preferred Generic	001000	1
H8604	003	0	1	04	01	H8604_003_0	8	4	Specialty Tier	010010	
H8604	005	0	1	04	01	H8604_005_0	10	1	Preferred Generic	001000	
H8604	005	0	1	04	01	H8604_005_0	10	2	Non-Preferred Generic	000100	
H8604	005	0	1	04	01	H8604_005_0	10	3	Preferred Brand	000001	
H8604	005	0	1	04	01	H8604_005_0	10	1	Preferred Generic	001000	1
H8604	005	0	1	04	01	H8604_005_0	10	4	Specialty Tier	010010	
H8604	005	0	1	04	01	H8604_005_0	10	2	Non-Preferred Generic	000100	1
H8604	006	0	1	04	01	H8604_006_0	8	4	Specialty Tier	010010	
H8604	006	0	1	04	01	H8604_006_0	8	1	Preferred Generic	001000	1
H8604	006	0	1	04	01	H8604_006_0	8	2	Non-Preferred Generic	000100	1
H8604	006	0	1	04	01	H8604_006_0	8	1	Preferred Generic	001000	
H8604	006	0	1	04	01	H8604_006_0	8	2	Non-Preferred Generic	000100	
H8604	006	0	1	04	01	H8604_006_0	8	3	Preferred Brand	000001	
H8634	001	0	1	04	01	H8634_001_0	13	4	Non-Preferred Brand	110000	
H8634	001	0	1	04	01	H8634_001_0	13	3	Preferred Brand	000001	
H8634	001	0	1	04	01	H8634_001_0	13	2	Non-Preferred Generic	000100	
H8634	001	0	1	04	01	H8634_001_0	13	1	Preferred Generic	001000	
H8634	001	0	1	04	01	H8634_001_0	13	5	Specialty Tier	010010	
H8634	002	0	1	04	01	H8634_002_0	12	4	Non-Preferred Brand	110000	
H8634	002	0	1	04	01	H8634_002_0	12	3	Preferred Brand	000001	
H8634	002	0	1	04	01	H8634_002_0	12	2	Non-Preferred Generic	000100	
H8634	002	0	1	04	01	H8634_002_0	12	1	Preferred Generic	001000	
H8634	002	0	1	04	01	H8634_002_0	12	5	Specialty Tier	010010	
H8644	003	0	1	04	01	H8644_003_0	4	5	Specialty Tier	010010	
H8644	003	0	1	04	01	H8644_003_0	4	4	Non-Preferred Brand	110000	
H8644	003	0	1	04	01	H8644_003_0	4	3	Preferred Brand	000101	
H8644	003	0	1	04	01	H8644_003_0	4	2	Non-Preferred Generic	000101	
H8644	003	0	1	04	01	H8644_003_0	4	1	Preferred Generic	001010	
H8644	003	0	1	04	01	H8644_003_0	4	5	Specialty Tier	010010	2
H8644	003	0	1	04	01	H8644_003_0	4	4	Non-Preferred Brand	110000	2
H8644	003	0	1	04	01	H8644_003_0	4	3	Preferred Brand	000101	2
H8644	003	0	1	04	01	H8644_003_0	4	1	Preferred Generic	001010	2
H8644	003	0	1	04	01	H8644_003_0	4	2	Non-Preferred Generic	000101	2
H8644	005	0	1	04	01	H8644_005_0	4	5	Specialty Tier	010010	2
H8644	005	0	1	04	01	H8644_005_0	4	4	Non-Preferred Brand	110000	2
H8644	005	0	1	04	01	H8644_005_0	4	3	Preferred Brand	000101	2
H8644	005	0	1	04	01	H8644_005_0	4	2	Non-Preferred Generic	000101	2
H8644	005	0	1	04	01	H8644_005_0	4	5	Specialty Tier	010010	
H8644	005	0	1	04	01	H8644_005_0	4	2	Non-Preferred Generic	000101	
H8644	005	0	1	04	01	H8644_005_0	4	3	Preferred Brand	000101	
H8644	005	0	1	04	01	H8644_005_0	4	4	Non-Preferred Brand	110000	
H8644	005	0	1	04	01	H8644_005_0	4	1	Preferred Generic	001010	
H8649	003	0	1	02	01	H8649_003_0	17	5	Specialty Tier	010010	
H8649	003	0	1	02	01	H8649_003_0	17	4	Non-Preferred Brand	100100	
H8649	003	0	1	02	01	H8649_003_0	17	1	Preferred Generic	001000	
H8649	003	0	1	02	01	H8649_003_0	17	2	Non-Preferred Generic	000100	
H8649	003	0	1	02	01	H8649_003_0	17	3	Preferred Brand	000001	
H8677	001	0	1	48	05	H8677_001_0	7	1	Generic Drugs	010000	
H8677	001	0	1	48	05	H8677_001_0	7	2	Brand Drugs	000010	
H8677	001	0	1	48	05	H8677_001_0	7	3	Non-Medicare Rx Generic Drugs	010000	
H8677	001	0	1	48	05	H8677_001_0	7	4	Non-Medicare Rx Brand Drugs	000010	
H8677	001	0	1	48	05	H8677_001_0	7	5	Non-Medicare OTC Drugs	010010	
H8677	002	0	1	48	05	H8677_002_0	1	5	Non-Medicare OTC Drugs	010010	
H8677	002	0	1	48	05	H8677_002_0	1	4	Non-Medicare Rx Brand Drugs	000010	
H8677	002	0	1	48	05	H8677_002_0	1	3	Non-Medicare Rx Generic Drugs	010000	
H8677	002	0	1	48	05	H8677_002_0	1	2	Brand Drugs	000010	
H8677	002	0	1	48	05	H8677_002_0	1	1	Generic Drugs	010000	
H8684	001	0	1	04	01	H8684_001_0	5	4	Specialty Tier	010010	
H8684	001	0	1	04	01	H8684_001_0	5	3	Non-Preferred Brand	110000	
H8684	001	0	1	04	01	H8684_001_0	5	2	Preferred Brand	010001	
H8684	001	0	1	04	01	H8684_001_0	5	1	Generic	010000	
H8684	001	0	1	04	01	H8684_001_0	5	5	Select Care Drugs	010000	1
H8684	001	0	1	04	01	H8684_001_0	5	5	Select Care Drugs	010000	
H8707	001	0	1	04	01	H8707_001_0	7	5	Specialty Tier	010010	2
H8707	001	0	1	04	01	H8707_001_0	7	4	Non-Preferred Brand	110000	2
H8707	001	0	1	04	01	H8707_001_0	7	3	Preferred Brand	000101	2
H8707	001	0	1	04	01	H8707_001_0	7	2	Non-Preferred Generic	000101	2
H8707	001	0	1	04	01	H8707_001_0	7	1	Preferred Generic	001010	
H8707	001	0	1	04	01	H8707_001_0	7	5	Specialty Tier	010010	
H8707	001	0	1	04	01	H8707_001_0	7	4	Non-Preferred Brand	110000	
H8707	001	0	1	04	01	H8707_001_0	7	3	Preferred Brand	000101	
H8707	001	0	1	04	01	H8707_001_0	7	2	Non-Preferred Generic	000101	
H8707	001	0	1	04	01	H8707_001_0	7	1	Preferred Generic	001010	2
H8707	003	0	1	04	01	H8707_003_0	6	2	Non-Preferred Generic	000101	
H8707	003	0	1	04	01	H8707_003_0	6	3	Preferred Brand	000101	
H8707	003	0	1	04	01	H8707_003_0	6	4	Non-Preferred Brand	110000	
H8707	003	0	1	04	01	H8707_003_0	6	5	Specialty Tier	010010	
H8707	003	0	1	04	01	H8707_003_0	6	1	Preferred Generic	001010	2
H8707	003	0	1	04	01	H8707_003_0	6	2	Non-Preferred Generic	000101	2
H8707	003	0	1	04	01	H8707_003_0	6	3	Preferred Brand	000101	2
H8707	003	0	1	04	01	H8707_003_0	6	4	Non-Preferred Brand	110000	2
H8707	003	0	1	04	01	H8707_003_0	6	1	Preferred Generic	001010	
H8707	003	0	1	04	01	H8707_003_0	6	5	Specialty Tier	010010	2
H8748	002	0	1	01	01	H8748_002_0	4	4	Non-Preferred Brand	100100	
H8748	002	0	1	01	01	H8748_002_0	4	5	Specialty Tier	010010	
H8748	002	0	1	01	01	H8748_002_0	4	3	Preferred Brand	010001	
H8748	002	0	1	01	01	H8748_002_0	4	2	Non-Preferred Generic	000100	
H8748	002	0	1	01	01	H8748_002_0	4	1	Preferred Generic	001000	
H8764	001	0	1	01	01	H8764_001_0	5	5	Specialty Tier	010010	
H8764	001	0	1	01	01	H8764_001_0	5	4	Non-Preferred Brand	100000	
H8764	001	0	1	01	01	H8764_001_0	5	3	Preferred Brand	000001	
H8764	001	0	1	01	01	H8764_001_0	5	2	Non-Preferred Generic	000100	
H8764	001	0	1	01	01	H8764_001_0	5	1	Preferred Generic	001000	
H8764	002	0	1	01	01	H8764_002_0	4	1	Preferred Generic	001000	
H8764	002	0	1	01	01	H8764_002_0	4	2	Non-Preferred Generic	000100	
H8764	002	0	1	01	01	H8764_002_0	4	3	Preferred Brand	000001	
H8764	002	0	1	01	01	H8764_002_0	4	4	Non-Preferred Brand	100000	
H8764	002	0	1	01	01	H8764_002_0	4	5	Specialty Tier	010010	
H8822	004	0	1	01	01	H8822_004_0	13	1	Preferred Generic	001000	
H8822	004	0	1	01	01	H8822_004_0	13	2	Non-Preferred Generic	000100	
H8822	004	0	1	01	01	H8822_004_0	13	3	Preferred Brand	000001	
H8822	004	0	1	01	01	H8822_004_0	13	4	Non-Preferred Brand	100000	
H8822	004	0	1	01	01	H8822_004_0	13	5	Specialty Tier	000010	
H8822	004	0	1	01	01	H8822_004_0	13	1	Preferred Generic	001000	1
H8822	004	0	1	01	01	H8822_004_0	13	2	Non-Preferred Generic	000100	1
H8870	001	0	1	01	01	H8870_001_0	10	1	Generic	010000	
H8870	001	0	1	01	01	H8870_001_0	10	2	Preferred Brand	000001	
H8870	001	0	1	01	01	H8870_001_0	10	3	Non-Preferred Brand	100000	
H8870	001	0	1	01	01	H8870_001_0	10	4	Specialty Tier	010010	
H8908	001	0	1	01	01	H8908_001_0	4	1	Preferred Generic	001010	
H8908	001	0	1	01	01	H8908_001_0	4	2	Non-Preferred Generic	000101	
H8908	001	0	1	01	01	H8908_001_0	4	3	Preferred Brand	000101	
H8908	001	0	1	01	01	H8908_001_0	4	4	Non-Preferred Brand	110000	
H8908	001	0	1	01	01	H8908_001_0	4	5	Specialty Tier	010010	2
H8908	001	0	1	01	01	H8908_001_0	4	1	Preferred Generic	001010	2
H8908	001	0	1	01	01	H8908_001_0	4	2	Non-Preferred Generic	000101	2
H8908	001	0	1	01	01	H8908_001_0	4	3	Preferred Brand	000101	2
H8908	001	0	1	01	01	H8908_001_0	4	4	Non-Preferred Brand	110000	2
H8908	001	0	1	01	01	H8908_001_0	4	5	Specialty Tier	010010	
H8953	001	0	1	01	01	H8953_001_0	5	1	Preferred Generic	001010	
H8953	001	0	1	01	01	H8953_001_0	5	2	Non-Preferred Generic	000101	
H8953	001	0	1	01	01	H8953_001_0	5	3	Preferred Brand	000101	
H8953	001	0	1	01	01	H8953_001_0	5	5	Specialty Tier	010010	2
H8953	001	0	1	01	01	H8953_001_0	5	4	Non-Preferred Brand	110000	
H8953	001	0	1	01	01	H8953_001_0	5	3	Preferred Brand	000101	2
H8953	001	0	1	01	01	H8953_001_0	5	2	Non-Preferred Generic	000101	2
H8953	001	0	1	01	01	H8953_001_0	5	1	Preferred Generic	001010	2
H8953	001	0	1	01	01	H8953_001_0	5	5	Specialty Tier	010010	
H8953	001	0	1	01	01	H8953_001_0	5	4	Non-Preferred Brand	110000	2
H8953	002	0	1	01	01	H8953_002_0	4	5	Specialty Tier	010010	2
H8953	002	0	1	01	01	H8953_002_0	4	2	Non-Preferred Generic	000101	2
H8953	002	0	1	01	01	H8953_002_0	4	3	Preferred Brand	000101	2
H8953	002	0	1	01	01	H8953_002_0	4	4	Non-Preferred Brand	110000	2
H8953	002	0	1	01	01	H8953_002_0	4	1	Preferred Generic	001010	2
H8953	002	0	1	01	01	H8953_002_0	4	5	Specialty Tier	010010	
H8953	002	0	1	01	01	H8953_002_0	4	4	Non-Preferred Brand	110000	
H8953	002	0	1	01	01	H8953_002_0	4	3	Preferred Brand	000101	
H8953	002	0	1	01	01	H8953_002_0	4	2	Non-Preferred Generic	000101	
H8953	002	0	1	01	01	H8953_002_0	4	1	Preferred Generic	001010	
H8953	003	0	1	01	01	H8953_003_0	5	5	Specialty Tier	010010	2
H8953	003	0	1	01	01	H8953_003_0	5	4	Non-Preferred Brand	110000	2
H8953	003	0	1	01	01	H8953_003_0	5	3	Preferred Brand	000101	2
H8953	003	0	1	01	01	H8953_003_0	5	1	Preferred Generic	001010	
H8953	003	0	1	01	01	H8953_003_0	5	2	Non-Preferred Generic	000101	2
H8953	003	0	1	01	01	H8953_003_0	5	3	Preferred Brand	000101	
H8953	003	0	1	01	01	H8953_003_0	5	4	Non-Preferred Brand	110000	
H8953	003	0	1	01	01	H8953_003_0	5	5	Specialty Tier	010010	
H8953	003	0	1	01	01	H8953_003_0	5	1	Preferred Generic	001010	2
H8953	003	0	1	01	01	H8953_003_0	5	2	Non-Preferred Generic	000101	
H8953	005	0	1	01	01	H8953_005_0	4	5	Specialty Tier	010010	2
H8953	005	0	1	01	01	H8953_005_0	4	1	Preferred Generic	001010	
H8953	005	0	1	01	01	H8953_005_0	4	3	Preferred Brand	000101	2
H8953	005	0	1	01	01	H8953_005_0	4	4	Non-Preferred Brand	110000	2
H8953	005	0	1	01	01	H8953_005_0	4	2	Non-Preferred Generic	000101	
H8953	005	0	1	01	01	H8953_005_0	4	3	Preferred Brand	000101	
H8953	005	0	1	01	01	H8953_005_0	4	4	Non-Preferred Brand	110000	
H8953	005	0	1	01	01	H8953_005_0	4	5	Specialty Tier	010010	
H8953	005	0	1	01	01	H8953_005_0	4	1	Preferred Generic	001010	2
H8953	005	0	1	01	01	H8953_005_0	4	2	Non-Preferred Generic	000101	2
H8953	006	0	1	01	01	H8953_006_0	4	1	Preferred Generic	001010	
H8953	006	0	1	01	01	H8953_006_0	4	2	Non-Preferred Generic	000101	
H8953	006	0	1	01	01	H8953_006_0	4	3	Preferred Brand	000101	
H8953	006	0	1	01	01	H8953_006_0	4	5	Specialty Tier	010010	2
H8953	006	0	1	01	01	H8953_006_0	4	4	Non-Preferred Brand	110000	
H8953	006	0	1	01	01	H8953_006_0	4	3	Preferred Brand	000101	2
H8953	006	0	1	01	01	H8953_006_0	4	2	Non-Preferred Generic	000101	2
H8953	006	0	1	01	01	H8953_006_0	4	1	Preferred Generic	001010	2
H8953	006	0	1	01	01	H8953_006_0	4	5	Specialty Tier	010010	
H8953	006	0	1	01	01	H8953_006_0	4	4	Non-Preferred Brand	110000	2
H8953	007	0	1	01	01	H8953_007_0	6	2	Non-Preferred Generic	000101	
H8953	007	0	1	01	01	H8953_007_0	6	1	Preferred Generic	001010	
H8953	007	0	1	01	01	H8953_007_0	6	3	Preferred Brand	000101	
H8953	007	0	1	01	01	H8953_007_0	6	4	Non-Preferred Brand	110000	
H8953	007	0	1	01	01	H8953_007_0	6	5	Specialty Tier	010010	
H8953	008	0	1	01	01	H8953_008_0	8	1	Preferred Generic	001010	
H8953	008	0	1	01	01	H8953_008_0	8	2	Non-Preferred Generic	000101	
H8953	008	0	1	01	01	H8953_008_0	8	3	Preferred Brand	000101	
H8953	008	0	1	01	01	H8953_008_0	8	4	Non-Preferred Brand	110000	
H8953	008	0	1	01	01	H8953_008_0	8	5	Specialty Tier	010010	
H8953	009	0	1	01	01	H8953_009_0	4	1	Preferred Generic	001010	
H8953	009	0	1	01	01	H8953_009_0	4	2	Non-Preferred Generic	000101	
H8953	009	0	1	01	01	H8953_009_0	4	3	Preferred Brand	000101	
H8953	009	0	1	01	01	H8953_009_0	4	4	Non-Preferred Brand	110000	
H8953	009	0	1	01	01	H8953_009_0	4	5	Specialty Tier	010010	
H8953	009	0	1	01	01	H8953_009_0	4	1	Preferred Generic	001010	2
H8953	009	0	1	01	01	H8953_009_0	4	2	Non-Preferred Generic	000101	2
H8953	009	0	1	01	01	H8953_009_0	4	3	Preferred Brand	000101	2
H8953	009	0	1	01	01	H8953_009_0	4	4	Non-Preferred Brand	110000	2
H8953	009	0	1	01	01	H8953_009_0	4	5	Specialty Tier	010010	2
H8953	010	0	1	01	01	H8953_010_0	4	1	Preferred Generic	001010	2
H8953	010	0	1	01	01	H8953_010_0	4	2	Non-Preferred Generic	000101	2
H8953	010	0	1	01	01	H8953_010_0	4	4	Non-Preferred Brand	110000	
H8953	010	0	1	01	01	H8953_010_0	4	3	Preferred Brand	000101	
H8953	010	0	1	01	01	H8953_010_0	4	2	Non-Preferred Generic	000101	
H8953	010	0	1	01	01	H8953_010_0	4	1	Preferred Generic	001010	
H8953	010	0	1	01	01	H8953_010_0	4	5	Specialty Tier	010010	
H8953	010	0	1	01	01	H8953_010_0	4	3	Preferred Brand	000101	2
H8953	010	0	1	01	01	H8953_010_0	4	4	Non-Preferred Brand	110000	2
H8953	010	0	1	01	01	H8953_010_0	4	5	Specialty Tier	010010	2
H8953	011	0	1	01	01	H8953_011_0	5	2	Non-Preferred Generic	000101	2
H8953	011	0	1	01	01	H8953_011_0	5	3	Preferred Brand	000101	2
H8953	011	0	1	01	01	H8953_011_0	5	4	Non-Preferred Brand	110000	2
H8953	011	0	1	01	01	H8953_011_0	5	5	Specialty Tier	010010	2
H8953	011	0	1	01	01	H8953_011_0	5	3	Preferred Brand	000101	
H8953	011	0	1	01	01	H8953_011_0	5	1	Preferred Generic	001010	
H8953	011	0	1	01	01	H8953_011_0	5	1	Preferred Generic	001010	2
H8953	011	0	1	01	01	H8953_011_0	5	5	Specialty Tier	010010	
H8953	011	0	1	01	01	H8953_011_0	5	2	Non-Preferred Generic	000101	
H8953	011	0	1	01	01	H8953_011_0	5	4	Non-Preferred Brand	110000	
H8953	012	0	1	01	01	H8953_012_0	4	5	Specialty Tier	010010	2
H8953	012	0	1	01	01	H8953_012_0	4	4	Non-Preferred Brand	110000	2
H8953	012	0	1	01	01	H8953_012_0	4	3	Preferred Brand	000101	2
H8953	012	0	1	01	01	H8953_012_0	4	2	Non-Preferred Generic	000101	2
H8953	012	0	1	01	01	H8953_012_0	4	1	Preferred Generic	001010	2
H8953	012	0	1	01	01	H8953_012_0	4	3	Preferred Brand	000101	
H8953	012	0	1	01	01	H8953_012_0	4	2	Non-Preferred Generic	000101	
H8953	012	0	1	01	01	H8953_012_0	4	1	Preferred Generic	001010	
H8953	012	0	1	01	01	H8953_012_0	4	4	Non-Preferred Brand	110000	
H8953	012	0	1	01	01	H8953_012_0	4	5	Specialty Tier	010010	
H8953	014	0	1	01	01	H8953_014_0	7	3	Preferred Brand	000101	
H8953	014	0	1	01	01	H8953_014_0	7	2	Non-Preferred Generic	000101	
H8953	014	0	1	01	01	H8953_014_0	7	1	Preferred Generic	001010	
H8953	014	0	1	01	01	H8953_014_0	7	4	Non-Preferred Brand	110000	
H8953	014	0	1	01	01	H8953_014_0	7	5	Specialty Tier	010010	
H8980	002	0	1	04	01	H8980_002_0	9	1	Preferred Generic	001000	
H8980	002	0	1	04	01	H8980_002_0	9	2	Non-Preferred Generic	000100	
H8980	002	0	1	04	01	H8980_002_0	9	5	Specialty Tier	010010	
H8980	002	0	1	04	01	H8980_002_0	9	4	Non-Preferred Brand	100100	
H8980	002	0	1	04	01	H8980_002_0	9	3	Preferred Brand	000001	
H8980	004	0	1	04	01	H8980_004_0	4	4	Non-Preferred Brand	100100	
H8980	004	0	1	04	01	H8980_004_0	4	5	Specialty Tier	010010	
H8980	004	0	1	04	01	H8980_004_0	4	1	Preferred Generic	001000	1
H8980	004	0	1	04	01	H8980_004_0	4	3	Preferred Brand	000001	
H8980	004	0	1	04	01	H8980_004_0	4	2	Non-Preferred Generic	000100	
H8980	004	0	1	04	01	H8980_004_0	4	1	Preferred Generic	001000	
H8980	005	0	1	04	01	H8980_005_0	10	3	Preferred Brand	000001	
H8980	005	0	1	04	01	H8980_005_0	10	1	Preferred Generic	001000	
H8980	005	0	1	04	01	H8980_005_0	10	2	Non-Preferred Generic	000100	
H8980	005	0	1	04	01	H8980_005_0	10	1	Preferred Generic	001000	1
H8980	005	0	1	04	01	H8980_005_0	10	4	Non-Preferred Brand	100100	
H8980	005	0	1	04	01	H8980_005_0	10	5	Specialty Tier	010010	
H8980	006	0	1	04	01	H8980_006_0	7	3	Preferred Brand	000001	
H8980	006	0	1	04	01	H8980_006_0	7	1	Preferred Generic	001000	
H8980	006	0	1	04	01	H8980_006_0	7	2	Non-Preferred Generic	000100	
H8980	006	0	1	04	01	H8980_006_0	7	1	Preferred Generic	001000	1
H8980	006	0	1	04	01	H8980_006_0	7	5	Specialty Tier	010010	
H8980	006	0	1	04	01	H8980_006_0	7	4	Non-Preferred Brand	100100	
H8991	017	0	1	01	01	H8991_017_0	5	2	Non-Preferred Generic	000100	
H8991	017	0	1	01	01	H8991_017_0	5	1	Preferred Generic	001000	
H8991	017	0	1	01	01	H8991_017_0	5	3	Preferred Brand	000001	
H8991	017	0	1	01	01	H8991_017_0	5	4	Non-Preferred Brand	100000	
H8991	017	0	1	01	01	H8991_017_0	5	5	Specialty Tier	010010	
H8991	017	0	1	01	01	H8991_017_0	5	1	Preferred Generic	001000	1
H8991	028	0	1	01	01	H8991_028_0	5	2	Non-Preferred Generic	000100	
H8991	028	0	1	01	01	H8991_028_0	5	1	Preferred Generic	001000	
H8991	028	0	1	01	01	H8991_028_0	5	3	Preferred Brand	000001	
H8991	028	0	1	01	01	H8991_028_0	5	5	Specialty Tier	010010	
H8991	028	0	1	01	01	H8991_028_0	5	4	Non-Preferred Brand	100000	
H8991	029	0	1	01	01	H8991_029_0	7	1	Preferred Generic	001000	
H8991	029	0	1	01	01	H8991_029_0	7	2	Non-Preferred Generic	000100	
H8991	029	0	1	01	01	H8991_029_0	7	3	Preferred Brand	000001	
H8991	029	0	1	01	01	H8991_029_0	7	5	Specialty Tier	010010	
H8991	029	0	1	01	01	H8991_029_0	7	4	Non-Preferred Brand	100000	
H8991	029	0	1	01	01	H8991_029_0	7	1	Preferred Generic	001000	1
H9001	013	0	1	02	01	H9001_013_0	7	1	Preferred Generic	001000	
H9001	013	0	1	02	01	H9001_013_0	7	2	Non-Preferred Generic	000100	
H9001	013	0	1	02	01	H9001_013_0	7	3	Preferred Brand	000001	
H9001	013	0	1	02	01	H9001_013_0	7	4	Non-Preferred Brand	100000	
H9001	013	0	1	02	01	H9001_013_0	7	5	Specialty Tier	100100	
H9001	015	0	1	01	01	H9001_015_0	9	1	Preferred Generic	001000	
H9001	015	0	1	01	01	H9001_015_0	9	2	Non-Preferred Generic	000100	
H9001	015	0	1	01	01	H9001_015_0	9	5	Specialty Tier	100100	
H9001	015	0	1	01	01	H9001_015_0	9	4	Non-Preferred Brand	100000	
H9001	015	0	1	01	01	H9001_015_0	9	3	Preferred Brand	000001	
H9001	019	0	1	01	01	H9001_019_0	8	1	Preferred Generic	001000	
H9001	019	0	1	01	01	H9001_019_0	8	2	Preferred Brand	000101	
H9001	019	0	1	01	01	H9001_019_0	8	3	Non-Preferred Brand	100000	
H9001	030	1	1	01	01	H9001_030_1	7	5	Specialty Tier	100100	
H9001	030	1	1	01	01	H9001_030_1	7	3	Preferred Brand	000001	
H9001	030	1	1	01	01	H9001_030_1	7	4	Non-Preferred Brand	100000	
H9001	030	1	1	01	01	H9001_030_1	7	2	Non-Preferred Generic	000100	
H9001	030	1	1	01	01	H9001_030_1	7	1	Preferred Generic	001000	
H9001	030	2	1	01	01	H9001_030_2	8	5	Specialty Tier	100100	
H9001	030	2	1	01	01	H9001_030_2	8	4	Non-Preferred Brand	100000	
H9001	030	2	1	01	01	H9001_030_2	8	1	Preferred Generic	001000	
H9001	030	2	1	01	01	H9001_030_2	8	2	Non-Preferred Generic	000100	
H9001	030	2	1	01	01	H9001_030_2	8	3	Preferred Brand	000001	
H9001	030	4	1	01	01	H9001_030_4	8	3	Preferred Brand	000001	
H9001	030	4	1	01	01	H9001_030_4	8	2	Non-Preferred Generic	000100	
H9001	030	4	1	01	01	H9001_030_4	8	5	Specialty Tier	100100	
H9001	030	4	1	01	01	H9001_030_4	8	4	Non-Preferred Brand	100000	
H9001	030	4	1	01	01	H9001_030_4	8	1	Preferred Generic	001000	
H9001	030	5	1	01	01	H9001_030_5	8	1	Preferred Generic	001000	
H9001	030	5	1	01	01	H9001_030_5	8	2	Non-Preferred Generic	000100	
H9001	030	5	1	01	01	H9001_030_5	8	4	Non-Preferred Brand	100000	
H9001	030	5	1	01	01	H9001_030_5	8	5	Specialty Tier	100100	
H9001	030	5	1	01	01	H9001_030_5	8	3	Preferred Brand	000001	
H9001	031	1	1	01	01	H9001_031_1	7	2	Non-Preferred Generic	000100	
H9001	031	1	1	01	01	H9001_031_1	7	3	Preferred Brand	000001	
H9001	031	1	1	01	01	H9001_031_1	7	5	Specialty Tier	100100	
H9001	031	1	1	01	01	H9001_031_1	7	4	Non-Preferred Brand	100000	
H9001	031	1	1	01	01	H9001_031_1	7	1	Preferred Generic	001000	
H9001	031	2	1	01	01	H9001_031_2	7	4	Non-Preferred Brand	100000	
H9001	031	2	1	01	01	H9001_031_2	7	3	Preferred Brand	000001	
H9001	031	2	1	01	01	H9001_031_2	7	5	Specialty Tier	100100	
H9001	031	2	1	01	01	H9001_031_2	7	2	Non-Preferred Generic	000100	
H9001	031	2	1	01	01	H9001_031_2	7	1	Preferred Generic	001000	
H9001	031	4	1	01	01	H9001_031_4	7	3	Preferred Brand	000001	
H9001	031	4	1	01	01	H9001_031_4	7	4	Non-Preferred Brand	100000	
H9001	031	4	1	01	01	H9001_031_4	7	5	Specialty Tier	100100	
H9001	031	4	1	01	01	H9001_031_4	7	2	Non-Preferred Generic	000100	
H9001	031	4	1	01	01	H9001_031_4	7	1	Preferred Generic	001000	
H9001	031	5	1	01	01	H9001_031_5	7	5	Specialty Tier	100100	
H9001	031	5	1	01	01	H9001_031_5	7	4	Non-Preferred Brand	100000	
H9001	031	5	1	01	01	H9001_031_5	7	1	Preferred Generic	001000	
H9001	031	5	1	01	01	H9001_031_5	7	2	Non-Preferred Generic	000100	
H9001	031	5	1	01	01	H9001_031_5	7	3	Preferred Brand	000001	
H9001	031	6	1	01	01	H9001_031_6	7	3	Preferred Brand	000001	
H9001	031	6	1	01	01	H9001_031_6	7	2	Non-Preferred Generic	000100	
H9001	031	6	1	01	01	H9001_031_6	7	5	Specialty Tier	100100	
H9001	031	6	1	01	01	H9001_031_6	7	4	Non-Preferred Brand	100000	
H9001	031	6	1	01	01	H9001_031_6	7	1	Preferred Generic	001000	
H9001	032	1	1	01	01	H9001_032_1	7	1	Preferred Generic	001000	
H9001	032	1	1	01	01	H9001_032_1	7	2	Non-Preferred Generic	000100	
H9001	032	1	1	01	01	H9001_032_1	7	4	Non-Preferred Brand	100000	
H9001	032	1	1	01	01	H9001_032_1	7	5	Specialty Tier	100100	
H9001	032	1	1	01	01	H9001_032_1	7	3	Preferred Brand	000001	
H9001	032	2	1	01	01	H9001_032_2	7	2	Non-Preferred Generic	000100	
H9001	032	2	1	01	01	H9001_032_2	7	3	Preferred Brand	000001	
H9001	032	2	1	01	01	H9001_032_2	7	5	Specialty Tier	100100	
H9001	032	2	1	01	01	H9001_032_2	7	4	Non-Preferred Brand	100000	
H9001	032	2	1	01	01	H9001_032_2	7	1	Preferred Generic	001000	
H9001	032	4	1	01	01	H9001_032_4	8	4	Non-Preferred Brand	100000	
H9001	032	4	1	01	01	H9001_032_4	8	3	Preferred Brand	000001	
H9001	032	4	1	01	01	H9001_032_4	8	5	Specialty Tier	100100	
H9001	032	4	1	01	01	H9001_032_4	8	2	Non-Preferred Generic	000100	
H9001	032	4	1	01	01	H9001_032_4	8	1	Preferred Generic	001000	
H9001	032	5	1	01	01	H9001_032_5	7	1	Preferred Generic	001000	
H9001	032	5	1	01	01	H9001_032_5	7	2	Non-Preferred Generic	000100	
H9001	032	5	1	01	01	H9001_032_5	7	3	Preferred Brand	000001	
H9001	032	5	1	01	01	H9001_032_5	7	4	Non-Preferred Brand	100000	
H9001	032	5	1	01	01	H9001_032_5	7	5	Specialty Tier	100100	
H9001	032	6	1	01	01	H9001_032_6	7	1	Preferred Generic	001000	
H9001	032	6	1	01	01	H9001_032_6	7	5	Specialty Tier	100100	
H9001	032	6	1	01	01	H9001_032_6	7	4	Non-Preferred Brand	100000	
H9001	032	6	1	01	01	H9001_032_6	7	3	Preferred Brand	000001	
H9001	032	6	1	01	01	H9001_032_6	7	2	Non-Preferred Generic	000100	
H9003	001	0	1	01	01	H9003_001_0	10	4	Non-Preferred Brand	100000	
H9003	001	0	1	01	01	H9003_001_0	10	3	Preferred Brand	000001	
H9003	001	0	1	01	01	H9003_001_0	10	1	Preferred Generic	001000	
H9003	001	0	1	01	01	H9003_001_0	10	2	Non-Preferred Generic	000100	
H9003	001	0	1	01	01	H9003_001_0	10	6	Vaccines	000001	1
H9003	001	0	1	01	01	H9003_001_0	10	6	Vaccines	000001	
H9003	001	0	1	01	01	H9003_001_0	10	1	Preferred Generic	001000	1
H9003	001	0	1	01	01	H9003_001_0	10	2	Non-Preferred Generic	000100	1
H9003	001	0	1	01	01	H9003_001_0	10	5	Specialty Tier	100001	
H9003	006	0	1	01	01	H9003_006_0	4	2	Non-Preferred Generic	000100	1
H9003	006	0	1	01	01	H9003_006_0	4	6	Vaccines	000001	1
H9003	006	0	1	01	01	H9003_006_0	4	1	Preferred Generic	001000	1
H9003	006	0	1	01	01	H9003_006_0	4	6	Vaccines	000001	
H9003	006	0	1	01	01	H9003_006_0	4	5	Specialty Tier	100001	
H9003	006	0	1	01	01	H9003_006_0	4	4	Non-Preferred Brand	100000	
H9003	006	0	1	01	01	H9003_006_0	4	1	Preferred Generic	001000	
H9003	006	0	1	01	01	H9003_006_0	4	2	Non-Preferred Generic	000100	
H9003	006	0	1	01	01	H9003_006_0	4	3	Preferred Brand	000001	
H9011	019	0	1	02	01	H9011_019_0	5	1	Preferred Generic	001000	
H9011	019	0	1	02	01	H9011_019_0	5	2	Non-Preferred Generic	000100	
H9011	019	0	1	02	01	H9011_019_0	5	3	Preferred Brand	010001	
H9011	019	0	1	02	01	H9011_019_0	5	4	Non-Preferred Brand	100100	
H9011	019	0	1	02	01	H9011_019_0	5	1	Preferred Generic	001000	1
H9011	019	0	1	02	01	H9011_019_0	5	5	Specialty Tier	010010	
H9011	020	0	1	01	01	H9011_020_0	5	5	Specialty Tier	010010	
H9011	020	0	1	01	01	H9011_020_0	5	4	Non-Preferred Brand	100100	
H9011	020	0	1	01	01	H9011_020_0	5	3	Preferred Brand	010001	
H9011	020	0	1	01	01	H9011_020_0	5	2	Non-Preferred Generic	000100	
H9011	020	0	1	01	01	H9011_020_0	5	1	Preferred Generic	001000	
H9047	001	0	1	01	01	H9047_001_0	10	6	Specialty Tier	010010	
H9047	001	0	1	01	01	H9047_001_0	10	5	Injectable Drugs	010010	
H9047	001	0	1	01	01	H9047_001_0	10	4	Non-Preferred Brand	100000	
H9047	001	0	1	01	01	H9047_001_0	10	3	Preferred Brand	000001	
H9047	001	0	1	01	01	H9047_001_0	10	2	Non-Preferred Generic	000100	
H9047	001	0	1	01	01	H9047_001_0	10	1	Preferred Generic	001000	
H9047	013	0	2	01	01	H9047_013_0	10	6	Specialty Tier	010010	
H9047	013	0	2	01	01	H9047_013_0	10	5	Injectable Drugs	010010	
H9047	013	0	2	01	01	H9047_013_0	10	4	Non-Preferred Brand	100000	
H9047	013	0	2	01	01	H9047_013_0	10	3	Preferred Brand	000001	
H9047	013	0	2	01	01	H9047_013_0	10	2	Non-Preferred Generic	000100	
H9047	013	0	2	01	01	H9047_013_0	10	1	Preferred Generic	001000	
H9047	024	0	1	02	01	H9047_024_0	10	1	Preferred Generic	001000	
H9047	024	0	1	02	01	H9047_024_0	10	5	Injectable Drugs	010010	
H9047	024	0	1	02	01	H9047_024_0	10	6	Specialty Tier	010010	
H9047	024	0	1	02	01	H9047_024_0	10	3	Preferred Brand	000001	
H9047	024	0	1	02	01	H9047_024_0	10	4	Non-Preferred Brand	100000	
H9047	024	0	1	02	01	H9047_024_0	10	2	Non-Preferred Generic	000100	
H9082	002	0	1	01	01	H9082_002_0	10	4	Specialty Tier	010010	
H9082	002	0	1	01	01	H9082_002_0	10	3	Non-Preferred Brand	100000	
H9082	002	0	1	01	01	H9082_002_0	10	2	Preferred Brand	000001	
H9082	002	0	1	01	01	H9082_002_0	10	1	Generic	010000	
H9104	006	0	1	01	01	H9104_006_0	4	1	Preferred Generic	001000	
H9104	006	0	1	01	01	H9104_006_0	4	2	Non-Preferred Generic	000100	
H9104	006	0	1	01	01	H9104_006_0	4	3	Preferred Brand	000001	
H9104	006	0	1	01	01	H9104_006_0	4	4	Non-Preferred Brand	100000	
H9104	006	0	1	01	01	H9104_006_0	4	5	Specialty Tier	010010	
H9104	006	0	1	01	01	H9104_006_0	4	6	Select Care Drugs	000010	
H9104	006	0	1	01	01	H9104_006_0	4	1	Preferred Generic	001000	1
H9104	006	0	1	01	01	H9104_006_0	4	2	Non-Preferred Generic	000100	1
H9110	002	0	1	01	01	H9110_002_0	8	2	Non-Preferred Generic	000100	
H9110	002	0	1	01	01	H9110_002_0	8	3	Preferred Brand	000001	
H9110	002	0	1	01	01	H9110_002_0	8	1	Preferred Generic	001000	
H9110	002	0	1	01	01	H9110_002_0	8	5	Specialty Tier	010010	
H9110	002	0	1	01	01	H9110_002_0	8	4	Non-Preferred Brand	100000	
H9122	001	0	1	01	01	H9122_001_0	6	3	Preferred Brand	000001	
H9122	001	0	1	01	01	H9122_001_0	6	2	Non-Preferred Generic	000100	
H9122	001	0	1	01	01	H9122_001_0	6	1	Preferred Generic	001000	
H9122	001	0	1	01	01	H9122_001_0	6	5	Specialty Tier	010010	
H9122	001	0	1	01	01	H9122_001_0	6	4	Non-Preferred Brand	100000	
H9190	003	0	1	01	01	H9190_003_0	4	4	Non-Preferred Brand	100000	
H9190	003	0	1	01	01	H9190_003_0	4	3	Preferred Brand	000001	
H9190	003	0	1	01	01	H9190_003_0	4	2	Non-Preferred Generic	000100	
H9190	003	0	1	01	01	H9190_003_0	4	6	Select Care Drugs	000010	
H9190	003	0	1	01	01	H9190_003_0	4	5	Specialty Tier	010010	
H9190	003	0	1	01	01	H9190_003_0	4	1	Preferred Generic	001000	
H9190	004	0	1	01	01	H9190_004_0	4	6	Select Care Drugs	000010	
H9190	004	0	1	01	01	H9190_004_0	4	5	Specialty Tier	010010	
H9190	004	0	1	01	01	H9190_004_0	4	4	Non-Preferred Brand	100000	
H9190	004	0	1	01	01	H9190_004_0	4	3	Preferred Brand	000001	
H9190	004	0	1	01	01	H9190_004_0	4	2	Non-Preferred Generic	000100	
H9190	004	0	1	01	01	H9190_004_0	4	1	Preferred Generic	001000	
H9190	005	0	1	01	01	H9190_005_0	4	5	Specialty Tier	010010	
H9190	005	0	1	01	01	H9190_005_0	4	1	Preferred Generic	001000	
H9190	005	0	1	01	01	H9190_005_0	4	2	Non-Preferred Generic	000100	
H9190	005	0	1	01	01	H9190_005_0	4	3	Preferred Brand	000001	
H9190	005	0	1	01	01	H9190_005_0	4	4	Non-Preferred Brand	100000	
H9190	006	0	1	01	01	H9190_006_0	4	5	Specialty Tier	010010	
H9190	006	0	1	01	01	H9190_006_0	4	1	Preferred Generic	001000	
H9190	006	0	1	01	01	H9190_006_0	4	2	Non-Preferred Generic	000100	
H9190	006	0	1	01	01	H9190_006_0	4	3	Preferred Brand	000001	
H9190	006	0	1	01	01	H9190_006_0	4	4	Non-Preferred Brand	100000	
H9207	002	0	1	01	01	H9207_002_0	6	1	Generic	010000	
H9207	002	0	1	01	01	H9207_002_0	6	2	Brand	000010	
H9207	002	0	1	01	01	H9207_002_0	6	3	Specialty Tier	000010	
H9207	003	0	1	01	01	H9207_003_0	6	1	Generic	010000	
H9207	003	0	1	01	01	H9207_003_0	6	2	Brand	000010	
H9207	003	0	1	01	01	H9207_003_0	6	3	Specialty Tier	000010	
H9264	001	0	1	48	05	H9264_001_0	5	1	Generic Drugs	010000	
H9264	001	0	1	48	05	H9264_001_0	5	2	Brand Drugs	000010	
H9264	001	0	1	48	05	H9264_001_0	5	3	Non-Medicare Rx/OTC Drugs	010010	
H9285	001	0	1	01	01	H9285_001_0	6	2	Preferred Brand	000101	
H9285	001	0	1	01	01	H9285_001_0	6	1	Preferred Generic	001010	
H9285	001	0	1	01	01	H9285_001_0	6	3	Non-Preferred Brand	100100	
H9285	001	0	1	01	01	H9285_001_0	6	4	Specialty Tier	100100	
H9285	002	0	1	01	01	H9285_002_0	6	2	Preferred Brand	000101	
H9285	002	0	1	01	01	H9285_002_0	6	1	Preferred Generic	001010	
H9285	002	0	1	01	01	H9285_002_0	6	3	Non-Preferred Brand	100100	
H9285	002	0	1	01	01	H9285_002_0	6	1	Preferred Generic	001010	1
H9285	002	0	1	01	01	H9285_002_0	6	4	Specialty Tier	100100	
H9285	003	0	1	01	01	H9285_003_0	6	1	Preferred Generic	001010	
H9285	003	0	1	01	01	H9285_003_0	6	3	Non-Preferred Brand	100100	
H9285	003	0	1	01	01	H9285_003_0	6	2	Preferred Brand	000101	
H9285	003	0	1	01	01	H9285_003_0	6	4	Specialty Tier	100100	
H9302	001	0	1	01	01	H9302_001_0	11	1	Preferred Generic	001000	
H9302	001	0	1	01	01	H9302_001_0	11	3	Preferred Brand	000001	
H9302	001	0	1	01	01	H9302_001_0	11	2	Non-Preferred Generic	000100	
H9302	001	0	1	01	01	H9302_001_0	11	4	Non-Preferred Brand	100000	
H9302	001	0	1	01	01	H9302_001_0	11	5	Specialty Tier	000010	
H9302	001	0	1	01	01	H9302_001_0	11	1	Preferred Generic	001000	1
H9302	001	0	1	01	01	H9302_001_0	11	2	Non-Preferred Generic	000100	1
H9302	003	0	1	01	01	H9302_003_0	10	4	Non-Preferred Brand	100000	
H9302	003	0	1	01	01	H9302_003_0	10	5	Specialty Tier	000010	
H9302	003	0	1	01	01	H9302_003_0	10	2	Non-Preferred Generic	000100	
H9302	003	0	1	01	01	H9302_003_0	10	3	Preferred Brand	000001	
H9302	003	0	1	01	01	H9302_003_0	10	1	Preferred Generic	001000	
H9302	003	0	1	01	01	H9302_003_0	10	1	Preferred Generic	001000	1
H9302	007	0	1	01	01	H9302_007_0	10	1	Preferred Generic	001000	
H9302	007	0	1	01	01	H9302_007_0	10	3	Preferred Brand	000001	
H9302	007	0	1	01	01	H9302_007_0	10	2	Non-Preferred Generic	000100	
H9302	007	0	1	01	01	H9302_007_0	10	5	Specialty Tier	000010	
H9302	007	0	1	01	01	H9302_007_0	10	4	Non-Preferred Brand	100000	
H9302	010	0	1	01	01	H9302_010_0	10	1	Preferred Generic	001000	
H9302	010	0	1	01	01	H9302_010_0	10	2	Non-Preferred Generic	000100	
H9302	010	0	1	01	01	H9302_010_0	10	3	Preferred Brand	000001	
H9302	010	0	1	01	01	H9302_010_0	10	5	Specialty Tier	000010	
H9302	010	0	1	01	01	H9302_010_0	10	4	Non-Preferred Brand	100000	
H9302	011	0	1	01	01	H9302_011_0	10	5	Specialty Tier	000010	
H9302	011	0	1	01	01	H9302_011_0	10	4	Non-Preferred Brand	100000	
H9302	011	0	1	01	01	H9302_011_0	10	2	Non-Preferred Generic	000100	
H9302	011	0	1	01	01	H9302_011_0	10	3	Preferred Brand	000001	
H9302	011	0	1	01	01	H9302_011_0	10	1	Preferred Generic	001000	
H9385	002	0	1	01	01	H9385_002_0	6	3	Preferred Brand	000001	
H9385	002	0	1	01	01	H9385_002_0	6	6	Select Care Drugs	000010	
H9385	002	0	1	01	01	H9385_002_0	6	1	Preferred Generic	001000	
H9385	002	0	1	01	01	H9385_002_0	6	2	Non-Preferred Generic	000100	
H9385	002	0	1	01	01	H9385_002_0	6	5	Specialty Tier	010010	
H9385	002	0	1	01	01	H9385_002_0	6	4	Non-Preferred Brand	100000	
H9385	003	0	1	01	01	H9385_003_0	6	1	Preferred Generic	001000	1
H9385	003	0	1	01	01	H9385_003_0	6	6	Select Care Drugs	000010	1
H9385	003	0	1	01	01	H9385_003_0	6	1	Preferred Generic	001000	
H9385	003	0	1	01	01	H9385_003_0	6	2	Non-Preferred Generic	000100	
H9385	003	0	1	01	01	H9385_003_0	6	3	Preferred Brand	000001	
H9385	003	0	1	01	01	H9385_003_0	6	4	Non-Preferred Brand	100000	
H9385	003	0	1	01	01	H9385_003_0	6	5	Specialty Tier	010010	
H9385	003	0	1	01	01	H9385_003_0	6	6	Select Care Drugs	000010	
H9385	004	0	1	01	01	H9385_004_0	6	1	Preferred Generic	001000	1
H9385	004	0	1	01	01	H9385_004_0	6	6	Select Care Drugs	000010	
H9385	004	0	1	01	01	H9385_004_0	6	1	Preferred Generic	001000	
H9385	004	0	1	01	01	H9385_004_0	6	2	Non-Preferred Generic	000100	
H9385	004	0	1	01	01	H9385_004_0	6	3	Preferred Brand	000001	
H9385	004	0	1	01	01	H9385_004_0	6	6	Select Care Drugs	000010	1
H9385	004	0	1	01	01	H9385_004_0	6	5	Specialty Tier	010010	
H9385	004	0	1	01	01	H9385_004_0	6	4	Non-Preferred Brand	100000	
H9412	003	0	1	04	01	H9412_003_0	5	1	Preferred Generic	001000	
H9412	003	0	1	04	01	H9412_003_0	5	2	Non-Preferred Generic	000100	
H9412	003	0	1	04	01	H9412_003_0	5	1	Preferred Generic	001000	1
H9412	003	0	1	04	01	H9412_003_0	5	4	Non-Preferred Brand	100000	
H9412	003	0	1	04	01	H9412_003_0	5	5	Specialty Tier	000010	
H9412	003	0	1	04	01	H9412_003_0	5	3	Preferred Brand	000001	
H9503	001	0	1	04	01	H9503_001_0	5	4	Non-Preferred Brand	110000	
H9503	001	0	1	04	01	H9503_001_0	5	3	Preferred Brand	000101	
H9503	001	0	1	04	01	H9503_001_0	5	2	Non-Preferred Generic	000101	
H9503	001	0	1	04	01	H9503_001_0	5	1	Preferred Generic	001010	
H9503	001	0	1	04	01	H9503_001_0	5	5	Specialty Tier	010010	2
H9503	001	0	1	04	01	H9503_001_0	5	1	Preferred Generic	001010	2
H9503	001	0	1	04	01	H9503_001_0	5	2	Non-Preferred Generic	000101	2
H9503	001	0	1	04	01	H9503_001_0	5	3	Preferred Brand	000101	2
H9503	001	0	1	04	01	H9503_001_0	5	4	Non-Preferred Brand	110000	2
H9503	001	0	1	04	01	H9503_001_0	5	5	Specialty Tier	010010	
H9503	003	0	1	04	01	H9503_003_0	4	4	Non-Preferred Brand	110000	
H9503	003	0	1	04	01	H9503_003_0	4	3	Preferred Brand	000101	
H9503	003	0	1	04	01	H9503_003_0	4	2	Non-Preferred Generic	000101	
H9503	003	0	1	04	01	H9503_003_0	4	1	Preferred Generic	001010	
H9503	003	0	1	04	01	H9503_003_0	4	5	Specialty Tier	010010	
H9503	003	0	1	04	01	H9503_003_0	4	5	Specialty Tier	010010	2
H9503	003	0	1	04	01	H9503_003_0	4	4	Non-Preferred Brand	110000	2
H9503	003	0	1	04	01	H9503_003_0	4	3	Preferred Brand	000101	2
H9503	003	0	1	04	01	H9503_003_0	4	2	Non-Preferred Generic	000101	2
H9503	003	0	1	04	01	H9503_003_0	4	1	Preferred Generic	001010	2
H9503	008	0	1	04	01	H9503_008_0	5	5	Specialty Tier	010010	
H9503	008	0	1	04	01	H9503_008_0	5	4	Non-Preferred Brand	110000	
H9503	008	0	1	04	01	H9503_008_0	5	3	Preferred Brand	000101	
H9503	008	0	1	04	01	H9503_008_0	5	2	Non-Preferred Generic	000101	
H9503	008	0	1	04	01	H9503_008_0	5	1	Preferred Generic	001010	
H9503	009	0	1	04	01	H9503_009_0	5	1	Preferred Generic	001010	
H9503	009	0	1	04	01	H9503_009_0	5	2	Non-Preferred Generic	000101	
H9503	009	0	1	04	01	H9503_009_0	5	3	Preferred Brand	000101	
H9503	009	0	1	04	01	H9503_009_0	5	5	Specialty Tier	010010	
H9503	009	0	1	04	01	H9503_009_0	5	4	Non-Preferred Brand	110000	
H9525	001	0	1	01	01	H9525_001_0	5	1	Preferred Generic	001000	
H9525	001	0	1	01	01	H9525_001_0	5	2	Non-Preferred Generic	000100	
H9525	001	0	1	01	01	H9525_001_0	5	3	Preferred Brand	000101	
H9525	001	0	1	01	01	H9525_001_0	5	4	Non-Preferred Brand	100100	
H9525	001	0	1	01	01	H9525_001_0	5	5	Injectable Drugs	010010	
H9525	001	0	1	01	01	H9525_001_0	5	6	Specialty Tier	010010	
H9525	002	0	1	01	01	H9525_002_0	5	1	Preferred Generic	001000	
H9525	002	0	1	01	01	H9525_002_0	5	2	Non-Preferred Generic	000100	
H9525	002	0	1	01	01	H9525_002_0	5	3	Preferred Brand	000101	
H9525	002	0	1	01	01	H9525_002_0	5	4	Non-Preferred Brand	100100	
H9525	002	0	1	01	01	H9525_002_0	5	5	Injectable Drugs	010010	
H9525	002	0	1	01	01	H9525_002_0	5	6	Specialty Tier	010010	
H9572	001	1	1	04	01	H9572_001_1	12	2	Non-Preferred Generic	000100	
H9572	001	1	1	04	01	H9572_001_1	12	3	Preferred Brand	000001	
H9572	001	1	1	04	01	H9572_001_1	12	1	Preferred Generic	001000	
H9572	001	1	1	04	01	H9572_001_1	12	4	Non-Preferred Brand	100000	
H9572	001	1	1	04	01	H9572_001_1	12	5	Specialty Tier	010010	
H9572	001	2	1	04	01	H9572_001_2	10	2	Non-Preferred Generic	000100	
H9572	001	2	1	04	01	H9572_001_2	10	1	Preferred Generic	001000	
H9572	001	2	1	04	01	H9572_001_2	10	3	Preferred Brand	000001	
H9572	001	2	1	04	01	H9572_001_2	10	5	Specialty Tier	010010	
H9572	001	2	1	04	01	H9572_001_2	10	4	Non-Preferred Brand	100000	
H9572	001	3	1	04	01	H9572_001_3	10	1	Preferred Generic	001000	
H9572	001	3	1	04	01	H9572_001_3	10	2	Non-Preferred Generic	000100	
H9572	001	3	1	04	01	H9572_001_3	10	4	Non-Preferred Brand	100000	
H9572	001	3	1	04	01	H9572_001_3	10	3	Preferred Brand	000001	
H9572	001	3	1	04	01	H9572_001_3	10	5	Specialty Tier	010010	
H9572	001	4	1	04	01	H9572_001_4	10	3	Preferred Brand	000001	
H9572	001	4	1	04	01	H9572_001_4	10	2	Non-Preferred Generic	000100	
H9572	001	4	1	04	01	H9572_001_4	10	1	Preferred Generic	001000	
H9572	001	4	1	04	01	H9572_001_4	10	4	Non-Preferred Brand	100000	
H9572	001	4	1	04	01	H9572_001_4	10	5	Specialty Tier	010010	
H9572	001	6	1	04	01	H9572_001_6	10	3	Preferred Brand	000001	
H9572	001	6	1	04	01	H9572_001_6	10	2	Non-Preferred Generic	000100	
H9572	001	6	1	04	01	H9572_001_6	10	1	Preferred Generic	001000	
H9572	001	6	1	04	01	H9572_001_6	10	4	Non-Preferred Brand	100000	
H9572	001	6	1	04	01	H9572_001_6	10	5	Specialty Tier	010010	
H9572	003	1	1	04	01	H9572_003_1	11	3	Preferred Brand	000001	
H9572	003	1	1	04	01	H9572_003_1	11	2	Non-Preferred Generic	000100	
H9572	003	1	1	04	01	H9572_003_1	11	1	Preferred Generic	001000	
H9572	003	1	1	04	01	H9572_003_1	11	4	Non-Preferred Brand	100000	
H9572	003	1	1	04	01	H9572_003_1	11	1	Preferred Generic	001000	1
H9572	003	1	1	04	01	H9572_003_1	11	5	Specialty Tier	010010	
H9572	003	2	1	04	01	H9572_003_2	9	1	Preferred Generic	001000	
H9572	003	2	1	04	01	H9572_003_2	9	2	Non-Preferred Generic	000100	
H9572	003	2	1	04	01	H9572_003_2	9	3	Preferred Brand	000001	
H9572	003	2	1	04	01	H9572_003_2	9	5	Specialty Tier	010010	
H9572	003	2	1	04	01	H9572_003_2	9	4	Non-Preferred Brand	100000	
H9572	003	2	1	04	01	H9572_003_2	9	1	Preferred Generic	001000	1
H9572	003	3	1	04	01	H9572_003_3	9	2	Non-Preferred Generic	000100	
H9572	003	3	1	04	01	H9572_003_3	9	3	Preferred Brand	000001	
H9572	003	3	1	04	01	H9572_003_3	9	4	Non-Preferred Brand	100000	
H9572	003	3	1	04	01	H9572_003_3	9	5	Specialty Tier	010010	
H9572	003	3	1	04	01	H9572_003_3	9	1	Preferred Generic	001000	1
H9572	003	3	1	04	01	H9572_003_3	9	1	Preferred Generic	001000	
H9572	003	4	1	04	01	H9572_003_4	9	1	Preferred Generic	001000	
H9572	003	4	1	04	01	H9572_003_4	9	2	Non-Preferred Generic	000100	
H9572	003	4	1	04	01	H9572_003_4	9	3	Preferred Brand	000001	
H9572	003	4	1	04	01	H9572_003_4	9	4	Non-Preferred Brand	100000	
H9572	003	4	1	04	01	H9572_003_4	9	5	Specialty Tier	010010	
H9572	003	4	1	04	01	H9572_003_4	9	1	Preferred Generic	001000	1
H9572	003	6	1	04	01	H9572_003_6	9	1	Preferred Generic	001000	
H9572	003	6	1	04	01	H9572_003_6	9	2	Non-Preferred Generic	000100	
H9572	003	6	1	04	01	H9572_003_6	9	3	Preferred Brand	000001	
H9572	003	6	1	04	01	H9572_003_6	9	4	Non-Preferred Brand	100000	
H9572	003	6	1	04	01	H9572_003_6	9	5	Specialty Tier	010010	
H9572	003	6	1	04	01	H9572_003_6	9	1	Preferred Generic	001000	1
H9615	002	0	1	04	01	H9615_002_0	7	5	Select Care Drugs	010010	1
H9615	002	0	1	04	01	H9615_002_0	7	5	Select Care Drugs	010010	
H9615	002	0	1	04	01	H9615_002_0	7	4	Specialty Tier	010010	
H9615	002	0	1	04	01	H9615_002_0	7	3	Non-Preferred Brand	100100	
H9615	002	0	1	04	01	H9615_002_0	7	2	Preferred Brand	000001	
H9615	002	0	1	04	01	H9615_002_0	7	1	Preferred Generic	001000	
H9615	007	0	1	04	01	H9615_007_0	5	5	Select Care Drugs	010010	
H9615	007	0	1	04	01	H9615_007_0	5	5	Select Care Drugs	010010	1
H9615	007	0	1	04	01	H9615_007_0	5	4	Specialty Tier	010010	
H9615	007	0	1	04	01	H9615_007_0	5	3	Non-Preferred Brand	100100	
H9615	007	0	1	04	01	H9615_007_0	5	2	Preferred Brand	000001	
H9615	007	0	1	04	01	H9615_007_0	5	1	Preferred Generic	001000	
H9670	004	0	1	04	01	H9670_004_0	9	3	Non-Preferred Brand	100000	
H9670	004	0	1	04	01	H9670_004_0	9	4	Specialty Tier	010010	
H9670	004	0	1	04	01	H9670_004_0	9	5	Select Care Drugs	010000	
H9670	004	0	1	04	01	H9670_004_0	9	1	Generic	010000	
H9670	004	0	1	04	01	H9670_004_0	9	2	Preferred Brand	000001	
H9699	001	0	1	01	01	H9699_001_0	6	1	Preferred Generic	001000	
H9699	001	0	1	01	01	H9699_001_0	6	2	Non-Preferred Generic	000100	
H9699	001	0	1	01	01	H9699_001_0	6	3	Preferred Brand	000001	
H9699	001	0	1	01	01	H9699_001_0	6	4	Non-Preferred Brand	110000	
H9699	001	0	1	01	01	H9699_001_0	6	5	Specialty Tier	010010	
H9725	001	0	1	01	01	H9725_001_0	5	2	Non-Preferred Generic	000100	1
H9725	001	0	1	01	01	H9725_001_0	5	1	Preferred Generic	001000	
H9725	001	0	1	01	01	H9725_001_0	5	2	Non-Preferred Generic	000100	
H9725	001	0	1	01	01	H9725_001_0	5	3	Preferred Brand	000001	
H9725	001	0	1	01	01	H9725_001_0	5	4	Non-Preferred Brand	100100	
H9725	001	0	1	01	01	H9725_001_0	5	5	Specialty Tier	010010	
H9725	001	0	1	01	01	H9725_001_0	5	1	Preferred Generic	001000	1
H9730	001	0	1	01	01	H9730_001_0	3	1	Preferred Generic	001000	
H9730	001	0	1	01	01	H9730_001_0	3	2	Non-Preferred Generic	000100	
H9730	001	0	1	01	01	H9730_001_0	3	5	Specialty Tier	010010	
H9730	001	0	1	01	01	H9730_001_0	3	4	Non-Preferred Brand	110000	
H9730	001	0	1	01	01	H9730_001_0	3	3	Preferred Brand	010001	
H9730	002	0	1	02	01	H9730_002_0	3	1	Preferred Generic	001000	
H9730	002	0	1	02	01	H9730_002_0	3	4	Non-Preferred Brand	100000	
H9730	002	0	1	02	01	H9730_002_0	3	3	Preferred Brand	000001	
H9730	002	0	1	02	01	H9730_002_0	3	2	Non-Preferred Generic	000100	
H9730	002	0	1	02	01	H9730_002_0	3	5	Specialty Tier	010010	
H9834	001	0	1	01	01	H9834_001_0	4	3	Preferred Brand	000001	
H9834	001	0	1	01	01	H9834_001_0	4	4	Non-Preferred Brand	100000	
H9834	001	0	1	01	01	H9834_001_0	4	5	Specialty Tier	010010	
H9834	001	0	1	01	01	H9834_001_0	4	2	Non-Preferred Generic	000100	
H9834	001	0	1	01	01	H9834_001_0	4	1	Preferred Generic	001000	
H9834	003	0	1	01	01	H9834_003_0	7	3	Preferred Brand	000001	
H9834	003	0	1	01	01	H9834_003_0	7	4	Non-Preferred Brand	100000	
H9834	003	0	1	01	01	H9834_003_0	7	1	Preferred Generic	001000	
H9834	003	0	1	01	01	H9834_003_0	7	2	Non-Preferred Generic	000100	
H9834	003	0	1	01	01	H9834_003_0	7	5	Specialty Tier	010010	
H9847	001	0	1	04	01	H9847_001_0	9	2	Non-Preferred Generic	000100	
H9847	001	0	1	04	01	H9847_001_0	9	3	Preferred Brand	000001	
H9847	001	0	1	04	01	H9847_001_0	9	4	Non-Preferred Brand	100100	
H9847	001	0	1	04	01	H9847_001_0	9	5	Specialty Tier	010010	
H9847	001	0	1	04	01	H9847_001_0	9	1	Preferred Generic	001000	
H9847	005	0	1	04	01	H9847_005_0	10	2	Non-Preferred Generic	000100	
H9847	005	0	1	04	01	H9847_005_0	10	3	Preferred Brand	000001	
H9847	005	0	1	04	01	H9847_005_0	10	4	Non-Preferred Brand	100100	
H9847	005	0	1	04	01	H9847_005_0	10	5	Specialty Tier	010010	
H9847	005	0	1	04	01	H9847_005_0	10	1	Preferred Generic	001000	
H9857	001	0	1	01	01	H9857_001_0	4	2	Non-Preferred Generic	000100	
H9857	001	0	1	01	01	H9857_001_0	4	3	Preferred Brand	000001	
H9857	001	0	1	01	01	H9857_001_0	4	1	Preferred Generic	001000	
H9857	001	0	1	01	01	H9857_001_0	4	1	Preferred Generic	001000	1
H9857	001	0	1	01	01	H9857_001_0	4	5	Specialty Tier	010010	
H9857	001	0	1	01	01	H9857_001_0	4	4	Non-Preferred Brand	100000	
H9859	002	0	1	02	01	H9859_002_0	6	3	Non-Preferred Brand	100100	
H9859	002	0	1	02	01	H9859_002_0	6	4	Specialty Tier	010010	
H9859	002	0	1	02	01	H9859_002_0	6	5	Select Care Drugs	010010	
H9859	002	0	1	02	01	H9859_002_0	6	5	Select Care Drugs	010010	1
H9859	002	0	1	02	01	H9859_002_0	6	1	Preferred Generic	001000	
H9859	002	0	1	02	01	H9859_002_0	6	2	Preferred Brand	000001	
H9859	013	0	1	02	01	H9859_013_0	6	1	Preferred Generic	001000	
H9859	013	0	1	02	01	H9859_013_0	6	2	Preferred Brand	000001	
H9859	013	0	1	02	01	H9859_013_0	6	3	Non-Preferred Brand	100100	
H9859	013	0	1	02	01	H9859_013_0	6	4	Specialty Tier	010010	
H9859	013	0	1	02	01	H9859_013_0	6	5	Select Care Drugs	010010	1
H9859	013	0	1	02	01	H9859_013_0	6	5	Select Care Drugs	010010	
H9886	001	0	1	01	01	H9886_001_0	7	4	Non-Preferred Brand	100100	
H9886	001	0	1	01	01	H9886_001_0	7	3	Preferred Brand	000101	
H9886	001	0	1	01	01	H9886_001_0	7	2	Non-Preferred Generic	000100	
H9886	001	0	1	01	01	H9886_001_0	7	1	Preferred Generic	001000	
H9886	001	0	1	01	01	H9886_001_0	7	5	Injectable Drugs	010010	
H9886	001	0	1	01	01	H9886_001_0	7	6	Specialty Tier	010010	
H9915	001	0	1	01	01	H9915_001_0	4	1	Preferred Generic	001000	
H9915	001	0	1	01	01	H9915_001_0	4	5	Specialty Tier	010010	
H9915	001	0	1	01	01	H9915_001_0	4	3	Preferred Brand	000001	
H9915	001	0	1	01	01	H9915_001_0	4	4	Non-Preferred Brand	100000	
H9915	001	0	1	01	01	H9915_001_0	4	2	Non-Preferred Generic	000100	
H9947	001	0	1	04	01	H9947_001_0	7	5	Injectable Drugs	010010	
H9947	001	0	1	04	01	H9947_001_0	7	4	Non-Preferred Brand	100100	
H9947	001	0	1	04	01	H9947_001_0	7	3	Preferred Brand	000101	
H9947	001	0	1	04	01	H9947_001_0	7	2	Non-Preferred Generic	000100	
H9947	001	0	1	04	01	H9947_001_0	7	1	Preferred Generic	001000	
H9947	001	0	1	04	01	H9947_001_0	7	6	Specialty Tier	010010	
H9954	001	0	1	01	01	H9954_001_0	7	3	Preferred Brand	000101	
H9954	001	0	1	01	01	H9954_001_0	7	1	Preferred Generic	001000	
H9954	001	0	1	01	01	H9954_001_0	7	6	Specialty Tier	010010	
H9954	001	0	1	01	01	H9954_001_0	7	5	Injectable Drugs	010010	
H9954	001	0	1	01	01	H9954_001_0	7	4	Non-Preferred Brand	100100	
H9954	001	0	1	01	01	H9954_001_0	7	2	Non-Preferred Generic	000100	
R3332	001	0	1	31	11	R3332_001_0	8	2	Non-Preferred Generic	000100	
R3332	001	0	1	31	11	R3332_001_0	8	1	Preferred Generic	001000	
R3332	001	0	1	31	11	R3332_001_0	8	3	Preferred Brand	000001	
R3332	001	0	1	31	11	R3332_001_0	8	4	Non-Preferred Brand	110000	
R3332	001	0	1	31	11	R3332_001_0	8	5	Specialty Tier	101101	
R3444	009	0	1	31	11	R3444_009_0	5	2	Non-Preferred Generic	000100	
R3444	009	0	1	31	11	R3444_009_0	5	1	Preferred Generic	001000	
R3444	009	0	1	31	11	R3444_009_0	5	3	Preferred Brand	010001	
R3444	009	0	1	31	11	R3444_009_0	5	5	Specialty Tier	010010	
R3444	009	0	1	31	11	R3444_009_0	5	4	Non-Preferred Brand	100100	
R3444	012	0	1	31	11	R3444_012_0	5	1	Preferred Generic	001000	
R3444	012	0	1	31	11	R3444_012_0	5	2	Non-Preferred Generic	000100	
R3444	012	0	1	31	11	R3444_012_0	5	4	Non-Preferred Brand	100100	
R3444	012	0	1	31	11	R3444_012_0	5	3	Preferred Brand	010001	
R3444	012	0	1	31	11	R3444_012_0	5	5	Specialty Tier	010010	
R5287	001	0	1	31	11	R5287_001_0	5	2	Non-Preferred Generic	000100	
R5287	001	0	1	31	11	R5287_001_0	5	1	Preferred Generic	001000	
R5287	001	0	1	31	11	R5287_001_0	5	4	Non-Preferred Brand	100100	
R5287	001	0	1	31	11	R5287_001_0	5	5	Specialty Tier	010010	
R5287	001	0	1	31	11	R5287_001_0	5	3	Preferred Brand	010001	
R5342	001	0	1	31	11	R5342_001_0	6	5	Specialty Tier	010010	
R5342	001	0	1	31	11	R5342_001_0	6	4	Non-Preferred Brand	100100	
R5342	001	0	1	31	11	R5342_001_0	6	2	Non-Preferred Generic	000100	
R5342	001	0	1	31	11	R5342_001_0	6	1	Preferred Generic	001000	
R5342	001	0	1	31	11	R5342_001_0	6	3	Preferred Brand	010001	
R5826	001	0	1	31	11	R5826_001_0	6	2	Non-Preferred Generic	000101	
R5826	001	0	1	31	11	R5826_001_0	6	1	Preferred Generic	001010	
R5826	001	0	1	31	11	R5826_001_0	6	3	Preferred Brand	000101	
R5826	001	0	1	31	11	R5826_001_0	6	5	Specialty Tier	010010	
R5826	001	0	1	31	11	R5826_001_0	6	4	Non-Preferred Brand	110000	
R5826	002	0	1	31	11	R5826_002_0	3	1	Preferred Generic	001010	
R5826	002	0	1	31	11	R5826_002_0	3	2	Non-Preferred Generic	000101	
R5826	002	0	1	31	11	R5826_002_0	3	3	Preferred Brand	000101	
R5826	002	0	1	31	11	R5826_002_0	3	4	Non-Preferred Brand	110000	
R5826	002	0	1	31	11	R5826_002_0	3	5	Specialty Tier	010010	2
R5826	002	0	1	31	11	R5826_002_0	3	1	Preferred Generic	001010	2
R5826	002	0	1	31	11	R5826_002_0	3	2	Non-Preferred Generic	000101	2
R5826	002	0	1	31	11	R5826_002_0	3	4	Non-Preferred Brand	110000	2
R5826	002	0	1	31	11	R5826_002_0	3	3	Preferred Brand	000101	2
R5826	002	0	1	31	11	R5826_002_0	3	5	Specialty Tier	010010	
R5826	003	0	1	31	11	R5826_003_0	4	4	Non-Preferred Brand	110000	
R5826	003	0	1	31	11	R5826_003_0	4	3	Preferred Brand	000101	
R5826	003	0	1	31	11	R5826_003_0	4	2	Non-Preferred Generic	000101	
R5826	003	0	1	31	11	R5826_003_0	4	1	Preferred Generic	001010	
R5826	003	0	1	31	11	R5826_003_0	4	5	Specialty Tier	010010	
R5826	003	0	1	31	11	R5826_003_0	4	5	Specialty Tier	010010	2
R5826	003	0	1	31	11	R5826_003_0	4	4	Non-Preferred Brand	110000	2
R5826	003	0	1	31	11	R5826_003_0	4	3	Preferred Brand	000101	2
R5826	003	0	1	31	11	R5826_003_0	4	2	Non-Preferred Generic	000101	2
R5826	003	0	1	31	11	R5826_003_0	4	1	Preferred Generic	001010	2
R5826	005	0	1	31	11	R5826_005_0	4	2	Non-Preferred Generic	000101	
R5826	005	0	1	31	11	R5826_005_0	4	1	Preferred Generic	001010	
R5826	005	0	1	31	11	R5826_005_0	4	3	Preferred Brand	000101	
R5826	005	0	1	31	11	R5826_005_0	4	4	Non-Preferred Brand	110000	
R5826	005	0	1	31	11	R5826_005_0	4	5	Specialty Tier	010010	2
R5826	005	0	1	31	11	R5826_005_0	4	1	Preferred Generic	001010	2
R5826	005	0	1	31	11	R5826_005_0	4	2	Non-Preferred Generic	000101	2
R5826	005	0	1	31	11	R5826_005_0	4	3	Preferred Brand	000101	2
R5826	005	0	1	31	11	R5826_005_0	4	4	Non-Preferred Brand	110000	2
R5826	005	0	1	31	11	R5826_005_0	4	5	Specialty Tier	010010	
R5826	007	0	1	31	11	R5826_007_0	3	2	Non-Preferred Generic	000101	
R5826	007	0	1	31	11	R5826_007_0	3	1	Preferred Generic	001010	
R5826	007	0	1	31	11	R5826_007_0	3	3	Preferred Brand	000101	
R5826	007	0	1	31	11	R5826_007_0	3	5	Specialty Tier	010010	
R5826	007	0	1	31	11	R5826_007_0	3	4	Non-Preferred Brand	110000	
R5826	008	0	1	31	11	R5826_008_0	3	1	Preferred Generic	001010	
R5826	008	0	1	31	11	R5826_008_0	3	2	Non-Preferred Generic	000101	
R5826	008	0	1	31	11	R5826_008_0	3	3	Preferred Brand	000101	
R5826	008	0	1	31	11	R5826_008_0	3	4	Non-Preferred Brand	110000	
R5826	008	0	1	31	11	R5826_008_0	3	5	Specialty Tier	010010	2
R5826	008	0	1	31	11	R5826_008_0	3	3	Preferred Brand	000101	2
R5826	008	0	1	31	11	R5826_008_0	3	2	Non-Preferred Generic	000101	2
R5826	008	0	1	31	11	R5826_008_0	3	5	Specialty Tier	010010	
R5826	008	0	1	31	11	R5826_008_0	3	1	Preferred Generic	001010	2
R5826	008	0	1	31	11	R5826_008_0	3	4	Non-Preferred Brand	110000	2
R5826	011	0	1	31	11	R5826_011_0	4	5	Specialty Tier	010010	
R5826	011	0	1	31	11	R5826_011_0	4	1	Preferred Generic	001010	2
R5826	011	0	1	31	11	R5826_011_0	4	2	Non-Preferred Generic	000101	2
R5826	011	0	1	31	11	R5826_011_0	4	3	Preferred Brand	000101	2
R5826	011	0	1	31	11	R5826_011_0	4	4	Non-Preferred Brand	110000	2
R5826	011	0	1	31	11	R5826_011_0	4	5	Specialty Tier	010010	2
R5826	011	0	1	31	11	R5826_011_0	4	1	Preferred Generic	001010	
R5826	011	0	1	31	11	R5826_011_0	4	2	Non-Preferred Generic	000101	
R5826	011	0	1	31	11	R5826_011_0	4	3	Preferred Brand	000101	
R5826	011	0	1	31	11	R5826_011_0	4	4	Non-Preferred Brand	110000	
R5826	012	0	1	31	11	R5826_012_0	8	5	Specialty Tier	010010	
R5826	012	0	1	31	11	R5826_012_0	8	1	Preferred Generic	001010	2
R5826	012	0	1	31	11	R5826_012_0	8	2	Non-Preferred Generic	000101	2
R5826	012	0	1	31	11	R5826_012_0	8	3	Preferred Brand	000101	2
R5826	012	0	1	31	11	R5826_012_0	8	4	Non-Preferred Brand	110000	2
R5826	012	0	1	31	11	R5826_012_0	8	5	Specialty Tier	010010	2
R5826	012	0	1	31	11	R5826_012_0	8	1	Preferred Generic	001010	
R5826	012	0	1	31	11	R5826_012_0	8	2	Non-Preferred Generic	000101	
R5826	012	0	1	31	11	R5826_012_0	8	3	Preferred Brand	000101	
R5826	012	0	1	31	11	R5826_012_0	8	4	Non-Preferred Brand	110000	
R5826	014	0	1	31	11	R5826_014_0	6	4	Non-Preferred Brand	110000	
R5826	014	0	1	31	11	R5826_014_0	6	5	Specialty Tier	010010	
R5826	014	0	1	31	11	R5826_014_0	6	1	Preferred Generic	001010	
R5826	014	0	1	31	11	R5826_014_0	6	2	Non-Preferred Generic	000101	
R5826	014	0	1	31	11	R5826_014_0	6	3	Preferred Brand	000101	
R5826	074	0	1	31	11	R5826_074_0	4	5	Specialty Tier	010010	
R5826	074	0	1	31	11	R5826_074_0	4	4	Non-Preferred Brand	110000	
R5826	074	0	1	31	11	R5826_074_0	4	3	Preferred Brand	000101	
R5826	074	0	1	31	11	R5826_074_0	4	2	Non-Preferred Generic	000101	2
R5826	074	0	1	31	11	R5826_074_0	4	3	Preferred Brand	000101	2
R5826	074	0	1	31	11	R5826_074_0	4	4	Non-Preferred Brand	110000	2
R5826	074	0	1	31	11	R5826_074_0	4	5	Specialty Tier	010010	2
R5826	074	0	1	31	11	R5826_074_0	4	1	Preferred Generic	001010	2
R5826	074	0	1	31	11	R5826_074_0	4	2	Non-Preferred Generic	000101	
R5826	074	0	1	31	11	R5826_074_0	4	1	Preferred Generic	001010	
R5826	077	0	1	31	11	R5826_077_0	6	4	Non-Preferred Brand	110000	
R5826	077	0	1	31	11	R5826_077_0	6	5	Specialty Tier	010010	
R5826	077	0	1	31	11	R5826_077_0	6	3	Preferred Brand	000101	
R5826	077	0	1	31	11	R5826_077_0	6	2	Non-Preferred Generic	000101	
R5826	077	0	1	31	11	R5826_077_0	6	1	Preferred Generic	001010	
R5826	091	0	1	31	11	R5826_091_0	4	4	Non-Preferred Brand	110000	
R5826	091	0	1	31	11	R5826_091_0	4	5	Specialty Tier	010010	
R5826	091	0	1	31	11	R5826_091_0	4	3	Preferred Brand	000101	
R5826	091	0	1	31	11	R5826_091_0	4	2	Non-Preferred Generic	000101	
R5826	091	0	1	31	11	R5826_091_0	4	1	Preferred Generic	001010	
R5941	008	0	1	31	11	R5941_008_0	8	2	Non-Preferred Generic	000100	
R5941	008	0	1	31	11	R5941_008_0	8	1	Preferred Generic	001000	
R5941	008	0	1	31	11	R5941_008_0	8	3	Preferred Brand	000101	
R5941	008	0	1	31	11	R5941_008_0	8	4	Non-Preferred Brand	100100	
R5941	008	0	1	31	11	R5941_008_0	8	5	Injectable Drugs	010010	
R5941	008	0	1	31	11	R5941_008_0	8	6	Specialty Tier	010010	
R5941	009	0	1	31	11	R5941_009_0	8	6	Specialty Tier	010010	
R5941	009	0	1	31	11	R5941_009_0	8	4	Non-Preferred Brand	100100	
R5941	009	0	1	31	11	R5941_009_0	8	3	Preferred Brand	000101	
R5941	009	0	1	31	11	R5941_009_0	8	2	Non-Preferred Generic	000100	
R5941	009	0	1	31	11	R5941_009_0	8	5	Injectable Drugs	010010	
R5941	009	0	1	31	11	R5941_009_0	8	1	Preferred Generic	001000	
R6801	009	0	1	31	11	R6801_009_0	5	1	Preferred Generic	001000	
R6801	009	0	1	31	11	R6801_009_0	5	2	Non-Preferred Generic	000100	
R6801	009	0	1	31	11	R6801_009_0	5	3	Preferred Brand	010001	
R6801	009	0	1	31	11	R6801_009_0	5	4	Non-Preferred Brand	100100	
R6801	009	0	1	31	11	R6801_009_0	5	5	Specialty Tier	010010	
R6801	012	0	1	31	11	R6801_012_0	5	1	Preferred Generic	001000	
R6801	012	0	1	31	11	R6801_012_0	5	2	Non-Preferred Generic	000100	
R6801	012	0	1	31	11	R6801_012_0	5	3	Preferred Brand	010001	
R6801	012	0	1	31	11	R6801_012_0	5	4	Non-Preferred Brand	100100	
R6801	012	0	1	31	11	R6801_012_0	5	5	Specialty Tier	010010	
R7439	001	0	1	31	11	R7439_001_0	10	2	Preferred Brand	000001	
R7439	001	0	1	31	11	R7439_001_0	10	4	Specialty Tier	010010	
R7439	001	0	1	31	11	R7439_001_0	10	3	Non-Preferred Brand	100000	
R7439	001	0	1	31	11	R7439_001_0	10	1	Generic	010000	
R7439	003	0	1	31	11	R7439_003_0	9	4	Specialty Tier	010010	
R7439	003	0	1	31	11	R7439_003_0	9	1	Generic	010000	
R7439	003	0	1	31	11	R7439_003_0	9	3	Non-Preferred Brand	100000	
R7439	003	0	1	31	11	R7439_003_0	9	1	Generic	010000	2
R7439	003	0	1	31	11	R7439_003_0	9	2	Preferred Brand	000001	
R7444	001	0	1	31	11	R7444_001_0	6	1	Preferred Generic	001000	
R7444	001	0	1	31	11	R7444_001_0	6	3	Preferred Brand	010001	
R7444	001	0	1	31	11	R7444_001_0	6	4	Non-Preferred Brand	100100	
R7444	001	0	1	31	11	R7444_001_0	6	2	Non-Preferred Generic	000100	
R7444	001	0	1	31	11	R7444_001_0	6	5	Specialty Tier	010010	
R9896	009	0	1	31	11	R9896_009_0	6	1	Preferred Generic	001000	
R9896	009	0	1	31	11	R9896_009_0	6	2	Non-Preferred Generic	000100	
R9896	009	0	1	31	11	R9896_009_0	6	3	Preferred Brand	010001	
R9896	009	0	1	31	11	R9896_009_0	6	4	Non-Preferred Brand	100100	
R9896	009	0	1	31	11	R9896_009_0	6	5	Specialty Tier	010010	
R9896	012	0	1	31	11	R9896_012_0	6	1	Preferred Generic	001000	
R9896	012	0	1	31	11	R9896_012_0	6	2	Non-Preferred Generic	000100	
R9896	012	0	1	31	11	R9896_012_0	6	3	Preferred Brand	010001	
R9896	012	0	1	31	11	R9896_012_0	6	4	Non-Preferred Brand	100100	
R9896	012	0	1	31	11	R9896_012_0	6	5	Specialty Tier	010010	
S0064	001	0		29	10	S0064_001_0	1	4	Non-Preferred Brand	100000	
S0064	001	0		29	10	S0064_001_0	1	3	Preferred Brand	010001	
S0064	001	0		29	10	S0064_001_0	1	1	Preferred Generic	001000	
S0064	001	0		29	10	S0064_001_0	1	2	Non-Preferred Generic	000100	
S0064	001	0		29	10	S0064_001_0	1	5	Specialty Tier	010010	
S0064	002	0		29	10	S0064_002_0	1	4	Non-Preferred Brand	100000	
S0064	002	0		29	10	S0064_002_0	1	3	Preferred Brand	010001	
S0064	002	0		29	10	S0064_002_0	1	2	Non-Preferred Generic	000100	
S0064	002	0		29	10	S0064_002_0	1	1	Preferred Generic	001000	
S0064	002	0		29	10	S0064_002_0	1	5	Specialty Tier	010010	
S0064	003	0		29	10	S0064_003_0	1	1	Preferred Generic	001000	
S0064	003	0		29	10	S0064_003_0	1	2	Non-Preferred Generic	000100	
S0064	003	0		29	10	S0064_003_0	1	3	Preferred Brand	010001	
S0064	003	0		29	10	S0064_003_0	1	4	Non-Preferred Brand	100000	
S0064	003	0		29	10	S0064_003_0	1	5	Specialty Tier	010010	
S0064	004	0		29	10	S0064_004_0	1	1	Preferred Generic	001000	
S0064	004	0		29	10	S0064_004_0	1	2	Non-Preferred Generic	000100	
S0064	004	0		29	10	S0064_004_0	1	3	Preferred Brand	010001	
S0064	004	0		29	10	S0064_004_0	1	4	Non-Preferred Brand	100000	
S0064	004	0		29	10	S0064_004_0	1	5	Specialty Tier	010010	
S0064	005	0		29	10	S0064_005_0	1	2	Non-Preferred Generic	000100	
S0064	005	0		29	10	S0064_005_0	1	1	Preferred Generic	001000	
S0064	005	0		29	10	S0064_005_0	1	3	Preferred Brand	010001	
S0064	005	0		29	10	S0064_005_0	1	5	Specialty Tier	010010	
S0064	005	0		29	10	S0064_005_0	1	4	Non-Preferred Brand	100000	
S0064	006	0		29	10	S0064_006_0	1	4	Non-Preferred Brand	100000	
S0064	006	0		29	10	S0064_006_0	1	3	Preferred Brand	010001	
S0064	006	0		29	10	S0064_006_0	1	2	Non-Preferred Generic	000100	
S0064	006	0		29	10	S0064_006_0	1	1	Preferred Generic	001000	
S0064	006	0		29	10	S0064_006_0	1	5	Specialty Tier	010010	
S0064	007	0		29	10	S0064_007_0	1	4	Non-Preferred Brand	100000	
S0064	007	0		29	10	S0064_007_0	1	3	Preferred Brand	010001	
S0064	007	0		29	10	S0064_007_0	1	2	Non-Preferred Generic	000100	
S0064	007	0		29	10	S0064_007_0	1	1	Preferred Generic	001000	
S0064	007	0		29	10	S0064_007_0	1	5	Specialty Tier	010010	
S0064	008	0		29	10	S0064_008_0	1	1	Preferred Generic	001000	
S0064	008	0		29	10	S0064_008_0	1	2	Non-Preferred Generic	000100	
S0064	008	0		29	10	S0064_008_0	1	3	Preferred Brand	010001	
S0064	008	0		29	10	S0064_008_0	1	4	Non-Preferred Brand	100000	
S0064	008	0		29	10	S0064_008_0	1	5	Specialty Tier	010010	
S0064	009	0		29	10	S0064_009_0	1	1	Preferred Generic	001000	
S0064	009	0		29	10	S0064_009_0	1	2	Non-Preferred Generic	000100	
S0064	009	0		29	10	S0064_009_0	1	4	Non-Preferred Brand	100000	
S0064	009	0		29	10	S0064_009_0	1	3	Preferred Brand	010001	
S0064	009	0		29	10	S0064_009_0	1	5	Specialty Tier	010010	
S0064	010	0		29	10	S0064_010_0	1	4	Non-Preferred Brand	100000	
S0064	010	0		29	10	S0064_010_0	1	1	Preferred Generic	001000	
S0064	010	0		29	10	S0064_010_0	1	2	Non-Preferred Generic	000100	
S0064	010	0		29	10	S0064_010_0	1	3	Preferred Brand	010001	
S0064	010	0		29	10	S0064_010_0	1	5	Specialty Tier	010010	
S0064	011	0		29	10	S0064_011_0	1	4	Non-Preferred Brand	100000	
S0064	011	0		29	10	S0064_011_0	1	3	Preferred Brand	010001	
S0064	011	0		29	10	S0064_011_0	1	2	Non-Preferred Generic	000100	
S0064	011	0		29	10	S0064_011_0	1	1	Preferred Generic	001000	
S0064	011	0		29	10	S0064_011_0	1	5	Specialty Tier	010010	
S0064	012	0		29	10	S0064_012_0	2	1	Preferred Generic	001000	
S0064	012	0		29	10	S0064_012_0	2	2	Non-Preferred Generic	000100	
S0064	012	0		29	10	S0064_012_0	2	3	Preferred Brand	010001	
S0064	012	0		29	10	S0064_012_0	2	4	Non-Preferred Brand	100000	
S0064	012	0		29	10	S0064_012_0	2	5	Specialty Tier	010010	
S0064	013	0		29	10	S0064_013_0	1	1	Preferred Generic	001000	
S0064	013	0		29	10	S0064_013_0	1	2	Non-Preferred Generic	000100	
S0064	013	0		29	10	S0064_013_0	1	3	Preferred Brand	010001	
S0064	013	0		29	10	S0064_013_0	1	4	Non-Preferred Brand	100000	
S0064	013	0		29	10	S0064_013_0	1	5	Specialty Tier	010010	
S0064	014	0		29	10	S0064_014_0	1	4	Non-Preferred Brand	100000	
S0064	014	0		29	10	S0064_014_0	1	3	Preferred Brand	010001	
S0064	014	0		29	10	S0064_014_0	1	2	Non-Preferred Generic	000100	
S0064	014	0		29	10	S0064_014_0	1	1	Preferred Generic	001000	
S0064	014	0		29	10	S0064_014_0	1	5	Specialty Tier	010010	
S0064	015	0		29	10	S0064_015_0	1	2	Non-Preferred Generic	000100	
S0064	015	0		29	10	S0064_015_0	1	1	Preferred Generic	001000	
S0064	015	0		29	10	S0064_015_0	1	3	Preferred Brand	010001	
S0064	015	0		29	10	S0064_015_0	1	4	Non-Preferred Brand	100000	
S0064	015	0		29	10	S0064_015_0	1	5	Specialty Tier	010010	
S0064	016	0		29	10	S0064_016_0	1	1	Preferred Generic	001000	
S0064	016	0		29	10	S0064_016_0	1	2	Non-Preferred Generic	000100	
S0064	016	0		29	10	S0064_016_0	1	3	Preferred Brand	010001	
S0064	016	0		29	10	S0064_016_0	1	4	Non-Preferred Brand	100000	
S0064	016	0		29	10	S0064_016_0	1	5	Specialty Tier	010010	
S0064	017	0		29	10	S0064_017_0	1	2	Non-Preferred Generic	000100	
S0064	017	0		29	10	S0064_017_0	1	1	Preferred Generic	001000	
S0064	017	0		29	10	S0064_017_0	1	3	Preferred Brand	010001	
S0064	017	0		29	10	S0064_017_0	1	5	Specialty Tier	010010	
S0064	017	0		29	10	S0064_017_0	1	4	Non-Preferred Brand	100000	
S0064	018	0		29	10	S0064_018_0	1	1	Preferred Generic	001000	
S0064	018	0		29	10	S0064_018_0	1	2	Non-Preferred Generic	000100	
S0064	018	0		29	10	S0064_018_0	1	3	Preferred Brand	010001	
S0064	018	0		29	10	S0064_018_0	1	4	Non-Preferred Brand	100000	
S0064	018	0		29	10	S0064_018_0	1	5	Specialty Tier	010010	
S0064	019	0		29	10	S0064_019_0	1	1	Preferred Generic	001000	
S0064	019	0		29	10	S0064_019_0	1	2	Non-Preferred Generic	000100	
S0064	019	0		29	10	S0064_019_0	1	4	Non-Preferred Brand	100000	
S0064	019	0		29	10	S0064_019_0	1	3	Preferred Brand	010001	
S0064	019	0		29	10	S0064_019_0	1	5	Specialty Tier	010010	
S0064	020	0		29	10	S0064_020_0	1	5	Specialty Tier	010010	
S0064	020	0		29	10	S0064_020_0	1	4	Non-Preferred Brand	100000	
S0064	020	0		29	10	S0064_020_0	1	3	Preferred Brand	010001	
S0064	020	0		29	10	S0064_020_0	1	1	Preferred Generic	001000	
S0064	020	0		29	10	S0064_020_0	1	2	Non-Preferred Generic	000100	
S0064	021	0		29	10	S0064_021_0	1	1	Preferred Generic	001000	
S0064	021	0		29	10	S0064_021_0	1	5	Specialty Tier	010010	
S0064	021	0		29	10	S0064_021_0	1	4	Non-Preferred Brand	100000	
S0064	021	0		29	10	S0064_021_0	1	3	Preferred Brand	010001	
S0064	021	0		29	10	S0064_021_0	1	2	Non-Preferred Generic	000100	
S0064	022	0		29	10	S0064_022_0	1	5	Specialty Tier	010010	
S0064	022	0		29	10	S0064_022_0	1	4	Non-Preferred Brand	100000	
S0064	022	0		29	10	S0064_022_0	1	3	Preferred Brand	010001	
S0064	022	0		29	10	S0064_022_0	1	1	Preferred Generic	001000	
S0064	022	0		29	10	S0064_022_0	1	2	Non-Preferred Generic	000100	
S0064	023	0		29	10	S0064_023_0	1	3	Preferred Brand	010001	
S0064	023	0		29	10	S0064_023_0	1	1	Preferred Generic	001000	
S0064	023	0		29	10	S0064_023_0	1	5	Specialty Tier	010010	
S0064	023	0		29	10	S0064_023_0	1	4	Non-Preferred Brand	100000	
S0064	023	0		29	10	S0064_023_0	1	2	Non-Preferred Generic	000100	
S0064	024	0		29	10	S0064_024_0	1	4	Non-Preferred Brand	100000	
S0064	024	0		29	10	S0064_024_0	1	3	Preferred Brand	010001	
S0064	024	0		29	10	S0064_024_0	1	2	Non-Preferred Generic	000100	
S0064	024	0		29	10	S0064_024_0	1	1	Preferred Generic	001000	
S0064	024	0		29	10	S0064_024_0	1	5	Specialty Tier	010010	
S0064	025	0		29	10	S0064_025_0	1	2	Non-Preferred Generic	000100	
S0064	025	0		29	10	S0064_025_0	1	1	Preferred Generic	001000	
S0064	025	0		29	10	S0064_025_0	1	3	Preferred Brand	010001	
S0064	025	0		29	10	S0064_025_0	1	4	Non-Preferred Brand	100000	
S0064	025	0		29	10	S0064_025_0	1	5	Specialty Tier	010010	
S0064	026	0		29	10	S0064_026_0	1	1	Preferred Generic	001000	
S0064	026	0		29	10	S0064_026_0	1	2	Non-Preferred Generic	000100	
S0064	026	0		29	10	S0064_026_0	1	3	Preferred Brand	010001	
S0064	026	0		29	10	S0064_026_0	1	4	Non-Preferred Brand	100000	
S0064	026	0		29	10	S0064_026_0	1	5	Specialty Tier	010010	
S0064	027	0		29	10	S0064_027_0	1	2	Non-Preferred Generic	000100	
S0064	027	0		29	10	S0064_027_0	1	1	Preferred Generic	001000	
S0064	027	0		29	10	S0064_027_0	1	3	Preferred Brand	010001	
S0064	027	0		29	10	S0064_027_0	1	5	Specialty Tier	010010	
S0064	027	0		29	10	S0064_027_0	1	4	Non-Preferred Brand	100000	
S0064	028	0		29	10	S0064_028_0	1	1	Preferred Generic	001000	
S0064	028	0		29	10	S0064_028_0	1	2	Non-Preferred Generic	000100	
S0064	028	0		29	10	S0064_028_0	1	3	Preferred Brand	010001	
S0064	028	0		29	10	S0064_028_0	1	4	Non-Preferred Brand	100000	
S0064	028	0		29	10	S0064_028_0	1	5	Specialty Tier	010010	
S0064	029	0		29	10	S0064_029_0	1	1	Preferred Generic	001000	
S0064	029	0		29	10	S0064_029_0	1	2	Non-Preferred Generic	000100	
S0064	029	0		29	10	S0064_029_0	1	4	Non-Preferred Brand	100000	
S0064	029	0		29	10	S0064_029_0	1	3	Preferred Brand	010001	
S0064	029	0		29	10	S0064_029_0	1	5	Specialty Tier	010010	
S0064	030	0		29	10	S0064_030_0	1	2	Non-Preferred Generic	000100	
S0064	030	0		29	10	S0064_030_0	1	4	Non-Preferred Brand	100000	
S0064	030	0		29	10	S0064_030_0	1	3	Preferred Brand	010001	
S0064	030	0		29	10	S0064_030_0	1	1	Preferred Generic	001000	
S0064	030	0		29	10	S0064_030_0	1	5	Specialty Tier	010010	
S0064	031	0		29	10	S0064_031_0	1	4	Non-Preferred Brand	100000	
S0064	031	0		29	10	S0064_031_0	1	1	Preferred Generic	001000	
S0064	031	0		29	10	S0064_031_0	1	2	Non-Preferred Generic	000100	
S0064	031	0		29	10	S0064_031_0	1	3	Preferred Brand	010001	
S0064	031	0		29	10	S0064_031_0	1	5	Specialty Tier	010010	
S0064	032	0		29	10	S0064_032_0	1	5	Specialty Tier	010010	
S0064	032	0		29	10	S0064_032_0	1	4	Non-Preferred Brand	100000	
S0064	032	0		29	10	S0064_032_0	1	1	Preferred Generic	001000	
S0064	032	0		29	10	S0064_032_0	1	2	Non-Preferred Generic	000100	
S0064	032	0		29	10	S0064_032_0	1	3	Preferred Brand	010001	
S0064	033	0		29	10	S0064_033_0	1	5	Specialty Tier	010010	
S0064	033	0		29	10	S0064_033_0	1	4	Non-Preferred Brand	100000	
S0064	033	0		29	10	S0064_033_0	1	2	Non-Preferred Generic	000100	
S0064	033	0		29	10	S0064_033_0	1	3	Preferred Brand	010001	
S0064	033	0		29	10	S0064_033_0	1	1	Preferred Generic	001000	
S0064	034	0		29	10	S0064_034_0	1	2	Non-Preferred Generic	000100	
S0064	034	0		29	10	S0064_034_0	1	3	Preferred Brand	010001	
S0064	034	0		29	10	S0064_034_0	1	4	Non-Preferred Brand	100000	
S0064	034	0		29	10	S0064_034_0	1	5	Specialty Tier	010010	
S0064	034	0		29	10	S0064_034_0	1	1	Preferred Generic	001000	
S0064	035	0		29	10	S0064_035_0	1	2	Non-Preferred Generic	000100	
S0064	035	0		29	10	S0064_035_0	1	3	Preferred Brand	010001	
S0064	035	0		29	10	S0064_035_0	1	4	Non-Preferred Brand	100000	
S0064	035	0		29	10	S0064_035_0	1	5	Specialty Tier	010010	
S0064	035	0		29	10	S0064_035_0	1	1	Preferred Generic	001000	
S0064	036	0		29	10	S0064_036_0	1	1	Preferred Generic	001000	
S0064	036	0		29	10	S0064_036_0	1	2	Non-Preferred Generic	000100	
S0064	036	0		29	10	S0064_036_0	1	1	Preferred Generic	001000	1
S0064	036	0		29	10	S0064_036_0	1	5	Specialty Tier	010010	
S0064	036	0		29	10	S0064_036_0	1	4	Non-Preferred Brand	100000	
S0064	036	0		29	10	S0064_036_0	1	3	Preferred Brand	010001	
S0064	037	0		29	10	S0064_037_0	1	2	Non-Preferred Generic	000100	
S0064	037	0		29	10	S0064_037_0	1	1	Preferred Generic	001000	
S0064	037	0		29	10	S0064_037_0	1	3	Preferred Brand	010001	
S0064	037	0		29	10	S0064_037_0	1	4	Non-Preferred Brand	100000	
S0064	037	0		29	10	S0064_037_0	1	5	Specialty Tier	010010	
S0064	037	0		29	10	S0064_037_0	1	1	Preferred Generic	001000	1
S0064	038	0		29	10	S0064_038_0	1	2	Non-Preferred Generic	000100	
S0064	038	0		29	10	S0064_038_0	1	1	Preferred Generic	001000	
S0064	038	0		29	10	S0064_038_0	1	3	Preferred Brand	010001	
S0064	038	0		29	10	S0064_038_0	1	1	Preferred Generic	001000	1
S0064	038	0		29	10	S0064_038_0	1	5	Specialty Tier	010010	
S0064	038	0		29	10	S0064_038_0	1	4	Non-Preferred Brand	100000	
S0064	039	0		29	10	S0064_039_0	1	4	Non-Preferred Brand	100000	
S0064	039	0		29	10	S0064_039_0	1	3	Preferred Brand	010001	
S0064	039	0		29	10	S0064_039_0	1	5	Specialty Tier	010010	
S0064	039	0		29	10	S0064_039_0	1	1	Preferred Generic	001000	
S0064	039	0		29	10	S0064_039_0	1	2	Non-Preferred Generic	000100	
S0064	039	0		29	10	S0064_039_0	1	1	Preferred Generic	001000	1
S0064	040	0		29	10	S0064_040_0	1	1	Preferred Generic	001000	
S0064	040	0		29	10	S0064_040_0	1	2	Non-Preferred Generic	000100	
S0064	040	0		29	10	S0064_040_0	1	3	Preferred Brand	010001	
S0064	040	0		29	10	S0064_040_0	1	1	Preferred Generic	001000	1
S0064	040	0		29	10	S0064_040_0	1	5	Specialty Tier	010010	
S0064	040	0		29	10	S0064_040_0	1	4	Non-Preferred Brand	100000	
S0064	041	0		29	10	S0064_041_0	1	3	Preferred Brand	010001	
S0064	041	0		29	10	S0064_041_0	1	2	Non-Preferred Generic	000100	
S0064	041	0		29	10	S0064_041_0	1	5	Specialty Tier	010010	
S0064	041	0		29	10	S0064_041_0	1	4	Non-Preferred Brand	100000	
S0064	041	0		29	10	S0064_041_0	1	1	Preferred Generic	001000	
S0064	041	0		29	10	S0064_041_0	1	1	Preferred Generic	001000	1
S0064	042	0		29	10	S0064_042_0	1	5	Specialty Tier	010010	
S0064	042	0		29	10	S0064_042_0	1	4	Non-Preferred Brand	100000	
S0064	042	0		29	10	S0064_042_0	1	2	Non-Preferred Generic	000100	
S0064	042	0		29	10	S0064_042_0	1	3	Preferred Brand	010001	
S0064	042	0		29	10	S0064_042_0	1	1	Preferred Generic	001000	
S0064	042	0		29	10	S0064_042_0	1	1	Preferred Generic	001000	1
S0064	043	0		29	10	S0064_043_0	1	5	Specialty Tier	010010	
S0064	043	0		29	10	S0064_043_0	1	4	Non-Preferred Brand	100000	
S0064	043	0		29	10	S0064_043_0	1	3	Preferred Brand	010001	
S0064	043	0		29	10	S0064_043_0	1	1	Preferred Generic	001000	
S0064	043	0		29	10	S0064_043_0	1	1	Preferred Generic	001000	1
S0064	043	0		29	10	S0064_043_0	1	2	Non-Preferred Generic	000100	
S0064	044	0		29	10	S0064_044_0	1	1	Preferred Generic	001000	1
S0064	044	0		29	10	S0064_044_0	1	5	Specialty Tier	010010	
S0064	044	0		29	10	S0064_044_0	1	3	Preferred Brand	010001	
S0064	044	0		29	10	S0064_044_0	1	4	Non-Preferred Brand	100000	
S0064	044	0		29	10	S0064_044_0	1	2	Non-Preferred Generic	000100	
S0064	044	0		29	10	S0064_044_0	1	1	Preferred Generic	001000	
S0064	045	0		29	10	S0064_045_0	1	1	Preferred Generic	001000	
S0064	045	0		29	10	S0064_045_0	1	2	Non-Preferred Generic	000100	
S0064	045	0		29	10	S0064_045_0	1	3	Preferred Brand	010001	
S0064	045	0		29	10	S0064_045_0	1	1	Preferred Generic	001000	1
S0064	045	0		29	10	S0064_045_0	1	5	Specialty Tier	010010	
S0064	045	0		29	10	S0064_045_0	1	4	Non-Preferred Brand	100000	
S0064	046	0		29	10	S0064_046_0	1	1	Preferred Generic	001000	
S0064	046	0		29	10	S0064_046_0	1	1	Preferred Generic	001000	1
S0064	046	0		29	10	S0064_046_0	1	3	Preferred Brand	010001	
S0064	046	0		29	10	S0064_046_0	1	2	Non-Preferred Generic	000100	
S0064	046	0		29	10	S0064_046_0	1	5	Specialty Tier	010010	
S0064	046	0		29	10	S0064_046_0	1	4	Non-Preferred Brand	100000	
S0064	047	0		29	10	S0064_047_0	1	2	Non-Preferred Generic	000100	
S0064	047	0		29	10	S0064_047_0	1	1	Preferred Generic	001000	
S0064	047	0		29	10	S0064_047_0	1	3	Preferred Brand	010001	
S0064	047	0		29	10	S0064_047_0	1	4	Non-Preferred Brand	100000	
S0064	047	0		29	10	S0064_047_0	1	5	Specialty Tier	010010	
S0064	047	0		29	10	S0064_047_0	1	1	Preferred Generic	001000	1
S0064	048	0		29	10	S0064_048_0	1	2	Non-Preferred Generic	000100	
S0064	048	0		29	10	S0064_048_0	1	1	Preferred Generic	001000	
S0064	048	0		29	10	S0064_048_0	1	3	Preferred Brand	010001	
S0064	048	0		29	10	S0064_048_0	1	1	Preferred Generic	001000	1
S0064	048	0		29	10	S0064_048_0	1	5	Specialty Tier	010010	
S0064	048	0		29	10	S0064_048_0	1	4	Non-Preferred Brand	100000	
S0064	049	0		29	10	S0064_049_0	1	1	Preferred Generic	001000	
S0064	049	0		29	10	S0064_049_0	1	2	Non-Preferred Generic	000100	
S0064	049	0		29	10	S0064_049_0	1	4	Non-Preferred Brand	100000	
S0064	049	0		29	10	S0064_049_0	1	5	Specialty Tier	010010	
S0064	049	0		29	10	S0064_049_0	1	3	Preferred Brand	010001	
S0064	049	0		29	10	S0064_049_0	1	1	Preferred Generic	001000	1
S0064	050	0		29	10	S0064_050_0	1	1	Preferred Generic	001000	1
S0064	050	0		29	10	S0064_050_0	1	1	Preferred Generic	001000	
S0064	050	0		29	10	S0064_050_0	1	4	Non-Preferred Brand	100000	
S0064	050	0		29	10	S0064_050_0	1	3	Preferred Brand	010001	
S0064	050	0		29	10	S0064_050_0	1	2	Non-Preferred Generic	000100	
S0064	050	0		29	10	S0064_050_0	1	5	Specialty Tier	010010	
S0064	051	0		29	10	S0064_051_0	1	1	Preferred Generic	001000	
S0064	051	0		29	10	S0064_051_0	1	2	Non-Preferred Generic	000100	
S0064	051	0		29	10	S0064_051_0	1	3	Preferred Brand	010001	
S0064	051	0		29	10	S0064_051_0	1	4	Non-Preferred Brand	100000	
S0064	051	0		29	10	S0064_051_0	1	1	Preferred Generic	001000	1
S0064	051	0		29	10	S0064_051_0	1	5	Specialty Tier	010010	
S0064	052	0		29	10	S0064_052_0	1	3	Preferred Brand	010001	
S0064	052	0		29	10	S0064_052_0	1	4	Non-Preferred Brand	100000	
S0064	052	0		29	10	S0064_052_0	1	5	Specialty Tier	010010	
S0064	052	0		29	10	S0064_052_0	1	2	Non-Preferred Generic	000100	
S0064	052	0		29	10	S0064_052_0	1	1	Preferred Generic	001000	1
S0064	052	0		29	10	S0064_052_0	1	1	Preferred Generic	001000	
S0064	053	0		29	10	S0064_053_0	1	3	Preferred Brand	010001	
S0064	053	0		29	10	S0064_053_0	1	1	Preferred Generic	001000	
S0064	053	0		29	10	S0064_053_0	1	5	Specialty Tier	010010	
S0064	053	0		29	10	S0064_053_0	1	4	Non-Preferred Brand	100000	
S0064	053	0		29	10	S0064_053_0	1	1	Preferred Generic	001000	1
S0064	053	0		29	10	S0064_053_0	1	2	Non-Preferred Generic	000100	
S0064	054	0		29	10	S0064_054_0	1	1	Preferred Generic	001000	1
S0064	054	0		29	10	S0064_054_0	1	5	Specialty Tier	010010	
S0064	054	0		29	10	S0064_054_0	1	4	Non-Preferred Brand	100000	
S0064	054	0		29	10	S0064_054_0	1	2	Non-Preferred Generic	000100	
S0064	054	0		29	10	S0064_054_0	1	1	Preferred Generic	001000	
S0064	054	0		29	10	S0064_054_0	1	3	Preferred Brand	010001	
S0064	055	0		29	10	S0064_055_0	1	1	Preferred Generic	001000	1
S0064	055	0		29	10	S0064_055_0	1	5	Specialty Tier	010010	
S0064	055	0		29	10	S0064_055_0	1	4	Non-Preferred Brand	100000	
S0064	055	0		29	10	S0064_055_0	1	3	Preferred Brand	010001	
S0064	055	0		29	10	S0064_055_0	1	1	Preferred Generic	001000	
S0064	055	0		29	10	S0064_055_0	1	2	Non-Preferred Generic	000100	
S0064	056	0		29	10	S0064_056_0	1	1	Preferred Generic	001000	
S0064	056	0		29	10	S0064_056_0	1	2	Non-Preferred Generic	000100	
S0064	056	0		29	10	S0064_056_0	1	3	Preferred Brand	010001	
S0064	056	0		29	10	S0064_056_0	1	1	Preferred Generic	001000	1
S0064	056	0		29	10	S0064_056_0	1	5	Specialty Tier	010010	
S0064	056	0		29	10	S0064_056_0	1	4	Non-Preferred Brand	100000	
S0064	057	0		29	10	S0064_057_0	1	1	Preferred Generic	001000	
S0064	057	0		29	10	S0064_057_0	1	4	Non-Preferred Brand	100000	
S0064	057	0		29	10	S0064_057_0	1	3	Preferred Brand	010001	
S0064	057	0		29	10	S0064_057_0	1	2	Non-Preferred Generic	000100	
S0064	057	0		29	10	S0064_057_0	1	1	Preferred Generic	001000	1
S0064	057	0		29	10	S0064_057_0	1	5	Specialty Tier	010010	
S0064	058	0		29	10	S0064_058_0	1	1	Preferred Generic	001000	
S0064	058	0		29	10	S0064_058_0	1	2	Non-Preferred Generic	000100	
S0064	058	0		29	10	S0064_058_0	1	3	Preferred Brand	010001	
S0064	058	0		29	10	S0064_058_0	1	4	Non-Preferred Brand	100000	
S0064	058	0		29	10	S0064_058_0	1	5	Specialty Tier	010010	
S0064	058	0		29	10	S0064_058_0	1	1	Preferred Generic	001000	1
S0064	059	0		29	10	S0064_059_0	1	1	Preferred Generic	001000	
S0064	059	0		29	10	S0064_059_0	1	2	Non-Preferred Generic	000100	
S0064	059	0		29	10	S0064_059_0	1	3	Preferred Brand	010001	
S0064	059	0		29	10	S0064_059_0	1	5	Specialty Tier	010010	
S0064	059	0		29	10	S0064_059_0	1	4	Non-Preferred Brand	100000	
S0064	059	0		29	10	S0064_059_0	1	1	Preferred Generic	001000	1
S0064	060	0		29	10	S0064_060_0	1	4	Non-Preferred Brand	100000	
S0064	060	0		29	10	S0064_060_0	1	5	Specialty Tier	010010	
S0064	060	0		29	10	S0064_060_0	1	1	Preferred Generic	001000	1
S0064	060	0		29	10	S0064_060_0	1	1	Preferred Generic	001000	
S0064	060	0		29	10	S0064_060_0	1	2	Non-Preferred Generic	000100	
S0064	060	0		29	10	S0064_060_0	1	3	Preferred Brand	010001	
S0064	061	0		29	10	S0064_061_0	1	1	Preferred Generic	001000	
S0064	061	0		29	10	S0064_061_0	1	2	Non-Preferred Generic	000100	
S0064	061	0		29	10	S0064_061_0	1	4	Non-Preferred Brand	100000	
S0064	061	0		29	10	S0064_061_0	1	5	Specialty Tier	010010	
S0064	061	0		29	10	S0064_061_0	1	1	Preferred Generic	001000	1
S0064	061	0		29	10	S0064_061_0	1	3	Preferred Brand	010001	
S0064	062	0		29	10	S0064_062_0	1	4	Non-Preferred Brand	100000	
S0064	062	0		29	10	S0064_062_0	1	1	Preferred Generic	001000	1
S0064	062	0		29	10	S0064_062_0	1	5	Specialty Tier	010010	
S0064	062	0		29	10	S0064_062_0	1	3	Preferred Brand	010001	
S0064	062	0		29	10	S0064_062_0	1	2	Non-Preferred Generic	000100	
S0064	062	0		29	10	S0064_062_0	1	1	Preferred Generic	001000	
S0064	063	0		29	10	S0064_063_0	1	2	Non-Preferred Generic	000100	
S0064	063	0		29	10	S0064_063_0	1	3	Preferred Brand	010001	
S0064	063	0		29	10	S0064_063_0	1	4	Non-Preferred Brand	100000	
S0064	063	0		29	10	S0064_063_0	1	5	Specialty Tier	010010	
S0064	063	0		29	10	S0064_063_0	1	1	Preferred Generic	001000	1
S0064	063	0		29	10	S0064_063_0	1	1	Preferred Generic	001000	
S0064	064	0		29	10	S0064_064_0	1	1	Preferred Generic	001000	1
S0064	064	0		29	10	S0064_064_0	1	5	Specialty Tier	010010	
S0064	064	0		29	10	S0064_064_0	1	3	Preferred Brand	010001	
S0064	064	0		29	10	S0064_064_0	1	2	Non-Preferred Generic	000100	
S0064	064	0		29	10	S0064_064_0	1	1	Preferred Generic	001000	
S0064	064	0		29	10	S0064_064_0	1	4	Non-Preferred Brand	100000	
S0064	065	0		29	10	S0064_065_0	1	4	Non-Preferred Brand	100000	
S0064	065	0		29	10	S0064_065_0	1	5	Specialty Tier	010010	
S0064	065	0		29	10	S0064_065_0	1	1	Preferred Generic	001000	1
S0064	065	0		29	10	S0064_065_0	1	3	Preferred Brand	010001	
S0064	065	0		29	10	S0064_065_0	1	2	Non-Preferred Generic	000100	
S0064	065	0		29	10	S0064_065_0	1	1	Preferred Generic	001000	
S0064	066	0		29	10	S0064_066_0	1	3	Preferred Brand	010001	
S0064	066	0		29	10	S0064_066_0	1	1	Preferred Generic	001000	
S0064	066	0		29	10	S0064_066_0	1	2	Non-Preferred Generic	000100	
S0064	066	0		29	10	S0064_066_0	1	4	Non-Preferred Brand	100000	
S0064	066	0		29	10	S0064_066_0	1	5	Specialty Tier	010010	
S0064	066	0		29	10	S0064_066_0	1	1	Preferred Generic	001000	1
S0064	067	0		29	10	S0064_067_0	1	1	Preferred Generic	001000	1
S0064	067	0		29	10	S0064_067_0	1	3	Preferred Brand	010001	
S0064	067	0		29	10	S0064_067_0	1	5	Specialty Tier	010010	
S0064	067	0		29	10	S0064_067_0	1	4	Non-Preferred Brand	100000	
S0064	067	0		29	10	S0064_067_0	1	1	Preferred Generic	001000	
S0064	067	0		29	10	S0064_067_0	1	2	Non-Preferred Generic	000100	
S0064	068	0		29	10	S0064_068_0	1	1	Preferred Generic	001000	
S0064	068	0		29	10	S0064_068_0	1	2	Non-Preferred Generic	000100	
S0064	068	0		29	10	S0064_068_0	1	3	Preferred Brand	010001	
S0064	068	0		29	10	S0064_068_0	1	4	Non-Preferred Brand	100000	
S0064	068	0		29	10	S0064_068_0	1	5	Specialty Tier	010010	
S0064	068	0		29	10	S0064_068_0	1	1	Preferred Generic	001000	1
S0064	069	0		29	10	S0064_069_0	1	1	Preferred Generic	001000	
S0064	069	0		29	10	S0064_069_0	1	2	Non-Preferred Generic	000100	
S0064	069	0		29	10	S0064_069_0	1	3	Preferred Brand	010001	
S0064	069	0		29	10	S0064_069_0	1	4	Non-Preferred Brand	100000	
S0064	069	0		29	10	S0064_069_0	1	5	Specialty Tier	010010	
S0064	069	0		29	10	S0064_069_0	1	1	Preferred Generic	001000	1
S0064	070	0		29	10	S0064_070_0	1	1	Preferred Generic	001000	
S0064	070	0		29	10	S0064_070_0	1	2	Non-Preferred Generic	000100	
S0064	070	0		29	10	S0064_070_0	1	3	Preferred Brand	010001	
S0064	070	0		29	10	S0064_070_0	1	4	Non-Preferred Brand	100000	
S0064	070	0		29	10	S0064_070_0	1	5	Specialty Tier	010010	
S0064	070	0		29	10	S0064_070_0	1	1	Preferred Generic	001000	1
S0128	003	0		29	10	S0128_003_0	6	3	Preferred Brand	000101	
S0128	003	0		29	10	S0128_003_0	6	2	Non-Preferred Generic	000101	
S0128	003	0		29	10	S0128_003_0	6	1	Preferred Generic	001010	
S0128	003	0		29	10	S0128_003_0	6	5	Specialty Tier	010010	
S0128	003	0		29	10	S0128_003_0	6	4	Non-Preferred Brand	110000	
S0128	004	0		29	10	S0128_004_0	6	5	Specialty Tier	010010	
S0128	004	0		29	10	S0128_004_0	6	4	Non-Preferred Brand	110000	
S0128	004	0		29	10	S0128_004_0	6	3	Preferred Brand	000101	
S0128	004	0		29	10	S0128_004_0	6	2	Non-Preferred Generic	000101	
S0128	004	0		29	10	S0128_004_0	6	1	Preferred Generic	001010	
S0128	005	0		29	10	S0128_005_0	6	4	Non-Preferred Brand	110000	
S0128	005	0		29	10	S0128_005_0	6	2	Non-Preferred Generic	000101	
S0128	005	0		29	10	S0128_005_0	6	3	Preferred Brand	000101	
S0128	005	0		29	10	S0128_005_0	6	5	Specialty Tier	010010	
S0128	005	0		29	10	S0128_005_0	6	1	Preferred Generic	001010	
S0128	006	0		29	10	S0128_006_0	6	2	Non-Preferred Generic	000101	
S0128	006	0		29	10	S0128_006_0	6	1	Preferred Generic	001010	
S0128	006	0		29	10	S0128_006_0	6	3	Preferred Brand	000101	
S0128	006	0		29	10	S0128_006_0	6	5	Specialty Tier	010010	
S0128	006	0		29	10	S0128_006_0	6	4	Non-Preferred Brand	110000	
S0128	007	0		29	10	S0128_007_0	6	2	Non-Preferred Generic	000101	
S0128	007	0		29	10	S0128_007_0	6	1	Preferred Generic	001010	
S0128	007	0		29	10	S0128_007_0	6	3	Preferred Brand	000101	
S0128	007	0		29	10	S0128_007_0	6	4	Non-Preferred Brand	110000	
S0128	007	0		29	10	S0128_007_0	6	5	Specialty Tier	010010	
S0128	008	0		29	10	S0128_008_0	6	2	Non-Preferred Generic	000101	
S0128	008	0		29	10	S0128_008_0	6	1	Preferred Generic	001010	
S0128	008	0		29	10	S0128_008_0	6	3	Preferred Brand	000101	
S0128	008	0		29	10	S0128_008_0	6	5	Specialty Tier	010010	
S0128	008	0		29	10	S0128_008_0	6	4	Non-Preferred Brand	110000	
S0128	009	0		29	10	S0128_009_0	6	1	Preferred Generic	001010	
S0128	009	0		29	10	S0128_009_0	6	2	Non-Preferred Generic	000101	
S0128	009	0		29	10	S0128_009_0	6	3	Preferred Brand	000101	
S0128	009	0		29	10	S0128_009_0	6	4	Non-Preferred Brand	110000	
S0128	009	0		29	10	S0128_009_0	6	5	Specialty Tier	010010	
S0128	010	0		29	10	S0128_010_0	6	5	Specialty Tier	010010	
S0128	010	0		29	10	S0128_010_0	6	4	Non-Preferred Brand	110000	
S0128	010	0		29	10	S0128_010_0	6	3	Preferred Brand	000101	
S0128	010	0		29	10	S0128_010_0	6	2	Non-Preferred Generic	000101	
S0128	010	0		29	10	S0128_010_0	6	1	Preferred Generic	001010	
S0128	011	0		29	10	S0128_011_0	6	5	Specialty Tier	010010	
S0128	011	0		29	10	S0128_011_0	6	4	Non-Preferred Brand	110000	
S0128	011	0		29	10	S0128_011_0	6	3	Preferred Brand	000101	
S0128	011	0		29	10	S0128_011_0	6	2	Non-Preferred Generic	000101	
S0128	011	0		29	10	S0128_011_0	6	1	Preferred Generic	001010	
S0128	012	0		29	10	S0128_012_0	6	1	Preferred Generic	001010	
S0128	012	0		29	10	S0128_012_0	6	5	Specialty Tier	010010	
S0128	012	0		29	10	S0128_012_0	6	4	Non-Preferred Brand	110000	
S0128	012	0		29	10	S0128_012_0	6	3	Preferred Brand	000101	
S0128	012	0		29	10	S0128_012_0	6	2	Non-Preferred Generic	000101	
S0128	013	0		29	10	S0128_013_0	6	5	Specialty Tier	010010	
S0128	013	0		29	10	S0128_013_0	6	4	Non-Preferred Brand	110000	
S0128	013	0		29	10	S0128_013_0	6	3	Preferred Brand	000101	
S0128	013	0		29	10	S0128_013_0	6	2	Non-Preferred Generic	000101	
S0128	013	0		29	10	S0128_013_0	6	1	Preferred Generic	001010	
S0128	014	0		29	10	S0128_014_0	6	1	Preferred Generic	001010	
S0128	014	0		29	10	S0128_014_0	6	5	Specialty Tier	010010	
S0128	014	0		29	10	S0128_014_0	6	4	Non-Preferred Brand	110000	
S0128	014	0		29	10	S0128_014_0	6	3	Preferred Brand	000101	
S0128	014	0		29	10	S0128_014_0	6	2	Non-Preferred Generic	000101	
S0128	015	0		29	10	S0128_015_0	6	5	Specialty Tier	010010	
S0128	015	0		29	10	S0128_015_0	6	4	Non-Preferred Brand	110000	
S0128	015	0		29	10	S0128_015_0	6	3	Preferred Brand	000101	
S0128	015	0		29	10	S0128_015_0	6	2	Non-Preferred Generic	000101	
S0128	015	0		29	10	S0128_015_0	6	1	Preferred Generic	001010	
S0128	016	0		29	10	S0128_016_0	6	1	Preferred Generic	001010	
S0128	016	0		29	10	S0128_016_0	6	2	Non-Preferred Generic	000101	
S0128	016	0		29	10	S0128_016_0	6	3	Preferred Brand	000101	
S0128	016	0		29	10	S0128_016_0	6	4	Non-Preferred Brand	110000	
S0128	016	0		29	10	S0128_016_0	6	5	Specialty Tier	010010	
S0128	017	0		29	10	S0128_017_0	6	1	Preferred Generic	001010	
S0128	017	0		29	10	S0128_017_0	6	2	Non-Preferred Generic	000101	
S0128	017	0		29	10	S0128_017_0	6	3	Preferred Brand	000101	
S0128	017	0		29	10	S0128_017_0	6	4	Non-Preferred Brand	110000	
S0128	017	0		29	10	S0128_017_0	6	5	Specialty Tier	010010	
S0128	018	0		29	10	S0128_018_0	6	2	Non-Preferred Generic	000101	
S0128	018	0		29	10	S0128_018_0	6	1	Preferred Generic	001010	
S0128	018	0		29	10	S0128_018_0	6	3	Preferred Brand	000101	
S0128	018	0		29	10	S0128_018_0	6	4	Non-Preferred Brand	110000	
S0128	018	0		29	10	S0128_018_0	6	5	Specialty Tier	010010	
S0128	019	0		29	10	S0128_019_0	6	1	Preferred Generic	001010	
S0128	019	0		29	10	S0128_019_0	6	2	Non-Preferred Generic	000101	
S0128	019	0		29	10	S0128_019_0	6	3	Preferred Brand	000101	
S0128	019	0		29	10	S0128_019_0	6	4	Non-Preferred Brand	110000	
S0128	019	0		29	10	S0128_019_0	6	5	Specialty Tier	010010	
S0128	020	0		29	10	S0128_020_0	6	2	Non-Preferred Generic	000101	
S0128	020	0		29	10	S0128_020_0	6	1	Preferred Generic	001010	
S0128	020	0		29	10	S0128_020_0	6	3	Preferred Brand	000101	
S0128	020	0		29	10	S0128_020_0	6	5	Specialty Tier	010010	
S0128	020	0		29	10	S0128_020_0	6	4	Non-Preferred Brand	110000	
S0128	021	0		29	10	S0128_021_0	6	1	Preferred Generic	001010	
S0128	021	0		29	10	S0128_021_0	6	2	Non-Preferred Generic	000101	
S0128	021	0		29	10	S0128_021_0	6	3	Preferred Brand	000101	
S0128	021	0		29	10	S0128_021_0	6	4	Non-Preferred Brand	110000	
S0128	021	0		29	10	S0128_021_0	6	5	Specialty Tier	010010	
S0128	022	0		29	10	S0128_022_0	6	1	Preferred Generic	001010	
S0128	022	0		29	10	S0128_022_0	6	2	Non-Preferred Generic	000101	
S0128	022	0		29	10	S0128_022_0	6	4	Non-Preferred Brand	110000	
S0128	022	0		29	10	S0128_022_0	6	3	Preferred Brand	000101	
S0128	022	0		29	10	S0128_022_0	6	5	Specialty Tier	010010	
S0128	023	0		29	10	S0128_023_0	6	5	Specialty Tier	010010	
S0128	023	0		29	10	S0128_023_0	6	1	Preferred Generic	001010	
S0128	023	0		29	10	S0128_023_0	6	2	Non-Preferred Generic	000101	
S0128	023	0		29	10	S0128_023_0	6	3	Preferred Brand	000101	
S0128	023	0		29	10	S0128_023_0	6	4	Non-Preferred Brand	110000	
S0128	024	0		29	10	S0128_024_0	6	3	Preferred Brand	000101	
S0128	024	0		29	10	S0128_024_0	6	4	Non-Preferred Brand	110000	
S0128	024	0		29	10	S0128_024_0	6	2	Non-Preferred Generic	000101	
S0128	024	0		29	10	S0128_024_0	6	1	Preferred Generic	001010	
S0128	024	0		29	10	S0128_024_0	6	5	Specialty Tier	010010	
S0128	025	0		29	10	S0128_025_0	6	1	Preferred Generic	001010	
S0128	025	0		29	10	S0128_025_0	6	2	Non-Preferred Generic	000101	
S0128	025	0		29	10	S0128_025_0	6	3	Preferred Brand	000101	
S0128	025	0		29	10	S0128_025_0	6	4	Non-Preferred Brand	110000	
S0128	025	0		29	10	S0128_025_0	6	5	Specialty Tier	010010	
S0128	026	0		29	10	S0128_026_0	6	2	Non-Preferred Generic	000101	
S0128	026	0		29	10	S0128_026_0	6	1	Preferred Generic	001010	
S0128	026	0		29	10	S0128_026_0	6	3	Preferred Brand	000101	
S0128	026	0		29	10	S0128_026_0	6	5	Specialty Tier	010010	
S0128	026	0		29	10	S0128_026_0	6	4	Non-Preferred Brand	110000	
S0128	027	0		29	10	S0128_027_0	6	1	Preferred Generic	001010	
S0128	027	0		29	10	S0128_027_0	6	2	Non-Preferred Generic	000101	
S0128	027	0		29	10	S0128_027_0	6	3	Preferred Brand	000101	
S0128	027	0		29	10	S0128_027_0	6	4	Non-Preferred Brand	110000	
S0128	027	0		29	10	S0128_027_0	6	5	Specialty Tier	010010	
S0128	028	0		29	10	S0128_028_0	6	1	Preferred Generic	001010	
S0128	028	0		29	10	S0128_028_0	6	2	Non-Preferred Generic	000101	
S0128	028	0		29	10	S0128_028_0	6	4	Non-Preferred Brand	110000	
S0128	028	0		29	10	S0128_028_0	6	3	Preferred Brand	000101	
S0128	028	0		29	10	S0128_028_0	6	5	Specialty Tier	010010	
S0128	029	0		29	10	S0128_029_0	6	4	Non-Preferred Brand	110000	
S0128	029	0		29	10	S0128_029_0	6	3	Preferred Brand	000101	
S0128	029	0		29	10	S0128_029_0	6	2	Non-Preferred Generic	000101	
S0128	029	0		29	10	S0128_029_0	6	1	Preferred Generic	001010	
S0128	029	0		29	10	S0128_029_0	6	5	Specialty Tier	010010	
S0128	030	0		29	10	S0128_030_0	6	4	Non-Preferred Brand	110000	
S0128	030	0		29	10	S0128_030_0	6	3	Preferred Brand	000101	
S0128	030	0		29	10	S0128_030_0	6	2	Non-Preferred Generic	000101	
S0128	030	0		29	10	S0128_030_0	6	1	Preferred Generic	001010	
S0128	030	0		29	10	S0128_030_0	6	5	Specialty Tier	010010	
S0128	031	0		29	10	S0128_031_0	6	1	Preferred Generic	001010	
S0128	031	0		29	10	S0128_031_0	6	2	Non-Preferred Generic	000101	
S0128	031	0		29	10	S0128_031_0	6	3	Preferred Brand	000101	
S0128	031	0		29	10	S0128_031_0	6	4	Non-Preferred Brand	110000	
S0128	031	0		29	10	S0128_031_0	6	5	Specialty Tier	010010	
S0128	032	0		29	10	S0128_032_0	6	4	Non-Preferred Brand	110000	
S0128	032	0		29	10	S0128_032_0	6	3	Preferred Brand	000101	
S0128	032	0		29	10	S0128_032_0	6	2	Non-Preferred Generic	000101	
S0128	032	0		29	10	S0128_032_0	6	1	Preferred Generic	001010	
S0128	032	0		29	10	S0128_032_0	6	5	Specialty Tier	010010	
S0128	033	0		29	10	S0128_033_0	6	2	Non-Preferred Generic	000101	
S0128	033	0		29	10	S0128_033_0	6	1	Preferred Generic	001010	
S0128	033	0		29	10	S0128_033_0	6	3	Preferred Brand	000101	
S0128	033	0		29	10	S0128_033_0	6	4	Non-Preferred Brand	110000	
S0128	033	0		29	10	S0128_033_0	6	5	Specialty Tier	010010	
S0128	034	0		29	10	S0128_034_0	6	2	Non-Preferred Generic	000101	
S0128	034	0		29	10	S0128_034_0	6	1	Preferred Generic	001010	
S0128	034	0		29	10	S0128_034_0	6	3	Preferred Brand	000101	
S0128	034	0		29	10	S0128_034_0	6	5	Specialty Tier	010010	
S0128	034	0		29	10	S0128_034_0	6	4	Non-Preferred Brand	110000	
S0128	035	0		29	10	S0128_035_0	6	1	Preferred Generic	001010	
S0128	035	0		29	10	S0128_035_0	6	2	Non-Preferred Generic	000101	
S0128	035	0		29	10	S0128_035_0	6	4	Non-Preferred Brand	110000	
S0128	035	0		29	10	S0128_035_0	6	3	Preferred Brand	000101	
S0128	035	0		29	10	S0128_035_0	6	5	Specialty Tier	010010	
S0197	005	0		29	10	S0197_005_0	2	1	Preferred Generic	001000	
S0197	005	0		29	10	S0197_005_0	2	2	Non-Preferred Generic	000100	
S0197	005	0		29	10	S0197_005_0	2	3	Preferred Brand	000001	
S0197	005	0		29	10	S0197_005_0	2	4	Non-Preferred Brand	100100	2
S0197	005	0		29	10	S0197_005_0	2	5	Specialty Tier	010010	
S0197	005	0		29	10	S0197_005_0	2	1	Preferred Generic	001000	1
S0197	005	0		29	10	S0197_005_0	2	3	Preferred Brand	000001	2
S0197	005	0		29	10	S0197_005_0	2	4	Non-Preferred Brand	100100	
S0223	003	0		29	10	S0223_003_0	6	1	Preferred Generic	001000	
S0223	003	0		29	10	S0223_003_0	6	2	Non-Preferred Generic	000100	
S0223	003	0		29	10	S0223_003_0	6	5	Specialty Tier	010010	
S0223	003	0		29	10	S0223_003_0	6	4	Non-Preferred Brand	100000	
S0223	003	0		29	10	S0223_003_0	6	3	Preferred Brand	000001	
S0522	001	0		29	10	S0522_001_0	4	1	Preferred Generic	001000	
S0522	001	0		29	10	S0522_001_0	4	2	Non-Preferred Generic	000100	
S0522	001	0		29	10	S0522_001_0	4	3	Preferred Brand	000001	
S0522	001	0		29	10	S0522_001_0	4	4	Non-Preferred Brand	100000	
S0522	001	0		29	10	S0522_001_0	4	5	Specialty Tier	010010	
S0522	002	0		29	10	S0522_002_0	7	1	Preferred Generic	001000	
S0522	002	0		29	10	S0522_002_0	7	5	Specialty Tier	010010	
S0522	002	0		29	10	S0522_002_0	7	4	Non-Preferred Brand	100000	
S0522	002	0		29	10	S0522_002_0	7	3	Preferred Brand	000001	
S0522	002	0		29	10	S0522_002_0	7	2	Non-Preferred Generic	000100	
S0522	004	0		29	10	S0522_004_0	3	2	Non-Preferred Generic	000100	
S0522	004	0		29	10	S0522_004_0	3	3	Preferred Brand	000001	
S0522	004	0		29	10	S0522_004_0	3	4	Non-Preferred Brand	100000	
S0522	004	0		29	10	S0522_004_0	3	5	Specialty Tier	010010	
S0522	004	0		29	10	S0522_004_0	3	1	Preferred Generic	001000	
S0522	006	0		29	10	S0522_006_0	3	2	Non-Preferred Generic	000100	
S0522	006	0		29	10	S0522_006_0	3	3	Preferred Brand	000001	
S0522	006	0		29	10	S0522_006_0	3	4	Non-Preferred Brand	100000	
S0522	006	0		29	10	S0522_006_0	3	5	Specialty Tier	010010	
S0522	006	0		29	10	S0522_006_0	3	1	Preferred Generic	001000	
S0522	008	0		29	10	S0522_008_0	3	5	Specialty Tier	010010	
S0522	008	0		29	10	S0522_008_0	3	4	Non-Preferred Brand	100000	
S0522	008	0		29	10	S0522_008_0	3	3	Preferred Brand	000001	
S0522	008	0		29	10	S0522_008_0	3	2	Non-Preferred Generic	000100	
S0522	008	0		29	10	S0522_008_0	3	1	Preferred Generic	001000	
S0522	010	0		29	10	S0522_010_0	3	2	Non-Preferred Generic	000100	
S0522	010	0		29	10	S0522_010_0	3	3	Preferred Brand	000001	
S0522	010	0		29	10	S0522_010_0	3	4	Non-Preferred Brand	100000	
S0522	010	0		29	10	S0522_010_0	3	5	Specialty Tier	010010	
S0522	010	0		29	10	S0522_010_0	3	1	Preferred Generic	001000	
S0522	012	0		29	10	S0522_012_0	3	1	Preferred Generic	001000	
S0522	012	0		29	10	S0522_012_0	3	2	Non-Preferred Generic	000100	
S0522	012	0		29	10	S0522_012_0	3	3	Preferred Brand	000001	
S0522	012	0		29	10	S0522_012_0	3	5	Specialty Tier	010010	
S0522	012	0		29	10	S0522_012_0	3	4	Non-Preferred Brand	100000	
S0522	014	0		29	10	S0522_014_0	3	1	Preferred Generic	001000	
S0522	014	0		29	10	S0522_014_0	3	2	Non-Preferred Generic	000100	
S0522	014	0		29	10	S0522_014_0	3	3	Preferred Brand	000001	
S0522	014	0		29	10	S0522_014_0	3	4	Non-Preferred Brand	100000	
S0522	014	0		29	10	S0522_014_0	3	5	Specialty Tier	010010	
S0522	016	0		29	10	S0522_016_0	3	1	Preferred Generic	001000	
S0522	016	0		29	10	S0522_016_0	3	2	Non-Preferred Generic	000100	
S0522	016	0		29	10	S0522_016_0	3	3	Preferred Brand	000001	
S0522	016	0		29	10	S0522_016_0	3	4	Non-Preferred Brand	100000	
S0522	016	0		29	10	S0522_016_0	3	5	Specialty Tier	010010	
S0522	018	0		29	10	S0522_018_0	3	1	Preferred Generic	001000	
S0522	018	0		29	10	S0522_018_0	3	2	Non-Preferred Generic	000100	
S0522	018	0		29	10	S0522_018_0	3	5	Specialty Tier	010010	
S0522	018	0		29	10	S0522_018_0	3	4	Non-Preferred Brand	100000	
S0522	018	0		29	10	S0522_018_0	3	3	Preferred Brand	000001	
S0522	020	0		29	10	S0522_020_0	3	4	Non-Preferred Brand	100000	
S0522	020	0		29	10	S0522_020_0	3	3	Preferred Brand	000001	
S0522	020	0		29	10	S0522_020_0	3	5	Specialty Tier	010010	
S0522	020	0		29	10	S0522_020_0	3	2	Non-Preferred Generic	000100	
S0522	020	0		29	10	S0522_020_0	3	1	Preferred Generic	001000	
S0522	022	0		29	10	S0522_022_0	3	2	Non-Preferred Generic	000100	
S0522	022	0		29	10	S0522_022_0	3	1	Preferred Generic	001000	
S0522	022	0		29	10	S0522_022_0	3	4	Non-Preferred Brand	100000	
S0522	022	0		29	10	S0522_022_0	3	3	Preferred Brand	000001	
S0522	022	0		29	10	S0522_022_0	3	5	Specialty Tier	010010	
S0522	024	0		29	10	S0522_024_0	3	1	Preferred Generic	001000	
S0522	024	0		29	10	S0522_024_0	3	5	Specialty Tier	010010	
S0522	024	0		29	10	S0522_024_0	3	4	Non-Preferred Brand	100000	
S0522	024	0		29	10	S0522_024_0	3	3	Preferred Brand	000001	
S0522	024	0		29	10	S0522_024_0	3	2	Non-Preferred Generic	000100	
S0522	026	0		29	10	S0522_026_0	3	3	Preferred Brand	000001	
S0522	026	0		29	10	S0522_026_0	3	4	Non-Preferred Brand	100000	
S0522	026	0		29	10	S0522_026_0	3	5	Specialty Tier	010010	
S0522	026	0		29	10	S0522_026_0	3	2	Non-Preferred Generic	000100	
S0522	026	0		29	10	S0522_026_0	3	1	Preferred Generic	001000	
S0522	028	0		29	10	S0522_028_0	3	5	Specialty Tier	010010	
S0522	028	0		29	10	S0522_028_0	3	4	Non-Preferred Brand	100000	
S0522	028	0		29	10	S0522_028_0	3	3	Preferred Brand	000001	
S0522	028	0		29	10	S0522_028_0	3	2	Non-Preferred Generic	000100	
S0522	028	0		29	10	S0522_028_0	3	1	Preferred Generic	001000	
S0522	030	0		29	10	S0522_030_0	3	3	Preferred Brand	000001	
S0522	030	0		29	10	S0522_030_0	3	2	Non-Preferred Generic	000100	
S0522	030	0		29	10	S0522_030_0	3	4	Non-Preferred Brand	100000	
S0522	030	0		29	10	S0522_030_0	3	5	Specialty Tier	010010	
S0522	030	0		29	10	S0522_030_0	3	1	Preferred Generic	001000	
S0522	032	0		29	10	S0522_032_0	3	4	Non-Preferred Brand	100000	
S0522	032	0		29	10	S0522_032_0	3	5	Specialty Tier	010010	
S0522	032	0		29	10	S0522_032_0	3	3	Preferred Brand	000001	
S0522	032	0		29	10	S0522_032_0	3	1	Preferred Generic	001000	
S0522	032	0		29	10	S0522_032_0	3	2	Non-Preferred Generic	000100	
S0522	034	0		29	10	S0522_034_0	3	2	Non-Preferred Generic	000100	
S0522	034	0		29	10	S0522_034_0	3	3	Preferred Brand	000001	
S0522	034	0		29	10	S0522_034_0	3	5	Specialty Tier	010010	
S0522	034	0		29	10	S0522_034_0	3	4	Non-Preferred Brand	100000	
S0522	034	0		29	10	S0522_034_0	3	1	Preferred Generic	001000	
S0522	036	0		29	10	S0522_036_0	3	5	Specialty Tier	010010	
S0522	036	0		29	10	S0522_036_0	3	4	Non-Preferred Brand	100000	
S0522	036	0		29	10	S0522_036_0	3	3	Preferred Brand	000001	
S0522	036	0		29	10	S0522_036_0	3	2	Non-Preferred Generic	000100	
S0522	036	0		29	10	S0522_036_0	3	1	Preferred Generic	001000	
S0522	037	0		29	10	S0522_037_0	3	2	Non-Preferred Generic	000100	
S0522	037	0		29	10	S0522_037_0	3	3	Preferred Brand	000001	
S0522	037	0		29	10	S0522_037_0	3	4	Non-Preferred Brand	100000	
S0522	037	0		29	10	S0522_037_0	3	5	Specialty Tier	010010	
S0522	037	0		29	10	S0522_037_0	3	1	Preferred Generic	001000	
S0522	038	0		29	10	S0522_038_0	3	1	Preferred Generic	001000	
S0522	038	0		29	10	S0522_038_0	3	2	Non-Preferred Generic	000100	
S0522	038	0		29	10	S0522_038_0	3	3	Preferred Brand	000001	
S0522	038	0		29	10	S0522_038_0	3	5	Specialty Tier	010010	
S0522	038	0		29	10	S0522_038_0	3	4	Non-Preferred Brand	100000	
S0522	039	0		29	10	S0522_039_0	3	1	Preferred Generic	001000	
S0522	039	0		29	10	S0522_039_0	3	2	Non-Preferred Generic	000100	
S0522	039	0		29	10	S0522_039_0	3	3	Preferred Brand	000001	
S0522	039	0		29	10	S0522_039_0	3	4	Non-Preferred Brand	100000	
S0522	039	0		29	10	S0522_039_0	3	5	Specialty Tier	010010	
S0522	040	0		29	10	S0522_040_0	3	5	Specialty Tier	010010	
S0522	040	0		29	10	S0522_040_0	3	1	Preferred Generic	001000	
S0522	040	0		29	10	S0522_040_0	3	2	Non-Preferred Generic	000100	
S0522	040	0		29	10	S0522_040_0	3	4	Non-Preferred Brand	100000	
S0522	040	0		29	10	S0522_040_0	3	3	Preferred Brand	000001	
S0522	041	0		29	10	S0522_041_0	3	3	Preferred Brand	000001	
S0522	041	0		29	10	S0522_041_0	3	2	Non-Preferred Generic	000100	
S0522	041	0		29	10	S0522_041_0	3	1	Preferred Generic	001000	
S0522	041	0		29	10	S0522_041_0	3	5	Specialty Tier	010010	
S0522	041	0		29	10	S0522_041_0	3	4	Non-Preferred Brand	100000	
S0522	042	0		29	10	S0522_042_0	3	3	Preferred Brand	000001	
S0522	042	0		29	10	S0522_042_0	3	2	Non-Preferred Generic	000100	
S0522	042	0		29	10	S0522_042_0	3	5	Specialty Tier	010010	
S0522	042	0		29	10	S0522_042_0	3	4	Non-Preferred Brand	100000	
S0522	042	0		29	10	S0522_042_0	3	1	Preferred Generic	001000	
S0522	043	0		29	10	S0522_043_0	3	2	Non-Preferred Generic	000100	
S0522	043	0		29	10	S0522_043_0	3	1	Preferred Generic	001000	
S0522	043	0		29	10	S0522_043_0	3	3	Preferred Brand	000001	
S0522	043	0		29	10	S0522_043_0	3	4	Non-Preferred Brand	100000	
S0522	043	0		29	10	S0522_043_0	3	5	Specialty Tier	010010	
S0522	044	0		29	10	S0522_044_0	3	3	Preferred Brand	000001	
S0522	044	0		29	10	S0522_044_0	3	5	Specialty Tier	010010	
S0522	044	0		29	10	S0522_044_0	3	4	Non-Preferred Brand	100000	
S0522	044	0		29	10	S0522_044_0	3	2	Non-Preferred Generic	000100	
S0522	044	0		29	10	S0522_044_0	3	1	Preferred Generic	001000	
S0522	045	0		29	10	S0522_045_0	3	5	Specialty Tier	010010	
S0522	045	0		29	10	S0522_045_0	3	4	Non-Preferred Brand	100000	
S0522	045	0		29	10	S0522_045_0	3	3	Preferred Brand	000001	
S0522	045	0		29	10	S0522_045_0	3	1	Preferred Generic	001000	
S0522	045	0		29	10	S0522_045_0	3	2	Non-Preferred Generic	000100	
S0522	046	0		29	10	S0522_046_0	3	4	Non-Preferred Brand	100000	
S0522	046	0		29	10	S0522_046_0	3	1	Preferred Generic	001000	
S0522	046	0		29	10	S0522_046_0	3	2	Non-Preferred Generic	000100	
S0522	046	0		29	10	S0522_046_0	3	3	Preferred Brand	000001	
S0522	046	0		29	10	S0522_046_0	3	5	Specialty Tier	010010	
S0522	047	0		29	10	S0522_047_0	3	5	Specialty Tier	010010	
S0522	047	0		29	10	S0522_047_0	3	4	Non-Preferred Brand	100000	
S0522	047	0		29	10	S0522_047_0	3	1	Preferred Generic	001000	
S0522	047	0		29	10	S0522_047_0	3	2	Non-Preferred Generic	000100	
S0522	047	0		29	10	S0522_047_0	3	3	Preferred Brand	000001	
S1030	001	0		29	10	S1030_001_0	3	5	Specialty Tier	010010	
S1030	001	0		29	10	S1030_001_0	3	4	Non-Preferred Brand	110000	
S1030	001	0		29	10	S1030_001_0	3	3	Preferred Brand	000001	
S1030	001	0		29	10	S1030_001_0	3	2	Non-Preferred Generic	000100	
S1030	001	0		29	10	S1030_001_0	3	1	Preferred Generic	001000	
S1030	006	0		29	10	S1030_006_0	3	4	Non-Preferred Brand	110000	
S1030	006	0		29	10	S1030_006_0	3	5	Specialty Tier	010010	
S1030	006	0		29	10	S1030_006_0	3	3	Preferred Brand	000001	
S1030	006	0		29	10	S1030_006_0	3	2	Non-Preferred Generic	000100	
S1030	006	0		29	10	S1030_006_0	3	1	Preferred Generic	001000	
S1140	001	0		29	10	S1140_001_0	1	1	Preferred Generic	001000	
S1140	001	0		29	10	S1140_001_0	1	2	Non-Preferred Generic	000100	
S1140	001	0		29	10	S1140_001_0	1	3	Preferred Brand	000001	
S1140	001	0		29	10	S1140_001_0	1	4	Non-Preferred Brand	100000	
S1140	001	0		29	10	S1140_001_0	1	5	Specialty Tier	010010	
S2321	002	0		29	10	S2321_002_0	2	1	Preferred Generic	001000	
S2321	002	0		29	10	S2321_002_0	2	2	Non-Preferred Generic	000100	
S2321	002	0		29	10	S2321_002_0	2	3	Preferred Brand	000001	
S2321	002	0		29	10	S2321_002_0	2	4	Non-Preferred Brand	100000	
S2321	002	0		29	10	S2321_002_0	2	5	Specialty Tier	101101	
S2321	002	0		29	10	S2321_002_0	2	1	Preferred Generic	001000	1
S2321	002	0		29	10	S2321_002_0	2	2	Non-Preferred Generic	000100	1
S2321	005	0		29	10	S2321_005_0	2	1	Preferred Generic	001000	
S2321	005	0		29	10	S2321_005_0	2	2	Non-Preferred Generic	000100	
S2321	005	0		29	10	S2321_005_0	2	3	Preferred Brand	000001	
S2321	005	0		29	10	S2321_005_0	2	4	Non-Preferred Brand	100000	
S2321	005	0		29	10	S2321_005_0	2	5	Specialty Tier	101101	
S2468	003	0		29	10	S2468_003_0	4	1	Preferred Generic	001000	
S2468	003	0		29	10	S2468_003_0	4	2	Non-Preferred Generic	001100	
S2468	003	0		29	10	S2468_003_0	4	3	Preferred Brand	000101	
S2468	003	0		29	10	S2468_003_0	4	4	Non-Preferred Brand	100100	
S2468	003	0		29	10	S2468_003_0	4	5	Injectable Drugs	010010	
S2468	003	0		29	10	S2468_003_0	4	6	Specialty Tier	010010	
S2468	004	0		29	10	S2468_004_0	6	1	Preferred Generic	001000	
S2468	004	0		29	10	S2468_004_0	6	2	Non-Preferred Generic	001100	
S2468	004	0		29	10	S2468_004_0	6	3	Preferred Brand	000101	
S2468	004	0		29	10	S2468_004_0	6	4	Non-Preferred Brand	100100	
S2468	004	0		29	10	S2468_004_0	6	5	Injectable Drugs	010010	
S2468	004	0		29	10	S2468_004_0	6	6	Specialty Tier	010010	
S2505	001	0		29	10	S2505_001_0	3	4	Non-Preferred Brand	100000	
S2505	001	0		29	10	S2505_001_0	3	5	Specialty Tier	010010	
S2505	001	0		29	10	S2505_001_0	3	3	Preferred Brand	000001	
S2505	001	0		29	10	S2505_001_0	3	2	Non-Preferred Generic	000100	
S2505	001	0		29	10	S2505_001_0	3	1	Preferred Generic	001000	
S2505	003	0		29	10	S2505_003_0	3	4	Non-Preferred Brand	100000	
S2505	003	0		29	10	S2505_003_0	3	2	Non-Preferred Generic	000100	
S2505	003	0		29	10	S2505_003_0	3	1	Preferred Generic	001000	
S2505	003	0		29	10	S2505_003_0	3	3	Preferred Brand	000001	
S2505	003	0		29	10	S2505_003_0	3	5	Specialty Tier	010010	
S2505	005	0		29	10	S2505_005_0	3	4	Non-Preferred Brand	100000	
S2505	005	0		29	10	S2505_005_0	3	5	Specialty Tier	010010	
S2505	005	0		29	10	S2505_005_0	3	3	Preferred Brand	000001	
S2505	005	0		29	10	S2505_005_0	3	2	Non-Preferred Generic	000100	
S2505	005	0		29	10	S2505_005_0	3	1	Preferred Generic	001000	
S2505	007	0		29	10	S2505_007_0	3	5	Specialty Tier	010010	
S2505	007	0		29	10	S2505_007_0	3	1	Preferred Generic	001000	
S2505	007	0		29	10	S2505_007_0	3	2	Non-Preferred Generic	000100	
S2505	007	0		29	10	S2505_007_0	3	3	Preferred Brand	000001	
S2505	007	0		29	10	S2505_007_0	3	4	Non-Preferred Brand	100000	
S2505	009	0		29	10	S2505_009_0	1	2	Non-Preferred Generic	000100	
S2505	009	0		29	10	S2505_009_0	1	5	Specialty Tier	010010	
S2505	009	0		29	10	S2505_009_0	1	4	Non-Preferred Brand	100000	
S2505	009	0		29	10	S2505_009_0	1	3	Preferred Brand	000001	
S2505	009	0		29	10	S2505_009_0	1	1	Preferred Generic	001000	
S2505	010	0		29	10	S2505_010_0	1	1	Preferred Generic	001000	
S2505	010	0		29	10	S2505_010_0	1	2	Non-Preferred Generic	000100	
S2505	010	0		29	10	S2505_010_0	1	5	Specialty Tier	010010	
S2505	010	0		29	10	S2505_010_0	1	4	Non-Preferred Brand	100000	
S2505	010	0		29	10	S2505_010_0	1	3	Preferred Brand	000001	
S2874	001	0		29	10	S2874_001_0	3	1	Preferred Generic	001010	
S2874	001	0		29	10	S2874_001_0	3	2	Non-Preferred Generic	000101	
S2874	001	0		29	10	S2874_001_0	3	3	Preferred Brand	000101	
S2874	001	0		29	10	S2874_001_0	3	4	Non-Preferred Brand	110000	
S2874	001	0		29	10	S2874_001_0	3	5	Specialty Tier	010010	
S2874	001	0		29	10	S2874_001_0	3	3	Preferred Brand	000101	2
S2874	001	0		29	10	S2874_001_0	3	4	Non-Preferred Brand	110000	2
S2874	004	0		29	10	S2874_004_0	5	1	Preferred Generic	001010	
S2874	004	0		29	10	S2874_004_0	5	2	Non-Preferred Generic	000101	
S2874	004	0		29	10	S2874_004_0	5	5	Specialty Tier	010010	
S2874	004	0		29	10	S2874_004_0	5	4	Non-Preferred Brand	110000	
S2874	004	0		29	10	S2874_004_0	5	3	Preferred Brand	000101	
S2893	001	0		29	10	S2893_001_0	1	1	Preferred Generic	001000	
S2893	001	0		29	10	S2893_001_0	1	4	Non-Preferred Brand	100100	
S2893	001	0		29	10	S2893_001_0	1	3	Preferred Brand	000101	
S2893	001	0		29	10	S2893_001_0	1	2	Non-Preferred Generic	000100	
S2893	001	0		29	10	S2893_001_0	1	5	Specialty Tier	010010	
S2893	003	0		29	10	S2893_003_0	1	1	Preferred Generic	001000	1
S2893	003	0		29	10	S2893_003_0	1	2	Non-Preferred Generic	000100	1
S2893	003	0		29	10	S2893_003_0	1	1	Preferred Generic	001000	
S2893	003	0		29	10	S2893_003_0	1	2	Non-Preferred Generic	000100	
S2893	003	0		29	10	S2893_003_0	1	3	Preferred Brand	000001	
S2893	003	0		29	10	S2893_003_0	1	4	Non-Preferred Brand	100000	
S2893	003	0		29	10	S2893_003_0	1	5	Specialty Tier	010010	
S3440	004	0		29	10	S3440_004_0	6	1	Preferred Generic	001000	
S3440	004	0		29	10	S3440_004_0	6	2	Non-Preferred Generic	000100	
S3440	004	0		29	10	S3440_004_0	6	3	Preferred Brand	000001	
S3440	004	0		29	10	S3440_004_0	6	4	Non-Preferred Brand	100000	
S3440	004	0		29	10	S3440_004_0	6	5	Specialty Tier	000010	
S3521	001	0		29	10	S3521_001_0	4	1	Preferred Generic	001000	
S3521	001	0		29	10	S3521_001_0	4	2	Non-Preferred Generic	000100	
S3521	001	0		29	10	S3521_001_0	4	3	Preferred Brand	000001	
S3521	001	0		29	10	S3521_001_0	4	4	Non-Preferred Brand	100000	
S4219	001	0		29	10	S4219_001_0	1	4	Non-Preferred Brand	100000	
S4219	001	0		29	10	S4219_001_0	1	3	Preferred Brand	000001	
S4219	001	0		29	10	S4219_001_0	1	2	Non-Preferred Generic	000100	
S4219	001	0		29	10	S4219_001_0	1	1	Preferred Generic	001000	
S4219	001	0		29	10	S4219_001_0	1	5	Specialty Tier	100000	
S4219	003	0		29	10	S4219_003_0	1	1	Preferred Generic	001000	
S4219	003	0		29	10	S4219_003_0	1	2	Non-Preferred Generic	000100	
S4219	003	0		29	10	S4219_003_0	1	3	Preferred Brand	000001	
S4219	003	0		29	10	S4219_003_0	1	4	Non-Preferred Brand	100000	
S4219	003	0		29	10	S4219_003_0	1	5	Specialty Tier	100000	
S4802	012	0		29	10	S4802_012_0	3	5	Specialty Tier	010010	
S4802	012	0		29	10	S4802_012_0	3	4	Non-Preferred Brand	100000	
S4802	012	0		29	10	S4802_012_0	3	3	Preferred Brand	000001	
S4802	012	0		29	10	S4802_012_0	3	1	Preferred Generic	001000	
S4802	012	0		29	10	S4802_012_0	3	2	Non-Preferred Generic	000100	
S4802	013	0		29	10	S4802_013_0	3	4	Non-Preferred Brand	100000	
S4802	013	0		29	10	S4802_013_0	3	3	Preferred Brand	000001	
S4802	013	0		29	10	S4802_013_0	3	2	Non-Preferred Generic	000100	
S4802	013	0		29	10	S4802_013_0	3	1	Preferred Generic	001000	
S4802	013	0		29	10	S4802_013_0	3	5	Specialty Tier	010010	
S4802	014	0		29	10	S4802_014_0	3	4	Non-Preferred Brand	100000	
S4802	014	0		29	10	S4802_014_0	3	3	Preferred Brand	000001	
S4802	014	0		29	10	S4802_014_0	3	2	Non-Preferred Generic	000100	
S4802	014	0		29	10	S4802_014_0	3	1	Preferred Generic	001000	
S4802	014	0		29	10	S4802_014_0	3	5	Specialty Tier	010010	
S4802	020	0		29	10	S4802_020_0	3	5	Specialty Tier	010010	
S4802	020	0		29	10	S4802_020_0	3	4	Non-Preferred Brand	100000	
S4802	020	0		29	10	S4802_020_0	3	3	Preferred Brand	000001	
S4802	020	0		29	10	S4802_020_0	3	1	Preferred Generic	001000	
S4802	020	0		29	10	S4802_020_0	3	2	Non-Preferred Generic	000100	
S4802	021	0		29	10	S4802_021_0	3	4	Non-Preferred Brand	100000	
S4802	021	0		29	10	S4802_021_0	3	3	Preferred Brand	000001	
S4802	021	0		29	10	S4802_021_0	3	2	Non-Preferred Generic	000100	
S4802	021	0		29	10	S4802_021_0	3	1	Preferred Generic	001000	
S4802	021	0		29	10	S4802_021_0	3	5	Specialty Tier	010010	
S5540	002	0		29	10	S5540_002_0	5	5	Specialty Tier	101101	
S5540	002	0		29	10	S5540_002_0	5	4	Non-Preferred Brand	110000	
S5540	002	0		29	10	S5540_002_0	5	3	Preferred Brand	000001	
S5540	002	0		29	10	S5540_002_0	5	2	Non-Preferred Generic	000100	
S5540	002	0		29	10	S5540_002_0	5	1	Preferred Generic	001000	
S5540	004	0		29	10	S5540_004_0	4	5	Specialty Tier	101101	
S5540	004	0		29	10	S5540_004_0	4	4	Non-Preferred Brand	110000	
S5540	004	0		29	10	S5540_004_0	4	3	Preferred Brand	000001	
S5540	004	0		29	10	S5540_004_0	4	2	Non-Preferred Generic	000100	
S5540	004	0		29	10	S5540_004_0	4	1	Preferred Generic	001000	1
S5540	004	0		29	10	S5540_004_0	4	1	Preferred Generic	001000	
S5552	003	0		29	10	S5552_003_0	4	4	Non-Preferred Brand	110000	2
S5552	003	0		29	10	S5552_003_0	4	3	Preferred Brand	000101	2
S5552	003	0		29	10	S5552_003_0	4	5	Specialty Tier	010010	
S5552	003	0		29	10	S5552_003_0	4	4	Non-Preferred Brand	110000	
S5552	003	0		29	10	S5552_003_0	4	1	Preferred Generic	001010	
S5552	003	0		29	10	S5552_003_0	4	2	Non-Preferred Generic	000101	
S5552	003	0		29	10	S5552_003_0	4	3	Preferred Brand	000101	
S5552	004	0		29	10	S5552_004_0	6	5	Specialty Tier	010010	
S5552	004	0		29	10	S5552_004_0	6	4	Non-Preferred Brand	110000	
S5552	004	0		29	10	S5552_004_0	6	3	Preferred Brand	000101	
S5552	004	0		29	10	S5552_004_0	6	2	Non-Preferred Generic	000101	
S5552	004	0		29	10	S5552_004_0	6	1	Preferred Generic	001010	
S5552	005	0		29	10	S5552_005_0	7	1	Preferred Generic	001010	
S5552	005	0		29	10	S5552_005_0	7	2	Non-Preferred Generic	000101	
S5552	005	0		29	10	S5552_005_0	7	3	Preferred Brand	000101	
S5552	005	0		29	10	S5552_005_0	7	4	Non-Preferred Brand	110000	
S5552	005	0		29	10	S5552_005_0	7	5	Specialty Tier	010010	
S5569	006	0		29	10	S5569_006_0	4	1	Preferred Generic	001000	
S5569	006	0		29	10	S5569_006_0	4	2	Non-Preferred Generic	000100	
S5569	006	0		29	10	S5569_006_0	4	3	Preferred Brand	000001	
S5569	006	0		29	10	S5569_006_0	4	4	Non-Preferred Brand	100100	
S5569	006	0		29	10	S5569_006_0	4	5	Specialty Tier	010010	
S5569	007	0		29	10	S5569_007_0	3	1	Preferred Generic	001000	
S5569	007	0		29	10	S5569_007_0	3	2	Preferred Brand	000001	
S5569	007	0		29	10	S5569_007_0	3	3	Non-Preferred Brand	100100	
S5580	003	0		29	10	S5580_003_0	2	3	Preferred Brand	010001	
S5580	003	0		29	10	S5580_003_0	2	1	Preferred Generic	001010	
S5580	003	0		29	10	S5580_003_0	2	2	Non-Preferred Generic	000110	
S5580	003	0		29	10	S5580_003_0	2	4	Non-Preferred Brand	110000	
S5580	003	0		29	10	S5580_003_0	2	5	Specialty Tier	010010	
S5580	006	0		29	10	S5580_006_0	2	3	Preferred Brand	010001	
S5580	006	0		29	10	S5580_006_0	2	2	Non-Preferred Generic	000110	
S5580	006	0		29	10	S5580_006_0	2	4	Non-Preferred Brand	110000	
S5580	006	0		29	10	S5580_006_0	2	5	Specialty Tier	010010	
S5580	006	0		29	10	S5580_006_0	2	1	Preferred Generic	001010	
S5584	001	0		29	10	S5584_001_0	6	5	Specialty Tier	010010	
S5584	001	0		29	10	S5584_001_0	6	4	Non-Preferred Brand	100000	
S5584	001	0		29	10	S5584_001_0	6	3	Preferred Brand	000001	
S5584	001	0		29	10	S5584_001_0	6	1	Preferred Generic	001000	
S5584	001	0		29	10	S5584_001_0	6	2	Non-Preferred Generic	000100	
S5584	002	0		29	10	S5584_002_0	7	5	Specialty Tier	010010	
S5584	002	0		29	10	S5584_002_0	7	4	Non-Preferred Brand	100000	
S5584	002	0		29	10	S5584_002_0	7	3	Preferred Brand	000001	
S5584	002	0		29	10	S5584_002_0	7	2	Non-Preferred Generic	000100	
S5584	002	0		29	10	S5584_002_0	7	1	Preferred Generic	001000	
S5584	002	0		29	10	S5584_002_0	7	1	Preferred Generic	001000	1
S5593	002	0		29	10	S5593_002_0	5	1	Preferred Generic	001000	
S5593	002	0		29	10	S5593_002_0	5	5	Specialty Tier	010010	
S5593	002	0		29	10	S5593_002_0	5	4	Non-Preferred Brand	100000	
S5593	002	0		29	10	S5593_002_0	5	3	Preferred Brand	000001	
S5593	002	0		29	10	S5593_002_0	5	2	Non-Preferred Generic	000100	
S5593	003	0		29	10	S5593_003_0	5	1	Generic	010000	
S5593	003	0		29	10	S5593_003_0	5	2	Preferred Brand	000001	
S5593	003	0		29	10	S5593_003_0	5	3	Non-Preferred Brand	100000	
S5593	003	0		29	10	S5593_003_0	5	4	Specialty Tier	010010	
S5593	003	0		29	10	S5593_003_0	5	1	Generic	010000	1
S5593	007	0		29	10	S5593_007_0	5	5	Specialty Tier	010010	
S5593	007	0		29	10	S5593_007_0	5	4	Non-Preferred Brand	100000	
S5593	007	0		29	10	S5593_007_0	5	3	Preferred Brand	000001	
S5593	007	0		29	10	S5593_007_0	5	2	Non-Preferred Generic	000100	
S5593	007	0		29	10	S5593_007_0	5	1	Preferred Generic	001000	
S5593	008	0		29	10	S5593_008_0	5	1	Generic	010000	
S5593	008	0		29	10	S5593_008_0	5	2	Preferred Brand	000001	
S5593	008	0		29	10	S5593_008_0	5	3	Non-Preferred Brand	100000	
S5593	008	0		29	10	S5593_008_0	5	4	Specialty Tier	010010	
S5593	008	0		29	10	S5593_008_0	5	1	Generic	010000	1
S5596	001	0		29	10	S5596_001_0	4	1	Preferred Generic	001000	1
S5596	001	0		29	10	S5596_001_0	4	6	Specialty Tier	010010	
S5596	001	0		29	10	S5596_001_0	4	5	Injectable Drugs	010010	
S5596	001	0		29	10	S5596_001_0	4	4	Non-Preferred Brand	100100	
S5596	001	0		29	10	S5596_001_0	4	3	Preferred Brand	000101	
S5596	001	0		29	10	S5596_001_0	4	2	Non-Preferred Generic	000100	
S5596	001	0		29	10	S5596_001_0	4	1	Preferred Generic	001000	
S5596	003	0		29	10	S5596_003_0	4	1	Preferred Generic	001000	1
S5596	003	0		29	10	S5596_003_0	4	6	Specialty Tier	010010	
S5596	003	0		29	10	S5596_003_0	4	5	Injectable Drugs	010010	
S5596	003	0		29	10	S5596_003_0	4	4	Non-Preferred Brand	100100	
S5596	003	0		29	10	S5596_003_0	4	3	Preferred Brand	000101	
S5596	003	0		29	10	S5596_003_0	4	2	Non-Preferred Generic	000100	
S5596	003	0		29	10	S5596_003_0	4	1	Preferred Generic	001000	
S5596	003	0		29	10	S5596_003_0	4	2	Non-Preferred Generic	000100	1
S5596	003	0		29	10	S5596_003_0	4	3	Preferred Brand	000101	2
S5596	005	0		29	10	S5596_005_0	3	6	Specialty Tier	010010	
S5596	005	0		29	10	S5596_005_0	3	5	Injectable Drugs	010010	
S5596	005	0		29	10	S5596_005_0	3	4	Non-Preferred Brand	100100	
S5596	005	0		29	10	S5596_005_0	3	3	Preferred Brand	000101	
S5596	005	0		29	10	S5596_005_0	3	2	Non-Preferred Generic	000100	
S5596	005	0		29	10	S5596_005_0	3	1	Preferred Generic	001000	
S5596	006	0		29	10	S5596_006_0	4	6	Specialty Tier	010010	
S5596	006	0		29	10	S5596_006_0	4	5	Injectable Drugs	010010	
S5596	006	0		29	10	S5596_006_0	4	4	Non-Preferred Brand	100100	
S5596	006	0		29	10	S5596_006_0	4	3	Preferred Brand	000101	
S5596	006	0		29	10	S5596_006_0	4	2	Non-Preferred Generic	000100	
S5596	006	0		29	10	S5596_006_0	4	1	Preferred Generic	001000	1
S5596	006	0		29	10	S5596_006_0	4	1	Preferred Generic	001000	
S5596	007	0		29	10	S5596_007_0	4	1	Preferred Generic	001000	
S5596	007	0		29	10	S5596_007_0	4	3	Preferred Brand	000101	2
S5596	007	0		29	10	S5596_007_0	4	2	Non-Preferred Generic	000100	1
S5596	007	0		29	10	S5596_007_0	4	1	Preferred Generic	001000	1
S5596	007	0		29	10	S5596_007_0	4	6	Specialty Tier	010010	
S5596	007	0		29	10	S5596_007_0	4	5	Injectable Drugs	010010	
S5596	007	0		29	10	S5596_007_0	4	4	Non-Preferred Brand	100100	
S5596	007	0		29	10	S5596_007_0	4	3	Preferred Brand	000101	
S5596	007	0		29	10	S5596_007_0	4	2	Non-Preferred Generic	000100	
S5596	009	0		29	10	S5596_009_0	3	4	Non-Preferred Brand	100100	
S5596	009	0		29	10	S5596_009_0	3	3	Preferred Brand	000101	
S5596	009	0		29	10	S5596_009_0	3	2	Non-Preferred Generic	000100	
S5596	009	0		29	10	S5596_009_0	3	1	Preferred Generic	001000	
S5596	009	0		29	10	S5596_009_0	3	5	Injectable Drugs	010010	
S5596	009	0		29	10	S5596_009_0	3	6	Specialty Tier	010010	
S5596	010	0		29	10	S5596_010_0	4	4	Non-Preferred Brand	100100	
S5596	010	0		29	10	S5596_010_0	4	3	Preferred Brand	000101	
S5596	010	0		29	10	S5596_010_0	4	2	Non-Preferred Generic	000100	
S5596	010	0		29	10	S5596_010_0	4	1	Preferred Generic	001000	
S5596	010	0		29	10	S5596_010_0	4	5	Injectable Drugs	010010	
S5596	010	0		29	10	S5596_010_0	4	1	Preferred Generic	001000	1
S5596	010	0		29	10	S5596_010_0	4	6	Specialty Tier	010010	
S5596	011	0		29	10	S5596_011_0	4	2	Non-Preferred Generic	000100	1
S5596	011	0		29	10	S5596_011_0	4	1	Preferred Generic	001000	1
S5596	011	0		29	10	S5596_011_0	4	6	Specialty Tier	010010	
S5596	011	0		29	10	S5596_011_0	4	5	Injectable Drugs	010010	
S5596	011	0		29	10	S5596_011_0	4	3	Preferred Brand	000101	2
S5596	011	0		29	10	S5596_011_0	4	3	Preferred Brand	000101	
S5596	011	0		29	10	S5596_011_0	4	1	Preferred Generic	001000	
S5596	011	0		29	10	S5596_011_0	4	2	Non-Preferred Generic	000100	
S5596	011	0		29	10	S5596_011_0	4	4	Non-Preferred Brand	100100	
S5596	013	0		29	10	S5596_013_0	3	4	Non-Preferred Brand	100100	
S5596	013	0		29	10	S5596_013_0	3	5	Injectable Drugs	010010	
S5596	013	0		29	10	S5596_013_0	3	6	Specialty Tier	010010	
S5596	013	0		29	10	S5596_013_0	3	1	Preferred Generic	001000	
S5596	013	0		29	10	S5596_013_0	3	2	Non-Preferred Generic	000100	
S5596	013	0		29	10	S5596_013_0	3	3	Preferred Brand	000101	
S5596	014	0		29	10	S5596_014_0	3	1	Preferred Generic	001000	
S5596	014	0		29	10	S5596_014_0	3	2	Non-Preferred Generic	000100	
S5596	014	0		29	10	S5596_014_0	3	1	Preferred Generic	001000	1
S5596	014	0		29	10	S5596_014_0	3	6	Specialty Tier	010010	
S5596	014	0		29	10	S5596_014_0	3	5	Injectable Drugs	010010	
S5596	014	0		29	10	S5596_014_0	3	4	Non-Preferred Brand	100100	
S5596	014	0		29	10	S5596_014_0	3	3	Preferred Brand	000101	
S5596	015	0		29	10	S5596_015_0	3	2	Non-Preferred Generic	000100	
S5596	015	0		29	10	S5596_015_0	3	3	Preferred Brand	000101	
S5596	015	0		29	10	S5596_015_0	3	1	Preferred Generic	001000	
S5596	015	0		29	10	S5596_015_0	3	5	Injectable Drugs	010010	
S5596	015	0		29	10	S5596_015_0	3	4	Non-Preferred Brand	100100	
S5596	015	0		29	10	S5596_015_0	3	1	Preferred Generic	001000	1
S5596	015	0		29	10	S5596_015_0	3	2	Non-Preferred Generic	000100	1
S5596	015	0		29	10	S5596_015_0	3	3	Preferred Brand	000101	2
S5596	015	0		29	10	S5596_015_0	3	6	Specialty Tier	010010	
S5596	017	0		29	10	S5596_017_0	3	5	Injectable Drugs	010010	
S5596	017	0		29	10	S5596_017_0	3	6	Specialty Tier	010010	
S5596	017	0		29	10	S5596_017_0	3	4	Non-Preferred Brand	100100	
S5596	017	0		29	10	S5596_017_0	3	3	Preferred Brand	000101	
S5596	017	0		29	10	S5596_017_0	3	2	Non-Preferred Generic	000100	
S5596	017	0		29	10	S5596_017_0	3	1	Preferred Generic	001000	
S5596	018	0		29	10	S5596_018_0	4	3	Preferred Brand	000101	
S5596	018	0		29	10	S5596_018_0	4	2	Non-Preferred Generic	000100	
S5596	018	0		29	10	S5596_018_0	4	1	Preferred Generic	001000	
S5596	018	0		29	10	S5596_018_0	4	1	Preferred Generic	001000	1
S5596	018	0		29	10	S5596_018_0	4	6	Specialty Tier	010010	
S5596	018	0		29	10	S5596_018_0	4	5	Injectable Drugs	010010	
S5596	018	0		29	10	S5596_018_0	4	4	Non-Preferred Brand	100100	
S5596	019	0		29	10	S5596_019_0	4	3	Preferred Brand	000101	
S5596	019	0		29	10	S5596_019_0	4	2	Non-Preferred Generic	000100	
S5596	019	0		29	10	S5596_019_0	4	1	Preferred Generic	001000	
S5596	019	0		29	10	S5596_019_0	4	1	Preferred Generic	001000	1
S5596	019	0		29	10	S5596_019_0	4	2	Non-Preferred Generic	000100	1
S5596	019	0		29	10	S5596_019_0	4	3	Preferred Brand	000101	2
S5596	019	0		29	10	S5596_019_0	4	4	Non-Preferred Brand	100100	
S5596	019	0		29	10	S5596_019_0	4	6	Specialty Tier	010010	
S5596	019	0		29	10	S5596_019_0	4	5	Injectable Drugs	010010	
S5596	033	0		29	10	S5596_033_0	4	6	Specialty Tier	010010	
S5596	033	0		29	10	S5596_033_0	4	4	Non-Preferred Brand	100100	
S5596	033	0		29	10	S5596_033_0	4	5	Injectable Drugs	010010	
S5596	033	0		29	10	S5596_033_0	4	3	Preferred Brand	000101	
S5596	033	0		29	10	S5596_033_0	4	2	Non-Preferred Generic	000100	
S5596	033	0		29	10	S5596_033_0	4	1	Preferred Generic	001000	
S5596	034	0		29	10	S5596_034_0	4	5	Injectable Drugs	010010	
S5596	034	0		29	10	S5596_034_0	4	6	Specialty Tier	010010	
S5596	034	0		29	10	S5596_034_0	4	3	Preferred Brand	000101	
S5596	034	0		29	10	S5596_034_0	4	4	Non-Preferred Brand	100100	
S5596	034	0		29	10	S5596_034_0	4	1	Preferred Generic	001000	1
S5596	034	0		29	10	S5596_034_0	4	2	Non-Preferred Generic	000100	
S5596	034	0		29	10	S5596_034_0	4	1	Preferred Generic	001000	
S5596	035	0		29	10	S5596_035_0	4	1	Preferred Generic	001000	
S5596	035	0		29	10	S5596_035_0	4	2	Non-Preferred Generic	000100	
S5596	035	0		29	10	S5596_035_0	4	3	Preferred Brand	000101	
S5596	035	0		29	10	S5596_035_0	4	4	Non-Preferred Brand	100100	
S5596	035	0		29	10	S5596_035_0	4	5	Injectable Drugs	010010	
S5596	035	0		29	10	S5596_035_0	4	6	Specialty Tier	010010	
S5596	035	0		29	10	S5596_035_0	4	1	Preferred Generic	001000	1
S5596	035	0		29	10	S5596_035_0	4	2	Non-Preferred Generic	000100	1
S5596	035	0		29	10	S5596_035_0	4	3	Preferred Brand	000101	2
S5596	043	0		29	10	S5596_043_0	3	1	Preferred Generic	001000	
S5596	043	0		29	10	S5596_043_0	3	2	Non-Preferred Generic	000100	
S5596	043	0		29	10	S5596_043_0	3	6	Specialty Tier	010010	
S5596	043	0		29	10	S5596_043_0	3	5	Injectable Drugs	010010	
S5596	043	0		29	10	S5596_043_0	3	4	Non-Preferred Brand	100100	
S5596	043	0		29	10	S5596_043_0	3	3	Preferred Brand	000101	
S5596	044	0		29	10	S5596_044_0	4	1	Preferred Generic	001000	1
S5596	044	0		29	10	S5596_044_0	4	5	Injectable Drugs	010010	
S5596	044	0		29	10	S5596_044_0	4	6	Specialty Tier	010010	
S5596	044	0		29	10	S5596_044_0	4	4	Non-Preferred Brand	100100	
S5596	044	0		29	10	S5596_044_0	4	3	Preferred Brand	000101	
S5596	044	0		29	10	S5596_044_0	4	2	Non-Preferred Generic	000100	
S5596	044	0		29	10	S5596_044_0	4	1	Preferred Generic	001000	
S5596	045	0		29	10	S5596_045_0	4	2	Non-Preferred Generic	000100	
S5596	045	0		29	10	S5596_045_0	4	1	Preferred Generic	001000	1
S5596	045	0		29	10	S5596_045_0	4	2	Non-Preferred Generic	000100	1
S5596	045	0		29	10	S5596_045_0	4	3	Preferred Brand	000101	2
S5596	045	0		29	10	S5596_045_0	4	5	Injectable Drugs	010010	
S5596	045	0		29	10	S5596_045_0	4	1	Preferred Generic	001000	
S5596	045	0		29	10	S5596_045_0	4	4	Non-Preferred Brand	100100	
S5596	045	0		29	10	S5596_045_0	4	3	Preferred Brand	000101	
S5596	045	0		29	10	S5596_045_0	4	6	Specialty Tier	010010	
S5596	046	0		29	10	S5596_046_0	3	1	Preferred Generic	001000	
S5596	046	0		29	10	S5596_046_0	3	6	Specialty Tier	010010	
S5596	046	0		29	10	S5596_046_0	3	5	Injectable Drugs	010010	
S5596	046	0		29	10	S5596_046_0	3	4	Non-Preferred Brand	100100	
S5596	046	0		29	10	S5596_046_0	3	3	Preferred Brand	000101	
S5596	046	0		29	10	S5596_046_0	3	2	Non-Preferred Generic	000100	
S5596	056	0		29	10	S5596_056_0	3	6	Specialty Tier	010010	
S5596	056	0		29	10	S5596_056_0	3	5	Injectable Drugs	010010	
S5596	056	0		29	10	S5596_056_0	3	4	Non-Preferred Brand	100100	
S5596	056	0		29	10	S5596_056_0	3	3	Preferred Brand	000101	
S5596	056	0		29	10	S5596_056_0	3	2	Non-Preferred Generic	000100	
S5596	056	0		29	10	S5596_056_0	3	1	Preferred Generic	001000	
S5596	057	0		29	10	S5596_057_0	4	6	Specialty Tier	010010	
S5596	057	0		29	10	S5596_057_0	4	5	Injectable Drugs	010010	
S5596	057	0		29	10	S5596_057_0	4	4	Non-Preferred Brand	100100	
S5596	057	0		29	10	S5596_057_0	4	3	Preferred Brand	000101	
S5596	057	0		29	10	S5596_057_0	4	2	Non-Preferred Generic	000100	
S5596	057	0		29	10	S5596_057_0	4	1	Preferred Generic	001000	1
S5596	057	0		29	10	S5596_057_0	4	1	Preferred Generic	001000	
S5596	058	0		29	10	S5596_058_0	4	1	Preferred Generic	001000	
S5596	058	0		29	10	S5596_058_0	4	3	Preferred Brand	000101	2
S5596	058	0		29	10	S5596_058_0	4	2	Non-Preferred Generic	000100	1
S5596	058	0		29	10	S5596_058_0	4	1	Preferred Generic	001000	1
S5596	058	0		29	10	S5596_058_0	4	6	Specialty Tier	010010	
S5596	058	0		29	10	S5596_058_0	4	5	Injectable Drugs	010010	
S5596	058	0		29	10	S5596_058_0	4	2	Non-Preferred Generic	000100	
S5596	058	0		29	10	S5596_058_0	4	3	Preferred Brand	000101	
S5596	058	0		29	10	S5596_058_0	4	4	Non-Preferred Brand	100100	
S5596	059	0		29	10	S5596_059_0	3	2	Non-Preferred Generic	000100	
S5596	059	0		29	10	S5596_059_0	3	1	Preferred Generic	001000	
S5596	059	0		29	10	S5596_059_0	3	5	Injectable Drugs	010010	
S5596	059	0		29	10	S5596_059_0	3	4	Non-Preferred Brand	100100	
S5596	059	0		29	10	S5596_059_0	3	3	Preferred Brand	000101	
S5596	059	0		29	10	S5596_059_0	3	6	Specialty Tier	010010	
S5596	060	0		29	10	S5596_060_0	4	1	Preferred Generic	001000	1
S5596	060	0		29	10	S5596_060_0	4	4	Non-Preferred Brand	100100	
S5596	060	0		29	10	S5596_060_0	4	3	Preferred Brand	000101	
S5596	060	0		29	10	S5596_060_0	4	2	Non-Preferred Generic	000100	
S5596	060	0		29	10	S5596_060_0	4	1	Preferred Generic	001000	
S5596	060	0		29	10	S5596_060_0	4	6	Specialty Tier	010010	
S5596	060	0		29	10	S5596_060_0	4	5	Injectable Drugs	010010	
S5596	061	0		29	10	S5596_061_0	4	2	Non-Preferred Generic	000100	1
S5596	061	0		29	10	S5596_061_0	4	1	Preferred Generic	001000	
S5596	061	0		29	10	S5596_061_0	4	2	Non-Preferred Generic	000100	
S5596	061	0		29	10	S5596_061_0	4	3	Preferred Brand	000101	2
S5596	061	0		29	10	S5596_061_0	4	4	Non-Preferred Brand	100100	
S5596	061	0		29	10	S5596_061_0	4	5	Injectable Drugs	010010	
S5596	061	0		29	10	S5596_061_0	4	6	Specialty Tier	010010	
S5596	061	0		29	10	S5596_061_0	4	1	Preferred Generic	001000	1
S5596	061	0		29	10	S5596_061_0	4	3	Preferred Brand	000101	
S5596	062	0		29	10	S5596_062_0	3	2	Non-Preferred Generic	000100	
S5596	062	0		29	10	S5596_062_0	3	1	Preferred Generic	001000	
S5596	062	0		29	10	S5596_062_0	3	3	Preferred Brand	000101	
S5596	062	0		29	10	S5596_062_0	3	6	Specialty Tier	010010	
S5596	062	0		29	10	S5596_062_0	3	5	Injectable Drugs	010010	
S5596	062	0		29	10	S5596_062_0	3	4	Non-Preferred Brand	100100	
S5596	063	0		29	10	S5596_063_0	4	2	Non-Preferred Generic	000100	
S5596	063	0		29	10	S5596_063_0	4	1	Preferred Generic	001000	
S5596	063	0		29	10	S5596_063_0	4	1	Preferred Generic	001000	1
S5596	063	0		29	10	S5596_063_0	4	6	Specialty Tier	010010	
S5596	063	0		29	10	S5596_063_0	4	5	Injectable Drugs	010010	
S5596	063	0		29	10	S5596_063_0	4	4	Non-Preferred Brand	100100	
S5596	063	0		29	10	S5596_063_0	4	3	Preferred Brand	000101	
S5596	064	0		29	10	S5596_064_0	4	2	Non-Preferred Generic	000100	
S5596	064	0		29	10	S5596_064_0	4	1	Preferred Generic	001000	
S5596	064	0		29	10	S5596_064_0	4	3	Preferred Brand	000101	
S5596	064	0		29	10	S5596_064_0	4	4	Non-Preferred Brand	100100	
S5596	064	0		29	10	S5596_064_0	4	5	Injectable Drugs	010010	
S5596	064	0		29	10	S5596_064_0	4	6	Specialty Tier	010010	
S5596	064	0		29	10	S5596_064_0	4	3	Preferred Brand	000101	2
S5596	064	0		29	10	S5596_064_0	4	2	Non-Preferred Generic	000100	1
S5596	064	0		29	10	S5596_064_0	4	1	Preferred Generic	001000	1
S5601	002	0		29	10	S5601_002_0	2	1	Generic	010001	
S5601	002	0		29	10	S5601_002_0	2	2	Preferred Brand	000101	
S5601	002	0		29	10	S5601_002_0	2	3	Non-Preferred Brand	100100	
S5601	002	0		29	10	S5601_002_0	2	4	Specialty Tier	010010	
S5601	003	0		29	10	S5601_003_0	2	1	Generic	010001	
S5601	003	0		29	10	S5601_003_0	2	2	Preferred Brand	000101	
S5601	003	0		29	10	S5601_003_0	2	3	Non-Preferred Brand	100100	
S5601	003	0		29	10	S5601_003_0	2	1	Generic	010001	1
S5601	003	0		29	10	S5601_003_0	2	2	Preferred Brand	000101	1
S5601	003	0		29	10	S5601_003_0	2	4	Specialty Tier	010010	
S5601	004	0		29	10	S5601_004_0	3	2	Preferred Brand	000101	
S5601	004	0		29	10	S5601_004_0	3	4	Specialty Tier	010010	
S5601	004	0		29	10	S5601_004_0	3	3	Non-Preferred Brand	100100	
S5601	004	0		29	10	S5601_004_0	3	1	Generic	010001	
S5601	005	0		29	10	S5601_005_0	3	3	Non-Preferred Brand	100100	
S5601	005	0		29	10	S5601_005_0	3	4	Specialty Tier	010010	
S5601	005	0		29	10	S5601_005_0	3	1	Generic	010001	1
S5601	005	0		29	10	S5601_005_0	3	2	Preferred Brand	000101	1
S5601	005	0		29	10	S5601_005_0	3	2	Preferred Brand	000101	
S5601	005	0		29	10	S5601_005_0	3	1	Generic	010001	
S5601	006	0		29	10	S5601_006_0	2	2	Preferred Brand	000101	
S5601	006	0		29	10	S5601_006_0	2	4	Specialty Tier	010010	
S5601	006	0		29	10	S5601_006_0	2	3	Non-Preferred Brand	100100	
S5601	006	0		29	10	S5601_006_0	2	1	Generic	010001	
S5601	007	0		29	10	S5601_007_0	2	3	Non-Preferred Brand	100100	
S5601	007	0		29	10	S5601_007_0	2	4	Specialty Tier	010010	
S5601	007	0		29	10	S5601_007_0	2	1	Generic	010001	1
S5601	007	0		29	10	S5601_007_0	2	2	Preferred Brand	000101	1
S5601	007	0		29	10	S5601_007_0	2	2	Preferred Brand	000101	
S5601	007	0		29	10	S5601_007_0	2	1	Generic	010001	
S5601	008	0		29	10	S5601_008_0	2	2	Preferred Brand	000101	
S5601	008	0		29	10	S5601_008_0	2	3	Non-Preferred Brand	100100	
S5601	008	0		29	10	S5601_008_0	2	4	Specialty Tier	010010	
S5601	008	0		29	10	S5601_008_0	2	1	Generic	010001	
S5601	009	0		29	10	S5601_009_0	2	4	Specialty Tier	010010	
S5601	009	0		29	10	S5601_009_0	2	3	Non-Preferred Brand	100100	
S5601	009	0		29	10	S5601_009_0	2	2	Preferred Brand	000101	
S5601	009	0		29	10	S5601_009_0	2	1	Generic	010001	
S5601	009	0		29	10	S5601_009_0	2	1	Generic	010001	1
S5601	009	0		29	10	S5601_009_0	2	2	Preferred Brand	000101	1
S5601	010	0		29	10	S5601_010_0	2	1	Generic	010001	
S5601	010	0		29	10	S5601_010_0	2	2	Preferred Brand	000101	
S5601	010	0		29	10	S5601_010_0	2	3	Non-Preferred Brand	100100	
S5601	010	0		29	10	S5601_010_0	2	4	Specialty Tier	010010	
S5601	011	0		29	10	S5601_011_0	2	1	Generic	010001	
S5601	011	0		29	10	S5601_011_0	2	2	Preferred Brand	000101	
S5601	011	0		29	10	S5601_011_0	2	3	Non-Preferred Brand	100100	
S5601	011	0		29	10	S5601_011_0	2	4	Specialty Tier	010010	
S5601	011	0		29	10	S5601_011_0	2	1	Generic	010001	1
S5601	011	0		29	10	S5601_011_0	2	2	Preferred Brand	000101	1
S5601	012	0		29	10	S5601_012_0	2	1	Generic	010001	
S5601	012	0		29	10	S5601_012_0	2	4	Specialty Tier	010010	
S5601	012	0		29	10	S5601_012_0	2	3	Non-Preferred Brand	100100	
S5601	012	0		29	10	S5601_012_0	2	2	Preferred Brand	000101	
S5601	013	0		29	10	S5601_013_0	2	2	Preferred Brand	000101	1
S5601	013	0		29	10	S5601_013_0	2	1	Generic	010001	
S5601	013	0		29	10	S5601_013_0	2	4	Specialty Tier	010010	
S5601	013	0		29	10	S5601_013_0	2	1	Generic	010001	1
S5601	013	0		29	10	S5601_013_0	2	2	Preferred Brand	000101	
S5601	013	0		29	10	S5601_013_0	2	3	Non-Preferred Brand	100100	
S5601	014	0		29	10	S5601_014_0	2	4	Specialty Tier	010010	
S5601	014	0		29	10	S5601_014_0	2	3	Non-Preferred Brand	100100	
S5601	014	0		29	10	S5601_014_0	2	2	Preferred Brand	000101	
S5601	014	0		29	10	S5601_014_0	2	1	Generic	010001	
S5601	015	0		29	10	S5601_015_0	2	4	Specialty Tier	010010	
S5601	015	0		29	10	S5601_015_0	2	2	Preferred Brand	000101	
S5601	015	0		29	10	S5601_015_0	2	1	Generic	010001	
S5601	015	0		29	10	S5601_015_0	2	2	Preferred Brand	000101	1
S5601	015	0		29	10	S5601_015_0	2	1	Generic	010001	1
S5601	015	0		29	10	S5601_015_0	2	3	Non-Preferred Brand	100100	
S5601	016	0		29	10	S5601_016_0	2	1	Generic	010001	
S5601	016	0		29	10	S5601_016_0	2	2	Preferred Brand	000101	
S5601	016	0		29	10	S5601_016_0	2	4	Specialty Tier	010010	
S5601	016	0		29	10	S5601_016_0	2	3	Non-Preferred Brand	100100	
S5601	017	0		29	10	S5601_017_0	2	2	Preferred Brand	000101	
S5601	017	0		29	10	S5601_017_0	2	3	Non-Preferred Brand	100100	
S5601	017	0		29	10	S5601_017_0	2	4	Specialty Tier	010010	
S5601	017	0		29	10	S5601_017_0	2	1	Generic	010001	1
S5601	017	0		29	10	S5601_017_0	2	2	Preferred Brand	000101	1
S5601	017	0		29	10	S5601_017_0	2	1	Generic	010001	
S5601	018	0		29	10	S5601_018_0	2	4	Specialty Tier	010010	
S5601	018	0		29	10	S5601_018_0	2	3	Non-Preferred Brand	100100	
S5601	018	0		29	10	S5601_018_0	2	2	Preferred Brand	000101	
S5601	018	0		29	10	S5601_018_0	2	1	Generic	010001	
S5601	019	0		29	10	S5601_019_0	2	1	Generic	010001	
S5601	019	0		29	10	S5601_019_0	2	2	Preferred Brand	000101	
S5601	019	0		29	10	S5601_019_0	2	3	Non-Preferred Brand	100100	
S5601	019	0		29	10	S5601_019_0	2	2	Preferred Brand	000101	1
S5601	019	0		29	10	S5601_019_0	2	1	Generic	010001	1
S5601	019	0		29	10	S5601_019_0	2	4	Specialty Tier	010010	
S5601	020	0		29	10	S5601_020_0	2	4	Specialty Tier	010010	
S5601	020	0		29	10	S5601_020_0	2	1	Generic	010001	
S5601	020	0		29	10	S5601_020_0	2	2	Preferred Brand	000101	
S5601	020	0		29	10	S5601_020_0	2	3	Non-Preferred Brand	100100	
S5601	021	0		29	10	S5601_021_0	2	3	Non-Preferred Brand	100100	
S5601	021	0		29	10	S5601_021_0	2	4	Specialty Tier	010010	
S5601	021	0		29	10	S5601_021_0	2	1	Generic	010001	1
S5601	021	0		29	10	S5601_021_0	2	2	Preferred Brand	000101	
S5601	021	0		29	10	S5601_021_0	2	2	Preferred Brand	000101	1
S5601	021	0		29	10	S5601_021_0	2	1	Generic	010001	
S5601	022	0		29	10	S5601_022_0	2	4	Specialty Tier	010010	
S5601	022	0		29	10	S5601_022_0	2	1	Generic	010001	
S5601	022	0		29	10	S5601_022_0	2	2	Preferred Brand	000101	
S5601	022	0		29	10	S5601_022_0	2	3	Non-Preferred Brand	100100	
S5601	023	0		29	10	S5601_023_0	2	2	Preferred Brand	000101	1
S5601	023	0		29	10	S5601_023_0	2	1	Generic	010001	1
S5601	023	0		29	10	S5601_023_0	2	3	Non-Preferred Brand	100100	
S5601	023	0		29	10	S5601_023_0	2	2	Preferred Brand	000101	
S5601	023	0		29	10	S5601_023_0	2	1	Generic	010001	
S5601	023	0		29	10	S5601_023_0	2	4	Specialty Tier	010010	
S5601	024	0		29	10	S5601_024_0	2	1	Generic	010001	
S5601	024	0		29	10	S5601_024_0	2	3	Non-Preferred Brand	100100	
S5601	024	0		29	10	S5601_024_0	2	4	Specialty Tier	010010	
S5601	024	0		29	10	S5601_024_0	2	2	Preferred Brand	000101	
S5601	025	0		29	10	S5601_025_0	2	1	Generic	010001	1
S5601	025	0		29	10	S5601_025_0	2	2	Preferred Brand	000101	1
S5601	025	0		29	10	S5601_025_0	2	4	Specialty Tier	010010	
S5601	025	0		29	10	S5601_025_0	2	3	Non-Preferred Brand	100100	
S5601	025	0		29	10	S5601_025_0	2	2	Preferred Brand	000101	
S5601	025	0		29	10	S5601_025_0	2	1	Generic	010001	
S5601	026	0		29	10	S5601_026_0	2	2	Preferred Brand	000101	
S5601	026	0		29	10	S5601_026_0	2	3	Non-Preferred Brand	100100	
S5601	026	0		29	10	S5601_026_0	2	4	Specialty Tier	010010	
S5601	026	0		29	10	S5601_026_0	2	1	Generic	010001	
S5601	027	0		29	10	S5601_027_0	2	1	Generic	010001	1
S5601	027	0		29	10	S5601_027_0	2	2	Preferred Brand	000101	1
S5601	027	0		29	10	S5601_027_0	2	1	Generic	010001	
S5601	027	0		29	10	S5601_027_0	2	2	Preferred Brand	000101	
S5601	027	0		29	10	S5601_027_0	2	3	Non-Preferred Brand	100100	
S5601	027	0		29	10	S5601_027_0	2	4	Specialty Tier	010010	
S5601	028	0		29	10	S5601_028_0	2	1	Generic	010001	
S5601	028	0		29	10	S5601_028_0	2	4	Specialty Tier	010010	
S5601	028	0		29	10	S5601_028_0	2	2	Preferred Brand	000101	
S5601	028	0		29	10	S5601_028_0	2	3	Non-Preferred Brand	100100	
S5601	029	0		29	10	S5601_029_0	2	1	Generic	010001	
S5601	029	0		29	10	S5601_029_0	2	4	Specialty Tier	010010	
S5601	029	0		29	10	S5601_029_0	2	2	Preferred Brand	000101	
S5601	029	0		29	10	S5601_029_0	2	3	Non-Preferred Brand	100100	
S5601	029	0		29	10	S5601_029_0	2	2	Preferred Brand	000101	1
S5601	029	0		29	10	S5601_029_0	2	1	Generic	010001	1
S5601	030	0		29	10	S5601_030_0	2	1	Generic	010001	
S5601	030	0		29	10	S5601_030_0	2	2	Preferred Brand	000101	
S5601	030	0		29	10	S5601_030_0	2	3	Non-Preferred Brand	100100	
S5601	030	0		29	10	S5601_030_0	2	4	Specialty Tier	010010	
S5601	031	0		29	10	S5601_031_0	2	2	Preferred Brand	000101	1
S5601	031	0		29	10	S5601_031_0	2	3	Non-Preferred Brand	100100	
S5601	031	0		29	10	S5601_031_0	2	4	Specialty Tier	010010	
S5601	031	0		29	10	S5601_031_0	2	1	Generic	010001	1
S5601	031	0		29	10	S5601_031_0	2	2	Preferred Brand	000101	
S5601	031	0		29	10	S5601_031_0	2	1	Generic	010001	
S5601	032	0		29	10	S5601_032_0	2	3	Non-Preferred Brand	100100	
S5601	032	0		29	10	S5601_032_0	2	1	Generic	010001	
S5601	032	0		29	10	S5601_032_0	2	2	Preferred Brand	000101	
S5601	032	0		29	10	S5601_032_0	2	4	Specialty Tier	010010	
S5601	033	0		29	10	S5601_033_0	2	1	Generic	010001	
S5601	033	0		29	10	S5601_033_0	2	3	Non-Preferred Brand	100100	
S5601	033	0		29	10	S5601_033_0	2	2	Preferred Brand	000101	
S5601	033	0		29	10	S5601_033_0	2	2	Preferred Brand	000101	1
S5601	033	0		29	10	S5601_033_0	2	1	Generic	010001	1
S5601	033	0		29	10	S5601_033_0	2	4	Specialty Tier	010010	
S5601	034	0		29	10	S5601_034_0	2	1	Generic	010001	
S5601	034	0		29	10	S5601_034_0	2	2	Preferred Brand	000101	
S5601	034	0		29	10	S5601_034_0	2	4	Specialty Tier	010010	
S5601	034	0		29	10	S5601_034_0	2	3	Non-Preferred Brand	100100	
S5601	035	0		29	10	S5601_035_0	2	3	Non-Preferred Brand	100100	
S5601	035	0		29	10	S5601_035_0	2	2	Preferred Brand	000101	
S5601	035	0		29	10	S5601_035_0	2	1	Generic	010001	
S5601	035	0		29	10	S5601_035_0	2	4	Specialty Tier	010010	
S5601	035	0		29	10	S5601_035_0	2	1	Generic	010001	1
S5601	035	0		29	10	S5601_035_0	2	2	Preferred Brand	000101	1
S5601	036	0		29	10	S5601_036_0	2	3	Non-Preferred Brand	100100	
S5601	036	0		29	10	S5601_036_0	2	2	Preferred Brand	000101	
S5601	036	0		29	10	S5601_036_0	2	1	Generic	010001	
S5601	036	0		29	10	S5601_036_0	2	4	Specialty Tier	010010	
S5601	037	0		29	10	S5601_037_0	2	1	Generic	010001	
S5601	037	0		29	10	S5601_037_0	2	2	Preferred Brand	000101	
S5601	037	0		29	10	S5601_037_0	2	3	Non-Preferred Brand	100100	
S5601	037	0		29	10	S5601_037_0	2	4	Specialty Tier	010010	
S5601	037	0		29	10	S5601_037_0	2	1	Generic	010001	1
S5601	037	0		29	10	S5601_037_0	2	2	Preferred Brand	000101	1
S5601	038	0		29	10	S5601_038_0	2	1	Generic	010001	
S5601	038	0		29	10	S5601_038_0	2	3	Non-Preferred Brand	100100	
S5601	038	0		29	10	S5601_038_0	2	2	Preferred Brand	000101	
S5601	038	0		29	10	S5601_038_0	2	4	Specialty Tier	010010	
S5601	040	0		29	10	S5601_040_0	2	3	Non-Preferred Brand	100100	
S5601	040	0		29	10	S5601_040_0	2	4	Specialty Tier	010010	
S5601	040	0		29	10	S5601_040_0	2	2	Preferred Brand	000101	
S5601	040	0		29	10	S5601_040_0	2	1	Generic	010001	
S5601	041	0		29	10	S5601_041_0	2	1	Generic	010001	
S5601	041	0		29	10	S5601_041_0	2	2	Preferred Brand	000101	
S5601	041	0		29	10	S5601_041_0	2	4	Specialty Tier	010010	
S5601	041	0		29	10	S5601_041_0	2	1	Generic	010001	1
S5601	041	0		29	10	S5601_041_0	2	2	Preferred Brand	000101	1
S5601	041	0		29	10	S5601_041_0	2	3	Non-Preferred Brand	100100	
S5601	042	0		29	10	S5601_042_0	2	4	Specialty Tier	010010	
S5601	042	0		29	10	S5601_042_0	2	2	Preferred Brand	000101	
S5601	042	0		29	10	S5601_042_0	2	3	Non-Preferred Brand	100100	
S5601	042	0		29	10	S5601_042_0	2	1	Generic	010001	
S5601	044	0		29	10	S5601_044_0	2	2	Preferred Brand	000101	
S5601	044	0		29	10	S5601_044_0	2	3	Non-Preferred Brand	100100	
S5601	044	0		29	10	S5601_044_0	2	1	Generic	010001	
S5601	044	0		29	10	S5601_044_0	2	4	Specialty Tier	010010	
S5601	045	0		29	10	S5601_045_0	2	2	Preferred Brand	000101	1
S5601	045	0		29	10	S5601_045_0	2	1	Generic	010001	1
S5601	045	0		29	10	S5601_045_0	2	3	Non-Preferred Brand	100100	
S5601	045	0		29	10	S5601_045_0	2	2	Preferred Brand	000101	
S5601	045	0		29	10	S5601_045_0	2	1	Generic	010001	
S5601	045	0		29	10	S5601_045_0	2	4	Specialty Tier	010010	
S5601	046	0		29	10	S5601_046_0	2	4	Specialty Tier	010010	
S5601	046	0		29	10	S5601_046_0	2	2	Preferred Brand	000101	
S5601	046	0		29	10	S5601_046_0	2	3	Non-Preferred Brand	100100	
S5601	046	0		29	10	S5601_046_0	2	1	Generic	010001	
S5601	048	0		29	10	S5601_048_0	2	3	Non-Preferred Brand	100100	
S5601	048	0		29	10	S5601_048_0	2	1	Generic	010001	
S5601	048	0		29	10	S5601_048_0	2	2	Preferred Brand	000101	
S5601	048	0		29	10	S5601_048_0	2	4	Specialty Tier	010010	
S5601	049	0		29	10	S5601_049_0	2	2	Preferred Brand	000101	1
S5601	049	0		29	10	S5601_049_0	2	4	Specialty Tier	010010	
S5601	049	0		29	10	S5601_049_0	2	1	Generic	010001	1
S5601	049	0		29	10	S5601_049_0	2	1	Generic	010001	
S5601	049	0		29	10	S5601_049_0	2	2	Preferred Brand	000101	
S5601	049	0		29	10	S5601_049_0	2	3	Non-Preferred Brand	100100	
S5601	050	0		29	10	S5601_050_0	2	1	Generic	010001	
S5601	050	0		29	10	S5601_050_0	2	4	Specialty Tier	010010	
S5601	050	0		29	10	S5601_050_0	2	3	Non-Preferred Brand	100100	
S5601	050	0		29	10	S5601_050_0	2	2	Preferred Brand	000101	
S5601	051	0		29	10	S5601_051_0	2	1	Generic	010001	
S5601	051	0		29	10	S5601_051_0	2	2	Preferred Brand	000101	
S5601	051	0		29	10	S5601_051_0	2	3	Non-Preferred Brand	100100	
S5601	051	0		29	10	S5601_051_0	2	4	Specialty Tier	010010	
S5601	051	0		29	10	S5601_051_0	2	1	Generic	010001	1
S5601	051	0		29	10	S5601_051_0	2	2	Preferred Brand	000101	1
S5601	052	0		29	10	S5601_052_0	2	1	Generic	010001	
S5601	052	0		29	10	S5601_052_0	2	4	Specialty Tier	010010	
S5601	052	0		29	10	S5601_052_0	2	3	Non-Preferred Brand	100100	
S5601	052	0		29	10	S5601_052_0	2	2	Preferred Brand	000101	
S5601	053	0		29	10	S5601_053_0	2	1	Generic	010001	1
S5601	053	0		29	10	S5601_053_0	2	2	Preferred Brand	000101	1
S5601	053	0		29	10	S5601_053_0	2	4	Specialty Tier	010010	
S5601	053	0		29	10	S5601_053_0	2	3	Non-Preferred Brand	100100	
S5601	053	0		29	10	S5601_053_0	2	2	Preferred Brand	000101	
S5601	053	0		29	10	S5601_053_0	2	1	Generic	010001	
S5601	054	0		29	10	S5601_054_0	2	4	Specialty Tier	010010	
S5601	054	0		29	10	S5601_054_0	2	1	Generic	010001	
S5601	054	0		29	10	S5601_054_0	2	3	Non-Preferred Brand	100100	
S5601	054	0		29	10	S5601_054_0	2	2	Preferred Brand	000101	
S5601	055	0		29	10	S5601_055_0	2	1	Generic	010001	
S5601	055	0		29	10	S5601_055_0	2	2	Preferred Brand	000101	
S5601	055	0		29	10	S5601_055_0	2	3	Non-Preferred Brand	100100	
S5601	055	0		29	10	S5601_055_0	2	1	Generic	010001	1
S5601	055	0		29	10	S5601_055_0	2	2	Preferred Brand	000101	1
S5601	055	0		29	10	S5601_055_0	2	4	Specialty Tier	010010	
S5601	056	0		29	10	S5601_056_0	2	4	Specialty Tier	010010	
S5601	056	0		29	10	S5601_056_0	2	1	Generic	010001	
S5601	056	0		29	10	S5601_056_0	2	2	Preferred Brand	000101	
S5601	056	0		29	10	S5601_056_0	2	3	Non-Preferred Brand	100100	
S5601	057	0		29	10	S5601_057_0	2	4	Specialty Tier	010010	
S5601	057	0		29	10	S5601_057_0	2	3	Non-Preferred Brand	100100	
S5601	057	0		29	10	S5601_057_0	2	1	Generic	010001	
S5601	057	0		29	10	S5601_057_0	2	2	Preferred Brand	000101	
S5601	057	0		29	10	S5601_057_0	2	1	Generic	010001	1
S5601	057	0		29	10	S5601_057_0	2	2	Preferred Brand	000101	1
S5601	058	0		29	10	S5601_058_0	2	1	Generic	010001	
S5601	058	0		29	10	S5601_058_0	2	2	Preferred Brand	000101	
S5601	058	0		29	10	S5601_058_0	2	3	Non-Preferred Brand	100100	
S5601	058	0		29	10	S5601_058_0	2	4	Specialty Tier	010010	
S5601	059	0		29	10	S5601_059_0	2	4	Specialty Tier	010010	
S5601	059	0		29	10	S5601_059_0	2	3	Non-Preferred Brand	100100	
S5601	059	0		29	10	S5601_059_0	2	2	Preferred Brand	000101	
S5601	059	0		29	10	S5601_059_0	2	1	Generic	010001	
S5601	059	0		29	10	S5601_059_0	2	1	Generic	010001	1
S5601	059	0		29	10	S5601_059_0	2	2	Preferred Brand	000101	1
S5601	060	0		29	10	S5601_060_0	2	4	Specialty Tier	010010	
S5601	060	0		29	10	S5601_060_0	2	2	Preferred Brand	000101	
S5601	060	0		29	10	S5601_060_0	2	3	Non-Preferred Brand	100100	
S5601	060	0		29	10	S5601_060_0	2	1	Generic	010001	
S5601	061	0		29	10	S5601_061_0	2	4	Specialty Tier	010010	
S5601	061	0		29	10	S5601_061_0	2	1	Generic	010001	1
S5601	061	0		29	10	S5601_061_0	2	2	Preferred Brand	000101	
S5601	061	0		29	10	S5601_061_0	2	2	Preferred Brand	000101	1
S5601	061	0		29	10	S5601_061_0	2	3	Non-Preferred Brand	100100	
S5601	061	0		29	10	S5601_061_0	2	1	Generic	010001	
S5601	062	0		29	10	S5601_062_0	2	2	Preferred Brand	000101	
S5601	062	0		29	10	S5601_062_0	2	3	Non-Preferred Brand	100100	
S5601	062	0		29	10	S5601_062_0	2	4	Specialty Tier	010010	
S5601	062	0		29	10	S5601_062_0	2	1	Generic	010001	
S5601	063	0		29	10	S5601_063_0	2	2	Preferred Brand	000101	1
S5601	063	0		29	10	S5601_063_0	2	2	Preferred Brand	000101	
S5601	063	0		29	10	S5601_063_0	2	4	Specialty Tier	010010	
S5601	063	0		29	10	S5601_063_0	2	3	Non-Preferred Brand	100100	
S5601	063	0		29	10	S5601_063_0	2	1	Generic	010001	1
S5601	063	0		29	10	S5601_063_0	2	1	Generic	010001	
S5601	064	0		29	10	S5601_064_0	2	3	Non-Preferred Brand	100100	
S5601	064	0		29	10	S5601_064_0	2	2	Preferred Brand	000101	
S5601	064	0		29	10	S5601_064_0	2	1	Generic	010001	
S5601	064	0		29	10	S5601_064_0	2	4	Specialty Tier	010010	
S5601	065	0		29	10	S5601_065_0	2	2	Preferred Brand	000101	1
S5601	065	0		29	10	S5601_065_0	2	1	Generic	010001	1
S5601	065	0		29	10	S5601_065_0	2	4	Specialty Tier	010010	
S5601	065	0		29	10	S5601_065_0	2	2	Preferred Brand	000101	
S5601	065	0		29	10	S5601_065_0	2	3	Non-Preferred Brand	100100	
S5601	065	0		29	10	S5601_065_0	2	1	Generic	010001	
S5601	066	0		29	10	S5601_066_0	2	4	Specialty Tier	010010	
S5601	066	0		29	10	S5601_066_0	2	3	Non-Preferred Brand	100100	
S5601	066	0		29	10	S5601_066_0	2	2	Preferred Brand	000101	
S5601	066	0		29	10	S5601_066_0	2	1	Generic	010001	
S5601	067	0		29	10	S5601_067_0	2	1	Generic	010001	1
S5601	067	0		29	10	S5601_067_0	2	2	Preferred Brand	000101	1
S5601	067	0		29	10	S5601_067_0	2	4	Specialty Tier	010010	
S5601	067	0		29	10	S5601_067_0	2	1	Generic	010001	
S5601	067	0		29	10	S5601_067_0	2	2	Preferred Brand	000101	
S5601	067	0		29	10	S5601_067_0	2	3	Non-Preferred Brand	100100	
S5601	068	0		29	10	S5601_068_0	2	3	Non-Preferred Brand	100100	
S5601	068	0		29	10	S5601_068_0	2	4	Specialty Tier	010010	
S5601	068	0		29	10	S5601_068_0	2	1	Generic	010001	
S5601	068	0		29	10	S5601_068_0	2	2	Preferred Brand	000101	
S5601	107	0		29	10	S5601_107_0	2	2	Preferred Brand	000101	1
S5601	107	0		29	10	S5601_107_0	2	4	Specialty Tier	010010	
S5601	107	0		29	10	S5601_107_0	2	1	Generic	010001	1
S5601	107	0		29	10	S5601_107_0	2	3	Non-Preferred Brand	100100	
S5601	107	0		29	10	S5601_107_0	2	2	Preferred Brand	000101	
S5601	107	0		29	10	S5601_107_0	2	1	Generic	010001	
S5601	108	0		29	10	S5601_108_0	2	3	Non-Preferred Brand	100100	
S5601	108	0		29	10	S5601_108_0	2	1	Generic	010001	
S5601	108	0		29	10	S5601_108_0	2	2	Preferred Brand	000101	
S5601	108	0		29	10	S5601_108_0	2	4	Specialty Tier	010010	
S5601	108	0		29	10	S5601_108_0	2	1	Generic	010001	1
S5601	108	0		29	10	S5601_108_0	2	2	Preferred Brand	000101	1
S5601	109	0		29	10	S5601_109_0	2	2	Preferred Brand	000101	1
S5601	109	0		29	10	S5601_109_0	2	3	Non-Preferred Brand	100100	
S5601	109	0		29	10	S5601_109_0	2	1	Generic	010001	1
S5601	109	0		29	10	S5601_109_0	2	4	Specialty Tier	010010	
S5601	109	0		29	10	S5601_109_0	2	1	Generic	010001	
S5601	109	0		29	10	S5601_109_0	2	2	Preferred Brand	000101	
S5601	110	0		29	10	S5601_110_0	4	2	Preferred Brand	000101	
S5601	110	0		29	10	S5601_110_0	4	4	Specialty Tier	010010	
S5601	110	0		29	10	S5601_110_0	4	3	Non-Preferred Brand	100100	
S5601	110	0		29	10	S5601_110_0	4	1	Generic	010001	
S5601	111	0		29	10	S5601_111_0	3	2	Preferred Brand	000101	
S5601	111	0		29	10	S5601_111_0	3	1	Generic	010001	
S5601	111	0		29	10	S5601_111_0	3	3	Non-Preferred Brand	100100	
S5601	111	0		29	10	S5601_111_0	3	4	Specialty Tier	010010	
S5601	112	0		29	10	S5601_112_0	3	3	Non-Preferred Brand	100100	
S5601	112	0		29	10	S5601_112_0	3	2	Preferred Brand	000101	
S5601	112	0		29	10	S5601_112_0	3	1	Generic	010001	
S5601	112	0		29	10	S5601_112_0	3	4	Specialty Tier	010010	
S5601	113	0		29	10	S5601_113_0	3	3	Non-Preferred Brand	100100	
S5601	113	0		29	10	S5601_113_0	3	4	Specialty Tier	010010	
S5601	113	0		29	10	S5601_113_0	3	1	Generic	010001	
S5601	113	0		29	10	S5601_113_0	3	2	Preferred Brand	000101	
S5601	114	0		29	10	S5601_114_0	3	2	Preferred Brand	000101	
S5601	114	0		29	10	S5601_114_0	3	3	Non-Preferred Brand	100100	
S5601	114	0		29	10	S5601_114_0	3	4	Specialty Tier	010010	
S5601	114	0		29	10	S5601_114_0	3	1	Generic	010001	
S5601	115	0		29	10	S5601_115_0	3	4	Specialty Tier	010010	
S5601	115	0		29	10	S5601_115_0	3	3	Non-Preferred Brand	100100	
S5601	115	0		29	10	S5601_115_0	3	1	Generic	010001	
S5601	115	0		29	10	S5601_115_0	3	2	Preferred Brand	000101	
S5601	116	0		29	10	S5601_116_0	3	2	Preferred Brand	000101	
S5601	116	0		29	10	S5601_116_0	3	3	Non-Preferred Brand	100100	
S5601	116	0		29	10	S5601_116_0	3	4	Specialty Tier	010010	
S5601	116	0		29	10	S5601_116_0	3	1	Generic	010001	
S5601	117	0		29	10	S5601_117_0	3	1	Generic	010001	
S5601	117	0		29	10	S5601_117_0	3	2	Preferred Brand	000101	
S5601	117	0		29	10	S5601_117_0	3	3	Non-Preferred Brand	100100	
S5601	117	0		29	10	S5601_117_0	3	4	Specialty Tier	010010	
S5601	118	0		29	10	S5601_118_0	3	1	Generic	010001	
S5601	118	0		29	10	S5601_118_0	3	2	Preferred Brand	000101	
S5601	118	0		29	10	S5601_118_0	3	3	Non-Preferred Brand	100100	
S5601	118	0		29	10	S5601_118_0	3	4	Specialty Tier	010010	
S5601	119	0		29	10	S5601_119_0	3	1	Generic	010001	
S5601	119	0		29	10	S5601_119_0	3	4	Specialty Tier	010010	
S5601	119	0		29	10	S5601_119_0	3	3	Non-Preferred Brand	100100	
S5601	119	0		29	10	S5601_119_0	3	2	Preferred Brand	000101	
S5601	120	0		29	10	S5601_120_0	3	3	Non-Preferred Brand	100100	
S5601	120	0		29	10	S5601_120_0	3	4	Specialty Tier	010010	
S5601	120	0		29	10	S5601_120_0	3	2	Preferred Brand	000101	
S5601	120	0		29	10	S5601_120_0	3	1	Generic	010001	
S5601	121	0		29	10	S5601_121_0	3	4	Specialty Tier	010010	
S5601	121	0		29	10	S5601_121_0	3	3	Non-Preferred Brand	100100	
S5601	121	0		29	10	S5601_121_0	3	2	Preferred Brand	000101	
S5601	121	0		29	10	S5601_121_0	3	1	Generic	010001	
S5601	122	0		29	10	S5601_122_0	3	1	Generic	010001	
S5601	122	0		29	10	S5601_122_0	3	2	Preferred Brand	000101	
S5601	122	0		29	10	S5601_122_0	3	3	Non-Preferred Brand	100100	
S5601	122	0		29	10	S5601_122_0	3	4	Specialty Tier	010010	
S5601	123	0		29	10	S5601_123_0	3	3	Non-Preferred Brand	100100	
S5601	123	0		29	10	S5601_123_0	3	2	Preferred Brand	000101	
S5601	123	0		29	10	S5601_123_0	3	1	Generic	010001	
S5601	123	0		29	10	S5601_123_0	3	4	Specialty Tier	010010	
S5601	124	0		29	10	S5601_124_0	3	3	Non-Preferred Brand	100100	
S5601	124	0		29	10	S5601_124_0	3	4	Specialty Tier	010010	
S5601	124	0		29	10	S5601_124_0	3	1	Generic	010001	
S5601	124	0		29	10	S5601_124_0	3	2	Preferred Brand	000101	
S5601	125	0		29	10	S5601_125_0	3	4	Specialty Tier	010010	
S5601	125	0		29	10	S5601_125_0	3	3	Non-Preferred Brand	100100	
S5601	125	0		29	10	S5601_125_0	3	1	Generic	010001	
S5601	125	0		29	10	S5601_125_0	3	2	Preferred Brand	000101	
S5601	126	0		29	10	S5601_126_0	3	2	Preferred Brand	000101	
S5601	126	0		29	10	S5601_126_0	3	4	Specialty Tier	010010	
S5601	126	0		29	10	S5601_126_0	3	3	Non-Preferred Brand	100100	
S5601	126	0		29	10	S5601_126_0	3	1	Generic	010001	
S5601	127	0		29	10	S5601_127_0	3	4	Specialty Tier	010010	
S5601	127	0		29	10	S5601_127_0	3	1	Generic	010001	
S5601	127	0		29	10	S5601_127_0	3	3	Non-Preferred Brand	100100	
S5601	127	0		29	10	S5601_127_0	3	2	Preferred Brand	000101	
S5601	128	0		29	10	S5601_128_0	3	4	Specialty Tier	010010	
S5601	128	0		29	10	S5601_128_0	3	1	Generic	010001	
S5601	128	0		29	10	S5601_128_0	3	3	Non-Preferred Brand	100100	
S5601	128	0		29	10	S5601_128_0	3	2	Preferred Brand	000101	
S5601	129	0		29	10	S5601_129_0	3	1	Generic	010001	
S5601	129	0		29	10	S5601_129_0	3	2	Preferred Brand	000101	
S5601	129	0		29	10	S5601_129_0	3	3	Non-Preferred Brand	100100	
S5601	129	0		29	10	S5601_129_0	3	4	Specialty Tier	010010	
S5601	130	0		29	10	S5601_130_0	3	3	Non-Preferred Brand	100100	
S5601	130	0		29	10	S5601_130_0	3	4	Specialty Tier	010010	
S5601	130	0		29	10	S5601_130_0	3	2	Preferred Brand	000101	
S5601	130	0		29	10	S5601_130_0	3	1	Generic	010001	
S5601	131	0		29	10	S5601_131_0	3	4	Specialty Tier	010010	
S5601	131	0		29	10	S5601_131_0	3	2	Preferred Brand	000101	
S5601	131	0		29	10	S5601_131_0	3	3	Non-Preferred Brand	100100	
S5601	131	0		29	10	S5601_131_0	3	1	Generic	010001	
S5601	132	0		29	10	S5601_132_0	3	3	Non-Preferred Brand	100100	
S5601	132	0		29	10	S5601_132_0	3	2	Preferred Brand	000101	
S5601	132	0		29	10	S5601_132_0	3	4	Specialty Tier	010010	
S5601	132	0		29	10	S5601_132_0	3	1	Generic	010001	
S5601	133	0		29	10	S5601_133_0	3	4	Specialty Tier	010010	
S5601	133	0		29	10	S5601_133_0	3	2	Preferred Brand	000101	
S5601	133	0		29	10	S5601_133_0	3	3	Non-Preferred Brand	100100	
S5601	133	0		29	10	S5601_133_0	3	1	Generic	010001	
S5601	134	0		29	10	S5601_134_0	3	3	Non-Preferred Brand	100100	
S5601	134	0		29	10	S5601_134_0	3	2	Preferred Brand	000101	
S5601	134	0		29	10	S5601_134_0	3	4	Specialty Tier	010010	
S5601	134	0		29	10	S5601_134_0	3	1	Generic	010001	
S5601	135	0		29	10	S5601_135_0	3	4	Specialty Tier	010010	
S5601	135	0		29	10	S5601_135_0	3	2	Preferred Brand	000101	
S5601	135	0		29	10	S5601_135_0	3	3	Non-Preferred Brand	100100	
S5601	135	0		29	10	S5601_135_0	3	1	Generic	010001	
S5601	136	0		29	10	S5601_136_0	3	3	Non-Preferred Brand	100100	
S5601	136	0		29	10	S5601_136_0	3	2	Preferred Brand	000101	
S5601	136	0		29	10	S5601_136_0	3	4	Specialty Tier	010010	
S5601	136	0		29	10	S5601_136_0	3	1	Generic	010001	
S5601	137	0		29	10	S5601_137_0	3	4	Specialty Tier	010010	
S5601	137	0		29	10	S5601_137_0	3	2	Preferred Brand	000101	
S5601	137	0		29	10	S5601_137_0	3	3	Non-Preferred Brand	100100	
S5601	137	0		29	10	S5601_137_0	3	1	Generic	010001	
S5601	138	0		29	10	S5601_138_0	3	3	Non-Preferred Brand	100100	
S5601	138	0		29	10	S5601_138_0	3	2	Preferred Brand	000101	
S5601	138	0		29	10	S5601_138_0	3	1	Generic	010001	
S5601	138	0		29	10	S5601_138_0	3	4	Specialty Tier	010010	
S5601	139	0		29	10	S5601_139_0	3	2	Preferred Brand	000101	
S5601	139	0		29	10	S5601_139_0	3	3	Non-Preferred Brand	100100	
S5601	139	0		29	10	S5601_139_0	3	4	Specialty Tier	010010	
S5601	139	0		29	10	S5601_139_0	3	1	Generic	010001	
S5601	140	0		29	10	S5601_140_0	3	4	Specialty Tier	010010	
S5601	140	0		29	10	S5601_140_0	3	3	Non-Preferred Brand	100100	
S5601	140	0		29	10	S5601_140_0	3	2	Preferred Brand	000101	
S5601	140	0		29	10	S5601_140_0	3	1	Generic	010001	
S5601	141	0		29	10	S5601_141_0	3	1	Generic	010001	
S5601	141	0		29	10	S5601_141_0	3	2	Preferred Brand	000101	
S5601	141	0		29	10	S5601_141_0	3	4	Specialty Tier	010010	
S5601	141	0		29	10	S5601_141_0	3	3	Non-Preferred Brand	100100	
S5601	142	0		29	10	S5601_142_0	3	1	Generic	010001	
S5601	142	0		29	10	S5601_142_0	3	2	Preferred Brand	000101	
S5601	142	0		29	10	S5601_142_0	3	4	Specialty Tier	010010	
S5601	142	0		29	10	S5601_142_0	3	3	Non-Preferred Brand	100100	
S5609	001	0		29	10	S5609_001_0	4	5	Specialty Tier	010010	
S5609	001	0		29	10	S5609_001_0	4	4	Non-Preferred Brand	100000	
S5609	001	0		29	10	S5609_001_0	4	3	Preferred Brand	000001	
S5609	001	0		29	10	S5609_001_0	4	2	Non-Preferred Generic	000100	
S5609	001	0		29	10	S5609_001_0	4	1	Preferred Generic	001000	
S5609	002	0		29	10	S5609_002_0	5	5	Specialty Tier	010010	
S5609	002	0		29	10	S5609_002_0	5	4	Non-Preferred Brand	100000	
S5609	002	0		29	10	S5609_002_0	5	3	Preferred Brand	000001	
S5609	002	0		29	10	S5609_002_0	5	2	Non-Preferred Generic	000100	
S5609	002	0		29	10	S5609_002_0	5	1	Preferred Generic	001000	1
S5609	002	0		29	10	S5609_002_0	5	1	Preferred Generic	001000	
S5617	003	0		29	10	S5617_003_0	4	5	Specialty Tier	010010	
S5617	003	0		29	10	S5617_003_0	4	2	Non-Preferred Generic	000101	
S5617	003	0		29	10	S5617_003_0	4	3	Preferred Brand	000101	
S5617	003	0		29	10	S5617_003_0	4	4	Non-Preferred Brand	100100	
S5617	003	0		29	10	S5617_003_0	4	1	Preferred Generic	001001	
S5617	008	0		29	10	S5617_008_0	3	4	Non-Preferred Brand	100100	
S5617	008	0		29	10	S5617_008_0	3	1	Preferred Generic	001001	
S5617	008	0		29	10	S5617_008_0	3	2	Non-Preferred Generic	000101	
S5617	008	0		29	10	S5617_008_0	3	3	Preferred Brand	000101	
S5617	008	0		29	10	S5617_008_0	3	5	Specialty Tier	010010	
S5617	013	0		29	10	S5617_013_0	5	5	Specialty Tier	010010	
S5617	013	0		29	10	S5617_013_0	5	4	Non-Preferred Brand	100100	
S5617	013	0		29	10	S5617_013_0	5	1	Preferred Generic	001001	
S5617	013	0		29	10	S5617_013_0	5	2	Non-Preferred Generic	000101	
S5617	013	0		29	10	S5617_013_0	5	3	Preferred Brand	000101	
S5617	018	0		29	10	S5617_018_0	3	3	Preferred Brand	000101	
S5617	018	0		29	10	S5617_018_0	3	2	Non-Preferred Generic	000101	
S5617	018	0		29	10	S5617_018_0	3	5	Specialty Tier	010010	
S5617	018	0		29	10	S5617_018_0	3	4	Non-Preferred Brand	100100	
S5617	018	0		29	10	S5617_018_0	3	1	Preferred Generic	001001	
S5617	053	0		29	10	S5617_053_0	3	2	Non-Preferred Generic	000101	
S5617	053	0		29	10	S5617_053_0	3	3	Preferred Brand	000101	
S5617	053	0		29	10	S5617_053_0	3	5	Specialty Tier	010010	
S5617	053	0		29	10	S5617_053_0	3	4	Non-Preferred Brand	100100	
S5617	053	0		29	10	S5617_053_0	3	1	Preferred Generic	001001	
S5617	068	0		29	10	S5617_068_0	3	5	Specialty Tier	010010	
S5617	068	0		29	10	S5617_068_0	3	4	Non-Preferred Brand	100100	
S5617	068	0		29	10	S5617_068_0	3	3	Preferred Brand	000101	
S5617	068	0		29	10	S5617_068_0	3	1	Preferred Generic	001001	
S5617	068	0		29	10	S5617_068_0	3	2	Non-Preferred Generic	000101	
S5617	088	0		29	10	S5617_088_0	3	5	Specialty Tier	010010	
S5617	088	0		29	10	S5617_088_0	3	2	Non-Preferred Generic	000101	
S5617	088	0		29	10	S5617_088_0	3	3	Preferred Brand	000101	
S5617	088	0		29	10	S5617_088_0	3	4	Non-Preferred Brand	100100	
S5617	088	0		29	10	S5617_088_0	3	1	Preferred Generic	001001	
S5617	103	0		29	10	S5617_103_0	3	4	Non-Preferred Brand	100100	
S5617	103	0		29	10	S5617_103_0	3	1	Preferred Generic	001001	
S5617	103	0		29	10	S5617_103_0	3	2	Non-Preferred Generic	000101	
S5617	103	0		29	10	S5617_103_0	3	3	Preferred Brand	000101	
S5617	103	0		29	10	S5617_103_0	3	5	Specialty Tier	010010	
S5617	108	0		29	10	S5617_108_0	3	5	Specialty Tier	010010	
S5617	108	0		29	10	S5617_108_0	3	4	Non-Preferred Brand	100100	
S5617	108	0		29	10	S5617_108_0	3	1	Preferred Generic	001001	
S5617	108	0		29	10	S5617_108_0	3	2	Non-Preferred Generic	000101	
S5617	108	0		29	10	S5617_108_0	3	3	Preferred Brand	000101	
S5617	113	0		29	10	S5617_113_0	3	1	Preferred Generic	001001	
S5617	113	0		29	10	S5617_113_0	3	2	Non-Preferred Generic	000101	
S5617	113	0		29	10	S5617_113_0	3	3	Preferred Brand	000101	
S5617	113	0		29	10	S5617_113_0	3	4	Non-Preferred Brand	100100	
S5617	113	0		29	10	S5617_113_0	3	5	Specialty Tier	010010	
S5617	118	0		29	10	S5617_118_0	3	1	Preferred Generic	001001	
S5617	118	0		29	10	S5617_118_0	3	2	Non-Preferred Generic	000101	
S5617	118	0		29	10	S5617_118_0	3	3	Preferred Brand	000101	
S5617	118	0		29	10	S5617_118_0	3	4	Non-Preferred Brand	100100	
S5617	118	0		29	10	S5617_118_0	3	5	Specialty Tier	010010	
S5617	123	0		29	10	S5617_123_0	3	4	Non-Preferred Brand	100100	
S5617	123	0		29	10	S5617_123_0	3	3	Preferred Brand	000101	
S5617	123	0		29	10	S5617_123_0	3	2	Non-Preferred Generic	000101	
S5617	123	0		29	10	S5617_123_0	3	1	Preferred Generic	001001	
S5617	123	0		29	10	S5617_123_0	3	5	Specialty Tier	010010	
S5617	128	0		29	10	S5617_128_0	3	1	Preferred Generic	001001	
S5617	128	0		29	10	S5617_128_0	3	2	Non-Preferred Generic	000101	
S5617	128	0		29	10	S5617_128_0	3	3	Preferred Brand	000101	
S5617	128	0		29	10	S5617_128_0	3	4	Non-Preferred Brand	100100	
S5617	128	0		29	10	S5617_128_0	3	5	Specialty Tier	010010	
S5617	133	0		29	10	S5617_133_0	3	1	Preferred Generic	001001	
S5617	133	0		29	10	S5617_133_0	3	2	Non-Preferred Generic	000101	
S5617	133	0		29	10	S5617_133_0	3	3	Preferred Brand	000101	
S5617	133	0		29	10	S5617_133_0	3	4	Non-Preferred Brand	100100	
S5617	133	0		29	10	S5617_133_0	3	5	Specialty Tier	010010	
S5617	138	0		29	10	S5617_138_0	3	4	Non-Preferred Brand	100100	
S5617	138	0		29	10	S5617_138_0	3	3	Preferred Brand	000101	
S5617	138	0		29	10	S5617_138_0	3	2	Non-Preferred Generic	000101	
S5617	138	0		29	10	S5617_138_0	3	1	Preferred Generic	001001	
S5617	138	0		29	10	S5617_138_0	3	5	Specialty Tier	010010	
S5617	143	0		29	10	S5617_143_0	3	5	Specialty Tier	010010	
S5617	143	0		29	10	S5617_143_0	3	2	Non-Preferred Generic	000101	
S5617	143	0		29	10	S5617_143_0	3	1	Preferred Generic	001001	
S5617	143	0		29	10	S5617_143_0	3	4	Non-Preferred Brand	100100	
S5617	143	0		29	10	S5617_143_0	3	3	Preferred Brand	000101	
S5617	148	0		29	10	S5617_148_0	3	5	Specialty Tier	010010	
S5617	148	0		29	10	S5617_148_0	3	2	Non-Preferred Generic	000101	
S5617	148	0		29	10	S5617_148_0	3	1	Preferred Generic	001001	
S5617	148	0		29	10	S5617_148_0	3	4	Non-Preferred Brand	100100	
S5617	148	0		29	10	S5617_148_0	3	3	Preferred Brand	000101	
S5617	153	0		29	10	S5617_153_0	3	5	Specialty Tier	010010	
S5617	153	0		29	10	S5617_153_0	3	4	Non-Preferred Brand	100100	
S5617	153	0		29	10	S5617_153_0	3	2	Non-Preferred Generic	000101	
S5617	153	0		29	10	S5617_153_0	3	3	Preferred Brand	000101	
S5617	153	0		29	10	S5617_153_0	3	1	Preferred Generic	001001	
S5617	158	0		29	10	S5617_158_0	3	3	Preferred Brand	000101	
S5617	158	0		29	10	S5617_158_0	3	5	Specialty Tier	010010	
S5617	158	0		29	10	S5617_158_0	3	1	Preferred Generic	001001	
S5617	158	0		29	10	S5617_158_0	3	2	Non-Preferred Generic	000101	
S5617	158	0		29	10	S5617_158_0	3	4	Non-Preferred Brand	100100	
S5617	163	0		29	10	S5617_163_0	3	1	Preferred Generic	001001	
S5617	163	0		29	10	S5617_163_0	3	5	Specialty Tier	010010	
S5617	163	0		29	10	S5617_163_0	3	4	Non-Preferred Brand	100100	
S5617	163	0		29	10	S5617_163_0	3	3	Preferred Brand	000101	
S5617	163	0		29	10	S5617_163_0	3	2	Non-Preferred Generic	000101	
S5617	172	0		29	10	S5617_172_0	4	1	Preferred Generic	001001	
S5617	172	0		29	10	S5617_172_0	4	2	Non-Preferred Generic	000101	
S5617	172	0		29	10	S5617_172_0	4	3	Preferred Brand	000101	
S5617	172	0		29	10	S5617_172_0	4	4	Non-Preferred Brand	100100	
S5617	172	0		29	10	S5617_172_0	4	5	Specialty Tier	010010	
S5617	172	0		29	10	S5617_172_0	4	1	Preferred Generic	001001	1
S5617	172	0		29	10	S5617_172_0	4	2	Non-Preferred Generic	000101	1
S5617	172	0		29	10	S5617_172_0	4	3	Preferred Brand	000101	2
S5617	172	0		29	10	S5617_172_0	4	4	Non-Preferred Brand	100100	2
S5617	176	0		29	10	S5617_176_0	3	3	Preferred Brand	000101	
S5617	176	0		29	10	S5617_176_0	3	2	Non-Preferred Generic	000101	
S5617	176	0		29	10	S5617_176_0	3	4	Non-Preferred Brand	100100	2
S5617	176	0		29	10	S5617_176_0	3	3	Preferred Brand	000101	2
S5617	176	0		29	10	S5617_176_0	3	2	Non-Preferred Generic	000101	1
S5617	176	0		29	10	S5617_176_0	3	1	Preferred Generic	001001	1
S5617	176	0		29	10	S5617_176_0	3	5	Specialty Tier	010010	
S5617	176	0		29	10	S5617_176_0	3	4	Non-Preferred Brand	100100	
S5617	176	0		29	10	S5617_176_0	3	1	Preferred Generic	001001	
S5617	177	0		29	10	S5617_177_0	3	3	Preferred Brand	000101	2
S5617	177	0		29	10	S5617_177_0	3	4	Non-Preferred Brand	100100	2
S5617	177	0		29	10	S5617_177_0	3	1	Preferred Generic	001001	1
S5617	177	0		29	10	S5617_177_0	3	2	Non-Preferred Generic	000101	1
S5617	177	0		29	10	S5617_177_0	3	5	Specialty Tier	010010	
S5617	177	0		29	10	S5617_177_0	3	4	Non-Preferred Brand	100100	
S5617	177	0		29	10	S5617_177_0	3	3	Preferred Brand	000101	
S5617	177	0		29	10	S5617_177_0	3	2	Non-Preferred Generic	000101	
S5617	177	0		29	10	S5617_177_0	3	1	Preferred Generic	001001	
S5617	178	0		29	10	S5617_178_0	4	3	Preferred Brand	000101	2
S5617	178	0		29	10	S5617_178_0	4	2	Non-Preferred Generic	000101	1
S5617	178	0		29	10	S5617_178_0	4	1	Preferred Generic	001001	1
S5617	178	0		29	10	S5617_178_0	4	5	Specialty Tier	010010	
S5617	178	0		29	10	S5617_178_0	4	4	Non-Preferred Brand	100100	
S5617	178	0		29	10	S5617_178_0	4	3	Preferred Brand	000101	
S5617	178	0		29	10	S5617_178_0	4	2	Non-Preferred Generic	000101	
S5617	178	0		29	10	S5617_178_0	4	1	Preferred Generic	001001	
S5617	178	0		29	10	S5617_178_0	4	4	Non-Preferred Brand	100100	2
S5617	179	0		29	10	S5617_179_0	3	3	Preferred Brand	000101	
S5617	179	0		29	10	S5617_179_0	3	2	Non-Preferred Generic	000101	
S5617	179	0		29	10	S5617_179_0	3	1	Preferred Generic	001001	
S5617	179	0		29	10	S5617_179_0	3	4	Non-Preferred Brand	100100	2
S5617	179	0		29	10	S5617_179_0	3	3	Preferred Brand	000101	2
S5617	179	0		29	10	S5617_179_0	3	2	Non-Preferred Generic	000101	1
S5617	179	0		29	10	S5617_179_0	3	4	Non-Preferred Brand	100100	
S5617	179	0		29	10	S5617_179_0	3	5	Specialty Tier	010010	
S5617	179	0		29	10	S5617_179_0	3	1	Preferred Generic	001001	1
S5617	181	0		29	10	S5617_181_0	3	2	Non-Preferred Generic	000101	1
S5617	181	0		29	10	S5617_181_0	3	3	Preferred Brand	000101	
S5617	181	0		29	10	S5617_181_0	3	2	Non-Preferred Generic	000101	
S5617	181	0		29	10	S5617_181_0	3	4	Non-Preferred Brand	100100	2
S5617	181	0		29	10	S5617_181_0	3	3	Preferred Brand	000101	2
S5617	181	0		29	10	S5617_181_0	3	1	Preferred Generic	001001	
S5617	181	0		29	10	S5617_181_0	3	5	Specialty Tier	010010	
S5617	181	0		29	10	S5617_181_0	3	1	Preferred Generic	001001	1
S5617	181	0		29	10	S5617_181_0	3	4	Non-Preferred Brand	100100	
S5617	182	0		29	10	S5617_182_0	4	1	Preferred Generic	001001	1
S5617	182	0		29	10	S5617_182_0	4	5	Specialty Tier	010010	
S5617	182	0		29	10	S5617_182_0	4	4	Non-Preferred Brand	100100	
S5617	182	0		29	10	S5617_182_0	4	3	Preferred Brand	000101	
S5617	182	0		29	10	S5617_182_0	4	1	Preferred Generic	001001	
S5617	182	0		29	10	S5617_182_0	4	4	Non-Preferred Brand	100100	2
S5617	182	0		29	10	S5617_182_0	4	3	Preferred Brand	000101	2
S5617	182	0		29	10	S5617_182_0	4	2	Non-Preferred Generic	000101	1
S5617	182	0		29	10	S5617_182_0	4	2	Non-Preferred Generic	000101	
S5617	183	0		29	10	S5617_183_0	4	4	Non-Preferred Brand	100100	
S5617	183	0		29	10	S5617_183_0	4	3	Preferred Brand	000101	
S5617	183	0		29	10	S5617_183_0	4	2	Non-Preferred Generic	000101	
S5617	183	0		29	10	S5617_183_0	4	1	Preferred Generic	001001	
S5617	183	0		29	10	S5617_183_0	4	5	Specialty Tier	010010	
S5617	183	0		29	10	S5617_183_0	4	4	Non-Preferred Brand	100100	2
S5617	183	0		29	10	S5617_183_0	4	3	Preferred Brand	000101	2
S5617	183	0		29	10	S5617_183_0	4	2	Non-Preferred Generic	000101	1
S5617	183	0		29	10	S5617_183_0	4	1	Preferred Generic	001001	1
S5617	184	0		29	10	S5617_184_0	3	1	Preferred Generic	001001	
S5617	184	0		29	10	S5617_184_0	3	2	Non-Preferred Generic	000101	
S5617	184	0		29	10	S5617_184_0	3	4	Non-Preferred Brand	100100	2
S5617	184	0		29	10	S5617_184_0	3	3	Preferred Brand	000101	2
S5617	184	0		29	10	S5617_184_0	3	2	Non-Preferred Generic	000101	1
S5617	184	0		29	10	S5617_184_0	3	1	Preferred Generic	001001	1
S5617	184	0		29	10	S5617_184_0	3	5	Specialty Tier	010010	
S5617	184	0		29	10	S5617_184_0	3	4	Non-Preferred Brand	100100	
S5617	184	0		29	10	S5617_184_0	3	3	Preferred Brand	000101	
S5617	185	0		29	10	S5617_185_0	3	1	Preferred Generic	001001	
S5617	185	0		29	10	S5617_185_0	3	5	Specialty Tier	010010	
S5617	185	0		29	10	S5617_185_0	3	1	Preferred Generic	001001	1
S5617	185	0		29	10	S5617_185_0	3	2	Non-Preferred Generic	000101	1
S5617	185	0		29	10	S5617_185_0	3	4	Non-Preferred Brand	100100	2
S5617	185	0		29	10	S5617_185_0	3	4	Non-Preferred Brand	100100	
S5617	185	0		29	10	S5617_185_0	3	3	Preferred Brand	000101	
S5617	185	0		29	10	S5617_185_0	3	2	Non-Preferred Generic	000101	
S5617	185	0		29	10	S5617_185_0	3	3	Preferred Brand	000101	2
S5617	187	0		29	10	S5617_187_0	4	2	Non-Preferred Generic	000101	1
S5617	187	0		29	10	S5617_187_0	4	3	Preferred Brand	000101	2
S5617	187	0		29	10	S5617_187_0	4	4	Non-Preferred Brand	100100	2
S5617	187	0		29	10	S5617_187_0	4	1	Preferred Generic	001001	
S5617	187	0		29	10	S5617_187_0	4	2	Non-Preferred Generic	000101	
S5617	187	0		29	10	S5617_187_0	4	3	Preferred Brand	000101	
S5617	187	0		29	10	S5617_187_0	4	4	Non-Preferred Brand	100100	
S5617	187	0		29	10	S5617_187_0	4	5	Specialty Tier	010010	
S5617	187	0		29	10	S5617_187_0	4	1	Preferred Generic	001001	1
S5617	188	0		29	10	S5617_188_0	3	1	Preferred Generic	001001	
S5617	188	0		29	10	S5617_188_0	3	2	Non-Preferred Generic	000101	
S5617	188	0		29	10	S5617_188_0	3	4	Non-Preferred Brand	100100	2
S5617	188	0		29	10	S5617_188_0	3	3	Preferred Brand	000101	2
S5617	188	0		29	10	S5617_188_0	3	2	Non-Preferred Generic	000101	1
S5617	188	0		29	10	S5617_188_0	3	1	Preferred Generic	001001	1
S5617	188	0		29	10	S5617_188_0	3	5	Specialty Tier	010010	
S5617	188	0		29	10	S5617_188_0	3	4	Non-Preferred Brand	100100	
S5617	188	0		29	10	S5617_188_0	3	3	Preferred Brand	000101	
S5617	189	0		29	10	S5617_189_0	3	1	Preferred Generic	001001	
S5617	189	0		29	10	S5617_189_0	3	2	Non-Preferred Generic	000101	1
S5617	189	0		29	10	S5617_189_0	3	1	Preferred Generic	001001	1
S5617	189	0		29	10	S5617_189_0	3	5	Specialty Tier	010010	
S5617	189	0		29	10	S5617_189_0	3	3	Preferred Brand	000101	2
S5617	189	0		29	10	S5617_189_0	3	3	Preferred Brand	000101	
S5617	189	0		29	10	S5617_189_0	3	4	Non-Preferred Brand	100100	2
S5617	189	0		29	10	S5617_189_0	3	2	Non-Preferred Generic	000101	
S5617	189	0		29	10	S5617_189_0	3	4	Non-Preferred Brand	100100	
S5617	192	0		29	10	S5617_192_0	3	4	Non-Preferred Brand	100100	
S5617	192	0		29	10	S5617_192_0	3	3	Preferred Brand	000101	
S5617	192	0		29	10	S5617_192_0	3	2	Non-Preferred Generic	000101	
S5617	192	0		29	10	S5617_192_0	3	1	Preferred Generic	001001	
S5617	192	0		29	10	S5617_192_0	3	4	Non-Preferred Brand	100100	2
S5617	192	0		29	10	S5617_192_0	3	1	Preferred Generic	001001	1
S5617	192	0		29	10	S5617_192_0	3	2	Non-Preferred Generic	000101	1
S5617	192	0		29	10	S5617_192_0	3	3	Preferred Brand	000101	2
S5617	192	0		29	10	S5617_192_0	3	5	Specialty Tier	010010	
S5617	195	0		29	10	S5617_195_0	3	4	Non-Preferred Brand	100100	
S5617	195	0		29	10	S5617_195_0	3	3	Preferred Brand	000101	
S5617	195	0		29	10	S5617_195_0	3	2	Non-Preferred Generic	000101	
S5617	195	0		29	10	S5617_195_0	3	1	Preferred Generic	001001	
S5617	195	0		29	10	S5617_195_0	3	5	Specialty Tier	010010	
S5617	195	0		29	10	S5617_195_0	3	4	Non-Preferred Brand	100100	2
S5617	195	0		29	10	S5617_195_0	3	3	Preferred Brand	000101	2
S5617	195	0		29	10	S5617_195_0	3	2	Non-Preferred Generic	000101	1
S5617	195	0		29	10	S5617_195_0	3	1	Preferred Generic	001001	1
S5617	198	0		29	10	S5617_198_0	3	1	Preferred Generic	001001	
S5617	198	0		29	10	S5617_198_0	3	2	Non-Preferred Generic	000101	
S5617	198	0		29	10	S5617_198_0	3	3	Preferred Brand	000101	
S5617	198	0		29	10	S5617_198_0	3	4	Non-Preferred Brand	100100	
S5617	198	0		29	10	S5617_198_0	3	4	Non-Preferred Brand	100100	2
S5617	198	0		29	10	S5617_198_0	3	2	Non-Preferred Generic	000101	1
S5617	198	0		29	10	S5617_198_0	3	1	Preferred Generic	001001	1
S5617	198	0		29	10	S5617_198_0	3	5	Specialty Tier	010010	
S5617	198	0		29	10	S5617_198_0	3	3	Preferred Brand	000101	2
S5617	214	0		29	10	S5617_214_0	3	4	Non-Preferred Brand	100100	
S5617	214	0		29	10	S5617_214_0	3	3	Preferred Brand	000101	
S5617	214	0		29	10	S5617_214_0	3	2	Non-Preferred Generic	000101	
S5617	214	0		29	10	S5617_214_0	3	1	Preferred Generic	001001	
S5617	214	0		29	10	S5617_214_0	3	5	Specialty Tier	010010	
S5617	215	0		29	10	S5617_215_0	3	1	Preferred Generic	001001	
S5617	215	0		29	10	S5617_215_0	3	2	Non-Preferred Generic	000101	
S5617	215	0		29	10	S5617_215_0	3	3	Preferred Brand	000101	
S5617	215	0		29	10	S5617_215_0	3	4	Non-Preferred Brand	100100	
S5617	215	0		29	10	S5617_215_0	3	5	Specialty Tier	010010	
S5617	216	0		29	10	S5617_216_0	3	4	Non-Preferred Brand	100100	
S5617	216	0		29	10	S5617_216_0	3	3	Preferred Brand	000101	
S5617	216	0		29	10	S5617_216_0	3	2	Non-Preferred Generic	000101	
S5617	216	0		29	10	S5617_216_0	3	1	Preferred Generic	001001	
S5617	216	0		29	10	S5617_216_0	3	5	Specialty Tier	010010	
S5617	217	0		29	10	S5617_217_0	3	2	Non-Preferred Generic	000101	
S5617	217	0		29	10	S5617_217_0	3	1	Preferred Generic	001001	
S5617	217	0		29	10	S5617_217_0	3	3	Preferred Brand	000101	
S5617	217	0		29	10	S5617_217_0	3	4	Non-Preferred Brand	100100	
S5617	217	0		29	10	S5617_217_0	3	5	Specialty Tier	010010	
S5617	218	0		29	10	S5617_218_0	3	2	Non-Preferred Generic	000101	
S5617	218	0		29	10	S5617_218_0	3	1	Preferred Generic	001001	
S5617	218	0		29	10	S5617_218_0	3	3	Preferred Brand	000101	
S5617	218	0		29	10	S5617_218_0	3	5	Specialty Tier	010010	
S5617	218	0		29	10	S5617_218_0	3	4	Non-Preferred Brand	100100	
S5617	219	0		29	10	S5617_219_0	3	1	Preferred Generic	001001	
S5617	219	0		29	10	S5617_219_0	3	2	Non-Preferred Generic	000101	
S5617	219	0		29	10	S5617_219_0	3	4	Non-Preferred Brand	100100	
S5617	219	0		29	10	S5617_219_0	3	3	Preferred Brand	000101	
S5617	219	0		29	10	S5617_219_0	3	5	Specialty Tier	010010	
S5617	220	0		29	10	S5617_220_0	3	1	Preferred Generic	001001	
S5617	220	0		29	10	S5617_220_0	3	2	Non-Preferred Generic	000101	
S5617	220	0		29	10	S5617_220_0	3	3	Preferred Brand	000101	
S5617	220	0		29	10	S5617_220_0	3	4	Non-Preferred Brand	100100	
S5617	220	0		29	10	S5617_220_0	3	5	Specialty Tier	010010	
S5617	221	0		29	10	S5617_221_0	3	5	Specialty Tier	010010	
S5617	221	0		29	10	S5617_221_0	3	4	Non-Preferred Brand	100100	
S5617	221	0		29	10	S5617_221_0	3	1	Preferred Generic	001001	
S5617	221	0		29	10	S5617_221_0	3	2	Non-Preferred Generic	000101	
S5617	221	0		29	10	S5617_221_0	3	3	Preferred Brand	000101	
S5617	222	0		29	10	S5617_222_0	3	5	Specialty Tier	010010	
S5617	222	0		29	10	S5617_222_0	3	4	Non-Preferred Brand	100100	
S5617	222	0		29	10	S5617_222_0	3	3	Preferred Brand	000101	
S5617	222	0		29	10	S5617_222_0	3	2	Non-Preferred Generic	000101	
S5617	222	0		29	10	S5617_222_0	3	1	Preferred Generic	001001	
S5617	223	0		29	10	S5617_223_0	3	5	Specialty Tier	010010	
S5617	223	0		29	10	S5617_223_0	3	4	Non-Preferred Brand	100100	
S5617	223	0		29	10	S5617_223_0	3	1	Preferred Generic	001001	
S5617	223	0		29	10	S5617_223_0	3	2	Non-Preferred Generic	000101	
S5617	223	0		29	10	S5617_223_0	3	3	Preferred Brand	000101	
S5617	224	0		29	10	S5617_224_0	3	5	Specialty Tier	010010	
S5617	224	0		29	10	S5617_224_0	3	4	Non-Preferred Brand	100100	
S5617	224	0		29	10	S5617_224_0	3	3	Preferred Brand	000101	
S5617	224	0		29	10	S5617_224_0	3	2	Non-Preferred Generic	000101	
S5617	224	0		29	10	S5617_224_0	3	1	Preferred Generic	001001	
S5617	225	0		29	10	S5617_225_0	3	5	Specialty Tier	010010	
S5617	225	0		29	10	S5617_225_0	3	4	Non-Preferred Brand	100100	
S5617	225	0		29	10	S5617_225_0	3	1	Preferred Generic	001001	
S5617	225	0		29	10	S5617_225_0	3	2	Non-Preferred Generic	000101	
S5617	225	0		29	10	S5617_225_0	3	3	Preferred Brand	000101	
S5617	226	0		29	10	S5617_226_0	3	5	Specialty Tier	010010	
S5617	226	0		29	10	S5617_226_0	3	4	Non-Preferred Brand	100100	
S5617	226	0		29	10	S5617_226_0	3	3	Preferred Brand	000101	
S5617	226	0		29	10	S5617_226_0	3	2	Non-Preferred Generic	000101	
S5617	226	0		29	10	S5617_226_0	3	1	Preferred Generic	001001	
S5617	227	0		29	10	S5617_227_0	3	5	Specialty Tier	010010	
S5617	227	0		29	10	S5617_227_0	3	4	Non-Preferred Brand	100100	
S5617	227	0		29	10	S5617_227_0	3	1	Preferred Generic	001001	
S5617	227	0		29	10	S5617_227_0	3	2	Non-Preferred Generic	000101	
S5617	227	0		29	10	S5617_227_0	3	3	Preferred Brand	000101	
S5617	228	0		29	10	S5617_228_0	3	2	Non-Preferred Generic	000101	1
S5617	228	0		29	10	S5617_228_0	3	1	Preferred Generic	001001	1
S5617	228	0		29	10	S5617_228_0	3	4	Non-Preferred Brand	100100	2
S5617	228	0		29	10	S5617_228_0	3	3	Preferred Brand	000101	2
S5617	228	0		29	10	S5617_228_0	3	1	Preferred Generic	001001	
S5617	228	0		29	10	S5617_228_0	3	2	Non-Preferred Generic	000101	
S5617	228	0		29	10	S5617_228_0	3	3	Preferred Brand	000101	
S5617	228	0		29	10	S5617_228_0	3	4	Non-Preferred Brand	100100	
S5617	228	0		29	10	S5617_228_0	3	5	Specialty Tier	010010	
S5617	229	0		29	10	S5617_229_0	3	2	Non-Preferred Generic	000101	1
S5617	229	0		29	10	S5617_229_0	3	3	Preferred Brand	000101	2
S5617	229	0		29	10	S5617_229_0	3	4	Non-Preferred Brand	100100	2
S5617	229	0		29	10	S5617_229_0	3	1	Preferred Generic	001001	1
S5617	229	0		29	10	S5617_229_0	3	1	Preferred Generic	001001	
S5617	229	0		29	10	S5617_229_0	3	4	Non-Preferred Brand	100100	
S5617	229	0		29	10	S5617_229_0	3	3	Preferred Brand	000101	
S5617	229	0		29	10	S5617_229_0	3	2	Non-Preferred Generic	000101	
S5617	229	0		29	10	S5617_229_0	3	5	Specialty Tier	010010	
S5617	230	0		29	10	S5617_230_0	2	3	Preferred Brand	000101	2
S5617	230	0		29	10	S5617_230_0	2	2	Non-Preferred Generic	000101	1
S5617	230	0		29	10	S5617_230_0	2	1	Preferred Generic	001001	1
S5617	230	0		29	10	S5617_230_0	2	5	Specialty Tier	010010	
S5617	230	0		29	10	S5617_230_0	2	4	Non-Preferred Brand	100100	
S5617	230	0		29	10	S5617_230_0	2	3	Preferred Brand	000101	
S5617	230	0		29	10	S5617_230_0	2	2	Non-Preferred Generic	000101	
S5617	230	0		29	10	S5617_230_0	2	1	Preferred Generic	001001	
S5617	230	0		29	10	S5617_230_0	2	4	Non-Preferred Brand	100100	2
S5617	231	0		29	10	S5617_231_0	2	4	Non-Preferred Brand	100100	
S5617	231	0		29	10	S5617_231_0	2	5	Specialty Tier	010010	
S5617	231	0		29	10	S5617_231_0	2	2	Non-Preferred Generic	000101	1
S5617	231	0		29	10	S5617_231_0	2	3	Preferred Brand	000101	2
S5617	231	0		29	10	S5617_231_0	2	1	Preferred Generic	001001	1
S5617	231	0		29	10	S5617_231_0	2	1	Preferred Generic	001001	
S5617	231	0		29	10	S5617_231_0	2	2	Non-Preferred Generic	000101	
S5617	231	0		29	10	S5617_231_0	2	3	Preferred Brand	000101	
S5617	231	0		29	10	S5617_231_0	2	4	Non-Preferred Brand	100100	2
S5617	232	0		29	10	S5617_232_0	2	5	Specialty Tier	010010	
S5617	232	0		29	10	S5617_232_0	2	4	Non-Preferred Brand	100100	
S5617	232	0		29	10	S5617_232_0	2	3	Preferred Brand	000101	
S5617	232	0		29	10	S5617_232_0	2	2	Non-Preferred Generic	000101	
S5617	232	0		29	10	S5617_232_0	2	1	Preferred Generic	001001	
S5617	232	0		29	10	S5617_232_0	2	3	Preferred Brand	000101	2
S5617	232	0		29	10	S5617_232_0	2	2	Non-Preferred Generic	000101	1
S5617	232	0		29	10	S5617_232_0	2	1	Preferred Generic	001001	1
S5617	232	0		29	10	S5617_232_0	2	4	Non-Preferred Brand	100100	2
S5617	233	0		29	10	S5617_233_0	3	4	Non-Preferred Brand	100100	
S5617	233	0		29	10	S5617_233_0	3	3	Preferred Brand	000101	
S5617	233	0		29	10	S5617_233_0	3	2	Non-Preferred Generic	000101	
S5617	233	0		29	10	S5617_233_0	3	1	Preferred Generic	001001	
S5617	233	0		29	10	S5617_233_0	3	4	Non-Preferred Brand	100100	2
S5617	233	0		29	10	S5617_233_0	3	1	Preferred Generic	001001	1
S5617	233	0		29	10	S5617_233_0	3	2	Non-Preferred Generic	000101	1
S5617	233	0		29	10	S5617_233_0	3	3	Preferred Brand	000101	2
S5617	233	0		29	10	S5617_233_0	3	5	Specialty Tier	010010	
S5617	234	0		29	10	S5617_234_0	3	4	Non-Preferred Brand	100100	
S5617	234	0		29	10	S5617_234_0	3	3	Preferred Brand	000101	
S5617	234	0		29	10	S5617_234_0	3	2	Non-Preferred Generic	000101	
S5617	234	0		29	10	S5617_234_0	3	1	Preferred Generic	001001	
S5617	234	0		29	10	S5617_234_0	3	5	Specialty Tier	010010	
S5617	234	0		29	10	S5617_234_0	3	4	Non-Preferred Brand	100100	2
S5617	234	0		29	10	S5617_234_0	3	3	Preferred Brand	000101	2
S5617	234	0		29	10	S5617_234_0	3	2	Non-Preferred Generic	000101	1
S5617	234	0		29	10	S5617_234_0	3	1	Preferred Generic	001001	1
S5617	235	0		29	10	S5617_235_0	2	1	Preferred Generic	001001	
S5617	235	0		29	10	S5617_235_0	2	2	Non-Preferred Generic	000101	
S5617	235	0		29	10	S5617_235_0	2	3	Preferred Brand	000101	
S5617	235	0		29	10	S5617_235_0	2	4	Non-Preferred Brand	100100	
S5617	235	0		29	10	S5617_235_0	2	4	Non-Preferred Brand	100100	2
S5617	235	0		29	10	S5617_235_0	2	2	Non-Preferred Generic	000101	1
S5617	235	0		29	10	S5617_235_0	2	1	Preferred Generic	001001	1
S5617	235	0		29	10	S5617_235_0	2	5	Specialty Tier	010010	
S5617	235	0		29	10	S5617_235_0	2	3	Preferred Brand	000101	2
S5617	236	0		29	10	S5617_236_0	2	3	Preferred Brand	000101	2
S5617	236	0		29	10	S5617_236_0	2	4	Non-Preferred Brand	100100	2
S5617	236	0		29	10	S5617_236_0	2	1	Preferred Generic	001001	
S5617	236	0		29	10	S5617_236_0	2	2	Non-Preferred Generic	000101	
S5617	236	0		29	10	S5617_236_0	2	3	Preferred Brand	000101	
S5617	236	0		29	10	S5617_236_0	2	4	Non-Preferred Brand	100100	
S5617	236	0		29	10	S5617_236_0	2	5	Specialty Tier	010010	
S5617	236	0		29	10	S5617_236_0	2	1	Preferred Generic	001001	1
S5617	236	0		29	10	S5617_236_0	2	2	Non-Preferred Generic	000101	1
S5617	237	0		29	10	S5617_237_0	3	1	Preferred Generic	001001	
S5617	237	0		29	10	S5617_237_0	3	2	Non-Preferred Generic	000101	
S5617	237	0		29	10	S5617_237_0	3	4	Non-Preferred Brand	100100	2
S5617	237	0		29	10	S5617_237_0	3	3	Preferred Brand	000101	2
S5617	237	0		29	10	S5617_237_0	3	2	Non-Preferred Generic	000101	1
S5617	237	0		29	10	S5617_237_0	3	1	Preferred Generic	001001	1
S5617	237	0		29	10	S5617_237_0	3	5	Specialty Tier	010010	
S5617	237	0		29	10	S5617_237_0	3	4	Non-Preferred Brand	100100	
S5617	237	0		29	10	S5617_237_0	3	3	Preferred Brand	000101	
S5617	238	0		29	10	S5617_238_0	2	2	Non-Preferred Generic	000101	1
S5617	238	0		29	10	S5617_238_0	2	3	Preferred Brand	000101	2
S5617	238	0		29	10	S5617_238_0	2	5	Specialty Tier	010010	
S5617	238	0		29	10	S5617_238_0	2	1	Preferred Generic	001001	1
S5617	238	0		29	10	S5617_238_0	2	4	Non-Preferred Brand	100100	
S5617	238	0		29	10	S5617_238_0	2	3	Preferred Brand	000101	
S5617	238	0		29	10	S5617_238_0	2	2	Non-Preferred Generic	000101	
S5617	238	0		29	10	S5617_238_0	2	1	Preferred Generic	001001	
S5617	238	0		29	10	S5617_238_0	2	4	Non-Preferred Brand	100100	2
S5617	239	0		29	10	S5617_239_0	2	1	Preferred Generic	001001	
S5617	239	0		29	10	S5617_239_0	2	4	Non-Preferred Brand	100100	
S5617	239	0		29	10	S5617_239_0	2	5	Specialty Tier	010010	
S5617	239	0		29	10	S5617_239_0	2	1	Preferred Generic	001001	1
S5617	239	0		29	10	S5617_239_0	2	4	Non-Preferred Brand	100100	2
S5617	239	0		29	10	S5617_239_0	2	3	Preferred Brand	000101	2
S5617	239	0		29	10	S5617_239_0	2	2	Non-Preferred Generic	000101	1
S5617	239	0		29	10	S5617_239_0	2	3	Preferred Brand	000101	
S5617	239	0		29	10	S5617_239_0	2	2	Non-Preferred Generic	000101	
S5617	240	0		29	10	S5617_240_0	2	1	Preferred Generic	001001	
S5617	240	0		29	10	S5617_240_0	2	2	Non-Preferred Generic	000101	
S5617	240	0		29	10	S5617_240_0	2	3	Preferred Brand	000101	
S5617	240	0		29	10	S5617_240_0	2	4	Non-Preferred Brand	100100	
S5617	240	0		29	10	S5617_240_0	2	4	Non-Preferred Brand	100100	2
S5617	240	0		29	10	S5617_240_0	2	1	Preferred Generic	001001	1
S5617	240	0		29	10	S5617_240_0	2	2	Non-Preferred Generic	000101	1
S5617	240	0		29	10	S5617_240_0	2	3	Preferred Brand	000101	2
S5617	240	0		29	10	S5617_240_0	2	5	Specialty Tier	010010	
S5617	241	0		29	10	S5617_241_0	2	1	Preferred Generic	001001	
S5617	241	0		29	10	S5617_241_0	2	2	Non-Preferred Generic	000101	
S5617	241	0		29	10	S5617_241_0	2	3	Preferred Brand	000101	
S5617	241	0		29	10	S5617_241_0	2	4	Non-Preferred Brand	100100	
S5617	241	0		29	10	S5617_241_0	2	4	Non-Preferred Brand	100100	2
S5617	241	0		29	10	S5617_241_0	2	1	Preferred Generic	001001	1
S5617	241	0		29	10	S5617_241_0	2	2	Non-Preferred Generic	000101	1
S5617	241	0		29	10	S5617_241_0	2	3	Preferred Brand	000101	2
S5617	241	0		29	10	S5617_241_0	2	5	Specialty Tier	010010	
S5617	242	0		29	10	S5617_242_0	2	1	Preferred Generic	001001	
S5617	242	0		29	10	S5617_242_0	2	2	Non-Preferred Generic	000101	
S5617	242	0		29	10	S5617_242_0	2	3	Preferred Brand	000101	
S5617	242	0		29	10	S5617_242_0	2	4	Non-Preferred Brand	100100	
S5617	242	0		29	10	S5617_242_0	2	4	Non-Preferred Brand	100100	2
S5617	242	0		29	10	S5617_242_0	2	1	Preferred Generic	001001	1
S5617	242	0		29	10	S5617_242_0	2	2	Non-Preferred Generic	000101	1
S5617	242	0		29	10	S5617_242_0	2	3	Preferred Brand	000101	2
S5617	242	0		29	10	S5617_242_0	2	5	Specialty Tier	010010	
S5617	243	0		29	10	S5617_243_0	2	1	Preferred Generic	001001	
S5617	243	0		29	10	S5617_243_0	2	2	Non-Preferred Generic	000101	
S5617	243	0		29	10	S5617_243_0	2	3	Preferred Brand	000101	
S5617	243	0		29	10	S5617_243_0	2	4	Non-Preferred Brand	100100	
S5617	243	0		29	10	S5617_243_0	2	4	Non-Preferred Brand	100100	2
S5617	243	0		29	10	S5617_243_0	2	1	Preferred Generic	001001	1
S5617	243	0		29	10	S5617_243_0	2	2	Non-Preferred Generic	000101	1
S5617	243	0		29	10	S5617_243_0	2	3	Preferred Brand	000101	2
S5617	243	0		29	10	S5617_243_0	2	5	Specialty Tier	010010	
S5617	244	0		29	10	S5617_244_0	2	4	Non-Preferred Brand	100100	2
S5617	244	0		29	10	S5617_244_0	2	1	Preferred Generic	001001	
S5617	244	0		29	10	S5617_244_0	2	2	Non-Preferred Generic	000101	
S5617	244	0		29	10	S5617_244_0	2	3	Preferred Brand	000101	
S5617	244	0		29	10	S5617_244_0	2	3	Preferred Brand	000101	2
S5617	244	0		29	10	S5617_244_0	2	5	Specialty Tier	010010	
S5617	244	0		29	10	S5617_244_0	2	1	Preferred Generic	001001	1
S5617	244	0		29	10	S5617_244_0	2	2	Non-Preferred Generic	000101	1
S5617	244	0		29	10	S5617_244_0	2	4	Non-Preferred Brand	100100	
S5617	245	0		29	10	S5617_245_0	2	1	Preferred Generic	001001	
S5617	245	0		29	10	S5617_245_0	2	2	Non-Preferred Generic	000101	
S5617	245	0		29	10	S5617_245_0	2	3	Preferred Brand	000101	
S5617	245	0		29	10	S5617_245_0	2	4	Non-Preferred Brand	100100	
S5617	245	0		29	10	S5617_245_0	2	4	Non-Preferred Brand	100100	2
S5617	245	0		29	10	S5617_245_0	2	1	Preferred Generic	001001	1
S5617	245	0		29	10	S5617_245_0	2	2	Non-Preferred Generic	000101	1
S5617	245	0		29	10	S5617_245_0	2	3	Preferred Brand	000101	2
S5617	245	0		29	10	S5617_245_0	2	5	Specialty Tier	010010	
S5617	246	0		29	10	S5617_246_0	3	2	Non-Preferred Generic	000101	
S5617	246	0		29	10	S5617_246_0	3	3	Preferred Brand	000101	
S5617	246	0		29	10	S5617_246_0	3	1	Preferred Generic	001001	
S5617	246	0		29	10	S5617_246_0	3	5	Specialty Tier	010010	
S5617	246	0		29	10	S5617_246_0	3	4	Non-Preferred Brand	100100	
S5617	247	0		29	10	S5617_247_0	2	1	Preferred Generic	001001	
S5617	247	0		29	10	S5617_247_0	2	2	Non-Preferred Generic	000101	
S5617	247	0		29	10	S5617_247_0	2	5	Specialty Tier	010010	
S5617	247	0		29	10	S5617_247_0	2	4	Non-Preferred Brand	100100	
S5617	247	0		29	10	S5617_247_0	2	3	Preferred Brand	000101	
S5617	248	0		29	10	S5617_248_0	3	1	Preferred Generic	001001	
S5617	248	0		29	10	S5617_248_0	3	2	Non-Preferred Generic	000101	
S5617	248	0		29	10	S5617_248_0	3	5	Specialty Tier	010010	
S5617	248	0		29	10	S5617_248_0	3	4	Non-Preferred Brand	100100	
S5617	248	0		29	10	S5617_248_0	3	3	Preferred Brand	000101	
S5617	249	0		29	10	S5617_249_0	2	2	Non-Preferred Generic	000101	
S5617	249	0		29	10	S5617_249_0	2	3	Preferred Brand	000101	
S5617	249	0		29	10	S5617_249_0	2	4	Non-Preferred Brand	100100	
S5617	249	0		29	10	S5617_249_0	2	5	Specialty Tier	010010	
S5617	249	0		29	10	S5617_249_0	2	1	Preferred Generic	001001	
S5617	250	0		29	10	S5617_250_0	2	1	Preferred Generic	001001	
S5617	250	0		29	10	S5617_250_0	2	2	Non-Preferred Generic	000101	
S5617	250	0		29	10	S5617_250_0	2	3	Preferred Brand	000101	
S5617	250	0		29	10	S5617_250_0	2	4	Non-Preferred Brand	100100	
S5617	250	0		29	10	S5617_250_0	2	5	Specialty Tier	010010	
S5617	251	0		29	10	S5617_251_0	2	2	Non-Preferred Generic	000101	
S5617	251	0		29	10	S5617_251_0	2	1	Preferred Generic	001001	
S5617	251	0		29	10	S5617_251_0	2	3	Preferred Brand	000101	
S5617	251	0		29	10	S5617_251_0	2	5	Specialty Tier	010010	
S5617	251	0		29	10	S5617_251_0	2	4	Non-Preferred Brand	100100	
S5617	252	0		29	10	S5617_252_0	2	1	Preferred Generic	001001	
S5617	252	0		29	10	S5617_252_0	2	2	Non-Preferred Generic	000101	
S5617	252	0		29	10	S5617_252_0	2	4	Non-Preferred Brand	100100	
S5617	252	0		29	10	S5617_252_0	2	3	Preferred Brand	000101	
S5617	252	0		29	10	S5617_252_0	2	5	Specialty Tier	010010	
S5617	253	0		29	10	S5617_253_0	3	2	Non-Preferred Generic	000101	
S5617	253	0		29	10	S5617_253_0	3	1	Preferred Generic	001001	
S5617	253	0		29	10	S5617_253_0	3	3	Preferred Brand	000101	
S5617	253	0		29	10	S5617_253_0	3	5	Specialty Tier	010010	
S5617	253	0		29	10	S5617_253_0	3	4	Non-Preferred Brand	100100	
S5617	254	0		29	10	S5617_254_0	2	2	Non-Preferred Generic	000101	
S5617	254	0		29	10	S5617_254_0	2	1	Preferred Generic	001001	
S5617	254	0		29	10	S5617_254_0	2	3	Preferred Brand	000101	
S5617	254	0		29	10	S5617_254_0	2	4	Non-Preferred Brand	100100	
S5617	254	0		29	10	S5617_254_0	2	5	Specialty Tier	010010	
S5617	255	0		29	10	S5617_255_0	2	2	Non-Preferred Generic	000101	
S5617	255	0		29	10	S5617_255_0	2	1	Preferred Generic	001001	
S5617	255	0		29	10	S5617_255_0	2	3	Preferred Brand	000101	
S5617	255	0		29	10	S5617_255_0	2	5	Specialty Tier	010010	
S5617	255	0		29	10	S5617_255_0	2	4	Non-Preferred Brand	100100	
S5617	256	0		29	10	S5617_256_0	2	1	Preferred Generic	001001	
S5617	256	0		29	10	S5617_256_0	2	2	Non-Preferred Generic	000101	
S5617	256	0		29	10	S5617_256_0	2	3	Preferred Brand	000101	
S5617	256	0		29	10	S5617_256_0	2	4	Non-Preferred Brand	100100	
S5617	256	0		29	10	S5617_256_0	2	5	Specialty Tier	010010	
S5617	257	0		29	10	S5617_257_0	3	1	Preferred Generic	001001	
S5617	257	0		29	10	S5617_257_0	3	2	Non-Preferred Generic	000101	
S5617	257	0		29	10	S5617_257_0	3	3	Preferred Brand	000101	
S5617	257	0		29	10	S5617_257_0	3	4	Non-Preferred Brand	100100	
S5617	257	0		29	10	S5617_257_0	3	5	Specialty Tier	010010	
S5617	258	0		29	10	S5617_258_0	3	4	Non-Preferred Brand	100100	
S5617	258	0		29	10	S5617_258_0	3	3	Preferred Brand	000101	
S5617	258	0		29	10	S5617_258_0	3	2	Non-Preferred Generic	000101	
S5617	258	0		29	10	S5617_258_0	3	1	Preferred Generic	001001	
S5617	258	0		29	10	S5617_258_0	3	5	Specialty Tier	010010	
S5617	259	0		29	10	S5617_259_0	2	4	Non-Preferred Brand	100100	
S5617	259	0		29	10	S5617_259_0	2	3	Preferred Brand	000101	
S5617	259	0		29	10	S5617_259_0	2	2	Non-Preferred Generic	000101	
S5617	259	0		29	10	S5617_259_0	2	1	Preferred Generic	001001	
S5617	259	0		29	10	S5617_259_0	2	5	Specialty Tier	010010	
S5617	260	0		29	10	S5617_260_0	2	1	Preferred Generic	001001	
S5617	260	0		29	10	S5617_260_0	2	2	Non-Preferred Generic	000101	
S5617	260	0		29	10	S5617_260_0	2	3	Preferred Brand	000101	
S5617	260	0		29	10	S5617_260_0	2	4	Non-Preferred Brand	100100	
S5617	260	0		29	10	S5617_260_0	2	5	Specialty Tier	010010	
S5617	261	0		29	10	S5617_261_0	3	4	Non-Preferred Brand	100100	
S5617	261	0		29	10	S5617_261_0	3	3	Preferred Brand	000101	
S5617	261	0		29	10	S5617_261_0	3	2	Non-Preferred Generic	000101	
S5617	261	0		29	10	S5617_261_0	3	1	Preferred Generic	001001	
S5617	261	0		29	10	S5617_261_0	3	5	Specialty Tier	010010	
S5617	262	0		29	10	S5617_262_0	3	1	Preferred Generic	001001	
S5617	262	0		29	10	S5617_262_0	3	2	Non-Preferred Generic	000101	
S5617	262	0		29	10	S5617_262_0	3	3	Preferred Brand	000101	
S5617	262	0		29	10	S5617_262_0	3	4	Non-Preferred Brand	100100	
S5617	262	0		29	10	S5617_262_0	3	5	Specialty Tier	010010	
S5617	263	0		29	10	S5617_263_0	2	1	Preferred Generic	001001	
S5617	263	0		29	10	S5617_263_0	2	2	Non-Preferred Generic	000101	
S5617	263	0		29	10	S5617_263_0	2	3	Preferred Brand	000101	
S5617	263	0		29	10	S5617_263_0	2	4	Non-Preferred Brand	100100	
S5617	263	0		29	10	S5617_263_0	2	5	Specialty Tier	010010	
S5617	264	0		29	10	S5617_264_0	2	4	Non-Preferred Brand	100100	
S5617	264	0		29	10	S5617_264_0	2	3	Preferred Brand	000101	
S5617	264	0		29	10	S5617_264_0	2	2	Non-Preferred Generic	000101	
S5617	264	0		29	10	S5617_264_0	2	1	Preferred Generic	001001	
S5617	264	0		29	10	S5617_264_0	2	5	Specialty Tier	010010	
S5617	265	0		29	10	S5617_265_0	3	2	Non-Preferred Generic	000101	
S5617	265	0		29	10	S5617_265_0	3	1	Preferred Generic	001001	
S5617	265	0		29	10	S5617_265_0	3	3	Preferred Brand	000101	
S5617	265	0		29	10	S5617_265_0	3	4	Non-Preferred Brand	100100	
S5617	265	0		29	10	S5617_265_0	3	5	Specialty Tier	010010	
S5617	266	0		29	10	S5617_266_0	2	1	Preferred Generic	001001	
S5617	266	0		29	10	S5617_266_0	2	2	Non-Preferred Generic	000101	
S5617	266	0		29	10	S5617_266_0	2	3	Preferred Brand	000101	
S5617	266	0		29	10	S5617_266_0	2	4	Non-Preferred Brand	100100	
S5617	266	0		29	10	S5617_266_0	2	5	Specialty Tier	010010	
S5617	267	0		29	10	S5617_267_0	2	2	Non-Preferred Generic	000101	
S5617	267	0		29	10	S5617_267_0	2	1	Preferred Generic	001001	
S5617	267	0		29	10	S5617_267_0	2	3	Preferred Brand	000101	
S5617	267	0		29	10	S5617_267_0	2	5	Specialty Tier	010010	
S5617	267	0		29	10	S5617_267_0	2	4	Non-Preferred Brand	100100	
S5617	268	0		29	10	S5617_268_0	2	1	Preferred Generic	001001	
S5617	268	0		29	10	S5617_268_0	2	2	Non-Preferred Generic	000101	
S5617	268	0		29	10	S5617_268_0	2	3	Preferred Brand	000101	
S5617	268	0		29	10	S5617_268_0	2	4	Non-Preferred Brand	100100	
S5617	268	0		29	10	S5617_268_0	2	5	Specialty Tier	010010	
S5617	269	0		29	10	S5617_269_0	3	1	Preferred Generic	001001	
S5617	269	0		29	10	S5617_269_0	3	2	Non-Preferred Generic	000101	
S5617	269	0		29	10	S5617_269_0	3	4	Non-Preferred Brand	100100	
S5617	269	0		29	10	S5617_269_0	3	3	Preferred Brand	000101	
S5617	269	0		29	10	S5617_269_0	3	5	Specialty Tier	010010	
S5617	270	0		29	10	S5617_270_0	2	1	Preferred Generic	001001	
S5617	270	0		29	10	S5617_270_0	2	5	Specialty Tier	010010	
S5617	270	0		29	10	S5617_270_0	2	4	Non-Preferred Brand	100100	
S5617	270	0		29	10	S5617_270_0	2	3	Preferred Brand	000101	
S5617	270	0		29	10	S5617_270_0	2	2	Non-Preferred Generic	000101	
S5617	271	0		29	10	S5617_271_0	2	5	Specialty Tier	010010	
S5617	271	0		29	10	S5617_271_0	2	3	Preferred Brand	000101	
S5617	271	0		29	10	S5617_271_0	2	4	Non-Preferred Brand	100100	
S5617	271	0		29	10	S5617_271_0	2	2	Non-Preferred Generic	000101	
S5617	271	0		29	10	S5617_271_0	2	1	Preferred Generic	001001	
S5617	272	0		29	10	S5617_272_0	2	1	Preferred Generic	001001	
S5617	272	0		29	10	S5617_272_0	2	2	Non-Preferred Generic	000101	
S5617	272	0		29	10	S5617_272_0	2	3	Preferred Brand	000101	
S5617	272	0		29	10	S5617_272_0	2	4	Non-Preferred Brand	100100	
S5617	272	0		29	10	S5617_272_0	2	5	Specialty Tier	010010	
S5617	273	0		29	10	S5617_273_0	2	1	Preferred Generic	001001	
S5617	273	0		29	10	S5617_273_0	2	2	Non-Preferred Generic	000101	
S5617	273	0		29	10	S5617_273_0	2	3	Preferred Brand	000101	
S5617	273	0		29	10	S5617_273_0	2	4	Non-Preferred Brand	100100	
S5617	273	0		29	10	S5617_273_0	2	5	Specialty Tier	010010	
S5617	274	0		29	10	S5617_274_0	2	4	Non-Preferred Brand	100100	
S5617	274	0		29	10	S5617_274_0	2	3	Preferred Brand	000101	
S5617	274	0		29	10	S5617_274_0	2	2	Non-Preferred Generic	000101	
S5617	274	0		29	10	S5617_274_0	2	1	Preferred Generic	001001	
S5617	274	0		29	10	S5617_274_0	2	5	Specialty Tier	010010	
S5617	275	0		29	10	S5617_275_0	2	1	Preferred Generic	001001	
S5617	275	0		29	10	S5617_275_0	2	2	Non-Preferred Generic	000101	
S5617	275	0		29	10	S5617_275_0	2	3	Preferred Brand	000101	
S5617	275	0		29	10	S5617_275_0	2	4	Non-Preferred Brand	100100	
S5617	275	0		29	10	S5617_275_0	2	5	Specialty Tier	010010	
S5617	276	0		29	10	S5617_276_0	2	4	Non-Preferred Brand	100100	
S5617	276	0		29	10	S5617_276_0	2	3	Preferred Brand	000101	
S5617	276	0		29	10	S5617_276_0	2	2	Non-Preferred Generic	000101	
S5617	276	0		29	10	S5617_276_0	2	1	Preferred Generic	001001	
S5617	276	0		29	10	S5617_276_0	2	5	Specialty Tier	010010	
S5617	277	0		29	10	S5617_277_0	2	2	Non-Preferred Generic	000101	
S5617	277	0		29	10	S5617_277_0	2	1	Preferred Generic	001001	
S5617	277	0		29	10	S5617_277_0	2	3	Preferred Brand	000101	
S5617	277	0		29	10	S5617_277_0	2	4	Non-Preferred Brand	100100	
S5617	277	0		29	10	S5617_277_0	2	5	Specialty Tier	010010	
S5617	278	0		29	10	S5617_278_0	2	2	Non-Preferred Generic	000101	
S5617	278	0		29	10	S5617_278_0	2	1	Preferred Generic	001001	
S5617	278	0		29	10	S5617_278_0	2	3	Preferred Brand	000101	
S5617	278	0		29	10	S5617_278_0	2	5	Specialty Tier	010010	
S5617	278	0		29	10	S5617_278_0	2	4	Non-Preferred Brand	100100	
S5617	279	0		29	10	S5617_279_0	2	1	Preferred Generic	001001	
S5617	279	0		29	10	S5617_279_0	2	2	Non-Preferred Generic	000101	
S5617	279	0		29	10	S5617_279_0	2	4	Non-Preferred Brand	100100	
S5617	279	0		29	10	S5617_279_0	2	3	Preferred Brand	000101	
S5617	279	0		29	10	S5617_279_0	2	5	Specialty Tier	010010	
S5660	104	0		29	10	S5660_104_0	1	4	Non-Preferred Brand	110000	
S5660	104	0		29	10	S5660_104_0	1	3	Preferred Brand	010001	
S5660	104	0		29	10	S5660_104_0	1	2	Non-Preferred Generic	000110	
S5660	104	0		29	10	S5660_104_0	1	1	Preferred Generic	001010	
S5660	104	0		29	10	S5660_104_0	1	5	Specialty Tier	010010	
S5660	105	0		29	10	S5660_105_0	1	1	Preferred Generic	001010	
S5660	105	0		29	10	S5660_105_0	1	2	Non-Preferred Generic	000110	
S5660	105	0		29	10	S5660_105_0	1	3	Preferred Brand	010001	
S5660	105	0		29	10	S5660_105_0	1	4	Non-Preferred Brand	110000	
S5660	105	0		29	10	S5660_105_0	1	5	Specialty Tier	010010	
S5660	106	0		29	10	S5660_106_0	1	4	Non-Preferred Brand	110000	
S5660	106	0		29	10	S5660_106_0	1	3	Preferred Brand	010001	
S5660	106	0		29	10	S5660_106_0	1	2	Non-Preferred Generic	000110	
S5660	106	0		29	10	S5660_106_0	1	1	Preferred Generic	001010	
S5660	106	0		29	10	S5660_106_0	1	5	Specialty Tier	010010	
S5660	107	0		29	10	S5660_107_0	1	2	Non-Preferred Generic	000110	
S5660	107	0		29	10	S5660_107_0	1	1	Preferred Generic	001010	
S5660	107	0		29	10	S5660_107_0	1	3	Preferred Brand	010001	
S5660	107	0		29	10	S5660_107_0	1	4	Non-Preferred Brand	110000	
S5660	107	0		29	10	S5660_107_0	1	5	Specialty Tier	010010	
S5660	108	0		29	10	S5660_108_0	1	2	Non-Preferred Generic	000110	
S5660	108	0		29	10	S5660_108_0	1	1	Preferred Generic	001010	
S5660	108	0		29	10	S5660_108_0	1	3	Preferred Brand	010001	
S5660	108	0		29	10	S5660_108_0	1	5	Specialty Tier	010010	
S5660	108	0		29	10	S5660_108_0	1	4	Non-Preferred Brand	110000	
S5660	109	0		29	10	S5660_109_0	1	1	Preferred Generic	001010	
S5660	109	0		29	10	S5660_109_0	1	2	Non-Preferred Generic	000110	
S5660	109	0		29	10	S5660_109_0	1	4	Non-Preferred Brand	110000	
S5660	109	0		29	10	S5660_109_0	1	3	Preferred Brand	010001	
S5660	109	0		29	10	S5660_109_0	1	5	Specialty Tier	010010	
S5660	110	0		29	10	S5660_110_0	1	1	Preferred Generic	001010	
S5660	110	0		29	10	S5660_110_0	1	2	Non-Preferred Generic	000110	
S5660	110	0		29	10	S5660_110_0	1	3	Preferred Brand	010001	
S5660	110	0		29	10	S5660_110_0	1	4	Non-Preferred Brand	110000	
S5660	110	0		29	10	S5660_110_0	1	5	Specialty Tier	010010	
S5660	111	0		29	10	S5660_111_0	1	4	Non-Preferred Brand	110000	
S5660	111	0		29	10	S5660_111_0	1	3	Preferred Brand	010001	
S5660	111	0		29	10	S5660_111_0	1	2	Non-Preferred Generic	000110	
S5660	111	0		29	10	S5660_111_0	1	1	Preferred Generic	001010	
S5660	111	0		29	10	S5660_111_0	1	5	Specialty Tier	010010	
S5660	112	0		29	10	S5660_112_0	1	1	Preferred Generic	001010	
S5660	112	0		29	10	S5660_112_0	1	2	Non-Preferred Generic	000110	
S5660	112	0		29	10	S5660_112_0	1	3	Preferred Brand	010001	
S5660	112	0		29	10	S5660_112_0	1	4	Non-Preferred Brand	110000	
S5660	112	0		29	10	S5660_112_0	1	5	Specialty Tier	010010	
S5660	113	0		29	10	S5660_113_0	1	1	Preferred Generic	001010	
S5660	113	0		29	10	S5660_113_0	1	2	Non-Preferred Generic	000110	
S5660	113	0		29	10	S5660_113_0	1	3	Preferred Brand	010001	
S5660	113	0		29	10	S5660_113_0	1	4	Non-Preferred Brand	110000	
S5660	113	0		29	10	S5660_113_0	1	5	Specialty Tier	010010	
S5660	114	0		29	10	S5660_114_0	1	4	Non-Preferred Brand	110000	
S5660	114	0		29	10	S5660_114_0	1	3	Preferred Brand	010001	
S5660	114	0		29	10	S5660_114_0	1	2	Non-Preferred Generic	000110	
S5660	114	0		29	10	S5660_114_0	1	1	Preferred Generic	001010	
S5660	114	0		29	10	S5660_114_0	1	5	Specialty Tier	010010	
S5660	115	0		29	10	S5660_115_0	1	2	Non-Preferred Generic	000110	
S5660	115	0		29	10	S5660_115_0	1	1	Preferred Generic	001010	
S5660	115	0		29	10	S5660_115_0	1	3	Preferred Brand	010001	
S5660	115	0		29	10	S5660_115_0	1	4	Non-Preferred Brand	110000	
S5660	115	0		29	10	S5660_115_0	1	5	Specialty Tier	010010	
S5660	116	0		29	10	S5660_116_0	1	1	Preferred Generic	001010	
S5660	116	0		29	10	S5660_116_0	1	2	Non-Preferred Generic	000110	
S5660	116	0		29	10	S5660_116_0	1	3	Preferred Brand	010001	
S5660	116	0		29	10	S5660_116_0	1	4	Non-Preferred Brand	110000	
S5660	116	0		29	10	S5660_116_0	1	5	Specialty Tier	010010	
S5660	117	0		29	10	S5660_117_0	1	2	Non-Preferred Generic	000110	
S5660	117	0		29	10	S5660_117_0	1	1	Preferred Generic	001010	
S5660	117	0		29	10	S5660_117_0	1	3	Preferred Brand	010001	
S5660	117	0		29	10	S5660_117_0	1	5	Specialty Tier	010010	
S5660	117	0		29	10	S5660_117_0	1	4	Non-Preferred Brand	110000	
S5660	118	0		29	10	S5660_118_0	1	1	Preferred Generic	001010	
S5660	118	0		29	10	S5660_118_0	1	2	Non-Preferred Generic	000110	
S5660	118	0		29	10	S5660_118_0	1	3	Preferred Brand	010001	
S5660	118	0		29	10	S5660_118_0	1	4	Non-Preferred Brand	110000	
S5660	118	0		29	10	S5660_118_0	1	5	Specialty Tier	010010	
S5660	119	0		29	10	S5660_119_0	1	1	Preferred Generic	001010	
S5660	119	0		29	10	S5660_119_0	1	2	Non-Preferred Generic	000110	
S5660	119	0		29	10	S5660_119_0	1	4	Non-Preferred Brand	110000	
S5660	119	0		29	10	S5660_119_0	1	3	Preferred Brand	010001	
S5660	119	0		29	10	S5660_119_0	1	5	Specialty Tier	010010	
S5660	120	0		29	10	S5660_120_0	1	5	Specialty Tier	010010	
S5660	120	0		29	10	S5660_120_0	1	2	Non-Preferred Generic	000110	
S5660	120	0		29	10	S5660_120_0	1	3	Preferred Brand	010001	
S5660	120	0		29	10	S5660_120_0	1	4	Non-Preferred Brand	110000	
S5660	120	0		29	10	S5660_120_0	1	1	Preferred Generic	001010	
S5660	121	0		29	10	S5660_121_0	1	3	Preferred Brand	010001	
S5660	121	0		29	10	S5660_121_0	1	4	Non-Preferred Brand	110000	
S5660	121	0		29	10	S5660_121_0	1	1	Preferred Generic	001010	
S5660	121	0		29	10	S5660_121_0	1	5	Specialty Tier	010010	
S5660	121	0		29	10	S5660_121_0	1	2	Non-Preferred Generic	000110	
S5660	122	0		29	10	S5660_122_0	1	4	Non-Preferred Brand	110000	
S5660	122	0		29	10	S5660_122_0	1	3	Preferred Brand	010001	
S5660	122	0		29	10	S5660_122_0	1	2	Non-Preferred Generic	000110	
S5660	122	0		29	10	S5660_122_0	1	1	Preferred Generic	001010	
S5660	122	0		29	10	S5660_122_0	1	5	Specialty Tier	010010	
S5660	123	0		29	10	S5660_123_0	1	5	Specialty Tier	010010	
S5660	123	0		29	10	S5660_123_0	1	4	Non-Preferred Brand	110000	
S5660	123	0		29	10	S5660_123_0	1	3	Preferred Brand	010001	
S5660	123	0		29	10	S5660_123_0	1	2	Non-Preferred Generic	000110	
S5660	123	0		29	10	S5660_123_0	1	1	Preferred Generic	001010	
S5660	124	0		29	10	S5660_124_0	1	5	Specialty Tier	010010	
S5660	124	0		29	10	S5660_124_0	1	1	Preferred Generic	001010	
S5660	124	0		29	10	S5660_124_0	1	2	Non-Preferred Generic	000110	
S5660	124	0		29	10	S5660_124_0	1	3	Preferred Brand	010001	
S5660	124	0		29	10	S5660_124_0	1	4	Non-Preferred Brand	110000	
S5660	125	0		29	10	S5660_125_0	1	4	Non-Preferred Brand	110000	
S5660	125	0		29	10	S5660_125_0	1	1	Preferred Generic	001010	
S5660	125	0		29	10	S5660_125_0	1	2	Non-Preferred Generic	000110	
S5660	125	0		29	10	S5660_125_0	1	3	Preferred Brand	010001	
S5660	125	0		29	10	S5660_125_0	1	5	Specialty Tier	010010	
S5660	126	0		29	10	S5660_126_0	1	3	Preferred Brand	010001	
S5660	126	0		29	10	S5660_126_0	1	2	Non-Preferred Generic	000110	
S5660	126	0		29	10	S5660_126_0	1	1	Preferred Generic	001010	
S5660	126	0		29	10	S5660_126_0	1	4	Non-Preferred Brand	110000	
S5660	126	0		29	10	S5660_126_0	1	5	Specialty Tier	010010	
S5660	127	0		29	10	S5660_127_0	1	2	Non-Preferred Generic	000110	
S5660	127	0		29	10	S5660_127_0	1	1	Preferred Generic	001010	
S5660	127	0		29	10	S5660_127_0	1	3	Preferred Brand	010001	
S5660	127	0		29	10	S5660_127_0	1	4	Non-Preferred Brand	110000	
S5660	127	0		29	10	S5660_127_0	1	5	Specialty Tier	010010	
S5660	128	0		29	10	S5660_128_0	1	2	Non-Preferred Generic	000110	
S5660	128	0		29	10	S5660_128_0	1	1	Preferred Generic	001010	
S5660	128	0		29	10	S5660_128_0	1	3	Preferred Brand	010001	
S5660	128	0		29	10	S5660_128_0	1	5	Specialty Tier	010010	
S5660	128	0		29	10	S5660_128_0	1	4	Non-Preferred Brand	110000	
S5660	129	0		29	10	S5660_129_0	1	1	Preferred Generic	001010	
S5660	129	0		29	10	S5660_129_0	1	2	Non-Preferred Generic	000110	
S5660	129	0		29	10	S5660_129_0	1	4	Non-Preferred Brand	110000	
S5660	129	0		29	10	S5660_129_0	1	3	Preferred Brand	010001	
S5660	129	0		29	10	S5660_129_0	1	5	Specialty Tier	010010	
S5660	130	0		29	10	S5660_130_0	1	4	Non-Preferred Brand	110000	
S5660	130	0		29	10	S5660_130_0	1	3	Preferred Brand	010001	
S5660	130	0		29	10	S5660_130_0	1	2	Non-Preferred Generic	000110	
S5660	130	0		29	10	S5660_130_0	1	1	Preferred Generic	001010	
S5660	130	0		29	10	S5660_130_0	1	5	Specialty Tier	010010	
S5660	131	0		29	10	S5660_131_0	1	1	Preferred Generic	001010	
S5660	131	0		29	10	S5660_131_0	1	2	Non-Preferred Generic	000110	
S5660	131	0		29	10	S5660_131_0	1	3	Preferred Brand	010001	
S5660	131	0		29	10	S5660_131_0	1	4	Non-Preferred Brand	110000	
S5660	131	0		29	10	S5660_131_0	1	5	Specialty Tier	010010	
S5660	132	0		29	10	S5660_132_0	1	1	Preferred Generic	001010	
S5660	132	0		29	10	S5660_132_0	1	2	Non-Preferred Generic	000110	
S5660	132	0		29	10	S5660_132_0	1	3	Preferred Brand	010001	
S5660	132	0		29	10	S5660_132_0	1	5	Specialty Tier	010010	
S5660	132	0		29	10	S5660_132_0	1	4	Non-Preferred Brand	110000	
S5660	133	0		29	10	S5660_133_0	1	3	Preferred Brand	010001	
S5660	133	0		29	10	S5660_133_0	1	2	Non-Preferred Generic	000110	
S5660	133	0		29	10	S5660_133_0	1	1	Preferred Generic	001010	
S5660	133	0		29	10	S5660_133_0	1	4	Non-Preferred Brand	110000	
S5660	133	0		29	10	S5660_133_0	1	5	Specialty Tier	010010	
S5660	134	0		29	10	S5660_134_0	1	5	Specialty Tier	010010	
S5660	134	0		29	10	S5660_134_0	1	4	Non-Preferred Brand	110000	
S5660	134	0		29	10	S5660_134_0	1	3	Preferred Brand	010001	
S5660	134	0		29	10	S5660_134_0	1	1	Preferred Generic	001010	
S5660	134	0		29	10	S5660_134_0	1	2	Non-Preferred Generic	000110	
S5660	135	0		29	10	S5660_135_0	1	4	Non-Preferred Brand	110000	
S5660	135	0		29	10	S5660_135_0	1	5	Specialty Tier	010010	
S5660	135	0		29	10	S5660_135_0	1	3	Preferred Brand	010001	
S5660	135	0		29	10	S5660_135_0	1	2	Non-Preferred Generic	000110	
S5660	135	0		29	10	S5660_135_0	1	1	Preferred Generic	001010	
S5660	136	0		29	10	S5660_136_0	1	1	Preferred Generic	001010	
S5660	136	0		29	10	S5660_136_0	1	3	Preferred Brand	010001	
S5660	136	0		29	10	S5660_136_0	1	4	Non-Preferred Brand	110000	
S5660	136	0		29	10	S5660_136_0	1	5	Specialty Tier	010010	
S5660	136	0		29	10	S5660_136_0	1	2	Non-Preferred Generic	000110	
S5660	137	0		29	10	S5660_137_0	1	1	Preferred Generic	001010	
S5660	137	0		29	10	S5660_137_0	1	2	Non-Preferred Generic	000110	
S5660	137	0		29	10	S5660_137_0	1	3	Preferred Brand	010001	
S5660	137	0		29	10	S5660_137_0	1	4	Non-Preferred Brand	110000	
S5660	137	0		29	10	S5660_137_0	1	5	Specialty Tier	010010	
S5660	172	0		29	10	S5660_172_0	1	1	Preferred Generic	001010	
S5660	172	0		29	10	S5660_172_0	1	2	Non-Preferred Generic	000110	
S5660	172	0		29	10	S5660_172_0	1	3	Preferred Brand	010001	
S5660	172	0		29	10	S5660_172_0	1	4	Non-Preferred Brand	110000	
S5660	172	0		29	10	S5660_172_0	1	5	Specialty Tier	010010	
S5660	176	0		29	10	S5660_176_0	1	1	Preferred Generic	001010	
S5660	176	0		29	10	S5660_176_0	1	2	Non-Preferred Generic	000110	
S5660	176	0		29	10	S5660_176_0	1	3	Preferred Brand	010001	
S5660	176	0		29	10	S5660_176_0	1	4	Non-Preferred Brand	110000	
S5660	176	0		29	10	S5660_176_0	1	5	Specialty Tier	010010	
S5660	180	0		29	10	S5660_180_0	2	3	Preferred Brand	010001	
S5660	180	0		29	10	S5660_180_0	2	2	Non-Preferred Generic	000110	
S5660	180	0		29	10	S5660_180_0	2	1	Preferred Generic	001010	
S5660	180	0		29	10	S5660_180_0	2	5	Specialty Tier	010010	
S5660	180	0		29	10	S5660_180_0	2	4	Non-Preferred Brand	110000	
S5660	181	0		29	10	S5660_181_0	1	1	Preferred Generic	001010	
S5660	181	0		29	10	S5660_181_0	1	3	Preferred Brand	010001	
S5660	181	0		29	10	S5660_181_0	1	4	Non-Preferred Brand	110000	
S5660	181	0		29	10	S5660_181_0	1	5	Specialty Tier	010010	
S5660	181	0		29	10	S5660_181_0	1	2	Non-Preferred Generic	000110	
S5660	182	0		29	10	S5660_182_0	2	5	Specialty Tier	010010	
S5660	182	0		29	10	S5660_182_0	2	3	Preferred Brand	010001	
S5660	182	0		29	10	S5660_182_0	2	4	Non-Preferred Brand	110000	
S5660	182	0		29	10	S5660_182_0	2	2	Non-Preferred Generic	000110	
S5660	182	0		29	10	S5660_182_0	2	1	Preferred Generic	001010	
S5660	183	0		29	10	S5660_183_0	1	5	Specialty Tier	010010	
S5660	183	0		29	10	S5660_183_0	1	4	Non-Preferred Brand	110000	
S5660	183	0		29	10	S5660_183_0	1	3	Preferred Brand	010001	
S5660	183	0		29	10	S5660_183_0	1	2	Non-Preferred Generic	000110	
S5660	183	0		29	10	S5660_183_0	1	1	Preferred Generic	001010	
S5660	184	0		29	10	S5660_184_0	1	5	Specialty Tier	010010	
S5660	184	0		29	10	S5660_184_0	1	3	Preferred Brand	010001	
S5660	184	0		29	10	S5660_184_0	1	4	Non-Preferred Brand	110000	
S5660	184	0		29	10	S5660_184_0	1	2	Non-Preferred Generic	000110	
S5660	184	0		29	10	S5660_184_0	1	1	Preferred Generic	001010	
S5660	185	0		29	10	S5660_185_0	1	5	Specialty Tier	010010	
S5660	185	0		29	10	S5660_185_0	1	4	Non-Preferred Brand	110000	
S5660	185	0		29	10	S5660_185_0	1	3	Preferred Brand	010001	
S5660	185	0		29	10	S5660_185_0	1	2	Non-Preferred Generic	000110	
S5660	185	0		29	10	S5660_185_0	1	1	Preferred Generic	001010	
S5660	186	0		29	10	S5660_186_0	1	5	Specialty Tier	010010	
S5660	186	0		29	10	S5660_186_0	1	3	Preferred Brand	010001	
S5660	186	0		29	10	S5660_186_0	1	4	Non-Preferred Brand	110000	
S5660	186	0		29	10	S5660_186_0	1	2	Non-Preferred Generic	000110	
S5660	186	0		29	10	S5660_186_0	1	1	Preferred Generic	001010	
S5660	187	0		29	10	S5660_187_0	1	1	Preferred Generic	001010	
S5660	187	0		29	10	S5660_187_0	1	2	Non-Preferred Generic	000110	
S5660	187	0		29	10	S5660_187_0	1	3	Preferred Brand	010001	
S5660	187	0		29	10	S5660_187_0	1	4	Non-Preferred Brand	110000	
S5660	187	0		29	10	S5660_187_0	1	5	Specialty Tier	010010	
S5660	190	0		29	10	S5660_190_0	3	1	Preferred Generic	001010	
S5660	190	0		29	10	S5660_190_0	3	2	Non-Preferred Generic	000110	
S5660	190	0		29	10	S5660_190_0	3	3	Preferred Brand	010001	
S5660	190	0		29	10	S5660_190_0	3	4	Non-Preferred Brand	110000	
S5660	190	0		29	10	S5660_190_0	3	5	Specialty Tier	010010	
S5660	192	0		29	10	S5660_192_0	1	1	Preferred Generic	001010	
S5660	192	0		29	10	S5660_192_0	1	2	Non-Preferred Generic	000110	
S5660	192	0		29	10	S5660_192_0	1	3	Preferred Brand	010001	
S5660	192	0		29	10	S5660_192_0	1	4	Non-Preferred Brand	110000	
S5660	192	0		29	10	S5660_192_0	1	5	Specialty Tier	010010	
S5660	194	0		29	10	S5660_194_0	1	1	Preferred Generic	001010	
S5660	194	0		29	10	S5660_194_0	1	2	Non-Preferred Generic	000110	
S5660	194	0		29	10	S5660_194_0	1	3	Preferred Brand	010001	
S5660	194	0		29	10	S5660_194_0	1	4	Non-Preferred Brand	110000	
S5660	194	0		29	10	S5660_194_0	1	5	Specialty Tier	010010	
S5660	195	0		29	10	S5660_195_0	1	2	Non-Preferred Generic	000110	
S5660	195	0		29	10	S5660_195_0	1	1	Preferred Generic	001010	
S5660	195	0		29	10	S5660_195_0	1	3	Preferred Brand	010001	
S5660	195	0		29	10	S5660_195_0	1	4	Non-Preferred Brand	110000	
S5660	195	0		29	10	S5660_195_0	1	5	Specialty Tier	010010	
S5660	196	0		29	10	S5660_196_0	1	1	Preferred Generic	001010	
S5660	196	0		29	10	S5660_196_0	1	2	Non-Preferred Generic	000110	
S5660	196	0		29	10	S5660_196_0	1	3	Preferred Brand	010001	
S5660	196	0		29	10	S5660_196_0	1	4	Non-Preferred Brand	110000	
S5660	196	0		29	10	S5660_196_0	1	5	Specialty Tier	010010	
S5660	197	0		29	10	S5660_197_0	1	2	Non-Preferred Generic	000110	
S5660	197	0		29	10	S5660_197_0	1	1	Preferred Generic	001010	
S5660	197	0		29	10	S5660_197_0	1	3	Preferred Brand	010001	
S5660	197	0		29	10	S5660_197_0	1	5	Specialty Tier	010010	
S5660	197	0		29	10	S5660_197_0	1	4	Non-Preferred Brand	110000	
S5660	198	0		29	10	S5660_198_0	1	1	Preferred Generic	001010	
S5660	198	0		29	10	S5660_198_0	1	2	Non-Preferred Generic	000110	
S5660	198	0		29	10	S5660_198_0	1	3	Preferred Brand	010001	
S5660	198	0		29	10	S5660_198_0	1	4	Non-Preferred Brand	110000	
S5660	198	0		29	10	S5660_198_0	1	5	Specialty Tier	010010	
S5660	199	0		29	10	S5660_199_0	1	1	Preferred Generic	001010	
S5660	199	0		29	10	S5660_199_0	1	2	Non-Preferred Generic	000110	
S5660	199	0		29	10	S5660_199_0	1	4	Non-Preferred Brand	110000	
S5660	199	0		29	10	S5660_199_0	1	3	Preferred Brand	010001	
S5660	199	0		29	10	S5660_199_0	1	5	Specialty Tier	010010	
S5660	202	0		29	10	S5660_202_0	1	3	Preferred Brand	010001	
S5660	202	0		29	10	S5660_202_0	1	4	Non-Preferred Brand	110000	
S5660	202	0		29	10	S5660_202_0	1	5	Specialty Tier	010010	
S5660	202	0		29	10	S5660_202_0	1	1	Preferred Generic	001010	
S5660	202	0		29	10	S5660_202_0	1	2	Non-Preferred Generic	000110	
S5660	203	0		29	10	S5660_203_0	1	1	Preferred Generic	001010	
S5660	203	0		29	10	S5660_203_0	1	2	Non-Preferred Generic	000110	
S5660	203	0		29	10	S5660_203_0	1	3	Preferred Brand	010001	
S5660	203	0		29	10	S5660_203_0	1	4	Non-Preferred Brand	110000	
S5660	203	0		29	10	S5660_203_0	1	5	Specialty Tier	010010	
S5660	204	0		29	10	S5660_204_0	1	2	Non-Preferred Generic	000110	
S5660	204	0		29	10	S5660_204_0	1	1	Preferred Generic	001010	
S5660	204	0		29	10	S5660_204_0	1	3	Preferred Brand	010001	
S5660	204	0		29	10	S5660_204_0	1	5	Specialty Tier	010010	
S5660	204	0		29	10	S5660_204_0	1	4	Non-Preferred Brand	110000	
S5660	205	0		29	10	S5660_205_0	1	1	Preferred Generic	001010	
S5660	205	0		29	10	S5660_205_0	1	2	Non-Preferred Generic	000110	
S5660	205	0		29	10	S5660_205_0	1	4	Non-Preferred Brand	110000	
S5660	205	0		29	10	S5660_205_0	1	3	Preferred Brand	010001	
S5660	205	0		29	10	S5660_205_0	1	5	Specialty Tier	010010	
S5660	206	0		29	10	S5660_206_0	1	2	Non-Preferred Generic	000110	
S5660	206	0		29	10	S5660_206_0	1	1	Preferred Generic	001010	
S5660	206	0		29	10	S5660_206_0	1	3	Preferred Brand	010001	
S5660	206	0		29	10	S5660_206_0	1	5	Specialty Tier	010010	
S5660	206	0		29	10	S5660_206_0	1	4	Non-Preferred Brand	110000	
S5660	207	0		29	10	S5660_207_0	1	2	Non-Preferred Generic	000110	
S5660	207	0		29	10	S5660_207_0	1	1	Preferred Generic	001010	
S5660	207	0		29	10	S5660_207_0	1	3	Preferred Brand	010001	
S5660	207	0		29	10	S5660_207_0	1	4	Non-Preferred Brand	110000	
S5660	207	0		29	10	S5660_207_0	1	5	Specialty Tier	010010	
S5660	208	0		29	10	S5660_208_0	1	2	Non-Preferred Generic	000110	
S5660	208	0		29	10	S5660_208_0	1	1	Preferred Generic	001010	
S5660	208	0		29	10	S5660_208_0	1	3	Preferred Brand	010001	
S5660	208	0		29	10	S5660_208_0	1	5	Specialty Tier	010010	
S5660	208	0		29	10	S5660_208_0	1	4	Non-Preferred Brand	110000	
S5660	209	0		29	10	S5660_209_0	1	1	Preferred Generic	001010	
S5660	209	0		29	10	S5660_209_0	1	2	Non-Preferred Generic	000110	
S5660	209	0		29	10	S5660_209_0	1	3	Preferred Brand	010001	
S5660	209	0		29	10	S5660_209_0	1	4	Non-Preferred Brand	110000	
S5660	209	0		29	10	S5660_209_0	1	5	Specialty Tier	010010	
S5660	210	0		29	10	S5660_210_0	1	1	Preferred Generic	001010	
S5660	210	0		29	10	S5660_210_0	1	2	Non-Preferred Generic	000110	
S5660	210	0		29	10	S5660_210_0	1	5	Specialty Tier	010010	
S5660	210	0		29	10	S5660_210_0	1	4	Non-Preferred Brand	110000	
S5660	210	0		29	10	S5660_210_0	1	3	Preferred Brand	010001	
S5660	211	0		29	10	S5660_211_0	1	1	Preferred Generic	001010	
S5660	211	0		29	10	S5660_211_0	1	2	Non-Preferred Generic	000110	
S5660	211	0		29	10	S5660_211_0	1	3	Preferred Brand	010001	
S5660	211	0		29	10	S5660_211_0	1	4	Non-Preferred Brand	110000	
S5660	211	0		29	10	S5660_211_0	1	5	Specialty Tier	010010	
S5660	212	0		29	10	S5660_212_0	2	1	Preferred Generic	001010	
S5660	212	0		29	10	S5660_212_0	2	3	Preferred Brand	010001	
S5660	212	0		29	10	S5660_212_0	2	4	Non-Preferred Brand	110000	
S5660	212	0		29	10	S5660_212_0	2	2	Non-Preferred Generic	000110	
S5660	212	0		29	10	S5660_212_0	2	5	Specialty Tier	010010	
S5660	213	0		29	10	S5660_213_0	2	1	Preferred Generic	001010	
S5660	213	0		29	10	S5660_213_0	2	3	Preferred Brand	010001	
S5660	213	0		29	10	S5660_213_0	2	4	Non-Preferred Brand	110000	
S5660	213	0		29	10	S5660_213_0	2	2	Non-Preferred Generic	000110	
S5660	213	0		29	10	S5660_213_0	2	5	Specialty Tier	010010	
S5660	214	0		29	10	S5660_214_0	1	1	Preferred Generic	001010	
S5660	214	0		29	10	S5660_214_0	1	3	Preferred Brand	010001	
S5660	214	0		29	10	S5660_214_0	1	4	Non-Preferred Brand	110000	
S5660	214	0		29	10	S5660_214_0	1	2	Non-Preferred Generic	000110	
S5660	214	0		29	10	S5660_214_0	1	5	Specialty Tier	010010	
S5660	215	0		29	10	S5660_215_0	1	1	Preferred Generic	001010	
S5660	215	0		29	10	S5660_215_0	1	3	Preferred Brand	010001	
S5660	215	0		29	10	S5660_215_0	1	4	Non-Preferred Brand	110000	
S5660	215	0		29	10	S5660_215_0	1	2	Non-Preferred Generic	000110	
S5660	215	0		29	10	S5660_215_0	1	5	Specialty Tier	010010	
S5660	216	0		29	10	S5660_216_0	1	1	Preferred Generic	001010	
S5660	216	0		29	10	S5660_216_0	1	3	Preferred Brand	010001	
S5660	216	0		29	10	S5660_216_0	1	4	Non-Preferred Brand	110000	
S5660	216	0		29	10	S5660_216_0	1	2	Non-Preferred Generic	000110	
S5660	216	0		29	10	S5660_216_0	1	5	Specialty Tier	010010	
S5660	217	0		29	10	S5660_217_0	1	1	Preferred Generic	001010	
S5660	217	0		29	10	S5660_217_0	1	5	Specialty Tier	010010	
S5660	217	0		29	10	S5660_217_0	1	2	Non-Preferred Generic	000110	
S5660	217	0		29	10	S5660_217_0	1	3	Preferred Brand	010001	
S5660	217	0		29	10	S5660_217_0	1	4	Non-Preferred Brand	110000	
S5670	030	0		29	10	S5670_030_0	2	3	Preferred Brand	000001	
S5670	030	0		29	10	S5670_030_0	2	2	Non-Preferred Generic	000100	
S5670	030	0		29	10	S5670_030_0	2	4	Non-Preferred Brand	100100	2
S5670	030	0		29	10	S5670_030_0	2	3	Preferred Brand	000001	2
S5670	030	0		29	10	S5670_030_0	2	1	Preferred Generic	001000	1
S5670	030	0		29	10	S5670_030_0	2	5	Specialty Tier	010010	
S5670	030	0		29	10	S5670_030_0	2	4	Non-Preferred Brand	100100	
S5670	030	0		29	10	S5670_030_0	2	1	Preferred Generic	001000	
S5670	036	0		29	10	S5670_036_0	2	1	Preferred Generic	001000	
S5670	036	0		29	10	S5670_036_0	2	3	Preferred Brand	000001	2
S5670	036	0		29	10	S5670_036_0	2	1	Preferred Generic	001000	1
S5670	036	0		29	10	S5670_036_0	2	5	Specialty Tier	010010	
S5670	036	0		29	10	S5670_036_0	2	4	Non-Preferred Brand	100100	
S5670	036	0		29	10	S5670_036_0	2	3	Preferred Brand	000001	
S5670	036	0		29	10	S5670_036_0	2	2	Non-Preferred Generic	000100	
S5670	036	0		29	10	S5670_036_0	2	4	Non-Preferred Brand	100100	2
S5670	042	0		29	10	S5670_042_0	2	3	Preferred Brand	000001	
S5670	042	0		29	10	S5670_042_0	2	2	Non-Preferred Generic	000100	
S5670	042	0		29	10	S5670_042_0	2	1	Preferred Generic	001000	
S5670	042	0		29	10	S5670_042_0	2	4	Non-Preferred Brand	100100	
S5670	042	0		29	10	S5670_042_0	2	4	Non-Preferred Brand	100100	2
S5670	042	0		29	10	S5670_042_0	2	3	Preferred Brand	000001	2
S5670	042	0		29	10	S5670_042_0	2	1	Preferred Generic	001000	1
S5670	042	0		29	10	S5670_042_0	2	5	Specialty Tier	010010	
S5670	048	0		29	10	S5670_048_0	2	1	Preferred Generic	001000	
S5670	048	0		29	10	S5670_048_0	2	2	Non-Preferred Generic	000100	
S5670	048	0		29	10	S5670_048_0	2	4	Non-Preferred Brand	100100	2
S5670	048	0		29	10	S5670_048_0	2	3	Preferred Brand	000001	2
S5670	048	0		29	10	S5670_048_0	2	1	Preferred Generic	001000	1
S5670	048	0		29	10	S5670_048_0	2	5	Specialty Tier	010010	
S5670	048	0		29	10	S5670_048_0	2	4	Non-Preferred Brand	100100	
S5670	048	0		29	10	S5670_048_0	2	3	Preferred Brand	000001	
S5670	054	0		29	10	S5670_054_0	2	1	Preferred Generic	001000	
S5670	054	0		29	10	S5670_054_0	2	4	Non-Preferred Brand	100100	
S5670	054	0		29	10	S5670_054_0	2	5	Specialty Tier	010010	
S5670	054	0		29	10	S5670_054_0	2	1	Preferred Generic	001000	1
S5670	054	0		29	10	S5670_054_0	2	3	Preferred Brand	000001	2
S5670	054	0		29	10	S5670_054_0	2	3	Preferred Brand	000001	
S5670	054	0		29	10	S5670_054_0	2	2	Non-Preferred Generic	000100	
S5670	054	0		29	10	S5670_054_0	2	4	Non-Preferred Brand	100100	2
S5670	060	0		29	10	S5670_060_0	2	3	Preferred Brand	000001	2
S5670	060	0		29	10	S5670_060_0	2	4	Non-Preferred Brand	100100	2
S5670	060	0		29	10	S5670_060_0	2	1	Preferred Generic	001000	
S5670	060	0		29	10	S5670_060_0	2	2	Non-Preferred Generic	000100	
S5670	060	0		29	10	S5670_060_0	2	3	Preferred Brand	000001	
S5670	060	0		29	10	S5670_060_0	2	4	Non-Preferred Brand	100100	
S5670	060	0		29	10	S5670_060_0	2	5	Specialty Tier	010010	
S5670	060	0		29	10	S5670_060_0	2	1	Preferred Generic	001000	1
S5670	066	0		29	10	S5670_066_0	2	3	Preferred Brand	000001	2
S5670	066	0		29	10	S5670_066_0	2	1	Preferred Generic	001000	1
S5670	066	0		29	10	S5670_066_0	2	4	Non-Preferred Brand	100100	2
S5670	066	0		29	10	S5670_066_0	2	1	Preferred Generic	001000	
S5670	066	0		29	10	S5670_066_0	2	2	Non-Preferred Generic	000100	
S5670	066	0		29	10	S5670_066_0	2	3	Preferred Brand	000001	
S5670	066	0		29	10	S5670_066_0	2	4	Non-Preferred Brand	100100	
S5670	066	0		29	10	S5670_066_0	2	5	Specialty Tier	010010	
S5670	072	0		29	10	S5670_072_0	2	1	Preferred Generic	001000	
S5670	072	0		29	10	S5670_072_0	2	3	Preferred Brand	000001	2
S5670	072	0		29	10	S5670_072_0	2	1	Preferred Generic	001000	1
S5670	072	0		29	10	S5670_072_0	2	5	Specialty Tier	010010	
S5670	072	0		29	10	S5670_072_0	2	4	Non-Preferred Brand	100100	
S5670	072	0		29	10	S5670_072_0	2	3	Preferred Brand	000001	
S5670	072	0		29	10	S5670_072_0	2	2	Non-Preferred Generic	000100	
S5670	072	0		29	10	S5670_072_0	2	4	Non-Preferred Brand	100100	2
S5670	078	0		29	10	S5670_078_0	2	3	Preferred Brand	000001	2
S5670	078	0		29	10	S5670_078_0	2	1	Preferred Generic	001000	1
S5670	078	0		29	10	S5670_078_0	2	5	Specialty Tier	010010	
S5670	078	0		29	10	S5670_078_0	2	4	Non-Preferred Brand	100100	
S5670	078	0		29	10	S5670_078_0	2	3	Preferred Brand	000001	
S5670	078	0		29	10	S5670_078_0	2	2	Non-Preferred Generic	000100	
S5670	078	0		29	10	S5670_078_0	2	1	Preferred Generic	001000	
S5670	078	0		29	10	S5670_078_0	2	4	Non-Preferred Brand	100100	2
S5670	084	0		29	10	S5670_084_0	2	3	Preferred Brand	000001	
S5670	084	0		29	10	S5670_084_0	2	2	Non-Preferred Generic	000100	
S5670	084	0		29	10	S5670_084_0	2	1	Preferred Generic	001000	
S5670	084	0		29	10	S5670_084_0	2	4	Non-Preferred Brand	100100	
S5670	084	0		29	10	S5670_084_0	2	5	Specialty Tier	010010	
S5670	084	0		29	10	S5670_084_0	2	1	Preferred Generic	001000	1
S5670	084	0		29	10	S5670_084_0	2	3	Preferred Brand	000001	2
S5670	084	0		29	10	S5670_084_0	2	4	Non-Preferred Brand	100100	2
S5670	090	0		29	10	S5670_090_0	2	3	Preferred Brand	000001	
S5670	090	0		29	10	S5670_090_0	2	2	Non-Preferred Generic	000100	
S5670	090	0		29	10	S5670_090_0	2	1	Preferred Generic	001000	
S5670	090	0		29	10	S5670_090_0	2	4	Non-Preferred Brand	100100	
S5670	090	0		29	10	S5670_090_0	2	4	Non-Preferred Brand	100100	2
S5670	090	0		29	10	S5670_090_0	2	3	Preferred Brand	000001	2
S5670	090	0		29	10	S5670_090_0	2	1	Preferred Generic	001000	1
S5670	090	0		29	10	S5670_090_0	2	5	Specialty Tier	010010	
S5670	096	0		29	10	S5670_096_0	2	1	Preferred Generic	001000	
S5670	096	0		29	10	S5670_096_0	2	2	Non-Preferred Generic	000100	
S5670	096	0		29	10	S5670_096_0	2	3	Preferred Brand	000001	
S5670	096	0		29	10	S5670_096_0	2	3	Preferred Brand	000001	2
S5670	096	0		29	10	S5670_096_0	2	1	Preferred Generic	001000	1
S5670	096	0		29	10	S5670_096_0	2	5	Specialty Tier	010010	
S5670	096	0		29	10	S5670_096_0	2	4	Non-Preferred Brand	100100	
S5670	096	0		29	10	S5670_096_0	2	4	Non-Preferred Brand	100100	2
S5670	102	0		29	10	S5670_102_0	2	1	Preferred Generic	001000	
S5670	102	0		29	10	S5670_102_0	2	2	Non-Preferred Generic	000100	
S5670	102	0		29	10	S5670_102_0	2	3	Preferred Brand	000001	
S5670	102	0		29	10	S5670_102_0	2	4	Non-Preferred Brand	100100	
S5670	102	0		29	10	S5670_102_0	2	4	Non-Preferred Brand	100100	2
S5670	102	0		29	10	S5670_102_0	2	3	Preferred Brand	000001	2
S5670	102	0		29	10	S5670_102_0	2	1	Preferred Generic	001000	1
S5670	102	0		29	10	S5670_102_0	2	5	Specialty Tier	010010	
S5670	108	0		29	10	S5670_108_0	2	4	Non-Preferred Brand	100100	2
S5670	108	0		29	10	S5670_108_0	2	3	Preferred Brand	000001	2
S5670	108	0		29	10	S5670_108_0	2	4	Non-Preferred Brand	100100	
S5670	108	0		29	10	S5670_108_0	2	5	Specialty Tier	010010	
S5670	108	0		29	10	S5670_108_0	2	1	Preferred Generic	001000	1
S5670	108	0		29	10	S5670_108_0	2	3	Preferred Brand	000001	
S5670	108	0		29	10	S5670_108_0	2	2	Non-Preferred Generic	000100	
S5670	108	0		29	10	S5670_108_0	2	1	Preferred Generic	001000	
S5670	114	0		29	10	S5670_114_0	2	4	Non-Preferred Brand	100100	
S5670	114	0		29	10	S5670_114_0	2	3	Preferred Brand	000001	
S5670	114	0		29	10	S5670_114_0	2	2	Non-Preferred Generic	000100	
S5670	114	0		29	10	S5670_114_0	2	1	Preferred Generic	001000	
S5670	114	0		29	10	S5670_114_0	2	5	Specialty Tier	010010	
S5670	114	0		29	10	S5670_114_0	2	1	Preferred Generic	001000	1
S5670	114	0		29	10	S5670_114_0	2	3	Preferred Brand	000001	2
S5670	114	0		29	10	S5670_114_0	2	4	Non-Preferred Brand	100100	2
S5670	120	0		29	10	S5670_120_0	2	3	Preferred Brand	000001	2
S5670	120	0		29	10	S5670_120_0	2	4	Non-Preferred Brand	100100	2
S5670	120	0		29	10	S5670_120_0	2	1	Preferred Generic	001000	
S5670	120	0		29	10	S5670_120_0	2	2	Non-Preferred Generic	000100	
S5670	120	0		29	10	S5670_120_0	2	3	Preferred Brand	000001	
S5670	120	0		29	10	S5670_120_0	2	4	Non-Preferred Brand	100100	
S5670	120	0		29	10	S5670_120_0	2	5	Specialty Tier	010010	
S5670	120	0		29	10	S5670_120_0	2	1	Preferred Generic	001000	1
S5670	126	0		29	10	S5670_126_0	2	1	Preferred Generic	001000	
S5670	126	0		29	10	S5670_126_0	2	2	Non-Preferred Generic	000100	
S5670	126	0		29	10	S5670_126_0	2	3	Preferred Brand	000001	
S5670	126	0		29	10	S5670_126_0	2	4	Non-Preferred Brand	100100	2
S5670	126	0		29	10	S5670_126_0	2	3	Preferred Brand	000001	2
S5670	126	0		29	10	S5670_126_0	2	1	Preferred Generic	001000	1
S5670	126	0		29	10	S5670_126_0	2	5	Specialty Tier	010010	
S5670	126	0		29	10	S5670_126_0	2	4	Non-Preferred Brand	100100	
S5670	132	0		29	10	S5670_132_0	2	4	Non-Preferred Brand	100100	2
S5670	132	0		29	10	S5670_132_0	2	5	Specialty Tier	010010	
S5670	132	0		29	10	S5670_132_0	2	1	Preferred Generic	001000	1
S5670	132	0		29	10	S5670_132_0	2	3	Preferred Brand	000001	2
S5670	132	0		29	10	S5670_132_0	2	4	Non-Preferred Brand	100100	
S5670	132	0		29	10	S5670_132_0	2	3	Preferred Brand	000001	
S5670	132	0		29	10	S5670_132_0	2	2	Non-Preferred Generic	000100	
S5670	132	0		29	10	S5670_132_0	2	1	Preferred Generic	001000	
S5670	138	0		29	10	S5670_138_0	2	4	Non-Preferred Brand	100100	2
S5670	138	0		29	10	S5670_138_0	2	3	Preferred Brand	000001	2
S5670	138	0		29	10	S5670_138_0	2	1	Preferred Generic	001000	1
S5670	138	0		29	10	S5670_138_0	2	1	Preferred Generic	001000	
S5670	138	0		29	10	S5670_138_0	2	2	Non-Preferred Generic	000100	
S5670	138	0		29	10	S5670_138_0	2	3	Preferred Brand	000001	
S5670	138	0		29	10	S5670_138_0	2	4	Non-Preferred Brand	100100	
S5670	138	0		29	10	S5670_138_0	2	5	Specialty Tier	010010	
S5670	144	0		29	10	S5670_144_0	2	4	Non-Preferred Brand	100100	2
S5670	144	0		29	10	S5670_144_0	2	1	Preferred Generic	001000	
S5670	144	0		29	10	S5670_144_0	2	1	Preferred Generic	001000	1
S5670	144	0		29	10	S5670_144_0	2	3	Preferred Brand	000001	2
S5670	144	0		29	10	S5670_144_0	2	2	Non-Preferred Generic	000100	
S5670	144	0		29	10	S5670_144_0	2	3	Preferred Brand	000001	
S5670	144	0		29	10	S5670_144_0	2	4	Non-Preferred Brand	100100	
S5670	144	0		29	10	S5670_144_0	2	5	Specialty Tier	010010	
S5670	150	0		29	10	S5670_150_0	2	3	Preferred Brand	000001	
S5670	150	0		29	10	S5670_150_0	2	2	Non-Preferred Generic	000100	
S5670	150	0		29	10	S5670_150_0	2	1	Preferred Generic	001000	
S5670	150	0		29	10	S5670_150_0	2	4	Non-Preferred Brand	100100	
S5670	150	0		29	10	S5670_150_0	2	5	Specialty Tier	010010	
S5670	150	0		29	10	S5670_150_0	2	1	Preferred Generic	001000	1
S5670	150	0		29	10	S5670_150_0	2	3	Preferred Brand	000001	2
S5670	150	0		29	10	S5670_150_0	2	4	Non-Preferred Brand	100100	2
S5674	005	0		29	10	S5674_005_0	2	1	Preferred Generic	001000	
S5674	005	0		29	10	S5674_005_0	2	2	Non-Preferred Generic	000100	
S5674	005	0		29	10	S5674_005_0	2	4	Non-Preferred Brand	100100	2
S5674	005	0		29	10	S5674_005_0	2	1	Preferred Generic	001000	1
S5674	005	0		29	10	S5674_005_0	2	3	Preferred Brand	000001	2
S5674	005	0		29	10	S5674_005_0	2	5	Specialty Tier	010010	
S5674	005	0		29	10	S5674_005_0	2	4	Non-Preferred Brand	100100	
S5674	005	0		29	10	S5674_005_0	2	3	Preferred Brand	000001	
S5674	011	0		29	10	S5674_011_0	2	5	Specialty Tier	010010	
S5674	011	0		29	10	S5674_011_0	2	4	Non-Preferred Brand	100100	
S5674	011	0		29	10	S5674_011_0	2	2	Non-Preferred Generic	000100	
S5674	011	0		29	10	S5674_011_0	2	3	Preferred Brand	000001	
S5674	011	0		29	10	S5674_011_0	2	4	Non-Preferred Brand	100100	2
S5674	011	0		29	10	S5674_011_0	2	3	Preferred Brand	000001	2
S5674	011	0		29	10	S5674_011_0	2	1	Preferred Generic	001000	1
S5674	011	0		29	10	S5674_011_0	2	1	Preferred Generic	001000	
S5674	017	0		29	10	S5674_017_0	2	1	Preferred Generic	001000	1
S5674	017	0		29	10	S5674_017_0	2	5	Specialty Tier	010010	
S5674	017	0		29	10	S5674_017_0	2	4	Non-Preferred Brand	100100	
S5674	017	0		29	10	S5674_017_0	2	3	Preferred Brand	000001	
S5674	017	0		29	10	S5674_017_0	2	2	Non-Preferred Generic	000100	
S5674	017	0		29	10	S5674_017_0	2	1	Preferred Generic	001000	
S5674	017	0		29	10	S5674_017_0	2	3	Preferred Brand	000001	2
S5674	017	0		29	10	S5674_017_0	2	4	Non-Preferred Brand	100100	2
S5674	023	0		29	10	S5674_023_0	2	4	Non-Preferred Brand	100100	
S5674	023	0		29	10	S5674_023_0	2	5	Specialty Tier	010010	
S5674	023	0		29	10	S5674_023_0	2	1	Preferred Generic	001000	1
S5674	023	0		29	10	S5674_023_0	2	3	Preferred Brand	000001	2
S5674	023	0		29	10	S5674_023_0	2	4	Non-Preferred Brand	100100	2
S5674	023	0		29	10	S5674_023_0	2	1	Preferred Generic	001000	
S5674	023	0		29	10	S5674_023_0	2	2	Non-Preferred Generic	000100	
S5674	023	0		29	10	S5674_023_0	2	3	Preferred Brand	000001	
S5674	029	0		29	10	S5674_029_0	2	4	Non-Preferred Brand	100100	2
S5674	029	0		29	10	S5674_029_0	2	3	Preferred Brand	000001	2
S5674	029	0		29	10	S5674_029_0	2	1	Preferred Generic	001000	1
S5674	029	0		29	10	S5674_029_0	2	4	Non-Preferred Brand	100100	
S5674	029	0		29	10	S5674_029_0	2	5	Specialty Tier	010010	
S5674	029	0		29	10	S5674_029_0	2	3	Preferred Brand	000001	
S5674	029	0		29	10	S5674_029_0	2	2	Non-Preferred Generic	000100	
S5674	029	0		29	10	S5674_029_0	2	1	Preferred Generic	001000	
S5674	035	0		29	10	S5674_035_0	2	2	Non-Preferred Generic	000100	
S5674	035	0		29	10	S5674_035_0	2	1	Preferred Generic	001000	1
S5674	035	0		29	10	S5674_035_0	2	3	Preferred Brand	000001	2
S5674	035	0		29	10	S5674_035_0	2	4	Non-Preferred Brand	100100	2
S5674	035	0		29	10	S5674_035_0	2	1	Preferred Generic	001000	
S5674	035	0		29	10	S5674_035_0	2	5	Specialty Tier	010010	
S5674	035	0		29	10	S5674_035_0	2	3	Preferred Brand	000001	
S5674	035	0		29	10	S5674_035_0	2	4	Non-Preferred Brand	100100	
S5674	041	0		29	10	S5674_041_0	2	3	Preferred Brand	000001	
S5674	041	0		29	10	S5674_041_0	2	4	Non-Preferred Brand	100100	
S5674	041	0		29	10	S5674_041_0	2	5	Specialty Tier	010010	
S5674	041	0		29	10	S5674_041_0	2	1	Preferred Generic	001000	1
S5674	041	0		29	10	S5674_041_0	2	3	Preferred Brand	000001	2
S5674	041	0		29	10	S5674_041_0	2	4	Non-Preferred Brand	100100	2
S5674	041	0		29	10	S5674_041_0	2	1	Preferred Generic	001000	
S5674	041	0		29	10	S5674_041_0	2	2	Non-Preferred Generic	000100	
S5674	047	0		29	10	S5674_047_0	2	1	Preferred Generic	001000	
S5674	047	0		29	10	S5674_047_0	2	1	Preferred Generic	001000	1
S5674	047	0		29	10	S5674_047_0	2	3	Preferred Brand	000001	2
S5674	047	0		29	10	S5674_047_0	2	4	Non-Preferred Brand	100100	2
S5674	047	0		29	10	S5674_047_0	2	3	Preferred Brand	000001	
S5674	047	0		29	10	S5674_047_0	2	4	Non-Preferred Brand	100100	
S5674	047	0		29	10	S5674_047_0	2	2	Non-Preferred Generic	000100	
S5674	047	0		29	10	S5674_047_0	2	5	Specialty Tier	010010	
S5674	053	0		29	10	S5674_053_0	2	3	Preferred Brand	000001	2
S5674	053	0		29	10	S5674_053_0	2	4	Non-Preferred Brand	100100	2
S5674	053	0		29	10	S5674_053_0	2	1	Preferred Generic	001000	
S5674	053	0		29	10	S5674_053_0	2	2	Non-Preferred Generic	000100	
S5674	053	0		29	10	S5674_053_0	2	3	Preferred Brand	000001	
S5674	053	0		29	10	S5674_053_0	2	4	Non-Preferred Brand	100100	
S5674	053	0		29	10	S5674_053_0	2	5	Specialty Tier	010010	
S5674	053	0		29	10	S5674_053_0	2	1	Preferred Generic	001000	1
S5674	059	0		29	10	S5674_059_0	2	3	Preferred Brand	000001	
S5674	059	0		29	10	S5674_059_0	2	2	Non-Preferred Generic	000100	
S5674	059	0		29	10	S5674_059_0	2	1	Preferred Generic	001000	
S5674	059	0		29	10	S5674_059_0	2	4	Non-Preferred Brand	100100	
S5674	059	0		29	10	S5674_059_0	2	5	Specialty Tier	010010	
S5674	059	0		29	10	S5674_059_0	2	1	Preferred Generic	001000	1
S5674	059	0		29	10	S5674_059_0	2	3	Preferred Brand	000001	2
S5674	059	0		29	10	S5674_059_0	2	4	Non-Preferred Brand	100100	2
S5674	065	0		29	10	S5674_065_0	2	3	Preferred Brand	000001	
S5674	065	0		29	10	S5674_065_0	2	2	Non-Preferred Generic	000100	
S5674	065	0		29	10	S5674_065_0	2	1	Preferred Generic	001000	
S5674	065	0		29	10	S5674_065_0	2	4	Non-Preferred Brand	100100	
S5674	065	0		29	10	S5674_065_0	2	4	Non-Preferred Brand	100100	2
S5674	065	0		29	10	S5674_065_0	2	3	Preferred Brand	000001	2
S5674	065	0		29	10	S5674_065_0	2	1	Preferred Generic	001000	1
S5674	065	0		29	10	S5674_065_0	2	5	Specialty Tier	010010	
S5674	071	0		29	10	S5674_071_0	2	1	Preferred Generic	001000	
S5674	071	0		29	10	S5674_071_0	2	2	Non-Preferred Generic	000100	
S5674	071	0		29	10	S5674_071_0	2	3	Preferred Brand	000001	
S5674	071	0		29	10	S5674_071_0	2	3	Preferred Brand	000001	2
S5674	071	0		29	10	S5674_071_0	2	1	Preferred Generic	001000	1
S5674	071	0		29	10	S5674_071_0	2	5	Specialty Tier	010010	
S5674	071	0		29	10	S5674_071_0	2	4	Non-Preferred Brand	100100	
S5674	071	0		29	10	S5674_071_0	2	4	Non-Preferred Brand	100100	2
S5715	001	0		29	10	S5715_001_0	11	1	Preferred Generic	001000	
S5715	001	0		29	10	S5715_001_0	11	5	Specialty Tier	010010	
S5715	001	0		29	10	S5715_001_0	11	4	Non-Preferred Brand	110000	
S5715	001	0		29	10	S5715_001_0	11	3	Preferred Brand	000001	
S5715	001	0		29	10	S5715_001_0	11	2	Non-Preferred Generic	000100	
S5715	002	0		29	10	S5715_002_0	9	3	Preferred Brand	000001	
S5715	002	0		29	10	S5715_002_0	9	4	Non-Preferred Brand	110000	
S5715	002	0		29	10	S5715_002_0	9	5	Specialty Tier	010010	
S5715	002	0		29	10	S5715_002_0	9	1	Preferred Generic	001000	1
S5715	002	0		29	10	S5715_002_0	9	2	Non-Preferred Generic	000100	
S5715	002	0		29	10	S5715_002_0	9	1	Preferred Generic	001000	
S5715	002	0		29	10	S5715_002_0	9	3	Preferred Brand	000001	2
S5715	002	0		29	10	S5715_002_0	9	4	Non-Preferred Brand	110000	2
S5715	002	0		29	10	S5715_002_0	9	2	Non-Preferred Generic	000100	1
S5715	002	0		29	10	S5715_002_0	9	5	Specialty Tier	010010	2
S5715	003	0		29	10	S5715_003_0	9	1	Preferred Generic	001000	
S5715	003	0		29	10	S5715_003_0	9	4	Non-Preferred Brand	110000	
S5715	003	0		29	10	S5715_003_0	9	2	Non-Preferred Generic	000100	
S5715	003	0		29	10	S5715_003_0	9	3	Preferred Brand	000001	
S5715	003	0		29	10	S5715_003_0	9	5	Specialty Tier	010010	
S5715	004	0		29	10	S5715_004_0	9	4	Non-Preferred Brand	110000	2
S5715	004	0		29	10	S5715_004_0	9	5	Specialty Tier	010010	2
S5715	004	0		29	10	S5715_004_0	9	3	Preferred Brand	000001	2
S5715	004	0		29	10	S5715_004_0	9	2	Non-Preferred Generic	000100	1
S5715	004	0		29	10	S5715_004_0	9	1	Preferred Generic	001000	1
S5715	004	0		29	10	S5715_004_0	9	5	Specialty Tier	010010	
S5715	004	0		29	10	S5715_004_0	9	4	Non-Preferred Brand	110000	
S5715	004	0		29	10	S5715_004_0	9	3	Preferred Brand	000001	
S5715	004	0		29	10	S5715_004_0	9	2	Non-Preferred Generic	000100	
S5715	004	0		29	10	S5715_004_0	9	1	Preferred Generic	001000	
S5715	005	0		29	10	S5715_005_0	9	4	Non-Preferred Brand	110000	
S5715	005	0		29	10	S5715_005_0	9	1	Preferred Generic	001000	
S5715	005	0		29	10	S5715_005_0	9	3	Preferred Brand	000001	
S5715	005	0		29	10	S5715_005_0	9	2	Non-Preferred Generic	000100	
S5715	005	0		29	10	S5715_005_0	9	5	Specialty Tier	010010	
S5715	006	0		29	10	S5715_006_0	9	4	Non-Preferred Brand	110000	
S5715	006	0		29	10	S5715_006_0	9	3	Preferred Brand	000001	
S5715	006	0		29	10	S5715_006_0	9	2	Non-Preferred Generic	000100	
S5715	006	0		29	10	S5715_006_0	9	5	Specialty Tier	010010	2
S5715	006	0		29	10	S5715_006_0	9	5	Specialty Tier	010010	
S5715	006	0		29	10	S5715_006_0	9	1	Preferred Generic	001000	1
S5715	006	0		29	10	S5715_006_0	9	3	Preferred Brand	000001	2
S5715	006	0		29	10	S5715_006_0	9	1	Preferred Generic	001000	
S5715	006	0		29	10	S5715_006_0	9	4	Non-Preferred Brand	110000	2
S5715	006	0		29	10	S5715_006_0	9	2	Non-Preferred Generic	000100	1
S5715	010	0		29	10	S5715_010_0	9	4	Non-Preferred Brand	110000	
S5715	010	0		29	10	S5715_010_0	9	5	Specialty Tier	010010	
S5715	010	0		29	10	S5715_010_0	9	1	Preferred Generic	001000	
S5715	010	0		29	10	S5715_010_0	9	2	Non-Preferred Generic	000100	
S5715	010	0		29	10	S5715_010_0	9	3	Preferred Brand	000001	
S5715	011	0		29	10	S5715_011_0	9	4	Non-Preferred Brand	110000	
S5715	011	0		29	10	S5715_011_0	9	3	Preferred Brand	000001	
S5715	011	0		29	10	S5715_011_0	9	2	Non-Preferred Generic	000100	
S5715	011	0		29	10	S5715_011_0	9	1	Preferred Generic	001000	
S5715	011	0		29	10	S5715_011_0	9	5	Specialty Tier	010010	2
S5715	011	0		29	10	S5715_011_0	9	1	Preferred Generic	001000	1
S5715	011	0		29	10	S5715_011_0	9	2	Non-Preferred Generic	000100	1
S5715	011	0		29	10	S5715_011_0	9	3	Preferred Brand	000001	2
S5715	011	0		29	10	S5715_011_0	9	4	Non-Preferred Brand	110000	2
S5715	011	0		29	10	S5715_011_0	9	5	Specialty Tier	010010	
S5715	012	0		29	10	S5715_012_0	7	4	Non-Preferred Brand	110000	
S5715	012	0		29	10	S5715_012_0	7	3	Preferred Brand	000001	
S5715	012	0		29	10	S5715_012_0	7	2	Non-Preferred Generic	000100	
S5715	012	0		29	10	S5715_012_0	7	1	Preferred Generic	001000	
S5715	012	0		29	10	S5715_012_0	7	5	Specialty Tier	010010	
S5715	013	0		29	10	S5715_013_0	7	2	Non-Preferred Generic	000100	
S5715	013	0		29	10	S5715_013_0	7	1	Preferred Generic	001000	
S5715	013	0		29	10	S5715_013_0	7	3	Preferred Brand	000001	
S5715	013	0		29	10	S5715_013_0	7	4	Non-Preferred Brand	110000	
S5715	013	0		29	10	S5715_013_0	7	5	Specialty Tier	010010	
S5715	014	0		29	10	S5715_014_0	7	2	Non-Preferred Generic	000100	
S5715	014	0		29	10	S5715_014_0	7	1	Preferred Generic	001000	
S5715	014	0		29	10	S5715_014_0	7	3	Preferred Brand	000001	
S5715	014	0		29	10	S5715_014_0	7	5	Specialty Tier	010010	
S5715	014	0		29	10	S5715_014_0	7	4	Non-Preferred Brand	110000	
S5715	015	0		29	10	S5715_015_0	7	1	Preferred Generic	001000	
S5715	015	0		29	10	S5715_015_0	7	2	Non-Preferred Generic	000100	
S5715	015	0		29	10	S5715_015_0	7	4	Non-Preferred Brand	110000	
S5715	015	0		29	10	S5715_015_0	7	3	Preferred Brand	000001	
S5715	015	0		29	10	S5715_015_0	7	5	Specialty Tier	010010	
S5726	013	0		29	10	S5726_013_0	3	1	Preferred Generic	001000	
S5726	013	0		29	10	S5726_013_0	3	6	Specialty Tier	010010	
S5726	013	0		29	10	S5726_013_0	3	5	Injectable Drugs	010010	
S5726	013	0		29	10	S5726_013_0	3	4	Non-Preferred Brand	100100	
S5726	013	0		29	10	S5726_013_0	3	3	Preferred Brand	000101	
S5726	013	0		29	10	S5726_013_0	3	2	Non-Preferred Generic	000100	
S5726	014	0		29	10	S5726_014_0	5	1	Preferred Generic	001000	1
S5726	014	0		29	10	S5726_014_0	5	5	Injectable Drugs	010010	
S5726	014	0		29	10	S5726_014_0	5	6	Specialty Tier	010010	
S5726	014	0		29	10	S5726_014_0	5	4	Non-Preferred Brand	100100	
S5726	014	0		29	10	S5726_014_0	5	3	Preferred Brand	000101	
S5726	014	0		29	10	S5726_014_0	5	2	Non-Preferred Generic	000100	
S5726	014	0		29	10	S5726_014_0	5	1	Preferred Generic	001000	
S5726	015	0		29	10	S5726_015_0	4	3	Preferred Brand	000101	
S5726	015	0		29	10	S5726_015_0	4	2	Non-Preferred Generic	000100	
S5726	015	0		29	10	S5726_015_0	4	1	Preferred Generic	001000	
S5726	015	0		29	10	S5726_015_0	4	4	Non-Preferred Brand	100100	
S5726	015	0		29	10	S5726_015_0	4	1	Preferred Generic	001000	1
S5726	015	0		29	10	S5726_015_0	4	6	Specialty Tier	010010	
S5726	015	0		29	10	S5726_015_0	4	3	Preferred Brand	000101	2
S5726	015	0		29	10	S5726_015_0	4	2	Non-Preferred Generic	000100	1
S5726	015	0		29	10	S5726_015_0	4	5	Injectable Drugs	010010	
S5743	001	0		29	10	S5743_001_0	4	1	Preferred Generic	001000	
S5743	001	0		29	10	S5743_001_0	4	4	Non-Preferred Brand	110000	
S5743	001	0		29	10	S5743_001_0	4	3	Preferred Brand	000001	
S5743	001	0		29	10	S5743_001_0	4	2	Non-Preferred Generic	000100	
S5743	004	0		29	10	S5743_004_0	3	1	Preferred Generic	001000	1
S5743	004	0		29	10	S5743_004_0	3	4	Non-Preferred Brand	110000	
S5743	004	0		29	10	S5743_004_0	3	3	Preferred Brand	000001	
S5743	004	0		29	10	S5743_004_0	3	2	Non-Preferred Generic	000100	
S5743	004	0		29	10	S5743_004_0	3	2	Non-Preferred Generic	000100	1
S5743	004	0		29	10	S5743_004_0	3	1	Preferred Generic	001000	
S5753	006	0		29	10	S5753_006_0	2	4	Non-Preferred Brand	100000	
S5753	006	0		29	10	S5753_006_0	2	3	Preferred Brand	000001	
S5753	006	0		29	10	S5753_006_0	2	2	Non-Preferred Generic	000100	
S5753	006	0		29	10	S5753_006_0	2	1	Preferred Generic	001000	
S5753	006	0		29	10	S5753_006_0	2	5	Specialty Tier	010010	
S5753	007	0		29	10	S5753_007_0	2	2	Non-Preferred Generic	000100	1
S5753	007	0		29	10	S5753_007_0	2	1	Preferred Generic	001000	1
S5753	007	0		29	10	S5753_007_0	2	5	Specialty Tier	010010	
S5753	007	0		29	10	S5753_007_0	2	2	Non-Preferred Generic	000100	
S5753	007	0		29	10	S5753_007_0	2	4	Non-Preferred Brand	100000	
S5753	007	0		29	10	S5753_007_0	2	3	Preferred Brand	000001	
S5753	007	0		29	10	S5753_007_0	2	1	Preferred Generic	001000	
S5755	006	0		29	10	S5755_006_0	2	3	Preferred Brand	010001	
S5755	006	0		29	10	S5755_006_0	2	4	Non-Preferred Brand	110000	
S5755	006	0		29	10	S5755_006_0	2	5	Specialty Tier	010010	
S5755	006	0		29	10	S5755_006_0	2	1	Preferred Generic	001010	
S5755	006	0		29	10	S5755_006_0	2	2	Non-Preferred Generic	000110	
S5755	007	0		29	10	S5755_007_0	2	3	Preferred Brand	010001	
S5755	007	0		29	10	S5755_007_0	2	2	Non-Preferred Generic	000110	
S5755	007	0		29	10	S5755_007_0	2	1	Preferred Generic	001010	
S5755	007	0		29	10	S5755_007_0	2	4	Non-Preferred Brand	110000	
S5755	007	0		29	10	S5755_007_0	2	5	Specialty Tier	010010	
S5755	008	0		29	10	S5755_008_0	2	4	Non-Preferred Brand	110000	
S5755	008	0		29	10	S5755_008_0	2	3	Preferred Brand	010001	
S5755	008	0		29	10	S5755_008_0	2	2	Non-Preferred Generic	000110	
S5755	008	0		29	10	S5755_008_0	2	1	Preferred Generic	001010	
S5755	008	0		29	10	S5755_008_0	2	5	Specialty Tier	010010	
S5755	009	0		29	10	S5755_009_0	2	4	Non-Preferred Brand	110000	
S5755	009	0		29	10	S5755_009_0	2	3	Preferred Brand	010001	
S5755	009	0		29	10	S5755_009_0	2	2	Non-Preferred Generic	000110	
S5755	009	0		29	10	S5755_009_0	2	1	Preferred Generic	001010	
S5755	009	0		29	10	S5755_009_0	2	5	Specialty Tier	010010	
S5755	010	0		29	10	S5755_010_0	2	1	Preferred Generic	001010	
S5755	010	0		29	10	S5755_010_0	2	2	Non-Preferred Generic	000110	
S5755	010	0		29	10	S5755_010_0	2	3	Preferred Brand	010001	
S5755	010	0		29	10	S5755_010_0	2	4	Non-Preferred Brand	110000	
S5755	010	0		29	10	S5755_010_0	2	5	Specialty Tier	010010	
S5755	011	0		29	10	S5755_011_0	2	1	Preferred Generic	001010	
S5755	011	0		29	10	S5755_011_0	2	2	Non-Preferred Generic	000110	
S5755	011	0		29	10	S5755_011_0	2	3	Preferred Brand	010001	
S5755	011	0		29	10	S5755_011_0	2	4	Non-Preferred Brand	110000	
S5755	011	0		29	10	S5755_011_0	2	5	Specialty Tier	010010	
S5755	012	0		29	10	S5755_012_0	2	4	Non-Preferred Brand	110000	
S5755	012	0		29	10	S5755_012_0	2	5	Specialty Tier	010010	
S5755	012	0		29	10	S5755_012_0	2	1	Preferred Generic	001010	
S5755	012	0		29	10	S5755_012_0	2	2	Non-Preferred Generic	000110	
S5755	012	0		29	10	S5755_012_0	2	3	Preferred Brand	010001	
S5755	013	0		29	10	S5755_013_0	2	2	Non-Preferred Generic	000110	
S5755	013	0		29	10	S5755_013_0	2	1	Preferred Generic	001010	
S5755	013	0		29	10	S5755_013_0	2	3	Preferred Brand	010001	
S5755	013	0		29	10	S5755_013_0	2	4	Non-Preferred Brand	110000	
S5755	013	0		29	10	S5755_013_0	2	5	Specialty Tier	010010	
S5755	014	0		29	10	S5755_014_0	3	1	Preferred Generic	001010	
S5755	014	0		29	10	S5755_014_0	3	2	Non-Preferred Generic	000110	
S5755	014	0		29	10	S5755_014_0	3	3	Preferred Brand	010001	
S5755	014	0		29	10	S5755_014_0	3	4	Non-Preferred Brand	110000	
S5755	014	0		29	10	S5755_014_0	3	5	Specialty Tier	010010	
S5755	015	0		29	10	S5755_015_0	2	2	Non-Preferred Generic	000110	
S5755	015	0		29	10	S5755_015_0	2	1	Preferred Generic	001010	
S5755	015	0		29	10	S5755_015_0	2	3	Preferred Brand	010001	
S5755	015	0		29	10	S5755_015_0	2	5	Specialty Tier	010010	
S5755	015	0		29	10	S5755_015_0	2	4	Non-Preferred Brand	110000	
S5755	016	0		29	10	S5755_016_0	2	1	Preferred Generic	001010	
S5755	016	0		29	10	S5755_016_0	2	2	Non-Preferred Generic	000110	
S5755	016	0		29	10	S5755_016_0	2	3	Preferred Brand	010001	
S5755	016	0		29	10	S5755_016_0	2	4	Non-Preferred Brand	110000	
S5755	016	0		29	10	S5755_016_0	2	5	Specialty Tier	010010	
S5755	017	0		29	10	S5755_017_0	2	1	Preferred Generic	001010	
S5755	017	0		29	10	S5755_017_0	2	2	Non-Preferred Generic	000110	
S5755	017	0		29	10	S5755_017_0	2	4	Non-Preferred Brand	110000	
S5755	017	0		29	10	S5755_017_0	2	3	Preferred Brand	010001	
S5755	017	0		29	10	S5755_017_0	2	5	Specialty Tier	010010	
S5755	018	0		29	10	S5755_018_0	2	1	Preferred Generic	001010	
S5755	018	0		29	10	S5755_018_0	2	2	Non-Preferred Generic	000110	
S5755	018	0		29	10	S5755_018_0	2	3	Preferred Brand	010001	
S5755	018	0		29	10	S5755_018_0	2	4	Non-Preferred Brand	110000	
S5755	018	0		29	10	S5755_018_0	2	5	Specialty Tier	010010	
S5755	020	0		29	10	S5755_020_0	2	1	Preferred Generic	001010	
S5755	020	0		29	10	S5755_020_0	2	4	Non-Preferred Brand	110000	
S5755	020	0		29	10	S5755_020_0	2	5	Specialty Tier	010010	
S5755	020	0		29	10	S5755_020_0	2	3	Preferred Brand	010001	
S5755	020	0		29	10	S5755_020_0	2	2	Non-Preferred Generic	000110	
S5755	021	0		29	10	S5755_021_0	2	4	Non-Preferred Brand	110000	
S5755	021	0		29	10	S5755_021_0	2	1	Preferred Generic	001010	
S5755	021	0		29	10	S5755_021_0	2	5	Specialty Tier	010010	
S5755	021	0		29	10	S5755_021_0	2	2	Non-Preferred Generic	000110	
S5755	021	0		29	10	S5755_021_0	2	3	Preferred Brand	010001	
S5755	022	0		29	10	S5755_022_0	2	4	Non-Preferred Brand	110000	
S5755	022	0		29	10	S5755_022_0	2	1	Preferred Generic	001010	
S5755	022	0		29	10	S5755_022_0	2	5	Specialty Tier	010010	
S5755	022	0		29	10	S5755_022_0	2	2	Non-Preferred Generic	000110	
S5755	022	0		29	10	S5755_022_0	2	3	Preferred Brand	010001	
S5755	023	0		29	10	S5755_023_0	2	4	Non-Preferred Brand	110000	
S5755	023	0		29	10	S5755_023_0	2	1	Preferred Generic	001010	
S5755	023	0		29	10	S5755_023_0	2	5	Specialty Tier	010010	
S5755	023	0		29	10	S5755_023_0	2	2	Non-Preferred Generic	000110	
S5755	023	0		29	10	S5755_023_0	2	3	Preferred Brand	010001	
S5755	024	0		29	10	S5755_024_0	2	4	Non-Preferred Brand	110000	
S5755	024	0		29	10	S5755_024_0	2	1	Preferred Generic	001010	
S5755	024	0		29	10	S5755_024_0	2	5	Specialty Tier	010010	
S5755	024	0		29	10	S5755_024_0	2	2	Non-Preferred Generic	000110	
S5755	024	0		29	10	S5755_024_0	2	3	Preferred Brand	010001	
S5755	025	0		29	10	S5755_025_0	2	4	Non-Preferred Brand	110000	
S5755	025	0		29	10	S5755_025_0	2	1	Preferred Generic	001010	
S5755	025	0		29	10	S5755_025_0	2	5	Specialty Tier	010010	
S5755	025	0		29	10	S5755_025_0	2	2	Non-Preferred Generic	000110	
S5755	025	0		29	10	S5755_025_0	2	3	Preferred Brand	010001	
S5755	026	0		29	10	S5755_026_0	2	4	Non-Preferred Brand	110000	
S5755	026	0		29	10	S5755_026_0	2	1	Preferred Generic	001010	
S5755	026	0		29	10	S5755_026_0	2	5	Specialty Tier	010010	
S5755	026	0		29	10	S5755_026_0	2	2	Non-Preferred Generic	000110	
S5755	026	0		29	10	S5755_026_0	2	3	Preferred Brand	010001	
S5755	028	0		29	10	S5755_028_0	2	2	Non-Preferred Generic	000110	
S5755	028	0		29	10	S5755_028_0	2	3	Preferred Brand	010001	
S5755	028	0		29	10	S5755_028_0	2	5	Specialty Tier	010010	
S5755	028	0		29	10	S5755_028_0	2	4	Non-Preferred Brand	110000	
S5755	028	0		29	10	S5755_028_0	2	1	Preferred Generic	001010	
S5755	029	0		29	10	S5755_029_0	2	5	Specialty Tier	010010	
S5755	029	0		29	10	S5755_029_0	2	4	Non-Preferred Brand	110000	
S5755	029	0		29	10	S5755_029_0	2	2	Non-Preferred Generic	000110	
S5755	029	0		29	10	S5755_029_0	2	1	Preferred Generic	001010	
S5755	029	0		29	10	S5755_029_0	2	3	Preferred Brand	010001	
S5755	030	0		29	10	S5755_030_0	2	3	Preferred Brand	010001	
S5755	030	0		29	10	S5755_030_0	2	4	Non-Preferred Brand	110000	
S5755	030	0		29	10	S5755_030_0	2	2	Non-Preferred Generic	000110	
S5755	030	0		29	10	S5755_030_0	2	1	Preferred Generic	001010	
S5755	030	0		29	10	S5755_030_0	2	5	Specialty Tier	010010	
S5755	031	0		29	10	S5755_031_0	2	2	Non-Preferred Generic	000110	
S5755	031	0		29	10	S5755_031_0	2	1	Preferred Generic	001010	
S5755	031	0		29	10	S5755_031_0	2	3	Preferred Brand	010001	
S5755	031	0		29	10	S5755_031_0	2	5	Specialty Tier	010010	
S5755	031	0		29	10	S5755_031_0	2	4	Non-Preferred Brand	110000	
S5755	032	0		29	10	S5755_032_0	2	1	Preferred Generic	001010	
S5755	032	0		29	10	S5755_032_0	2	2	Non-Preferred Generic	000110	
S5755	032	0		29	10	S5755_032_0	2	4	Non-Preferred Brand	110000	
S5755	032	0		29	10	S5755_032_0	2	3	Preferred Brand	010001	
S5755	032	0		29	10	S5755_032_0	2	5	Specialty Tier	010010	
S5755	033	0		29	10	S5755_033_0	2	4	Non-Preferred Brand	110000	
S5755	033	0		29	10	S5755_033_0	2	3	Preferred Brand	010001	
S5755	033	0		29	10	S5755_033_0	2	2	Non-Preferred Generic	000110	
S5755	033	0		29	10	S5755_033_0	2	1	Preferred Generic	001010	
S5755	033	0		29	10	S5755_033_0	2	5	Specialty Tier	010010	
S5755	034	0		29	10	S5755_034_0	2	4	Non-Preferred Brand	110000	
S5755	034	0		29	10	S5755_034_0	2	3	Preferred Brand	010001	
S5755	034	0		29	10	S5755_034_0	2	5	Specialty Tier	010010	
S5755	034	0		29	10	S5755_034_0	2	2	Non-Preferred Generic	000110	
S5755	034	0		29	10	S5755_034_0	2	1	Preferred Generic	001010	
S5755	035	0		29	10	S5755_035_0	2	4	Non-Preferred Brand	110000	
S5755	035	0		29	10	S5755_035_0	2	1	Preferred Generic	001010	
S5755	035	0		29	10	S5755_035_0	2	5	Specialty Tier	010010	
S5755	035	0		29	10	S5755_035_0	2	2	Non-Preferred Generic	000110	
S5755	035	0		29	10	S5755_035_0	2	3	Preferred Brand	010001	
S5755	038	0		29	10	S5755_038_0	2	2	Non-Preferred Generic	000110	
S5755	038	0		29	10	S5755_038_0	2	3	Preferred Brand	010001	
S5755	038	0		29	10	S5755_038_0	2	5	Specialty Tier	010010	
S5755	038	0		29	10	S5755_038_0	2	4	Non-Preferred Brand	110000	
S5755	038	0		29	10	S5755_038_0	2	1	Preferred Generic	001010	
S5755	039	0		29	10	S5755_039_0	2	5	Specialty Tier	010010	
S5755	039	0		29	10	S5755_039_0	2	4	Non-Preferred Brand	110000	
S5755	039	0		29	10	S5755_039_0	2	2	Non-Preferred Generic	000110	
S5755	039	0		29	10	S5755_039_0	2	1	Preferred Generic	001010	
S5755	039	0		29	10	S5755_039_0	2	3	Preferred Brand	010001	
S5755	073	0		29	10	S5755_073_0	2	1	Preferred Generic	001010	
S5755	073	0		29	10	S5755_073_0	2	5	Specialty Tier	010010	
S5755	073	0		29	10	S5755_073_0	2	4	Non-Preferred Brand	110000	
S5755	073	0		29	10	S5755_073_0	2	3	Preferred Brand	010001	
S5755	073	0		29	10	S5755_073_0	2	2	Non-Preferred Generic	000110	
S5755	074	0		29	10	S5755_074_0	2	4	Non-Preferred Brand	110000	
S5755	074	0		29	10	S5755_074_0	2	5	Specialty Tier	010010	
S5755	074	0		29	10	S5755_074_0	2	3	Preferred Brand	010001	
S5755	074	0		29	10	S5755_074_0	2	2	Non-Preferred Generic	000110	
S5755	074	0		29	10	S5755_074_0	2	1	Preferred Generic	001010	
S5755	075	0		29	10	S5755_075_0	2	5	Specialty Tier	010010	
S5755	075	0		29	10	S5755_075_0	2	4	Non-Preferred Brand	110000	
S5755	075	0		29	10	S5755_075_0	2	3	Preferred Brand	010001	
S5755	075	0		29	10	S5755_075_0	2	2	Non-Preferred Generic	000110	
S5755	075	0		29	10	S5755_075_0	2	1	Preferred Generic	001010	
S5755	076	0		29	10	S5755_076_0	2	4	Non-Preferred Brand	110000	
S5755	076	0		29	10	S5755_076_0	2	1	Preferred Generic	001010	
S5755	076	0		29	10	S5755_076_0	2	2	Non-Preferred Generic	000110	
S5755	076	0		29	10	S5755_076_0	2	3	Preferred Brand	010001	
S5755	076	0		29	10	S5755_076_0	2	5	Specialty Tier	010010	
S5755	077	0		29	10	S5755_077_0	2	2	Non-Preferred Generic	000110	
S5755	077	0		29	10	S5755_077_0	2	1	Preferred Generic	001010	
S5755	077	0		29	10	S5755_077_0	2	3	Preferred Brand	010001	
S5755	077	0		29	10	S5755_077_0	2	4	Non-Preferred Brand	110000	
S5755	077	0		29	10	S5755_077_0	2	5	Specialty Tier	010010	
S5755	078	0		29	10	S5755_078_0	2	2	Non-Preferred Generic	000110	
S5755	078	0		29	10	S5755_078_0	2	1	Preferred Generic	001010	
S5755	078	0		29	10	S5755_078_0	2	3	Preferred Brand	010001	
S5755	078	0		29	10	S5755_078_0	2	5	Specialty Tier	010010	
S5755	078	0		29	10	S5755_078_0	2	4	Non-Preferred Brand	110000	
S5755	079	0		29	10	S5755_079_0	2	1	Preferred Generic	001010	
S5755	079	0		29	10	S5755_079_0	2	5	Specialty Tier	010010	
S5755	079	0		29	10	S5755_079_0	2	3	Preferred Brand	010001	
S5755	079	0		29	10	S5755_079_0	2	4	Non-Preferred Brand	110000	
S5755	079	0		29	10	S5755_079_0	2	2	Non-Preferred Generic	000110	
S5755	080	0		29	10	S5755_080_0	2	2	Non-Preferred Generic	000110	
S5755	080	0		29	10	S5755_080_0	2	1	Preferred Generic	001010	
S5755	080	0		29	10	S5755_080_0	2	5	Specialty Tier	010010	
S5755	080	0		29	10	S5755_080_0	2	4	Non-Preferred Brand	110000	
S5755	080	0		29	10	S5755_080_0	2	3	Preferred Brand	010001	
S5755	081	0		29	10	S5755_081_0	2	1	Preferred Generic	001010	
S5755	081	0		29	10	S5755_081_0	2	5	Specialty Tier	010010	
S5755	081	0		29	10	S5755_081_0	2	2	Non-Preferred Generic	000110	
S5755	081	0		29	10	S5755_081_0	2	4	Non-Preferred Brand	110000	
S5755	081	0		29	10	S5755_081_0	2	3	Preferred Brand	010001	
S5755	082	0		29	10	S5755_082_0	3	3	Preferred Brand	010001	
S5755	082	0		29	10	S5755_082_0	3	4	Non-Preferred Brand	110000	
S5755	082	0		29	10	S5755_082_0	3	1	Preferred Generic	001010	
S5755	082	0		29	10	S5755_082_0	3	2	Non-Preferred Generic	000110	
S5755	082	0		29	10	S5755_082_0	3	5	Specialty Tier	010010	
S5755	083	0		29	10	S5755_083_0	2	2	Non-Preferred Generic	000110	
S5755	083	0		29	10	S5755_083_0	2	5	Specialty Tier	010010	
S5755	083	0		29	10	S5755_083_0	2	3	Preferred Brand	010001	
S5755	083	0		29	10	S5755_083_0	2	4	Non-Preferred Brand	110000	
S5755	083	0		29	10	S5755_083_0	2	1	Preferred Generic	001010	
S5755	084	0		29	10	S5755_084_0	2	5	Specialty Tier	010010	
S5755	084	0		29	10	S5755_084_0	2	3	Preferred Brand	010001	
S5755	084	0		29	10	S5755_084_0	2	4	Non-Preferred Brand	110000	
S5755	084	0		29	10	S5755_084_0	2	2	Non-Preferred Generic	000110	
S5755	084	0		29	10	S5755_084_0	2	1	Preferred Generic	001010	
S5755	085	0		29	10	S5755_085_0	2	2	Non-Preferred Generic	000110	
S5755	085	0		29	10	S5755_085_0	2	5	Specialty Tier	010010	
S5755	085	0		29	10	S5755_085_0	2	3	Preferred Brand	010001	
S5755	085	0		29	10	S5755_085_0	2	4	Non-Preferred Brand	110000	
S5755	085	0		29	10	S5755_085_0	2	1	Preferred Generic	001010	
S5755	086	0		29	10	S5755_086_0	2	2	Non-Preferred Generic	000110	
S5755	086	0		29	10	S5755_086_0	2	1	Preferred Generic	001010	
S5755	086	0		29	10	S5755_086_0	2	5	Specialty Tier	010010	
S5755	086	0		29	10	S5755_086_0	2	4	Non-Preferred Brand	110000	
S5755	086	0		29	10	S5755_086_0	2	3	Preferred Brand	010001	
S5755	087	0		29	10	S5755_087_0	2	5	Specialty Tier	010010	
S5755	087	0		29	10	S5755_087_0	2	4	Non-Preferred Brand	110000	
S5755	087	0		29	10	S5755_087_0	2	3	Preferred Brand	010001	
S5755	087	0		29	10	S5755_087_0	2	2	Non-Preferred Generic	000110	
S5755	087	0		29	10	S5755_087_0	2	1	Preferred Generic	001010	
S5755	088	0		29	10	S5755_088_0	2	3	Preferred Brand	010001	
S5755	088	0		29	10	S5755_088_0	2	1	Preferred Generic	001010	
S5755	088	0		29	10	S5755_088_0	2	2	Non-Preferred Generic	000110	
S5755	088	0		29	10	S5755_088_0	2	4	Non-Preferred Brand	110000	
S5755	088	0		29	10	S5755_088_0	2	5	Specialty Tier	010010	
S5755	089	0		29	10	S5755_089_0	2	3	Preferred Brand	010001	
S5755	089	0		29	10	S5755_089_0	2	4	Non-Preferred Brand	110000	
S5755	089	0		29	10	S5755_089_0	2	5	Specialty Tier	010010	
S5755	089	0		29	10	S5755_089_0	2	1	Preferred Generic	001010	
S5755	089	0		29	10	S5755_089_0	2	2	Non-Preferred Generic	000110	
S5755	091	0		29	10	S5755_091_0	2	3	Preferred Brand	010001	
S5755	091	0		29	10	S5755_091_0	2	4	Non-Preferred Brand	110000	
S5755	091	0		29	10	S5755_091_0	2	2	Non-Preferred Generic	000110	
S5755	091	0		29	10	S5755_091_0	2	1	Preferred Generic	001010	
S5755	091	0		29	10	S5755_091_0	2	5	Specialty Tier	010010	
S5755	092	0		29	10	S5755_092_0	2	2	Non-Preferred Generic	000110	
S5755	092	0		29	10	S5755_092_0	2	1	Preferred Generic	001010	
S5755	092	0		29	10	S5755_092_0	2	3	Preferred Brand	010001	
S5755	092	0		29	10	S5755_092_0	2	5	Specialty Tier	010010	
S5755	092	0		29	10	S5755_092_0	2	4	Non-Preferred Brand	110000	
S5755	093	0		29	10	S5755_093_0	2	1	Preferred Generic	001010	
S5755	093	0		29	10	S5755_093_0	2	2	Non-Preferred Generic	000110	
S5755	093	0		29	10	S5755_093_0	2	4	Non-Preferred Brand	110000	
S5755	093	0		29	10	S5755_093_0	2	3	Preferred Brand	010001	
S5755	093	0		29	10	S5755_093_0	2	5	Specialty Tier	010010	
S5755	094	0		29	10	S5755_094_0	2	4	Non-Preferred Brand	110000	
S5755	094	0		29	10	S5755_094_0	2	3	Preferred Brand	010001	
S5755	094	0		29	10	S5755_094_0	2	2	Non-Preferred Generic	000110	
S5755	094	0		29	10	S5755_094_0	2	1	Preferred Generic	001010	
S5755	094	0		29	10	S5755_094_0	2	5	Specialty Tier	010010	
S5755	095	0		29	10	S5755_095_0	2	4	Non-Preferred Brand	110000	
S5755	095	0		29	10	S5755_095_0	2	3	Preferred Brand	010001	
S5755	095	0		29	10	S5755_095_0	2	2	Non-Preferred Generic	000110	
S5755	095	0		29	10	S5755_095_0	2	1	Preferred Generic	001010	
S5755	095	0		29	10	S5755_095_0	2	5	Specialty Tier	010010	
S5755	096	0		29	10	S5755_096_0	2	4	Non-Preferred Brand	110000	
S5755	096	0		29	10	S5755_096_0	2	3	Preferred Brand	010001	
S5755	096	0		29	10	S5755_096_0	2	2	Non-Preferred Generic	000110	
S5755	096	0		29	10	S5755_096_0	2	1	Preferred Generic	001010	
S5755	096	0		29	10	S5755_096_0	2	5	Specialty Tier	010010	
S5755	097	0		29	10	S5755_097_0	2	1	Preferred Generic	001010	
S5755	097	0		29	10	S5755_097_0	2	2	Non-Preferred Generic	000110	
S5755	097	0		29	10	S5755_097_0	2	3	Preferred Brand	010001	
S5755	097	0		29	10	S5755_097_0	2	4	Non-Preferred Brand	110000	
S5755	097	0		29	10	S5755_097_0	2	5	Specialty Tier	010010	
S5755	098	0		29	10	S5755_098_0	2	1	Preferred Generic	001010	
S5755	098	0		29	10	S5755_098_0	2	2	Non-Preferred Generic	000110	
S5755	098	0		29	10	S5755_098_0	2	3	Preferred Brand	010001	
S5755	098	0		29	10	S5755_098_0	2	4	Non-Preferred Brand	110000	
S5755	098	0		29	10	S5755_098_0	2	5	Specialty Tier	010010	
S5755	099	0		29	10	S5755_099_0	2	1	Preferred Generic	001010	
S5755	099	0		29	10	S5755_099_0	2	2	Non-Preferred Generic	000110	
S5755	099	0		29	10	S5755_099_0	2	3	Preferred Brand	010001	
S5755	099	0		29	10	S5755_099_0	2	4	Non-Preferred Brand	110000	
S5755	099	0		29	10	S5755_099_0	2	5	Specialty Tier	010010	
S5755	100	0		29	10	S5755_100_0	2	2	Non-Preferred Generic	000110	
S5755	100	0		29	10	S5755_100_0	2	1	Preferred Generic	001010	
S5755	100	0		29	10	S5755_100_0	2	3	Preferred Brand	010001	
S5755	100	0		29	10	S5755_100_0	2	4	Non-Preferred Brand	110000	
S5755	100	0		29	10	S5755_100_0	2	5	Specialty Tier	010010	
S5755	101	0		29	10	S5755_101_0	2	1	Preferred Generic	001010	
S5755	101	0		29	10	S5755_101_0	2	2	Non-Preferred Generic	000110	
S5755	101	0		29	10	S5755_101_0	2	3	Preferred Brand	010001	
S5755	101	0		29	10	S5755_101_0	2	4	Non-Preferred Brand	110000	
S5755	101	0		29	10	S5755_101_0	2	5	Specialty Tier	010010	
S5755	102	0		29	10	S5755_102_0	2	2	Non-Preferred Generic	000110	
S5755	102	0		29	10	S5755_102_0	2	1	Preferred Generic	001010	
S5755	102	0		29	10	S5755_102_0	2	3	Preferred Brand	010001	
S5755	102	0		29	10	S5755_102_0	2	5	Specialty Tier	010010	
S5755	102	0		29	10	S5755_102_0	2	4	Non-Preferred Brand	110000	
S5755	103	0		29	10	S5755_103_0	2	1	Preferred Generic	001010	
S5755	103	0		29	10	S5755_103_0	2	2	Non-Preferred Generic	000110	
S5755	103	0		29	10	S5755_103_0	2	3	Preferred Brand	010001	
S5755	103	0		29	10	S5755_103_0	2	4	Non-Preferred Brand	110000	
S5755	103	0		29	10	S5755_103_0	2	5	Specialty Tier	010010	
S5755	106	0		29	10	S5755_106_0	2	1	Preferred Generic	001010	
S5755	106	0		29	10	S5755_106_0	2	2	Non-Preferred Generic	000110	
S5755	106	0		29	10	S5755_106_0	2	4	Non-Preferred Brand	110000	
S5755	106	0		29	10	S5755_106_0	2	3	Preferred Brand	010001	
S5755	106	0		29	10	S5755_106_0	2	5	Specialty Tier	010010	
S5766	002	0		29	10	S5766_002_0	4	2	Non-Preferred Generic	000100	
S5766	002	0		29	10	S5766_002_0	4	1	Preferred Generic	001000	
S5766	002	0		29	10	S5766_002_0	4	3	Preferred Brand	000001	
S5766	002	0		29	10	S5766_002_0	4	4	Non-Preferred Brand	100000	
S5766	002	0		29	10	S5766_002_0	4	5	Specialty Tier	010010	
S5766	003	0		29	10	S5766_003_0	4	2	Non-Preferred Generic	000100	
S5766	003	0		29	10	S5766_003_0	4	1	Preferred Generic	001000	
S5766	003	0		29	10	S5766_003_0	4	3	Preferred Brand	000001	
S5766	003	0		29	10	S5766_003_0	4	2	Non-Preferred Generic	000100	1
S5766	003	0		29	10	S5766_003_0	4	1	Preferred Generic	001000	1
S5766	003	0		29	10	S5766_003_0	4	4	Non-Preferred Brand	100000	
S5766	003	0		29	10	S5766_003_0	4	5	Specialty Tier	010010	
S5768	005	0		29	10	S5768_005_0	3	2	Preferred Brand	000001	
S5768	005	0		29	10	S5768_005_0	3	1	Preferred Generic	001000	
S5768	005	0		29	10	S5768_005_0	3	3	Non-Preferred Brand	100100	
S5768	007	0		29	10	S5768_007_0	3	3	Non-Preferred Brand	100100	
S5768	007	0		29	10	S5768_007_0	3	1	Preferred Generic	001000	
S5768	007	0		29	10	S5768_007_0	3	2	Preferred Brand	000001	
S5768	008	0		29	10	S5768_008_0	3	1	Preferred Generic	001000	
S5768	008	0		29	10	S5768_008_0	3	2	Preferred Brand	000001	
S5768	008	0		29	10	S5768_008_0	3	3	Non-Preferred Brand	100100	
S5768	009	0		29	10	S5768_009_0	3	2	Preferred Brand	000001	
S5768	009	0		29	10	S5768_009_0	3	1	Preferred Generic	001000	
S5768	009	0		29	10	S5768_009_0	3	3	Non-Preferred Brand	100100	
S5768	010	0		29	10	S5768_010_0	3	1	Preferred Generic	001000	
S5768	010	0		29	10	S5768_010_0	3	2	Preferred Brand	000001	
S5768	010	0		29	10	S5768_010_0	3	3	Non-Preferred Brand	100100	
S5768	012	0		29	10	S5768_012_0	3	1	Preferred Generic	001000	
S5768	012	0		29	10	S5768_012_0	3	2	Preferred Brand	000001	
S5768	012	0		29	10	S5768_012_0	3	3	Non-Preferred Brand	100100	
S5768	015	0		29	10	S5768_015_0	3	1	Preferred Generic	001000	
S5768	015	0		29	10	S5768_015_0	3	2	Preferred Brand	000001	
S5768	015	0		29	10	S5768_015_0	3	3	Non-Preferred Brand	100100	
S5768	016	0		29	10	S5768_016_0	3	2	Preferred Brand	000001	
S5768	016	0		29	10	S5768_016_0	3	1	Preferred Generic	001000	
S5768	016	0		29	10	S5768_016_0	3	3	Non-Preferred Brand	100100	
S5768	017	0		29	10	S5768_017_0	3	2	Preferred Brand	000001	
S5768	017	0		29	10	S5768_017_0	3	1	Preferred Generic	001000	
S5768	017	0		29	10	S5768_017_0	3	3	Non-Preferred Brand	100100	
S5768	018	0		29	10	S5768_018_0	3	1	Preferred Generic	001000	
S5768	018	0		29	10	S5768_018_0	3	2	Preferred Brand	000001	
S5768	018	0		29	10	S5768_018_0	3	3	Non-Preferred Brand	100100	
S5768	021	0		29	10	S5768_021_0	3	1	Preferred Generic	001000	
S5768	021	0		29	10	S5768_021_0	3	2	Preferred Brand	000001	
S5768	021	0		29	10	S5768_021_0	3	3	Non-Preferred Brand	100100	
S5768	031	0		29	10	S5768_031_0	3	2	Preferred Brand	000001	
S5768	031	0		29	10	S5768_031_0	3	1	Preferred Generic	001000	
S5768	031	0		29	10	S5768_031_0	3	3	Non-Preferred Brand	100100	
S5768	038	0		29	10	S5768_038_0	3	1	Preferred Generic	001000	
S5768	038	0		29	10	S5768_038_0	3	2	Preferred Brand	000001	
S5768	038	0		29	10	S5768_038_0	3	3	Non-Preferred Brand	100100	
S5768	039	0		29	10	S5768_039_0	3	2	Preferred Brand	000001	
S5768	039	0		29	10	S5768_039_0	3	1	Preferred Generic	001000	
S5768	039	0		29	10	S5768_039_0	3	3	Non-Preferred Brand	100100	
S5768	040	0		29	10	S5768_040_0	3	1	Preferred Generic	001000	
S5768	040	0		29	10	S5768_040_0	3	2	Preferred Brand	000001	
S5768	040	0		29	10	S5768_040_0	3	3	Non-Preferred Brand	100100	
S5768	041	0		29	10	S5768_041_0	3	1	Preferred Generic	001000	
S5768	041	0		29	10	S5768_041_0	3	2	Preferred Brand	000001	
S5768	041	0		29	10	S5768_041_0	3	3	Non-Preferred Brand	100100	
S5768	042	0		29	10	S5768_042_0	3	2	Preferred Brand	000001	
S5768	042	0		29	10	S5768_042_0	3	1	Preferred Generic	001000	
S5768	042	0		29	10	S5768_042_0	3	3	Non-Preferred Brand	100100	
S5768	043	0		29	10	S5768_043_0	3	1	Preferred Generic	001000	
S5768	043	0		29	10	S5768_043_0	3	2	Preferred Brand	000001	
S5768	043	0		29	10	S5768_043_0	3	3	Non-Preferred Brand	100100	
S5768	045	0		29	10	S5768_045_0	3	1	Preferred Generic	001000	
S5768	045	0		29	10	S5768_045_0	3	2	Preferred Brand	000001	
S5768	045	0		29	10	S5768_045_0	3	3	Non-Preferred Brand	100100	
S5768	048	0		29	10	S5768_048_0	3	1	Preferred Generic	001000	
S5768	048	0		29	10	S5768_048_0	3	2	Preferred Brand	000001	
S5768	048	0		29	10	S5768_048_0	3	3	Non-Preferred Brand	100100	
S5768	082	0		29	10	S5768_082_0	3	1	Preferred Generic	001000	
S5768	082	0		29	10	S5768_082_0	3	2	Preferred Brand	000001	
S5768	082	0		29	10	S5768_082_0	3	3	Non-Preferred Brand	100100	
S5768	083	0		29	10	S5768_083_0	3	1	Preferred Generic	001000	
S5768	083	0		29	10	S5768_083_0	3	2	Preferred Brand	000001	
S5768	083	0		29	10	S5768_083_0	3	3	Non-Preferred Brand	100100	
S5768	117	0		29	10	S5768_117_0	3	2	Preferred Brand	000001	
S5768	117	0		29	10	S5768_117_0	3	1	Preferred Generic	001000	
S5768	117	0		29	10	S5768_117_0	3	3	Non-Preferred Brand	100100	
S5768	118	0		29	10	S5768_118_0	3	1	Preferred Generic	001000	
S5768	118	0		29	10	S5768_118_0	3	2	Preferred Brand	000001	
S5768	118	0		29	10	S5768_118_0	3	3	Non-Preferred Brand	100100	
S5768	119	0		29	10	S5768_119_0	3	1	Preferred Generic	001000	
S5768	119	0		29	10	S5768_119_0	3	2	Preferred Brand	000001	
S5768	119	0		29	10	S5768_119_0	3	3	Non-Preferred Brand	100100	
S5768	122	0		29	10	S5768_122_0	3	3	Non-Preferred Brand	100100	
S5768	122	0		29	10	S5768_122_0	3	1	Preferred Generic	001000	
S5768	122	0		29	10	S5768_122_0	3	2	Preferred Brand	000001	
S5768	123	0		29	10	S5768_123_0	3	1	Preferred Generic	001000	
S5768	123	0		29	10	S5768_123_0	3	2	Preferred Brand	000001	
S5768	123	0		29	10	S5768_123_0	3	3	Non-Preferred Brand	100100	
S5768	125	0		29	10	S5768_125_0	4	1	Preferred Generic	001000	
S5768	125	0		29	10	S5768_125_0	4	2	Non-Preferred Generic	000100	
S5768	125	0		29	10	S5768_125_0	4	3	Preferred Brand	000001	
S5768	125	0		29	10	S5768_125_0	4	4	Non-Preferred Brand	100100	
S5768	125	0		29	10	S5768_125_0	4	5	Specialty Tier	010010	
S5768	126	0		29	10	S5768_126_0	4	1	Preferred Generic	001000	
S5768	126	0		29	10	S5768_126_0	4	4	Non-Preferred Brand	100100	
S5768	126	0		29	10	S5768_126_0	4	2	Non-Preferred Generic	000100	
S5768	126	0		29	10	S5768_126_0	4	3	Preferred Brand	000001	
S5768	126	0		29	10	S5768_126_0	4	5	Specialty Tier	010010	
S5768	127	0		29	10	S5768_127_0	4	5	Specialty Tier	010010	
S5768	127	0		29	10	S5768_127_0	4	4	Non-Preferred Brand	100100	
S5768	127	0		29	10	S5768_127_0	4	1	Preferred Generic	001000	
S5768	127	0		29	10	S5768_127_0	4	3	Preferred Brand	000001	
S5768	127	0		29	10	S5768_127_0	4	2	Non-Preferred Generic	000100	
S5768	128	0		29	10	S5768_128_0	4	1	Preferred Generic	001000	
S5768	128	0		29	10	S5768_128_0	4	2	Non-Preferred Generic	000100	
S5768	128	0		29	10	S5768_128_0	4	3	Preferred Brand	000001	
S5768	128	0		29	10	S5768_128_0	4	4	Non-Preferred Brand	100100	
S5768	128	0		29	10	S5768_128_0	4	5	Specialty Tier	010010	
S5768	129	0		29	10	S5768_129_0	4	5	Specialty Tier	010010	
S5768	129	0		29	10	S5768_129_0	4	1	Preferred Generic	001000	
S5768	129	0		29	10	S5768_129_0	4	2	Non-Preferred Generic	000100	
S5768	129	0		29	10	S5768_129_0	4	3	Preferred Brand	000001	
S5768	129	0		29	10	S5768_129_0	4	4	Non-Preferred Brand	100100	
S5768	130	0		29	10	S5768_130_0	4	5	Specialty Tier	010010	
S5768	130	0		29	10	S5768_130_0	4	3	Preferred Brand	000001	
S5768	130	0		29	10	S5768_130_0	4	2	Non-Preferred Generic	000100	
S5768	130	0		29	10	S5768_130_0	4	1	Preferred Generic	001000	
S5768	130	0		29	10	S5768_130_0	4	4	Non-Preferred Brand	100100	
S5768	131	0		29	10	S5768_131_0	4	5	Specialty Tier	010010	
S5768	131	0		29	10	S5768_131_0	4	4	Non-Preferred Brand	100100	
S5768	131	0		29	10	S5768_131_0	4	3	Preferred Brand	000001	
S5768	131	0		29	10	S5768_131_0	4	2	Non-Preferred Generic	000100	
S5768	131	0		29	10	S5768_131_0	4	1	Preferred Generic	001000	
S5768	132	0		29	10	S5768_132_0	4	2	Non-Preferred Generic	000100	
S5768	132	0		29	10	S5768_132_0	4	1	Preferred Generic	001000	
S5768	132	0		29	10	S5768_132_0	4	5	Specialty Tier	010010	
S5768	132	0		29	10	S5768_132_0	4	3	Preferred Brand	000001	
S5768	132	0		29	10	S5768_132_0	4	4	Non-Preferred Brand	100100	
S5768	133	0		29	10	S5768_133_0	4	2	Non-Preferred Generic	000100	
S5768	133	0		29	10	S5768_133_0	4	3	Preferred Brand	000001	
S5768	133	0		29	10	S5768_133_0	4	4	Non-Preferred Brand	100100	
S5768	133	0		29	10	S5768_133_0	4	5	Specialty Tier	010010	
S5768	133	0		29	10	S5768_133_0	4	1	Preferred Generic	001000	
S5768	134	0		29	10	S5768_134_0	4	4	Non-Preferred Brand	100100	
S5768	134	0		29	10	S5768_134_0	4	3	Preferred Brand	000001	
S5768	134	0		29	10	S5768_134_0	4	2	Non-Preferred Generic	000100	
S5768	134	0		29	10	S5768_134_0	4	1	Preferred Generic	001000	
S5768	134	0		29	10	S5768_134_0	4	5	Specialty Tier	010010	
S5768	135	0		29	10	S5768_135_0	4	1	Preferred Generic	001000	
S5768	135	0		29	10	S5768_135_0	4	2	Non-Preferred Generic	000100	
S5768	135	0		29	10	S5768_135_0	4	3	Preferred Brand	000001	
S5768	135	0		29	10	S5768_135_0	4	4	Non-Preferred Brand	100100	
S5768	135	0		29	10	S5768_135_0	4	5	Specialty Tier	010010	
S5768	136	0		29	10	S5768_136_0	4	4	Non-Preferred Brand	100100	
S5768	136	0		29	10	S5768_136_0	4	3	Preferred Brand	000001	
S5768	136	0		29	10	S5768_136_0	4	2	Non-Preferred Generic	000100	
S5768	136	0		29	10	S5768_136_0	4	1	Preferred Generic	001000	
S5768	136	0		29	10	S5768_136_0	4	5	Specialty Tier	010010	
S5768	137	0		29	10	S5768_137_0	4	2	Non-Preferred Generic	000100	
S5768	137	0		29	10	S5768_137_0	4	1	Preferred Generic	001000	
S5768	137	0		29	10	S5768_137_0	4	3	Preferred Brand	000001	
S5768	137	0		29	10	S5768_137_0	4	4	Non-Preferred Brand	100100	
S5768	137	0		29	10	S5768_137_0	4	5	Specialty Tier	010010	
S5768	138	0		29	10	S5768_138_0	4	2	Non-Preferred Generic	000100	
S5768	138	0		29	10	S5768_138_0	4	1	Preferred Generic	001000	
S5768	138	0		29	10	S5768_138_0	4	3	Preferred Brand	000001	
S5768	138	0		29	10	S5768_138_0	4	5	Specialty Tier	010010	
S5768	138	0		29	10	S5768_138_0	4	4	Non-Preferred Brand	100100	
S5768	139	0		29	10	S5768_139_0	4	1	Preferred Generic	001000	
S5768	139	0		29	10	S5768_139_0	4	2	Non-Preferred Generic	000100	
S5768	139	0		29	10	S5768_139_0	4	4	Non-Preferred Brand	100100	
S5768	139	0		29	10	S5768_139_0	4	3	Preferred Brand	000001	
S5768	139	0		29	10	S5768_139_0	4	5	Specialty Tier	010010	
S5768	140	0		29	10	S5768_140_0	4	3	Preferred Brand	000001	
S5768	140	0		29	10	S5768_140_0	4	4	Non-Preferred Brand	100100	
S5768	140	0		29	10	S5768_140_0	4	5	Specialty Tier	010010	
S5768	140	0		29	10	S5768_140_0	4	2	Non-Preferred Generic	000100	
S5768	140	0		29	10	S5768_140_0	4	1	Preferred Generic	001000	
S5768	141	0		29	10	S5768_141_0	4	5	Specialty Tier	010010	
S5768	141	0		29	10	S5768_141_0	4	4	Non-Preferred Brand	100100	
S5768	141	0		29	10	S5768_141_0	4	3	Preferred Brand	000001	
S5768	141	0		29	10	S5768_141_0	4	2	Non-Preferred Generic	000100	
S5768	141	0		29	10	S5768_141_0	4	1	Preferred Generic	001000	
S5768	142	0		29	10	S5768_142_0	4	1	Preferred Generic	001000	
S5768	142	0		29	10	S5768_142_0	4	3	Preferred Brand	000001	
S5768	142	0		29	10	S5768_142_0	4	5	Specialty Tier	010010	
S5768	142	0		29	10	S5768_142_0	4	4	Non-Preferred Brand	100100	
S5768	142	0		29	10	S5768_142_0	4	2	Non-Preferred Generic	000100	
S5768	143	0		29	10	S5768_143_0	5	5	Specialty Tier	010010	
S5768	143	0		29	10	S5768_143_0	5	4	Non-Preferred Brand	100100	
S5768	143	0		29	10	S5768_143_0	5	3	Preferred Brand	000001	
S5768	143	0		29	10	S5768_143_0	5	1	Preferred Generic	001000	
S5768	143	0		29	10	S5768_143_0	5	2	Non-Preferred Generic	000100	
S5768	144	0		29	10	S5768_144_0	5	5	Specialty Tier	010010	
S5768	144	0		29	10	S5768_144_0	5	4	Non-Preferred Brand	100100	
S5768	144	0		29	10	S5768_144_0	5	3	Preferred Brand	000001	
S5768	144	0		29	10	S5768_144_0	5	1	Preferred Generic	001000	
S5768	144	0		29	10	S5768_144_0	5	2	Non-Preferred Generic	000100	
S5768	145	0		29	10	S5768_145_0	4	1	Preferred Generic	001000	
S5768	145	0		29	10	S5768_145_0	4	3	Preferred Brand	000001	
S5768	145	0		29	10	S5768_145_0	4	2	Non-Preferred Generic	000100	
S5768	145	0		29	10	S5768_145_0	4	4	Non-Preferred Brand	100100	
S5768	145	0		29	10	S5768_145_0	4	5	Specialty Tier	010010	
S5768	146	0		29	10	S5768_146_0	5	2	Non-Preferred Generic	000100	
S5768	146	0		29	10	S5768_146_0	5	1	Preferred Generic	001000	
S5768	146	0		29	10	S5768_146_0	5	3	Preferred Brand	000001	
S5768	146	0		29	10	S5768_146_0	5	5	Specialty Tier	010010	
S5768	146	0		29	10	S5768_146_0	5	4	Non-Preferred Brand	100100	
S5768	147	0		29	10	S5768_147_0	4	1	Preferred Generic	001000	
S5768	147	0		29	10	S5768_147_0	4	2	Non-Preferred Generic	000100	
S5768	147	0		29	10	S5768_147_0	4	4	Non-Preferred Brand	100100	
S5768	147	0		29	10	S5768_147_0	4	3	Preferred Brand	000001	
S5768	147	0		29	10	S5768_147_0	4	5	Specialty Tier	010010	
S5768	148	0		29	10	S5768_148_0	5	2	Non-Preferred Generic	000100	
S5768	148	0		29	10	S5768_148_0	5	3	Preferred Brand	000001	
S5768	148	0		29	10	S5768_148_0	5	4	Non-Preferred Brand	100100	
S5768	148	0		29	10	S5768_148_0	5	5	Specialty Tier	010010	
S5768	148	0		29	10	S5768_148_0	5	1	Preferred Generic	001000	
S5768	149	0		29	10	S5768_149_0	4	1	Preferred Generic	001000	
S5768	149	0		29	10	S5768_149_0	4	5	Specialty Tier	010010	
S5768	149	0		29	10	S5768_149_0	4	4	Non-Preferred Brand	100100	
S5768	149	0		29	10	S5768_149_0	4	3	Preferred Brand	000001	
S5768	149	0		29	10	S5768_149_0	4	2	Non-Preferred Generic	000100	
S5768	150	0		29	10	S5768_150_0	4	5	Specialty Tier	010010	
S5768	150	0		29	10	S5768_150_0	4	3	Preferred Brand	000001	
S5768	150	0		29	10	S5768_150_0	4	4	Non-Preferred Brand	100100	
S5768	150	0		29	10	S5768_150_0	4	2	Non-Preferred Generic	000100	
S5768	150	0		29	10	S5768_150_0	4	1	Preferred Generic	001000	
S5768	151	0		29	10	S5768_151_0	4	5	Specialty Tier	010010	
S5768	151	0		29	10	S5768_151_0	4	4	Non-Preferred Brand	100100	
S5768	151	0		29	10	S5768_151_0	4	3	Preferred Brand	000001	
S5768	151	0		29	10	S5768_151_0	4	2	Non-Preferred Generic	000100	
S5768	151	0		29	10	S5768_151_0	4	1	Preferred Generic	001000	
S5768	152	0		29	10	S5768_152_0	4	5	Specialty Tier	010010	
S5768	152	0		29	10	S5768_152_0	4	3	Preferred Brand	000001	
S5768	152	0		29	10	S5768_152_0	4	4	Non-Preferred Brand	100100	
S5768	152	0		29	10	S5768_152_0	4	2	Non-Preferred Generic	000100	
S5768	152	0		29	10	S5768_152_0	4	1	Preferred Generic	001000	
S5768	153	0		29	10	S5768_153_0	4	4	Non-Preferred Brand	100100	
S5768	153	0		29	10	S5768_153_0	4	3	Preferred Brand	000001	
S5768	153	0		29	10	S5768_153_0	4	2	Non-Preferred Generic	000100	
S5768	153	0		29	10	S5768_153_0	4	1	Preferred Generic	001000	
S5768	153	0		29	10	S5768_153_0	4	5	Specialty Tier	010010	
S5768	154	0		29	10	S5768_154_0	4	5	Specialty Tier	010010	
S5768	154	0		29	10	S5768_154_0	4	3	Preferred Brand	000001	
S5768	154	0		29	10	S5768_154_0	4	4	Non-Preferred Brand	100100	
S5768	154	0		29	10	S5768_154_0	4	2	Non-Preferred Generic	000100	
S5768	154	0		29	10	S5768_154_0	4	1	Preferred Generic	001000	
S5768	155	0		29	10	S5768_155_0	4	5	Specialty Tier	010010	
S5768	155	0		29	10	S5768_155_0	4	4	Non-Preferred Brand	100100	
S5768	155	0		29	10	S5768_155_0	4	3	Preferred Brand	000001	
S5768	155	0		29	10	S5768_155_0	4	2	Non-Preferred Generic	000100	
S5768	155	0		29	10	S5768_155_0	4	1	Preferred Generic	001000	
S5768	158	0		29	10	S5768_158_0	3	2	Preferred Brand	000001	
S5768	158	0		29	10	S5768_158_0	3	3	Non-Preferred Brand	100100	
S5768	158	0		29	10	S5768_158_0	3	1	Preferred Generic	001000	
S5768	159	0		29	10	S5768_159_0	3	3	Non-Preferred Brand	100100	
S5768	159	0		29	10	S5768_159_0	3	2	Preferred Brand	000001	
S5768	159	0		29	10	S5768_159_0	3	1	Preferred Generic	001000	
S5768	160	0		29	10	S5768_160_0	3	1	Preferred Generic	001000	
S5768	160	0		29	10	S5768_160_0	3	2	Preferred Brand	000001	
S5768	160	0		29	10	S5768_160_0	3	3	Non-Preferred Brand	100100	
S5768	161	0		29	10	S5768_161_0	3	2	Preferred Brand	000001	
S5768	161	0		29	10	S5768_161_0	3	3	Non-Preferred Brand	100100	
S5768	161	0		29	10	S5768_161_0	3	1	Preferred Generic	001000	
S5768	162	0		29	10	S5768_162_0	3	3	Non-Preferred Brand	100100	
S5768	162	0		29	10	S5768_162_0	3	2	Preferred Brand	000001	
S5768	162	0		29	10	S5768_162_0	3	1	Preferred Generic	001000	
S5768	163	0		29	10	S5768_163_0	3	1	Preferred Generic	001000	
S5768	163	0		29	10	S5768_163_0	3	2	Preferred Brand	000001	
S5768	163	0		29	10	S5768_163_0	3	3	Non-Preferred Brand	100100	
S5775	001	0		29	10	S5775_001_0	2	3	Preferred Brand	000001	
S5775	001	0		29	10	S5775_001_0	2	5	Specialty Tier	100100	
S5775	001	0		29	10	S5775_001_0	2	4	Non-Preferred Brand	100000	
S5775	001	0		29	10	S5775_001_0	2	2	Non-Preferred Generic	000100	
S5775	001	0		29	10	S5775_001_0	2	1	Preferred Generic	001000	
S5775	002	0		29	10	S5775_002_0	2	3	Preferred Brand	000001	
S5775	002	0		29	10	S5775_002_0	2	2	Non-Preferred Generic	000100	
S5775	002	0		29	10	S5775_002_0	2	1	Preferred Generic	001000	
S5775	002	0		29	10	S5775_002_0	2	5	Specialty Tier	100100	
S5775	002	0		29	10	S5775_002_0	2	4	Non-Preferred Brand	100000	
S5795	002	0		29	10	S5795_002_0	6	1	Preferred Generic	001000	
S5795	002	0		29	10	S5795_002_0	6	1	Preferred Generic	001000	1
S5795	002	0		29	10	S5795_002_0	6	5	Specialty Tier	010010	
S5795	002	0		29	10	S5795_002_0	6	4	Non-Preferred Brand	110000	
S5795	002	0		29	10	S5795_002_0	6	3	Preferred Brand	000001	
S5795	002	0		29	10	S5795_002_0	6	2	Non-Preferred Generic	000100	1
S5795	002	0		29	10	S5795_002_0	6	2	Non-Preferred Generic	000100	
S5795	003	0		29	10	S5795_003_0	2	5	Specialty Tier	010010	
S5795	003	0		29	10	S5795_003_0	2	4	Non-Preferred Brand	110000	
S5795	003	0		29	10	S5795_003_0	2	3	Preferred Brand	000001	
S5795	003	0		29	10	S5795_003_0	2	2	Non-Preferred Generic	000100	
S5795	003	0		29	10	S5795_003_0	2	1	Preferred Generic	001000	
S5805	001	0		29	10	S5805_001_0	4	1	Preferred Generic	001000	
S5805	001	0		29	10	S5805_001_0	4	2	Non-Preferred Generic	000100	
S5805	001	0		29	10	S5805_001_0	4	5	Specialty Tier	010010	
S5805	001	0		29	10	S5805_001_0	4	4	Non-Preferred Brand	100100	
S5805	001	0		29	10	S5805_001_0	4	3	Preferred Brand	010001	
S5810	035	0		29	10	S5810_035_0	3	1	Generic	010000	
S5810	035	0		29	10	S5810_035_0	3	2	Preferred Brand	010001	
S5810	035	0		29	10	S5810_035_0	3	3	Non-Preferred Brand	110000	
S5810	035	0		29	10	S5810_035_0	3	4	Specialty Tier	010010	
S5810	035	0		29	10	S5810_035_0	3	5	Select Care Drugs	010000	
S5810	036	0		29	10	S5810_036_0	2	5	Select Care Drugs	010000	
S5810	036	0		29	10	S5810_036_0	2	4	Specialty Tier	010010	
S5810	036	0		29	10	S5810_036_0	2	3	Non-Preferred Brand	110000	
S5810	036	0		29	10	S5810_036_0	2	2	Preferred Brand	010001	
S5810	036	0		29	10	S5810_036_0	2	1	Generic	010000	
S5810	037	0		29	10	S5810_037_0	2	3	Non-Preferred Brand	110000	
S5810	037	0		29	10	S5810_037_0	2	2	Preferred Brand	010001	
S5810	037	0		29	10	S5810_037_0	2	1	Generic	010000	
S5810	037	0		29	10	S5810_037_0	2	4	Specialty Tier	010010	
S5810	037	0		29	10	S5810_037_0	2	5	Select Care Drugs	010000	
S5810	038	0		29	10	S5810_038_0	2	5	Select Care Drugs	010000	
S5810	038	0		29	10	S5810_038_0	2	4	Specialty Tier	010010	
S5810	038	0		29	10	S5810_038_0	2	3	Non-Preferred Brand	110000	
S5810	038	0		29	10	S5810_038_0	2	2	Preferred Brand	010001	
S5810	038	0		29	10	S5810_038_0	2	1	Generic	010000	
S5810	039	0		29	10	S5810_039_0	2	5	Select Care Drugs	010000	
S5810	039	0		29	10	S5810_039_0	2	3	Non-Preferred Brand	110000	
S5810	039	0		29	10	S5810_039_0	2	2	Preferred Brand	010001	
S5810	039	0		29	10	S5810_039_0	2	1	Generic	010000	
S5810	039	0		29	10	S5810_039_0	2	4	Specialty Tier	010010	
S5810	040	0		29	10	S5810_040_0	2	3	Non-Preferred Brand	110000	
S5810	040	0		29	10	S5810_040_0	2	4	Specialty Tier	010010	
S5810	040	0		29	10	S5810_040_0	2	5	Select Care Drugs	010000	
S5810	040	0		29	10	S5810_040_0	2	1	Generic	010000	
S5810	040	0		29	10	S5810_040_0	2	2	Preferred Brand	010001	
S5810	041	0		29	10	S5810_041_0	2	1	Generic	010000	
S5810	041	0		29	10	S5810_041_0	2	2	Preferred Brand	010001	
S5810	041	0		29	10	S5810_041_0	2	3	Non-Preferred Brand	110000	
S5810	041	0		29	10	S5810_041_0	2	4	Specialty Tier	010010	
S5810	041	0		29	10	S5810_041_0	2	5	Select Care Drugs	010000	
S5810	042	0		29	10	S5810_042_0	2	2	Preferred Brand	010001	
S5810	042	0		29	10	S5810_042_0	2	3	Non-Preferred Brand	110000	
S5810	042	0		29	10	S5810_042_0	2	4	Specialty Tier	010010	
S5810	042	0		29	10	S5810_042_0	2	5	Select Care Drugs	010000	
S5810	042	0		29	10	S5810_042_0	2	1	Generic	010000	
S5810	043	0		29	10	S5810_043_0	2	5	Select Care Drugs	010000	
S5810	043	0		29	10	S5810_043_0	2	3	Non-Preferred Brand	110000	
S5810	043	0		29	10	S5810_043_0	2	2	Preferred Brand	010001	
S5810	043	0		29	10	S5810_043_0	2	1	Generic	010000	
S5810	043	0		29	10	S5810_043_0	2	4	Specialty Tier	010010	
S5810	044	0		29	10	S5810_044_0	2	5	Select Care Drugs	010000	
S5810	044	0		29	10	S5810_044_0	2	1	Generic	010000	
S5810	044	0		29	10	S5810_044_0	2	4	Specialty Tier	010010	
S5810	044	0		29	10	S5810_044_0	2	3	Non-Preferred Brand	110000	
S5810	044	0		29	10	S5810_044_0	2	2	Preferred Brand	010001	
S5810	045	0		29	10	S5810_045_0	2	5	Select Care Drugs	010000	
S5810	045	0		29	10	S5810_045_0	2	3	Non-Preferred Brand	110000	
S5810	045	0		29	10	S5810_045_0	2	2	Preferred Brand	010001	
S5810	045	0		29	10	S5810_045_0	2	1	Generic	010000	
S5810	045	0		29	10	S5810_045_0	2	4	Specialty Tier	010010	
S5810	046	0		29	10	S5810_046_0	2	2	Preferred Brand	010001	
S5810	046	0		29	10	S5810_046_0	2	3	Non-Preferred Brand	110000	
S5810	046	0		29	10	S5810_046_0	2	4	Specialty Tier	010010	
S5810	046	0		29	10	S5810_046_0	2	5	Select Care Drugs	010000	
S5810	046	0		29	10	S5810_046_0	2	1	Generic	010000	
S5810	047	0		29	10	S5810_047_0	2	3	Non-Preferred Brand	110000	
S5810	047	0		29	10	S5810_047_0	2	2	Preferred Brand	010001	
S5810	047	0		29	10	S5810_047_0	2	1	Generic	010000	
S5810	047	0		29	10	S5810_047_0	2	4	Specialty Tier	010010	
S5810	047	0		29	10	S5810_047_0	2	5	Select Care Drugs	010000	
S5810	048	0		29	10	S5810_048_0	2	2	Preferred Brand	010001	
S5810	048	0		29	10	S5810_048_0	2	1	Generic	010000	
S5810	048	0		29	10	S5810_048_0	2	3	Non-Preferred Brand	110000	
S5810	048	0		29	10	S5810_048_0	2	4	Specialty Tier	010010	
S5810	048	0		29	10	S5810_048_0	2	5	Select Care Drugs	010000	
S5810	049	0		29	10	S5810_049_0	2	2	Preferred Brand	010001	
S5810	049	0		29	10	S5810_049_0	2	3	Non-Preferred Brand	110000	
S5810	049	0		29	10	S5810_049_0	2	5	Select Care Drugs	010000	
S5810	049	0		29	10	S5810_049_0	2	4	Specialty Tier	010010	
S5810	049	0		29	10	S5810_049_0	2	1	Generic	010000	
S5810	050	0		29	10	S5810_050_0	2	4	Specialty Tier	010010	
S5810	050	0		29	10	S5810_050_0	2	3	Non-Preferred Brand	110000	
S5810	050	0		29	10	S5810_050_0	2	1	Generic	010000	
S5810	050	0		29	10	S5810_050_0	2	5	Select Care Drugs	010000	
S5810	050	0		29	10	S5810_050_0	2	2	Preferred Brand	010001	
S5810	051	0		29	10	S5810_051_0	2	2	Preferred Brand	010001	
S5810	051	0		29	10	S5810_051_0	2	5	Select Care Drugs	010000	
S5810	051	0		29	10	S5810_051_0	2	4	Specialty Tier	010010	
S5810	051	0		29	10	S5810_051_0	2	3	Non-Preferred Brand	110000	
S5810	051	0		29	10	S5810_051_0	2	1	Generic	010000	
S5810	052	0		29	10	S5810_052_0	2	1	Generic	010000	
S5810	052	0		29	10	S5810_052_0	2	3	Non-Preferred Brand	110000	
S5810	052	0		29	10	S5810_052_0	2	4	Specialty Tier	010010	
S5810	052	0		29	10	S5810_052_0	2	5	Select Care Drugs	010000	
S5810	052	0		29	10	S5810_052_0	2	2	Preferred Brand	010001	
S5810	053	0		29	10	S5810_053_0	2	2	Preferred Brand	010001	
S5810	053	0		29	10	S5810_053_0	2	3	Non-Preferred Brand	110000	
S5810	053	0		29	10	S5810_053_0	2	4	Specialty Tier	010010	
S5810	053	0		29	10	S5810_053_0	2	5	Select Care Drugs	010000	
S5810	053	0		29	10	S5810_053_0	2	1	Generic	010000	
S5810	054	0		29	10	S5810_054_0	2	5	Select Care Drugs	010000	
S5810	054	0		29	10	S5810_054_0	2	3	Non-Preferred Brand	110000	
S5810	054	0		29	10	S5810_054_0	2	4	Specialty Tier	010010	
S5810	054	0		29	10	S5810_054_0	2	2	Preferred Brand	010001	
S5810	054	0		29	10	S5810_054_0	2	1	Generic	010000	
S5810	055	0		29	10	S5810_055_0	2	3	Non-Preferred Brand	110000	
S5810	055	0		29	10	S5810_055_0	2	4	Specialty Tier	010010	
S5810	055	0		29	10	S5810_055_0	2	5	Select Care Drugs	010000	
S5810	055	0		29	10	S5810_055_0	2	1	Generic	010000	
S5810	055	0		29	10	S5810_055_0	2	2	Preferred Brand	010001	
S5810	056	0		29	10	S5810_056_0	2	3	Non-Preferred Brand	110000	
S5810	056	0		29	10	S5810_056_0	2	5	Select Care Drugs	010000	
S5810	056	0		29	10	S5810_056_0	2	4	Specialty Tier	010010	
S5810	056	0		29	10	S5810_056_0	2	2	Preferred Brand	010001	
S5810	056	0		29	10	S5810_056_0	2	1	Generic	010000	
S5810	057	0		29	10	S5810_057_0	2	1	Generic	010000	
S5810	057	0		29	10	S5810_057_0	2	2	Preferred Brand	010001	
S5810	057	0		29	10	S5810_057_0	2	3	Non-Preferred Brand	110000	
S5810	057	0		29	10	S5810_057_0	2	4	Specialty Tier	010010	
S5810	057	0		29	10	S5810_057_0	2	5	Select Care Drugs	010000	
S5810	058	0		29	10	S5810_058_0	2	1	Generic	010000	
S5810	058	0		29	10	S5810_058_0	2	2	Preferred Brand	010001	
S5810	058	0		29	10	S5810_058_0	2	3	Non-Preferred Brand	110000	
S5810	058	0		29	10	S5810_058_0	2	4	Specialty Tier	010010	
S5810	058	0		29	10	S5810_058_0	2	5	Select Care Drugs	010000	
S5810	059	0		29	10	S5810_059_0	2	2	Preferred Brand	010001	
S5810	059	0		29	10	S5810_059_0	2	3	Non-Preferred Brand	110000	
S5810	059	0		29	10	S5810_059_0	2	4	Specialty Tier	010010	
S5810	059	0		29	10	S5810_059_0	2	5	Select Care Drugs	010000	
S5810	059	0		29	10	S5810_059_0	2	1	Generic	010000	
S5810	060	0		29	10	S5810_060_0	2	1	Generic	010000	
S5810	060	0		29	10	S5810_060_0	2	2	Preferred Brand	010001	
S5810	060	0		29	10	S5810_060_0	2	5	Select Care Drugs	010000	
S5810	060	0		29	10	S5810_060_0	2	4	Specialty Tier	010010	
S5810	060	0		29	10	S5810_060_0	2	3	Non-Preferred Brand	110000	
S5810	061	0		29	10	S5810_061_0	2	1	Generic	010000	
S5810	061	0		29	10	S5810_061_0	2	5	Select Care Drugs	010000	
S5810	061	0		29	10	S5810_061_0	2	4	Specialty Tier	010010	
S5810	061	0		29	10	S5810_061_0	2	3	Non-Preferred Brand	110000	
S5810	061	0		29	10	S5810_061_0	2	2	Preferred Brand	010001	
S5810	062	0		29	10	S5810_062_0	2	2	Preferred Brand	010001	
S5810	062	0		29	10	S5810_062_0	2	5	Select Care Drugs	010000	
S5810	062	0		29	10	S5810_062_0	2	3	Non-Preferred Brand	110000	
S5810	062	0		29	10	S5810_062_0	2	4	Specialty Tier	010010	
S5810	062	0		29	10	S5810_062_0	2	1	Generic	010000	
S5810	063	0		29	10	S5810_063_0	2	4	Specialty Tier	010010	
S5810	063	0		29	10	S5810_063_0	2	5	Select Care Drugs	010000	
S5810	063	0		29	10	S5810_063_0	2	3	Non-Preferred Brand	110000	
S5810	063	0		29	10	S5810_063_0	2	2	Preferred Brand	010001	
S5810	063	0		29	10	S5810_063_0	2	1	Generic	010000	
S5810	064	0		29	10	S5810_064_0	2	5	Select Care Drugs	010000	
S5810	064	0		29	10	S5810_064_0	2	2	Preferred Brand	010001	
S5810	064	0		29	10	S5810_064_0	2	3	Non-Preferred Brand	110000	
S5810	064	0		29	10	S5810_064_0	2	4	Specialty Tier	010010	
S5810	064	0		29	10	S5810_064_0	2	1	Generic	010000	
S5810	065	0		29	10	S5810_065_0	2	3	Non-Preferred Brand	110000	
S5810	065	0		29	10	S5810_065_0	2	2	Preferred Brand	010001	
S5810	065	0		29	10	S5810_065_0	2	1	Generic	010000	
S5810	065	0		29	10	S5810_065_0	2	4	Specialty Tier	010010	
S5810	065	0		29	10	S5810_065_0	2	5	Select Care Drugs	010000	
S5810	066	0		29	10	S5810_066_0	3	4	Specialty Tier	010010	
S5810	066	0		29	10	S5810_066_0	3	5	Select Care Drugs	010000	
S5810	066	0		29	10	S5810_066_0	3	3	Non-Preferred Brand	110000	
S5810	066	0		29	10	S5810_066_0	3	2	Preferred Brand	010001	
S5810	066	0		29	10	S5810_066_0	3	1	Generic	010000	
S5810	067	0		29	10	S5810_067_0	2	4	Specialty Tier	010010	
S5810	067	0		29	10	S5810_067_0	2	2	Preferred Brand	010001	
S5810	067	0		29	10	S5810_067_0	2	1	Generic	010000	
S5810	067	0		29	10	S5810_067_0	2	3	Non-Preferred Brand	110000	
S5810	067	0		29	10	S5810_067_0	2	5	Select Care Drugs	010000	
S5810	068	0		29	10	S5810_068_0	2	5	Select Care Drugs	010000	
S5810	068	0		29	10	S5810_068_0	2	4	Specialty Tier	010010	
S5810	068	0		29	10	S5810_068_0	2	1	Generic	010000	
S5810	068	0		29	10	S5810_068_0	2	2	Preferred Brand	010001	
S5810	068	0		29	10	S5810_068_0	2	3	Non-Preferred Brand	110000	
S5810	172	0		29	10	S5810_172_0	2	1	Generic	010000	
S5810	172	0		29	10	S5810_172_0	2	3	Non-Preferred Brand	110000	
S5810	172	0		29	10	S5810_172_0	2	2	Preferred Brand	010001	
S5810	172	0		29	10	S5810_172_0	2	4	Specialty Tier	010010	
S5810	172	0		29	10	S5810_172_0	2	5	Select Care Drugs	010000	
S5810	172	0		29	10	S5810_172_0	2	5	Select Care Drugs	010000	1
S5810	174	0		29	10	S5810_174_0	2	3	Non-Preferred Brand	110000	
S5810	174	0		29	10	S5810_174_0	2	1	Generic	010000	
S5810	174	0		29	10	S5810_174_0	2	2	Preferred Brand	010001	
S5810	174	0		29	10	S5810_174_0	2	4	Specialty Tier	010010	
S5810	174	0		29	10	S5810_174_0	2	5	Select Care Drugs	010000	
S5810	174	0		29	10	S5810_174_0	2	5	Select Care Drugs	010000	1
S5810	175	0		29	10	S5810_175_0	2	5	Select Care Drugs	010000	1
S5810	175	0		29	10	S5810_175_0	2	3	Non-Preferred Brand	110000	
S5810	175	0		29	10	S5810_175_0	2	5	Select Care Drugs	010000	
S5810	175	0		29	10	S5810_175_0	2	4	Specialty Tier	010010	
S5810	175	0		29	10	S5810_175_0	2	1	Generic	010000	
S5810	175	0		29	10	S5810_175_0	2	2	Preferred Brand	010001	
S5810	176	0		29	10	S5810_176_0	2	5	Select Care Drugs	010000	1
S5810	176	0		29	10	S5810_176_0	2	4	Specialty Tier	010010	
S5810	176	0		29	10	S5810_176_0	2	5	Select Care Drugs	010000	
S5810	176	0		29	10	S5810_176_0	2	3	Non-Preferred Brand	110000	
S5810	176	0		29	10	S5810_176_0	2	2	Preferred Brand	010001	
S5810	176	0		29	10	S5810_176_0	2	1	Generic	010000	
S5810	177	0		29	10	S5810_177_0	2	2	Preferred Brand	010001	
S5810	177	0		29	10	S5810_177_0	2	3	Non-Preferred Brand	110000	
S5810	177	0		29	10	S5810_177_0	2	4	Specialty Tier	010010	
S5810	177	0		29	10	S5810_177_0	2	5	Select Care Drugs	010000	
S5810	177	0		29	10	S5810_177_0	2	5	Select Care Drugs	010000	1
S5810	177	0		29	10	S5810_177_0	2	1	Generic	010000	
S5810	178	0		29	10	S5810_178_0	2	2	Preferred Brand	010001	
S5810	178	0		29	10	S5810_178_0	2	1	Generic	010000	
S5810	178	0		29	10	S5810_178_0	2	5	Select Care Drugs	010000	1
S5810	178	0		29	10	S5810_178_0	2	5	Select Care Drugs	010000	
S5810	178	0		29	10	S5810_178_0	2	4	Specialty Tier	010010	
S5810	178	0		29	10	S5810_178_0	2	3	Non-Preferred Brand	110000	
S5810	179	0		29	10	S5810_179_0	2	5	Select Care Drugs	010000	
S5810	179	0		29	10	S5810_179_0	2	4	Specialty Tier	010010	
S5810	179	0		29	10	S5810_179_0	2	3	Non-Preferred Brand	110000	
S5810	179	0		29	10	S5810_179_0	2	5	Select Care Drugs	010000	1
S5810	179	0		29	10	S5810_179_0	2	2	Preferred Brand	010001	
S5810	179	0		29	10	S5810_179_0	2	1	Generic	010000	
S5810	180	0		29	10	S5810_180_0	2	2	Preferred Brand	010001	
S5810	180	0		29	10	S5810_180_0	2	1	Generic	010000	
S5810	180	0		29	10	S5810_180_0	2	3	Non-Preferred Brand	110000	
S5810	180	0		29	10	S5810_180_0	2	4	Specialty Tier	010010	
S5810	180	0		29	10	S5810_180_0	2	5	Select Care Drugs	010000	
S5810	180	0		29	10	S5810_180_0	2	5	Select Care Drugs	010000	1
S5810	182	0		29	10	S5810_182_0	2	1	Generic	010000	
S5810	182	0		29	10	S5810_182_0	2	2	Preferred Brand	010001	
S5810	182	0		29	10	S5810_182_0	2	3	Non-Preferred Brand	110000	
S5810	182	0		29	10	S5810_182_0	2	4	Specialty Tier	010010	
S5810	182	0		29	10	S5810_182_0	2	5	Select Care Drugs	010000	
S5810	182	0		29	10	S5810_182_0	2	5	Select Care Drugs	010000	1
S5810	183	0		29	10	S5810_183_0	2	2	Preferred Brand	010001	
S5810	183	0		29	10	S5810_183_0	2	1	Generic	010000	
S5810	183	0		29	10	S5810_183_0	2	3	Non-Preferred Brand	110000	
S5810	183	0		29	10	S5810_183_0	2	5	Select Care Drugs	010000	1
S5810	183	0		29	10	S5810_183_0	2	5	Select Care Drugs	010000	
S5810	183	0		29	10	S5810_183_0	2	4	Specialty Tier	010010	
S5810	184	0		29	10	S5810_184_0	2	1	Generic	010000	
S5810	184	0		29	10	S5810_184_0	2	2	Preferred Brand	010001	
S5810	184	0		29	10	S5810_184_0	2	3	Non-Preferred Brand	110000	
S5810	184	0		29	10	S5810_184_0	2	4	Specialty Tier	010010	
S5810	184	0		29	10	S5810_184_0	2	5	Select Care Drugs	010000	
S5810	184	0		29	10	S5810_184_0	2	5	Select Care Drugs	010000	1
S5810	185	0		29	10	S5810_185_0	2	1	Generic	010000	
S5810	185	0		29	10	S5810_185_0	2	2	Preferred Brand	010001	
S5810	185	0		29	10	S5810_185_0	2	5	Select Care Drugs	010000	
S5810	185	0		29	10	S5810_185_0	2	4	Specialty Tier	010010	
S5810	185	0		29	10	S5810_185_0	2	3	Non-Preferred Brand	110000	
S5810	185	0		29	10	S5810_185_0	2	5	Select Care Drugs	010000	1
S5810	186	0		29	10	S5810_186_0	2	2	Preferred Brand	010001	
S5810	186	0		29	10	S5810_186_0	2	3	Non-Preferred Brand	110000	
S5810	186	0		29	10	S5810_186_0	2	4	Specialty Tier	010010	
S5810	186	0		29	10	S5810_186_0	2	5	Select Care Drugs	010000	
S5810	186	0		29	10	S5810_186_0	2	5	Select Care Drugs	010000	1
S5810	186	0		29	10	S5810_186_0	2	1	Generic	010000	
S5810	187	0		29	10	S5810_187_0	2	1	Generic	010000	
S5810	187	0		29	10	S5810_187_0	2	2	Preferred Brand	010001	
S5810	187	0		29	10	S5810_187_0	2	5	Select Care Drugs	010000	1
S5810	187	0		29	10	S5810_187_0	2	4	Specialty Tier	010010	
S5810	187	0		29	10	S5810_187_0	2	5	Select Care Drugs	010000	
S5810	187	0		29	10	S5810_187_0	2	3	Non-Preferred Brand	110000	
S5810	188	0		29	10	S5810_188_0	2	1	Generic	010000	
S5810	188	0		29	10	S5810_188_0	2	2	Preferred Brand	010001	
S5810	188	0		29	10	S5810_188_0	2	3	Non-Preferred Brand	110000	
S5810	188	0		29	10	S5810_188_0	2	4	Specialty Tier	010010	
S5810	188	0		29	10	S5810_188_0	2	5	Select Care Drugs	010000	
S5810	188	0		29	10	S5810_188_0	2	5	Select Care Drugs	010000	1
S5810	189	0		29	10	S5810_189_0	2	5	Select Care Drugs	010000	
S5810	189	0		29	10	S5810_189_0	2	5	Select Care Drugs	010000	1
S5810	189	0		29	10	S5810_189_0	2	1	Generic	010000	
S5810	189	0		29	10	S5810_189_0	2	2	Preferred Brand	010001	
S5810	189	0		29	10	S5810_189_0	2	3	Non-Preferred Brand	110000	
S5810	189	0		29	10	S5810_189_0	2	4	Specialty Tier	010010	
S5810	190	0		29	10	S5810_190_0	2	5	Select Care Drugs	010000	1
S5810	190	0		29	10	S5810_190_0	2	5	Select Care Drugs	010000	
S5810	190	0		29	10	S5810_190_0	2	4	Specialty Tier	010010	
S5810	190	0		29	10	S5810_190_0	2	3	Non-Preferred Brand	110000	
S5810	190	0		29	10	S5810_190_0	2	1	Generic	010000	
S5810	190	0		29	10	S5810_190_0	2	2	Preferred Brand	010001	
S5810	191	0		29	10	S5810_191_0	2	5	Select Care Drugs	010000	
S5810	191	0		29	10	S5810_191_0	2	4	Specialty Tier	010010	
S5810	191	0		29	10	S5810_191_0	2	3	Non-Preferred Brand	110000	
S5810	191	0		29	10	S5810_191_0	2	2	Preferred Brand	010001	
S5810	191	0		29	10	S5810_191_0	2	5	Select Care Drugs	010000	1
S5810	191	0		29	10	S5810_191_0	2	1	Generic	010000	
S5810	192	0		29	10	S5810_192_0	2	5	Select Care Drugs	010000	1
S5810	192	0		29	10	S5810_192_0	2	2	Preferred Brand	010001	
S5810	192	0		29	10	S5810_192_0	2	3	Non-Preferred Brand	110000	
S5810	192	0		29	10	S5810_192_0	2	5	Select Care Drugs	010000	
S5810	192	0		29	10	S5810_192_0	2	4	Specialty Tier	010010	
S5810	192	0		29	10	S5810_192_0	2	1	Generic	010000	
S5810	193	0		29	10	S5810_193_0	2	1	Generic	010000	
S5810	193	0		29	10	S5810_193_0	2	4	Specialty Tier	010010	
S5810	193	0		29	10	S5810_193_0	2	3	Non-Preferred Brand	110000	
S5810	193	0		29	10	S5810_193_0	2	2	Preferred Brand	010001	
S5810	193	0		29	10	S5810_193_0	2	5	Select Care Drugs	010000	1
S5810	193	0		29	10	S5810_193_0	2	5	Select Care Drugs	010000	
S5810	194	0		29	10	S5810_194_0	2	5	Select Care Drugs	010000	
S5810	194	0		29	10	S5810_194_0	2	4	Specialty Tier	010010	
S5810	194	0		29	10	S5810_194_0	2	3	Non-Preferred Brand	110000	
S5810	194	0		29	10	S5810_194_0	2	2	Preferred Brand	010001	
S5810	194	0		29	10	S5810_194_0	2	1	Generic	010000	
S5810	194	0		29	10	S5810_194_0	2	5	Select Care Drugs	010000	1
S5810	195	0		29	10	S5810_195_0	2	5	Select Care Drugs	010000	
S5810	195	0		29	10	S5810_195_0	2	4	Specialty Tier	010010	
S5810	195	0		29	10	S5810_195_0	2	3	Non-Preferred Brand	110000	
S5810	195	0		29	10	S5810_195_0	2	2	Preferred Brand	010001	
S5810	195	0		29	10	S5810_195_0	2	1	Generic	010000	
S5810	195	0		29	10	S5810_195_0	2	5	Select Care Drugs	010000	1
S5810	197	0		29	10	S5810_197_0	2	5	Select Care Drugs	010000	
S5810	197	0		29	10	S5810_197_0	2	4	Specialty Tier	010010	
S5810	197	0		29	10	S5810_197_0	2	3	Non-Preferred Brand	110000	
S5810	197	0		29	10	S5810_197_0	2	2	Preferred Brand	010001	
S5810	197	0		29	10	S5810_197_0	2	1	Generic	010000	
S5810	197	0		29	10	S5810_197_0	2	5	Select Care Drugs	010000	1
S5810	198	0		29	10	S5810_198_0	2	1	Generic	010000	
S5810	198	0		29	10	S5810_198_0	2	2	Preferred Brand	010001	
S5810	198	0		29	10	S5810_198_0	2	3	Non-Preferred Brand	110000	
S5810	198	0		29	10	S5810_198_0	2	4	Specialty Tier	010010	
S5810	198	0		29	10	S5810_198_0	2	5	Select Care Drugs	010000	
S5810	198	0		29	10	S5810_198_0	2	5	Select Care Drugs	010000	1
S5810	199	0		29	10	S5810_199_0	2	1	Generic	010000	
S5810	199	0		29	10	S5810_199_0	2	2	Preferred Brand	010001	
S5810	199	0		29	10	S5810_199_0	2	3	Non-Preferred Brand	110000	
S5810	199	0		29	10	S5810_199_0	2	4	Specialty Tier	010010	
S5810	199	0		29	10	S5810_199_0	2	5	Select Care Drugs	010000	
S5810	199	0		29	10	S5810_199_0	2	5	Select Care Drugs	010000	1
S5810	200	0		29	10	S5810_200_0	2	1	Generic	010000	
S5810	200	0		29	10	S5810_200_0	2	2	Preferred Brand	010001	
S5810	200	0		29	10	S5810_200_0	2	5	Select Care Drugs	010000	1
S5810	200	0		29	10	S5810_200_0	2	5	Select Care Drugs	010000	
S5810	200	0		29	10	S5810_200_0	2	4	Specialty Tier	010010	
S5810	200	0		29	10	S5810_200_0	2	3	Non-Preferred Brand	110000	
S5810	201	0		29	10	S5810_201_0	2	4	Specialty Tier	010010	
S5810	201	0		29	10	S5810_201_0	2	5	Select Care Drugs	010000	
S5810	201	0		29	10	S5810_201_0	2	5	Select Care Drugs	010000	1
S5810	201	0		29	10	S5810_201_0	2	3	Non-Preferred Brand	110000	
S5810	201	0		29	10	S5810_201_0	2	2	Preferred Brand	010001	
S5810	201	0		29	10	S5810_201_0	2	1	Generic	010000	
S5810	202	0		29	10	S5810_202_0	2	5	Select Care Drugs	010000	1
S5810	202	0		29	10	S5810_202_0	2	5	Select Care Drugs	010000	
S5810	202	0		29	10	S5810_202_0	2	1	Generic	010000	
S5810	202	0		29	10	S5810_202_0	2	2	Preferred Brand	010001	
S5810	202	0		29	10	S5810_202_0	2	3	Non-Preferred Brand	110000	
S5810	202	0		29	10	S5810_202_0	2	4	Specialty Tier	010010	
S5810	204	0		29	10	S5810_204_0	2	1	Generic	010000	
S5810	204	0		29	10	S5810_204_0	2	5	Select Care Drugs	010000	
S5810	204	0		29	10	S5810_204_0	2	5	Select Care Drugs	010000	1
S5810	204	0		29	10	S5810_204_0	2	2	Preferred Brand	010001	
S5810	204	0		29	10	S5810_204_0	2	3	Non-Preferred Brand	110000	
S5810	204	0		29	10	S5810_204_0	2	4	Specialty Tier	010010	
S5810	239	0		29	10	S5810_239_0	2	1	Generic	010000	
S5810	239	0		29	10	S5810_239_0	2	5	Select Care Drugs	010000	1
S5810	239	0		29	10	S5810_239_0	2	5	Select Care Drugs	010000	
S5810	239	0		29	10	S5810_239_0	2	4	Specialty Tier	010010	
S5810	239	0		29	10	S5810_239_0	2	3	Non-Preferred Brand	110000	
S5810	239	0		29	10	S5810_239_0	2	2	Preferred Brand	010001	
S5810	240	0		29	10	S5810_240_0	2	5	Select Care Drugs	010000	
S5810	240	0		29	10	S5810_240_0	2	2	Preferred Brand	010001	
S5810	240	0		29	10	S5810_240_0	2	1	Generic	010000	
S5810	240	0		29	10	S5810_240_0	2	3	Non-Preferred Brand	110000	
S5810	240	0		29	10	S5810_240_0	2	4	Specialty Tier	010010	
S5810	240	0		29	10	S5810_240_0	2	5	Select Care Drugs	010000	1
S5810	241	0		29	10	S5810_241_0	2	3	Non-Preferred Brand	110000	
S5810	241	0		29	10	S5810_241_0	2	2	Preferred Brand	010001	
S5810	241	0		29	10	S5810_241_0	2	1	Generic	010000	
S5810	241	0		29	10	S5810_241_0	2	4	Specialty Tier	010010	
S5810	241	0		29	10	S5810_241_0	2	5	Select Care Drugs	010000	1
S5810	241	0		29	10	S5810_241_0	2	5	Select Care Drugs	010000	
S5820	001	0		29	10	S5820_001_0	3	1	Preferred Generic	001000	
S5820	001	0		29	10	S5820_001_0	3	5	Specialty Tier	010010	
S5820	001	0		29	10	S5820_001_0	3	4	Non-Preferred Brand	100100	
S5820	001	0		29	10	S5820_001_0	3	3	Preferred Brand	010001	
S5820	001	0		29	10	S5820_001_0	3	2	Non-Preferred Generic	000100	
S5820	002	0		29	10	S5820_002_0	3	2	Non-Preferred Generic	000100	
S5820	002	0		29	10	S5820_002_0	3	5	Specialty Tier	010010	
S5820	002	0		29	10	S5820_002_0	3	3	Preferred Brand	010001	
S5820	002	0		29	10	S5820_002_0	3	1	Preferred Generic	001000	
S5820	002	0		29	10	S5820_002_0	3	4	Non-Preferred Brand	100100	
S5820	003	0		29	10	S5820_003_0	3	4	Non-Preferred Brand	100100	
S5820	003	0		29	10	S5820_003_0	3	3	Preferred Brand	010001	
S5820	003	0		29	10	S5820_003_0	3	2	Non-Preferred Generic	000100	
S5820	003	0		29	10	S5820_003_0	3	1	Preferred Generic	001000	
S5820	003	0		29	10	S5820_003_0	3	5	Specialty Tier	010010	
S5820	004	0		29	10	S5820_004_0	3	5	Specialty Tier	010010	
S5820	004	0		29	10	S5820_004_0	3	4	Non-Preferred Brand	100100	
S5820	004	0		29	10	S5820_004_0	3	1	Preferred Generic	001000	
S5820	004	0		29	10	S5820_004_0	3	2	Non-Preferred Generic	000100	
S5820	004	0		29	10	S5820_004_0	3	3	Preferred Brand	010001	
S5820	005	0		29	10	S5820_005_0	3	5	Specialty Tier	010010	
S5820	005	0		29	10	S5820_005_0	3	4	Non-Preferred Brand	100100	
S5820	005	0		29	10	S5820_005_0	3	3	Preferred Brand	010001	
S5820	005	0		29	10	S5820_005_0	3	1	Preferred Generic	001000	
S5820	005	0		29	10	S5820_005_0	3	2	Non-Preferred Generic	000100	
S5820	006	0		29	10	S5820_006_0	3	5	Specialty Tier	010010	
S5820	006	0		29	10	S5820_006_0	3	1	Preferred Generic	001000	
S5820	006	0		29	10	S5820_006_0	3	2	Non-Preferred Generic	000100	
S5820	006	0		29	10	S5820_006_0	3	3	Preferred Brand	010001	
S5820	006	0		29	10	S5820_006_0	3	4	Non-Preferred Brand	100100	
S5820	007	0		29	10	S5820_007_0	3	3	Preferred Brand	010001	
S5820	007	0		29	10	S5820_007_0	3	4	Non-Preferred Brand	100100	
S5820	007	0		29	10	S5820_007_0	3	5	Specialty Tier	010010	
S5820	007	0		29	10	S5820_007_0	3	2	Non-Preferred Generic	000100	
S5820	007	0		29	10	S5820_007_0	3	1	Preferred Generic	001000	
S5820	008	0		29	10	S5820_008_0	3	1	Preferred Generic	001000	
S5820	008	0		29	10	S5820_008_0	3	2	Non-Preferred Generic	000100	
S5820	008	0		29	10	S5820_008_0	3	3	Preferred Brand	010001	
S5820	008	0		29	10	S5820_008_0	3	4	Non-Preferred Brand	100100	
S5820	008	0		29	10	S5820_008_0	3	5	Specialty Tier	010010	
S5820	009	0		29	10	S5820_009_0	3	1	Preferred Generic	001000	
S5820	009	0		29	10	S5820_009_0	3	2	Non-Preferred Generic	000100	
S5820	009	0		29	10	S5820_009_0	3	3	Preferred Brand	010001	
S5820	009	0		29	10	S5820_009_0	3	4	Non-Preferred Brand	100100	
S5820	009	0		29	10	S5820_009_0	3	5	Specialty Tier	010010	
S5820	010	0		29	10	S5820_010_0	3	3	Preferred Brand	010001	
S5820	010	0		29	10	S5820_010_0	3	4	Non-Preferred Brand	100100	
S5820	010	0		29	10	S5820_010_0	3	2	Non-Preferred Generic	000100	
S5820	010	0		29	10	S5820_010_0	3	1	Preferred Generic	001000	
S5820	010	0		29	10	S5820_010_0	3	5	Specialty Tier	010010	
S5820	011	0		29	10	S5820_011_0	3	2	Non-Preferred Generic	000100	
S5820	011	0		29	10	S5820_011_0	3	1	Preferred Generic	001000	
S5820	011	0		29	10	S5820_011_0	3	3	Preferred Brand	010001	
S5820	011	0		29	10	S5820_011_0	3	5	Specialty Tier	010010	
S5820	011	0		29	10	S5820_011_0	3	4	Non-Preferred Brand	100100	
S5820	012	0		29	10	S5820_012_0	3	1	Preferred Generic	001000	
S5820	012	0		29	10	S5820_012_0	3	2	Non-Preferred Generic	000100	
S5820	012	0		29	10	S5820_012_0	3	4	Non-Preferred Brand	100100	
S5820	012	0		29	10	S5820_012_0	3	3	Preferred Brand	010001	
S5820	012	0		29	10	S5820_012_0	3	5	Specialty Tier	010010	
S5820	013	0		29	10	S5820_013_0	3	4	Non-Preferred Brand	100100	
S5820	013	0		29	10	S5820_013_0	3	3	Preferred Brand	010001	
S5820	013	0		29	10	S5820_013_0	3	2	Non-Preferred Generic	000100	
S5820	013	0		29	10	S5820_013_0	3	1	Preferred Generic	001000	
S5820	013	0		29	10	S5820_013_0	3	5	Specialty Tier	010010	
S5820	014	0		29	10	S5820_014_0	3	5	Specialty Tier	010010	
S5820	014	0		29	10	S5820_014_0	3	4	Non-Preferred Brand	100100	
S5820	014	0		29	10	S5820_014_0	3	3	Preferred Brand	010001	
S5820	014	0		29	10	S5820_014_0	3	2	Non-Preferred Generic	000100	
S5820	014	0		29	10	S5820_014_0	3	1	Preferred Generic	001000	
S5820	015	0		29	10	S5820_015_0	3	1	Preferred Generic	001000	
S5820	015	0		29	10	S5820_015_0	3	3	Preferred Brand	010001	
S5820	015	0		29	10	S5820_015_0	3	4	Non-Preferred Brand	100100	
S5820	015	0		29	10	S5820_015_0	3	5	Specialty Tier	010010	
S5820	015	0		29	10	S5820_015_0	3	2	Non-Preferred Generic	000100	
S5820	016	0		29	10	S5820_016_0	3	5	Specialty Tier	010010	
S5820	016	0		29	10	S5820_016_0	3	4	Non-Preferred Brand	100100	
S5820	016	0		29	10	S5820_016_0	3	3	Preferred Brand	010001	
S5820	016	0		29	10	S5820_016_0	3	2	Non-Preferred Generic	000100	
S5820	016	0		29	10	S5820_016_0	3	1	Preferred Generic	001000	
S5820	017	0		29	10	S5820_017_0	3	1	Preferred Generic	001000	
S5820	017	0		29	10	S5820_017_0	3	5	Specialty Tier	010010	
S5820	017	0		29	10	S5820_017_0	3	4	Non-Preferred Brand	100100	
S5820	017	0		29	10	S5820_017_0	3	3	Preferred Brand	010001	
S5820	017	0		29	10	S5820_017_0	3	2	Non-Preferred Generic	000100	
S5820	018	0		29	10	S5820_018_0	3	5	Specialty Tier	010010	
S5820	018	0		29	10	S5820_018_0	3	4	Non-Preferred Brand	100100	
S5820	018	0		29	10	S5820_018_0	3	3	Preferred Brand	010001	
S5820	018	0		29	10	S5820_018_0	3	2	Non-Preferred Generic	000100	
S5820	018	0		29	10	S5820_018_0	3	1	Preferred Generic	001000	
S5820	019	0		29	10	S5820_019_0	3	1	Preferred Generic	001000	
S5820	019	0		29	10	S5820_019_0	3	2	Non-Preferred Generic	000100	
S5820	019	0		29	10	S5820_019_0	3	3	Preferred Brand	010001	
S5820	019	0		29	10	S5820_019_0	3	4	Non-Preferred Brand	100100	
S5820	019	0		29	10	S5820_019_0	3	5	Specialty Tier	010010	
S5820	020	0		29	10	S5820_020_0	3	2	Non-Preferred Generic	000100	
S5820	020	0		29	10	S5820_020_0	3	1	Preferred Generic	001000	
S5820	020	0		29	10	S5820_020_0	3	3	Preferred Brand	010001	
S5820	020	0		29	10	S5820_020_0	3	4	Non-Preferred Brand	100100	
S5820	020	0		29	10	S5820_020_0	3	5	Specialty Tier	010010	
S5820	021	0		29	10	S5820_021_0	3	1	Preferred Generic	001000	
S5820	021	0		29	10	S5820_021_0	3	2	Non-Preferred Generic	000100	
S5820	021	0		29	10	S5820_021_0	3	3	Preferred Brand	010001	
S5820	021	0		29	10	S5820_021_0	3	4	Non-Preferred Brand	100100	
S5820	021	0		29	10	S5820_021_0	3	5	Specialty Tier	010010	
S5820	022	0		29	10	S5820_022_0	3	2	Non-Preferred Generic	000100	
S5820	022	0		29	10	S5820_022_0	3	1	Preferred Generic	001000	
S5820	022	0		29	10	S5820_022_0	3	3	Preferred Brand	010001	
S5820	022	0		29	10	S5820_022_0	3	5	Specialty Tier	010010	
S5820	022	0		29	10	S5820_022_0	3	4	Non-Preferred Brand	100100	
S5820	023	0		29	10	S5820_023_0	3	1	Preferred Generic	001000	
S5820	023	0		29	10	S5820_023_0	3	2	Non-Preferred Generic	000100	
S5820	023	0		29	10	S5820_023_0	3	3	Preferred Brand	010001	
S5820	023	0		29	10	S5820_023_0	3	4	Non-Preferred Brand	100100	
S5820	023	0		29	10	S5820_023_0	3	5	Specialty Tier	010010	
S5820	024	0		29	10	S5820_024_0	3	1	Preferred Generic	001000	
S5820	024	0		29	10	S5820_024_0	3	2	Non-Preferred Generic	000100	
S5820	024	0		29	10	S5820_024_0	3	4	Non-Preferred Brand	100100	
S5820	024	0		29	10	S5820_024_0	3	3	Preferred Brand	010001	
S5820	024	0		29	10	S5820_024_0	3	5	Specialty Tier	010010	
S5820	025	0		29	10	S5820_025_0	3	1	Preferred Generic	001000	
S5820	025	0		29	10	S5820_025_0	3	2	Non-Preferred Generic	000100	
S5820	025	0		29	10	S5820_025_0	3	3	Preferred Brand	010001	
S5820	025	0		29	10	S5820_025_0	3	4	Non-Preferred Brand	100100	
S5820	025	0		29	10	S5820_025_0	3	5	Specialty Tier	010010	
S5820	026	0		29	10	S5820_026_0	3	1	Preferred Generic	001000	
S5820	026	0		29	10	S5820_026_0	3	2	Non-Preferred Generic	000100	
S5820	026	0		29	10	S5820_026_0	3	5	Specialty Tier	010010	
S5820	026	0		29	10	S5820_026_0	3	4	Non-Preferred Brand	100100	
S5820	026	0		29	10	S5820_026_0	3	3	Preferred Brand	010001	
S5820	027	0		29	10	S5820_027_0	4	3	Preferred Brand	010001	
S5820	027	0		29	10	S5820_027_0	4	4	Non-Preferred Brand	100100	
S5820	027	0		29	10	S5820_027_0	4	5	Specialty Tier	010010	
S5820	027	0		29	10	S5820_027_0	4	2	Non-Preferred Generic	000100	
S5820	027	0		29	10	S5820_027_0	4	1	Preferred Generic	001000	
S5820	028	0		29	10	S5820_028_0	3	2	Non-Preferred Generic	000100	
S5820	028	0		29	10	S5820_028_0	3	1	Preferred Generic	001000	
S5820	028	0		29	10	S5820_028_0	3	3	Preferred Brand	010001	
S5820	028	0		29	10	S5820_028_0	3	4	Non-Preferred Brand	100100	
S5820	028	0		29	10	S5820_028_0	3	5	Specialty Tier	010010	
S5820	029	0		29	10	S5820_029_0	3	1	Preferred Generic	001000	
S5820	029	0		29	10	S5820_029_0	3	3	Preferred Brand	010001	
S5820	029	0		29	10	S5820_029_0	3	5	Specialty Tier	010010	
S5820	029	0		29	10	S5820_029_0	3	2	Non-Preferred Generic	000100	
S5820	029	0		29	10	S5820_029_0	3	4	Non-Preferred Brand	100100	
S5820	030	0		29	10	S5820_030_0	3	1	Preferred Generic	001000	
S5820	030	0		29	10	S5820_030_0	3	2	Non-Preferred Generic	000100	
S5820	030	0		29	10	S5820_030_0	3	3	Preferred Brand	010001	
S5820	030	0		29	10	S5820_030_0	3	4	Non-Preferred Brand	100100	
S5820	030	0		29	10	S5820_030_0	3	5	Specialty Tier	010010	
S5820	031	0		29	10	S5820_031_0	3	1	Preferred Generic	001000	
S5820	031	0		29	10	S5820_031_0	3	2	Non-Preferred Generic	000100	
S5820	031	0		29	10	S5820_031_0	3	3	Preferred Brand	010001	
S5820	031	0		29	10	S5820_031_0	3	4	Non-Preferred Brand	100100	
S5820	031	0		29	10	S5820_031_0	3	5	Specialty Tier	010010	
S5820	032	0		29	10	S5820_032_0	3	5	Specialty Tier	010010	
S5820	032	0		29	10	S5820_032_0	3	4	Non-Preferred Brand	100100	
S5820	032	0		29	10	S5820_032_0	3	3	Preferred Brand	010001	
S5820	032	0		29	10	S5820_032_0	3	2	Non-Preferred Generic	000100	
S5820	032	0		29	10	S5820_032_0	3	1	Preferred Generic	001000	
S5820	033	0		29	10	S5820_033_0	3	4	Non-Preferred Brand	100100	
S5820	033	0		29	10	S5820_033_0	3	3	Preferred Brand	010001	
S5820	033	0		29	10	S5820_033_0	3	2	Non-Preferred Generic	000100	
S5820	033	0		29	10	S5820_033_0	3	1	Preferred Generic	001000	
S5820	033	0		29	10	S5820_033_0	3	5	Specialty Tier	010010	
S5820	034	0		29	10	S5820_034_0	4	2	Non-Preferred Generic	000100	
S5820	034	0		29	10	S5820_034_0	4	1	Preferred Generic	001000	
S5820	034	0		29	10	S5820_034_0	4	3	Preferred Brand	010001	
S5820	034	0		29	10	S5820_034_0	4	5	Specialty Tier	010010	
S5820	034	0		29	10	S5820_034_0	4	4	Non-Preferred Brand	100100	
S5820	035	0		29	10	S5820_035_0	4	4	Non-Preferred Brand	100100	
S5820	035	0		29	10	S5820_035_0	4	3	Preferred Brand	010001	
S5820	035	0		29	10	S5820_035_0	4	2	Non-Preferred Generic	000100	
S5820	035	0		29	10	S5820_035_0	4	1	Preferred Generic	001000	
S5820	035	0		29	10	S5820_035_0	4	5	Specialty Tier	010010	
S5820	036	0		29	10	S5820_036_0	4	4	Non-Preferred Brand	100100	
S5820	036	0		29	10	S5820_036_0	4	3	Preferred Brand	010001	
S5820	036	0		29	10	S5820_036_0	4	2	Non-Preferred Generic	000100	
S5820	036	0		29	10	S5820_036_0	4	1	Preferred Generic	001000	
S5820	036	0		29	10	S5820_036_0	4	5	Specialty Tier	010010	
S5820	037	0		29	10	S5820_037_0	4	1	Preferred Generic	001000	
S5820	037	0		29	10	S5820_037_0	4	2	Non-Preferred Generic	000100	
S5820	037	0		29	10	S5820_037_0	4	3	Preferred Brand	010001	
S5820	037	0		29	10	S5820_037_0	4	4	Non-Preferred Brand	100100	
S5820	037	0		29	10	S5820_037_0	4	5	Specialty Tier	010010	
S5820	038	0		29	10	S5820_038_0	4	1	Preferred Generic	001000	
S5820	038	0		29	10	S5820_038_0	4	2	Non-Preferred Generic	000100	
S5820	038	0		29	10	S5820_038_0	4	4	Non-Preferred Brand	100100	
S5820	038	0		29	10	S5820_038_0	4	3	Preferred Brand	010001	
S5820	038	0		29	10	S5820_038_0	4	5	Specialty Tier	010010	
S5840	002	0		29	10	S5840_002_0	9	4	Non-Preferred Brand	100000	
S5840	002	0		29	10	S5840_002_0	9	5	Specialty Tier	010010	
S5840	002	0		29	10	S5840_002_0	9	1	Preferred Generic	001000	1
S5840	002	0		29	10	S5840_002_0	9	2	Non-Preferred Generic	000100	1
S5840	002	0		29	10	S5840_002_0	9	1	Preferred Generic	001000	
S5840	002	0		29	10	S5840_002_0	9	2	Non-Preferred Generic	000100	
S5840	002	0		29	10	S5840_002_0	9	3	Preferred Brand	000001	
S5877	004	0		29	10	S5877_004_0	3	1	Preferred Generic	001000	
S5877	004	0		29	10	S5877_004_0	3	2	Non-Preferred Generic	000100	
S5877	004	0		29	10	S5877_004_0	3	3	Preferred Brand	000001	
S5877	004	0		29	10	S5877_004_0	3	4	Specialty Tier	010010	
S5877	007	0		29	10	S5877_007_0	3	1	Generic	010000	
S5877	007	0		29	10	S5877_007_0	3	2	Preferred Brand	000001	
S5877	007	0		29	10	S5877_007_0	3	3	Non-Preferred Brand	100000	
S5877	007	0		29	10	S5877_007_0	3	4	Specialty Tier	010010	
S5884	001	0		29	10	S5884_001_0	3	1	Preferred Generic	001010	
S5884	001	0		29	10	S5884_001_0	3	4	Non-Preferred Brand	110000	2
S5884	001	0		29	10	S5884_001_0	3	3	Preferred Brand	000101	
S5884	001	0		29	10	S5884_001_0	3	4	Non-Preferred Brand	110000	
S5884	001	0		29	10	S5884_001_0	3	5	Specialty Tier	010010	
S5884	001	0		29	10	S5884_001_0	3	3	Preferred Brand	000101	2
S5884	001	0		29	10	S5884_001_0	3	2	Non-Preferred Generic	000101	
S5884	002	0		29	10	S5884_002_0	5	1	Preferred Generic	001010	
S5884	002	0		29	10	S5884_002_0	5	2	Non-Preferred Generic	000101	
S5884	002	0		29	10	S5884_002_0	5	3	Preferred Brand	000101	
S5884	002	0		29	10	S5884_002_0	5	4	Non-Preferred Brand	110000	
S5884	002	0		29	10	S5884_002_0	5	5	Specialty Tier	010010	
S5884	002	0		29	10	S5884_002_0	5	4	Non-Preferred Brand	110000	2
S5884	002	0		29	10	S5884_002_0	5	3	Preferred Brand	000101	2
S5884	004	0		29	10	S5884_004_0	4	3	Preferred Brand	000101	
S5884	004	0		29	10	S5884_004_0	4	4	Non-Preferred Brand	110000	
S5884	004	0		29	10	S5884_004_0	4	5	Specialty Tier	010010	
S5884	004	0		29	10	S5884_004_0	4	2	Non-Preferred Generic	000101	
S5884	004	0		29	10	S5884_004_0	4	4	Non-Preferred Brand	110000	2
S5884	004	0		29	10	S5884_004_0	4	3	Preferred Brand	000101	2
S5884	004	0		29	10	S5884_004_0	4	1	Preferred Generic	001010	
S5884	005	0		29	10	S5884_005_0	3	3	Preferred Brand	000101	
S5884	005	0		29	10	S5884_005_0	3	4	Non-Preferred Brand	110000	
S5884	005	0		29	10	S5884_005_0	3	5	Specialty Tier	010010	
S5884	005	0		29	10	S5884_005_0	3	3	Preferred Brand	000101	2
S5884	005	0		29	10	S5884_005_0	3	4	Non-Preferred Brand	110000	2
S5884	005	0		29	10	S5884_005_0	3	2	Non-Preferred Generic	000101	
S5884	005	0		29	10	S5884_005_0	3	1	Preferred Generic	001010	
S5884	008	0		29	10	S5884_008_0	3	4	Non-Preferred Brand	110000	2
S5884	008	0		29	10	S5884_008_0	3	3	Preferred Brand	000101	2
S5884	008	0		29	10	S5884_008_0	3	5	Specialty Tier	010010	
S5884	008	0		29	10	S5884_008_0	3	2	Non-Preferred Generic	000101	
S5884	008	0		29	10	S5884_008_0	3	3	Preferred Brand	000101	
S5884	008	0		29	10	S5884_008_0	3	4	Non-Preferred Brand	110000	
S5884	008	0		29	10	S5884_008_0	3	1	Preferred Generic	001010	
S5884	009	0		29	10	S5884_009_0	3	5	Specialty Tier	010010	
S5884	009	0		29	10	S5884_009_0	3	4	Non-Preferred Brand	110000	
S5884	009	0		29	10	S5884_009_0	3	3	Preferred Brand	000101	
S5884	009	0		29	10	S5884_009_0	3	2	Non-Preferred Generic	000101	
S5884	009	0		29	10	S5884_009_0	3	1	Preferred Generic	001010	
S5884	009	0		29	10	S5884_009_0	3	3	Preferred Brand	000101	2
S5884	009	0		29	10	S5884_009_0	3	4	Non-Preferred Brand	110000	2
S5884	010	0		29	10	S5884_010_0	3	5	Specialty Tier	010010	
S5884	010	0		29	10	S5884_010_0	3	4	Non-Preferred Brand	110000	
S5884	010	0		29	10	S5884_010_0	3	4	Non-Preferred Brand	110000	2
S5884	010	0		29	10	S5884_010_0	3	3	Preferred Brand	000101	2
S5884	010	0		29	10	S5884_010_0	3	3	Preferred Brand	000101	
S5884	010	0		29	10	S5884_010_0	3	2	Non-Preferred Generic	000101	
S5884	010	0		29	10	S5884_010_0	3	1	Preferred Generic	001010	
S5884	015	0		29	10	S5884_015_0	3	2	Non-Preferred Generic	000101	
S5884	015	0		29	10	S5884_015_0	3	3	Preferred Brand	000101	
S5884	015	0		29	10	S5884_015_0	3	4	Non-Preferred Brand	110000	
S5884	015	0		29	10	S5884_015_0	3	4	Non-Preferred Brand	110000	2
S5884	015	0		29	10	S5884_015_0	3	3	Preferred Brand	000101	2
S5884	015	0		29	10	S5884_015_0	3	5	Specialty Tier	010010	
S5884	015	0		29	10	S5884_015_0	3	1	Preferred Generic	001010	
S5884	019	0		29	10	S5884_019_0	3	4	Non-Preferred Brand	110000	2
S5884	019	0		29	10	S5884_019_0	3	3	Preferred Brand	000101	2
S5884	019	0		29	10	S5884_019_0	3	5	Specialty Tier	010010	
S5884	019	0		29	10	S5884_019_0	3	3	Preferred Brand	000101	
S5884	019	0		29	10	S5884_019_0	3	2	Non-Preferred Generic	000101	
S5884	019	0		29	10	S5884_019_0	3	1	Preferred Generic	001010	
S5884	019	0		29	10	S5884_019_0	3	4	Non-Preferred Brand	110000	
S5884	020	0		29	10	S5884_020_0	3	3	Preferred Brand	000101	2
S5884	020	0		29	10	S5884_020_0	3	5	Specialty Tier	010010	
S5884	020	0		29	10	S5884_020_0	3	4	Non-Preferred Brand	110000	
S5884	020	0		29	10	S5884_020_0	3	4	Non-Preferred Brand	110000	2
S5884	020	0		29	10	S5884_020_0	3	2	Non-Preferred Generic	000101	
S5884	020	0		29	10	S5884_020_0	3	1	Preferred Generic	001010	
S5884	020	0		29	10	S5884_020_0	3	3	Preferred Brand	000101	
S5884	021	0		29	10	S5884_021_0	3	3	Preferred Brand	000101	
S5884	021	0		29	10	S5884_021_0	3	2	Non-Preferred Generic	000101	
S5884	021	0		29	10	S5884_021_0	3	4	Non-Preferred Brand	110000	
S5884	021	0		29	10	S5884_021_0	3	1	Preferred Generic	001010	
S5884	021	0		29	10	S5884_021_0	3	5	Specialty Tier	010010	
S5884	021	0		29	10	S5884_021_0	3	3	Preferred Brand	000101	2
S5884	021	0		29	10	S5884_021_0	3	4	Non-Preferred Brand	110000	2
S5884	022	0		29	10	S5884_022_0	3	3	Preferred Brand	000101	2
S5884	022	0		29	10	S5884_022_0	3	4	Non-Preferred Brand	110000	2
S5884	022	0		29	10	S5884_022_0	3	1	Preferred Generic	001010	
S5884	022	0		29	10	S5884_022_0	3	5	Specialty Tier	010010	
S5884	022	0		29	10	S5884_022_0	3	4	Non-Preferred Brand	110000	
S5884	022	0		29	10	S5884_022_0	3	3	Preferred Brand	000101	
S5884	022	0		29	10	S5884_022_0	3	2	Non-Preferred Generic	000101	
S5884	024	0		29	10	S5884_024_0	3	4	Non-Preferred Brand	110000	2
S5884	024	0		29	10	S5884_024_0	3	3	Preferred Brand	000101	2
S5884	024	0		29	10	S5884_024_0	3	5	Specialty Tier	010010	
S5884	024	0		29	10	S5884_024_0	3	4	Non-Preferred Brand	110000	
S5884	024	0		29	10	S5884_024_0	3	3	Preferred Brand	000101	
S5884	024	0		29	10	S5884_024_0	3	1	Preferred Generic	001010	
S5884	024	0		29	10	S5884_024_0	3	2	Non-Preferred Generic	000101	
S5884	028	0		29	10	S5884_028_0	3	2	Non-Preferred Generic	000101	
S5884	028	0		29	10	S5884_028_0	3	1	Preferred Generic	001010	
S5884	028	0		29	10	S5884_028_0	3	4	Non-Preferred Brand	110000	2
S5884	028	0		29	10	S5884_028_0	3	3	Preferred Brand	000101	2
S5884	028	0		29	10	S5884_028_0	3	5	Specialty Tier	010010	
S5884	028	0		29	10	S5884_028_0	3	4	Non-Preferred Brand	110000	
S5884	028	0		29	10	S5884_028_0	3	3	Preferred Brand	000101	
S5884	030	0		29	10	S5884_030_0	4	1	Preferred Generic	001010	
S5884	030	0		29	10	S5884_030_0	4	2	Non-Preferred Generic	000101	
S5884	030	0		29	10	S5884_030_0	4	3	Preferred Brand	000101	
S5884	030	0		29	10	S5884_030_0	4	4	Non-Preferred Brand	110000	2
S5884	030	0		29	10	S5884_030_0	4	5	Specialty Tier	010010	
S5884	030	0		29	10	S5884_030_0	4	3	Preferred Brand	000101	2
S5884	030	0		29	10	S5884_030_0	4	4	Non-Preferred Brand	110000	
S5884	062	0		29	10	S5884_062_0	3	4	Non-Preferred Brand	110000	
S5884	062	0		29	10	S5884_062_0	3	3	Preferred Brand	000101	
S5884	062	0		29	10	S5884_062_0	3	2	Non-Preferred Generic	000101	
S5884	062	0		29	10	S5884_062_0	3	1	Preferred Generic	001010	
S5884	062	0		29	10	S5884_062_0	3	4	Non-Preferred Brand	110000	2
S5884	062	0		29	10	S5884_062_0	3	3	Preferred Brand	000101	2
S5884	062	0		29	10	S5884_062_0	3	5	Specialty Tier	010010	
S5884	065	0		29	10	S5884_065_0	3	4	Non-Preferred Brand	110000	2
S5884	065	0		29	10	S5884_065_0	3	3	Preferred Brand	000101	2
S5884	065	0		29	10	S5884_065_0	3	4	Non-Preferred Brand	110000	
S5884	065	0		29	10	S5884_065_0	3	3	Preferred Brand	000101	
S5884	065	0		29	10	S5884_065_0	3	2	Non-Preferred Generic	000101	
S5884	065	0		29	10	S5884_065_0	3	1	Preferred Generic	001010	
S5884	065	0		29	10	S5884_065_0	3	5	Specialty Tier	010010	
S5884	066	0		29	10	S5884_066_0	3	1	Preferred Generic	001010	
S5884	066	0		29	10	S5884_066_0	3	2	Non-Preferred Generic	000101	
S5884	066	0		29	10	S5884_066_0	3	3	Preferred Brand	000101	
S5884	066	0		29	10	S5884_066_0	3	4	Non-Preferred Brand	110000	
S5884	066	0		29	10	S5884_066_0	3	5	Specialty Tier	010010	
S5884	066	0		29	10	S5884_066_0	3	3	Preferred Brand	000101	2
S5884	066	0		29	10	S5884_066_0	3	4	Non-Preferred Brand	110000	2
S5884	071	0		29	10	S5884_071_0	3	4	Non-Preferred Brand	110000	2
S5884	071	0		29	10	S5884_071_0	3	5	Specialty Tier	010010	
S5884	071	0		29	10	S5884_071_0	3	4	Non-Preferred Brand	110000	
S5884	071	0		29	10	S5884_071_0	3	3	Preferred Brand	000101	
S5884	071	0		29	10	S5884_071_0	3	2	Non-Preferred Generic	000101	
S5884	071	0		29	10	S5884_071_0	3	1	Preferred Generic	001010	
S5884	071	0		29	10	S5884_071_0	3	3	Preferred Brand	000101	2
S5884	072	0		29	10	S5884_072_0	3	3	Preferred Brand	000101	2
S5884	072	0		29	10	S5884_072_0	3	4	Non-Preferred Brand	110000	2
S5884	072	0		29	10	S5884_072_0	3	5	Specialty Tier	010010	
S5884	072	0		29	10	S5884_072_0	3	4	Non-Preferred Brand	110000	
S5884	072	0		29	10	S5884_072_0	3	3	Preferred Brand	000101	
S5884	072	0		29	10	S5884_072_0	3	2	Non-Preferred Generic	000101	
S5884	072	0		29	10	S5884_072_0	3	1	Preferred Generic	001010	
S5884	073	0		29	10	S5884_073_0	3	4	Non-Preferred Brand	110000	2
S5884	073	0		29	10	S5884_073_0	3	3	Preferred Brand	000101	2
S5884	073	0		29	10	S5884_073_0	3	5	Specialty Tier	010010	
S5884	073	0		29	10	S5884_073_0	3	4	Non-Preferred Brand	110000	
S5884	073	0		29	10	S5884_073_0	3	3	Preferred Brand	000101	
S5884	073	0		29	10	S5884_073_0	3	1	Preferred Generic	001010	
S5884	073	0		29	10	S5884_073_0	3	2	Non-Preferred Generic	000101	
S5884	074	0		29	10	S5884_074_0	4	4	Non-Preferred Brand	110000	2
S5884	074	0		29	10	S5884_074_0	4	3	Preferred Brand	000101	2
S5884	074	0		29	10	S5884_074_0	4	5	Specialty Tier	010010	
S5884	074	0		29	10	S5884_074_0	4	4	Non-Preferred Brand	110000	
S5884	074	0		29	10	S5884_074_0	4	3	Preferred Brand	000101	
S5884	074	0		29	10	S5884_074_0	4	1	Preferred Generic	001010	
S5884	074	0		29	10	S5884_074_0	4	2	Non-Preferred Generic	000101	
S5884	076	0		29	10	S5884_076_0	3	4	Non-Preferred Brand	110000	2
S5884	076	0		29	10	S5884_076_0	3	3	Preferred Brand	000101	2
S5884	076	0		29	10	S5884_076_0	3	5	Specialty Tier	010010	
S5884	076	0		29	10	S5884_076_0	3	1	Preferred Generic	001010	
S5884	076	0		29	10	S5884_076_0	3	3	Preferred Brand	000101	
S5884	076	0		29	10	S5884_076_0	3	4	Non-Preferred Brand	110000	
S5884	076	0		29	10	S5884_076_0	3	2	Non-Preferred Generic	000101	
S5884	077	0		29	10	S5884_077_0	3	3	Preferred Brand	000101	2
S5884	077	0		29	10	S5884_077_0	3	1	Preferred Generic	001010	
S5884	077	0		29	10	S5884_077_0	3	2	Non-Preferred Generic	000101	
S5884	077	0		29	10	S5884_077_0	3	3	Preferred Brand	000101	
S5884	077	0		29	10	S5884_077_0	3	4	Non-Preferred Brand	110000	
S5884	077	0		29	10	S5884_077_0	3	5	Specialty Tier	010010	
S5884	077	0		29	10	S5884_077_0	3	4	Non-Preferred Brand	110000	2
S5884	078	0		29	10	S5884_078_0	3	1	Preferred Generic	001010	
S5884	078	0		29	10	S5884_078_0	3	3	Preferred Brand	000101	2
S5884	078	0		29	10	S5884_078_0	3	5	Specialty Tier	010010	
S5884	078	0		29	10	S5884_078_0	3	4	Non-Preferred Brand	110000	
S5884	078	0		29	10	S5884_078_0	3	3	Preferred Brand	000101	
S5884	078	0		29	10	S5884_078_0	3	2	Non-Preferred Generic	000101	
S5884	078	0		29	10	S5884_078_0	3	4	Non-Preferred Brand	110000	2
S5884	083	0		29	10	S5884_083_0	3	4	Non-Preferred Brand	110000	
S5884	083	0		29	10	S5884_083_0	3	5	Specialty Tier	010010	
S5884	083	0		29	10	S5884_083_0	3	3	Preferred Brand	000101	2
S5884	083	0		29	10	S5884_083_0	3	4	Non-Preferred Brand	110000	2
S5884	083	0		29	10	S5884_083_0	3	2	Non-Preferred Generic	000101	
S5884	083	0		29	10	S5884_083_0	3	1	Preferred Generic	001010	
S5884	083	0		29	10	S5884_083_0	3	3	Preferred Brand	000101	
S5884	085	0		29	10	S5884_085_0	4	5	Specialty Tier	010010	
S5884	085	0		29	10	S5884_085_0	4	3	Preferred Brand	000101	2
S5884	085	0		29	10	S5884_085_0	4	1	Preferred Generic	001010	
S5884	085	0		29	10	S5884_085_0	4	2	Non-Preferred Generic	000101	
S5884	085	0		29	10	S5884_085_0	4	3	Preferred Brand	000101	
S5884	085	0		29	10	S5884_085_0	4	4	Non-Preferred Brand	110000	
S5884	085	0		29	10	S5884_085_0	4	4	Non-Preferred Brand	110000	2
S5884	086	0		29	10	S5884_086_0	4	3	Preferred Brand	000101	2
S5884	086	0		29	10	S5884_086_0	4	5	Specialty Tier	010010	
S5884	086	0		29	10	S5884_086_0	4	4	Non-Preferred Brand	110000	
S5884	086	0		29	10	S5884_086_0	4	3	Preferred Brand	000101	
S5884	086	0		29	10	S5884_086_0	4	2	Non-Preferred Generic	000101	
S5884	086	0		29	10	S5884_086_0	4	1	Preferred Generic	001010	
S5884	086	0		29	10	S5884_086_0	4	4	Non-Preferred Brand	110000	2
S5884	087	0		29	10	S5884_087_0	4	3	Preferred Brand	000101	
S5884	087	0		29	10	S5884_087_0	4	4	Non-Preferred Brand	110000	
S5884	087	0		29	10	S5884_087_0	4	5	Specialty Tier	010010	
S5884	087	0		29	10	S5884_087_0	4	3	Preferred Brand	000101	2
S5884	087	0		29	10	S5884_087_0	4	4	Non-Preferred Brand	110000	2
S5884	087	0		29	10	S5884_087_0	4	2	Non-Preferred Generic	000101	
S5884	087	0		29	10	S5884_087_0	4	1	Preferred Generic	001010	
S5884	089	0		29	10	S5884_089_0	3	2	Non-Preferred Generic	000101	
S5884	089	0		29	10	S5884_089_0	3	1	Preferred Generic	001010	
S5884	089	0		29	10	S5884_089_0	3	4	Non-Preferred Brand	110000	2
S5884	089	0		29	10	S5884_089_0	3	3	Preferred Brand	000101	
S5884	089	0		29	10	S5884_089_0	3	5	Specialty Tier	010010	
S5884	089	0		29	10	S5884_089_0	3	4	Non-Preferred Brand	110000	
S5884	089	0		29	10	S5884_089_0	3	3	Preferred Brand	000101	2
S5884	092	0		29	10	S5884_092_0	4	3	Preferred Brand	000101	
S5884	092	0		29	10	S5884_092_0	4	2	Non-Preferred Generic	000101	
S5884	092	0		29	10	S5884_092_0	4	1	Preferred Generic	001010	
S5884	092	0		29	10	S5884_092_0	4	4	Non-Preferred Brand	110000	
S5884	092	0		29	10	S5884_092_0	4	5	Specialty Tier	010010	
S5884	092	0		29	10	S5884_092_0	4	3	Preferred Brand	000101	2
S5884	092	0		29	10	S5884_092_0	4	4	Non-Preferred Brand	110000	2
S5884	093	0		29	10	S5884_093_0	4	3	Preferred Brand	000101	
S5884	093	0		29	10	S5884_093_0	4	2	Non-Preferred Generic	000101	
S5884	093	0		29	10	S5884_093_0	4	1	Preferred Generic	001010	
S5884	093	0		29	10	S5884_093_0	4	4	Non-Preferred Brand	110000	
S5884	093	0		29	10	S5884_093_0	4	4	Non-Preferred Brand	110000	2
S5884	093	0		29	10	S5884_093_0	4	3	Preferred Brand	000101	2
S5884	093	0		29	10	S5884_093_0	4	5	Specialty Tier	010010	
S5884	094	0		29	10	S5884_094_0	3	1	Preferred Generic	001010	
S5884	094	0		29	10	S5884_094_0	3	2	Non-Preferred Generic	000101	
S5884	094	0		29	10	S5884_094_0	3	3	Preferred Brand	000101	
S5884	094	0		29	10	S5884_094_0	3	3	Preferred Brand	000101	2
S5884	094	0		29	10	S5884_094_0	3	5	Specialty Tier	010010	
S5884	094	0		29	10	S5884_094_0	3	4	Non-Preferred Brand	110000	
S5884	094	0		29	10	S5884_094_0	3	4	Non-Preferred Brand	110000	2
S5884	101	0		29	10	S5884_101_0	4	4	Non-Preferred Brand	110000	
S5884	101	0		29	10	S5884_101_0	4	3	Preferred Brand	000101	
S5884	101	0		29	10	S5884_101_0	4	2	Non-Preferred Generic	000101	
S5884	101	0		29	10	S5884_101_0	4	1	Preferred Generic	001010	
S5884	101	0		29	10	S5884_101_0	4	5	Specialty Tier	010010	
S5884	102	0		29	10	S5884_102_0	5	4	Non-Preferred Brand	110000	
S5884	102	0		29	10	S5884_102_0	5	3	Preferred Brand	000101	
S5884	102	0		29	10	S5884_102_0	5	2	Non-Preferred Generic	000101	
S5884	102	0		29	10	S5884_102_0	5	1	Preferred Generic	001010	
S5884	102	0		29	10	S5884_102_0	5	5	Specialty Tier	010010	
S5884	103	0		29	10	S5884_103_0	4	1	Preferred Generic	001010	
S5884	103	0		29	10	S5884_103_0	4	2	Non-Preferred Generic	000101	
S5884	103	0		29	10	S5884_103_0	4	3	Preferred Brand	000101	
S5884	103	0		29	10	S5884_103_0	4	4	Non-Preferred Brand	110000	
S5884	103	0		29	10	S5884_103_0	4	5	Specialty Tier	010010	
S5884	104	0		29	10	S5884_104_0	4	1	Preferred Generic	001010	
S5884	104	0		29	10	S5884_104_0	4	2	Non-Preferred Generic	000101	
S5884	104	0		29	10	S5884_104_0	4	3	Preferred Brand	000101	
S5884	104	0		29	10	S5884_104_0	4	4	Non-Preferred Brand	110000	
S5884	104	0		29	10	S5884_104_0	4	5	Specialty Tier	010010	
S5884	105	0		29	10	S5884_105_0	4	1	Preferred Generic	001010	
S5884	105	0		29	10	S5884_105_0	4	2	Non-Preferred Generic	000101	
S5884	105	0		29	10	S5884_105_0	4	3	Preferred Brand	000101	
S5884	105	0		29	10	S5884_105_0	4	4	Non-Preferred Brand	110000	
S5884	105	0		29	10	S5884_105_0	4	5	Specialty Tier	010010	
S5884	106	0		29	10	S5884_106_0	4	1	Preferred Generic	001010	
S5884	106	0		29	10	S5884_106_0	4	2	Non-Preferred Generic	000101	
S5884	106	0		29	10	S5884_106_0	4	3	Preferred Brand	000101	
S5884	106	0		29	10	S5884_106_0	4	4	Non-Preferred Brand	110000	
S5884	106	0		29	10	S5884_106_0	4	5	Specialty Tier	010010	
S5884	107	0		29	10	S5884_107_0	4	5	Specialty Tier	010010	
S5884	107	0		29	10	S5884_107_0	4	4	Non-Preferred Brand	110000	
S5884	107	0		29	10	S5884_107_0	4	3	Preferred Brand	000101	
S5884	107	0		29	10	S5884_107_0	4	1	Preferred Generic	001010	
S5884	107	0		29	10	S5884_107_0	4	2	Non-Preferred Generic	000101	
S5884	108	0		29	10	S5884_108_0	4	3	Preferred Brand	000101	
S5884	108	0		29	10	S5884_108_0	4	2	Non-Preferred Generic	000101	
S5884	108	0		29	10	S5884_108_0	4	1	Preferred Generic	001010	
S5884	108	0		29	10	S5884_108_0	4	5	Specialty Tier	010010	
S5884	108	0		29	10	S5884_108_0	4	4	Non-Preferred Brand	110000	
S5884	109	0		29	10	S5884_109_0	4	1	Preferred Generic	001010	
S5884	109	0		29	10	S5884_109_0	4	2	Non-Preferred Generic	000101	
S5884	109	0		29	10	S5884_109_0	4	3	Preferred Brand	000101	
S5884	109	0		29	10	S5884_109_0	4	4	Non-Preferred Brand	110000	
S5884	109	0		29	10	S5884_109_0	4	5	Specialty Tier	010010	
S5884	110	0		29	10	S5884_110_0	4	4	Non-Preferred Brand	110000	
S5884	110	0		29	10	S5884_110_0	4	5	Specialty Tier	010010	
S5884	110	0		29	10	S5884_110_0	4	1	Preferred Generic	001010	
S5884	110	0		29	10	S5884_110_0	4	3	Preferred Brand	000101	
S5884	110	0		29	10	S5884_110_0	4	2	Non-Preferred Generic	000101	
S5884	111	0		29	10	S5884_111_0	4	2	Non-Preferred Generic	000101	
S5884	111	0		29	10	S5884_111_0	4	5	Specialty Tier	010010	
S5884	111	0		29	10	S5884_111_0	4	3	Preferred Brand	000101	
S5884	111	0		29	10	S5884_111_0	4	4	Non-Preferred Brand	110000	
S5884	111	0		29	10	S5884_111_0	4	1	Preferred Generic	001010	
S5884	112	0		29	10	S5884_112_0	4	3	Preferred Brand	000101	
S5884	112	0		29	10	S5884_112_0	4	4	Non-Preferred Brand	110000	
S5884	112	0		29	10	S5884_112_0	4	5	Specialty Tier	010010	
S5884	112	0		29	10	S5884_112_0	4	2	Non-Preferred Generic	000101	
S5884	112	0		29	10	S5884_112_0	4	1	Preferred Generic	001010	
S5884	113	0		29	10	S5884_113_0	4	4	Non-Preferred Brand	110000	
S5884	113	0		29	10	S5884_113_0	4	5	Specialty Tier	010010	
S5884	113	0		29	10	S5884_113_0	4	3	Preferred Brand	000101	
S5884	113	0		29	10	S5884_113_0	4	2	Non-Preferred Generic	000101	
S5884	113	0		29	10	S5884_113_0	4	1	Preferred Generic	001010	
S5884	114	0		29	10	S5884_114_0	4	2	Non-Preferred Generic	000101	
S5884	114	0		29	10	S5884_114_0	4	1	Preferred Generic	001010	
S5884	114	0		29	10	S5884_114_0	4	5	Specialty Tier	010010	
S5884	114	0		29	10	S5884_114_0	4	4	Non-Preferred Brand	110000	
S5884	114	0		29	10	S5884_114_0	4	3	Preferred Brand	000101	
S5884	115	0		29	10	S5884_115_0	4	5	Specialty Tier	010010	
S5884	115	0		29	10	S5884_115_0	4	1	Preferred Generic	001010	
S5884	115	0		29	10	S5884_115_0	4	4	Non-Preferred Brand	110000	
S5884	115	0		29	10	S5884_115_0	4	3	Preferred Brand	000101	
S5884	115	0		29	10	S5884_115_0	4	2	Non-Preferred Generic	000101	
S5884	116	0		29	10	S5884_116_0	4	5	Specialty Tier	010010	
S5884	116	0		29	10	S5884_116_0	4	2	Non-Preferred Generic	000101	
S5884	116	0		29	10	S5884_116_0	4	3	Preferred Brand	000101	
S5884	116	0		29	10	S5884_116_0	4	1	Preferred Generic	001010	
S5884	116	0		29	10	S5884_116_0	4	4	Non-Preferred Brand	110000	
S5884	131	0		29	10	S5884_131_0	4	1	Preferred Generic	001010	
S5884	131	0		29	10	S5884_131_0	4	2	Non-Preferred Generic	000101	
S5884	131	0		29	10	S5884_131_0	4	3	Preferred Brand	000101	
S5884	131	0		29	10	S5884_131_0	4	4	Non-Preferred Brand	110000	
S5884	131	0		29	10	S5884_131_0	4	5	Specialty Tier	010010	
S5884	132	0		29	10	S5884_132_0	4	2	Non-Preferred Generic	000101	
S5884	132	0		29	10	S5884_132_0	4	3	Preferred Brand	000101	
S5884	132	0		29	10	S5884_132_0	4	1	Preferred Generic	001010	
S5884	132	0		29	10	S5884_132_0	4	5	Specialty Tier	010010	
S5884	132	0		29	10	S5884_132_0	4	4	Non-Preferred Brand	110000	
S5884	133	0		29	10	S5884_133_0	4	2	Non-Preferred Generic	000101	
S5884	133	0		29	10	S5884_133_0	4	3	Preferred Brand	000101	
S5884	133	0		29	10	S5884_133_0	4	4	Non-Preferred Brand	110000	
S5884	133	0		29	10	S5884_133_0	4	5	Specialty Tier	010010	
S5884	133	0		29	10	S5884_133_0	4	1	Preferred Generic	001010	
S5884	134	0		29	10	S5884_134_0	4	5	Specialty Tier	010010	
S5884	134	0		29	10	S5884_134_0	4	4	Non-Preferred Brand	110000	
S5884	134	0		29	10	S5884_134_0	4	3	Preferred Brand	000101	
S5884	134	0		29	10	S5884_134_0	4	2	Non-Preferred Generic	000101	
S5884	134	0		29	10	S5884_134_0	4	1	Preferred Generic	001010	
S5884	135	0		29	10	S5884_135_0	4	1	Preferred Generic	001010	
S5884	135	0		29	10	S5884_135_0	4	2	Non-Preferred Generic	000101	
S5884	135	0		29	10	S5884_135_0	4	3	Preferred Brand	000101	
S5884	135	0		29	10	S5884_135_0	4	4	Non-Preferred Brand	110000	
S5884	135	0		29	10	S5884_135_0	4	5	Specialty Tier	010010	
S5884	136	0		29	10	S5884_136_0	4	1	Preferred Generic	001010	
S5884	136	0		29	10	S5884_136_0	4	2	Non-Preferred Generic	000101	
S5884	136	0		29	10	S5884_136_0	4	3	Preferred Brand	000101	
S5884	136	0		29	10	S5884_136_0	4	4	Non-Preferred Brand	110000	
S5884	136	0		29	10	S5884_136_0	4	5	Specialty Tier	010010	
S5884	137	0		29	10	S5884_137_0	4	2	Non-Preferred Generic	000101	
S5884	137	0		29	10	S5884_137_0	4	1	Preferred Generic	001010	
S5884	137	0		29	10	S5884_137_0	4	3	Preferred Brand	000101	
S5884	137	0		29	10	S5884_137_0	4	5	Specialty Tier	010010	
S5884	137	0		29	10	S5884_137_0	4	4	Non-Preferred Brand	110000	
S5884	138	0		29	10	S5884_138_0	4	1	Preferred Generic	001010	
S5884	138	0		29	10	S5884_138_0	4	2	Non-Preferred Generic	000101	
S5884	138	0		29	10	S5884_138_0	4	3	Preferred Brand	000101	
S5884	138	0		29	10	S5884_138_0	4	4	Non-Preferred Brand	110000	
S5884	138	0		29	10	S5884_138_0	4	5	Specialty Tier	010010	
S5884	139	0		29	10	S5884_139_0	4	1	Preferred Generic	001010	
S5884	139	0		29	10	S5884_139_0	4	2	Non-Preferred Generic	000101	
S5884	139	0		29	10	S5884_139_0	4	4	Non-Preferred Brand	110000	
S5884	139	0		29	10	S5884_139_0	4	3	Preferred Brand	000101	
S5884	139	0		29	10	S5884_139_0	4	5	Specialty Tier	010010	
S5884	140	0		29	10	S5884_140_0	4	1	Preferred Generic	001010	
S5884	140	0		29	10	S5884_140_0	4	5	Specialty Tier	010010	
S5884	140	0		29	10	S5884_140_0	4	4	Non-Preferred Brand	110000	
S5884	140	0		29	10	S5884_140_0	4	3	Preferred Brand	000101	
S5884	140	0		29	10	S5884_140_0	4	2	Non-Preferred Generic	000101	
S5884	141	0		29	10	S5884_141_0	4	4	Non-Preferred Brand	110000	
S5884	141	0		29	10	S5884_141_0	4	5	Specialty Tier	010010	
S5884	141	0		29	10	S5884_141_0	4	3	Preferred Brand	000101	
S5884	141	0		29	10	S5884_141_0	4	2	Non-Preferred Generic	000101	
S5884	141	0		29	10	S5884_141_0	4	1	Preferred Generic	001010	
S5884	142	0		29	10	S5884_142_0	4	3	Preferred Brand	000101	
S5884	142	0		29	10	S5884_142_0	4	4	Non-Preferred Brand	110000	
S5884	142	0		29	10	S5884_142_0	4	1	Preferred Generic	001010	
S5884	142	0		29	10	S5884_142_0	4	5	Specialty Tier	010010	
S5884	142	0		29	10	S5884_142_0	4	2	Non-Preferred Generic	000101	
S5884	143	0		29	10	S5884_143_0	4	2	Non-Preferred Generic	000101	
S5884	143	0		29	10	S5884_143_0	4	4	Non-Preferred Brand	110000	
S5884	143	0		29	10	S5884_143_0	4	5	Specialty Tier	010010	
S5884	143	0		29	10	S5884_143_0	4	1	Preferred Generic	001010	
S5884	143	0		29	10	S5884_143_0	4	3	Preferred Brand	000101	
S5884	144	0		29	10	S5884_144_0	4	1	Preferred Generic	001010	
S5884	144	0		29	10	S5884_144_0	4	5	Specialty Tier	010010	
S5884	144	0		29	10	S5884_144_0	4	4	Non-Preferred Brand	110000	
S5884	144	0		29	10	S5884_144_0	4	3	Preferred Brand	000101	
S5884	144	0		29	10	S5884_144_0	4	2	Non-Preferred Generic	000101	
S5884	145	0		29	10	S5884_145_0	4	2	Non-Preferred Generic	000101	
S5884	145	0		29	10	S5884_145_0	4	3	Preferred Brand	000101	
S5884	145	0		29	10	S5884_145_0	4	4	Non-Preferred Brand	110000	
S5884	145	0		29	10	S5884_145_0	4	5	Specialty Tier	010010	
S5884	145	0		29	10	S5884_145_0	4	1	Preferred Generic	001010	
S5884	146	0		29	10	S5884_146_0	4	2	Non-Preferred Generic	000101	
S5884	146	0		29	10	S5884_146_0	4	4	Non-Preferred Brand	110000	
S5884	146	0		29	10	S5884_146_0	4	5	Specialty Tier	010010	
S5884	146	0		29	10	S5884_146_0	4	1	Preferred Generic	001010	
S5884	146	0		29	10	S5884_146_0	4	3	Preferred Brand	000101	
S5884	147	0		29	10	S5884_147_0	4	1	Preferred Generic	001010	
S5884	147	0		29	10	S5884_147_0	4	2	Non-Preferred Generic	000101	
S5884	147	0		29	10	S5884_147_0	4	3	Preferred Brand	000101	
S5884	147	0		29	10	S5884_147_0	4	4	Non-Preferred Brand	110000	
S5884	147	0		29	10	S5884_147_0	4	5	Specialty Tier	010010	
S5884	148	0		29	10	S5884_148_0	3	2	Non-Preferred Generic	000101	
S5884	148	0		29	10	S5884_148_0	3	1	Preferred Generic	001010	
S5884	148	0		29	10	S5884_148_0	3	3	Preferred Brand	000101	
S5884	148	0		29	10	S5884_148_0	3	4	Non-Preferred Brand	110000	
S5884	148	0		29	10	S5884_148_0	3	5	Specialty Tier	010010	
S5884	149	0		29	10	S5884_149_0	4	4	Non-Preferred Brand	110000	
S5884	149	0		29	10	S5884_149_0	4	3	Preferred Brand	000101	
S5884	149	0		29	10	S5884_149_0	4	2	Non-Preferred Generic	000101	
S5884	149	0		29	10	S5884_149_0	4	5	Specialty Tier	010010	
S5884	149	0		29	10	S5884_149_0	4	1	Preferred Generic	001010	
S5884	150	0		29	10	S5884_150_0	3	4	Non-Preferred Brand	110000	
S5884	150	0		29	10	S5884_150_0	3	5	Specialty Tier	010010	
S5884	150	0		29	10	S5884_150_0	3	3	Preferred Brand	000101	
S5884	150	0		29	10	S5884_150_0	3	2	Non-Preferred Generic	000101	
S5884	150	0		29	10	S5884_150_0	3	1	Preferred Generic	001010	
S5884	151	0		29	10	S5884_151_0	3	2	Non-Preferred Generic	000101	
S5884	151	0		29	10	S5884_151_0	3	3	Preferred Brand	000101	
S5884	151	0		29	10	S5884_151_0	3	4	Non-Preferred Brand	110000	
S5884	151	0		29	10	S5884_151_0	3	5	Specialty Tier	010010	
S5884	151	0		29	10	S5884_151_0	3	1	Preferred Generic	001010	
S5884	152	0		29	10	S5884_152_0	3	4	Non-Preferred Brand	110000	
S5884	152	0		29	10	S5884_152_0	3	5	Specialty Tier	010010	
S5884	152	0		29	10	S5884_152_0	3	3	Preferred Brand	000101	
S5884	152	0		29	10	S5884_152_0	3	1	Preferred Generic	001010	
S5884	152	0		29	10	S5884_152_0	3	2	Non-Preferred Generic	000101	
S5884	153	0		29	10	S5884_153_0	3	5	Specialty Tier	010010	
S5884	153	0		29	10	S5884_153_0	3	4	Non-Preferred Brand	110000	
S5884	153	0		29	10	S5884_153_0	3	3	Preferred Brand	000101	
S5884	153	0		29	10	S5884_153_0	3	2	Non-Preferred Generic	000101	
S5884	153	0		29	10	S5884_153_0	3	1	Preferred Generic	001010	
S5884	154	0		29	10	S5884_154_0	3	4	Non-Preferred Brand	110000	
S5884	154	0		29	10	S5884_154_0	3	5	Specialty Tier	010010	
S5884	154	0		29	10	S5884_154_0	3	3	Preferred Brand	000101	
S5884	154	0		29	10	S5884_154_0	3	2	Non-Preferred Generic	000101	
S5884	154	0		29	10	S5884_154_0	3	1	Preferred Generic	001010	
S5884	155	0		29	10	S5884_155_0	3	5	Specialty Tier	010010	
S5884	155	0		29	10	S5884_155_0	3	4	Non-Preferred Brand	110000	
S5884	155	0		29	10	S5884_155_0	3	3	Preferred Brand	000101	
S5884	155	0		29	10	S5884_155_0	3	2	Non-Preferred Generic	000101	
S5884	155	0		29	10	S5884_155_0	3	1	Preferred Generic	001010	
S5884	156	0		29	10	S5884_156_0	3	5	Specialty Tier	010010	
S5884	156	0		29	10	S5884_156_0	3	1	Preferred Generic	001010	
S5884	156	0		29	10	S5884_156_0	3	3	Preferred Brand	000101	
S5884	156	0		29	10	S5884_156_0	3	4	Non-Preferred Brand	110000	
S5884	156	0		29	10	S5884_156_0	3	2	Non-Preferred Generic	000101	
S5884	157	0		29	10	S5884_157_0	3	2	Non-Preferred Generic	000101	
S5884	157	0		29	10	S5884_157_0	3	4	Non-Preferred Brand	110000	
S5884	157	0		29	10	S5884_157_0	3	1	Preferred Generic	001010	
S5884	157	0		29	10	S5884_157_0	3	3	Preferred Brand	000101	
S5884	157	0		29	10	S5884_157_0	3	5	Specialty Tier	010010	
S5884	158	0		29	10	S5884_158_0	3	2	Non-Preferred Generic	000101	
S5884	158	0		29	10	S5884_158_0	3	1	Preferred Generic	001010	
S5884	158	0		29	10	S5884_158_0	3	5	Specialty Tier	010010	
S5884	158	0		29	10	S5884_158_0	3	4	Non-Preferred Brand	110000	
S5884	158	0		29	10	S5884_158_0	3	3	Preferred Brand	000101	
S5884	159	0		29	10	S5884_159_0	3	1	Preferred Generic	001010	
S5884	159	0		29	10	S5884_159_0	3	2	Non-Preferred Generic	000101	
S5884	159	0		29	10	S5884_159_0	3	5	Specialty Tier	010010	
S5884	159	0		29	10	S5884_159_0	3	4	Non-Preferred Brand	110000	
S5884	159	0		29	10	S5884_159_0	3	3	Preferred Brand	000101	
S5884	160	0		29	10	S5884_160_0	3	1	Preferred Generic	001010	
S5884	160	0		29	10	S5884_160_0	3	2	Non-Preferred Generic	000101	
S5884	160	0		29	10	S5884_160_0	3	3	Preferred Brand	000101	
S5884	160	0		29	10	S5884_160_0	3	4	Non-Preferred Brand	110000	
S5884	160	0		29	10	S5884_160_0	3	5	Specialty Tier	010010	
S5884	161	0		29	10	S5884_161_0	3	4	Non-Preferred Brand	110000	
S5884	161	0		29	10	S5884_161_0	3	3	Preferred Brand	000101	
S5884	161	0		29	10	S5884_161_0	3	1	Preferred Generic	001010	
S5884	161	0		29	10	S5884_161_0	3	2	Non-Preferred Generic	000101	
S5884	161	0		29	10	S5884_161_0	3	5	Specialty Tier	010010	
S5884	162	0		29	10	S5884_162_0	3	4	Non-Preferred Brand	110000	
S5884	162	0		29	10	S5884_162_0	3	3	Preferred Brand	000101	
S5884	162	0		29	10	S5884_162_0	3	2	Non-Preferred Generic	000101	
S5884	162	0		29	10	S5884_162_0	3	1	Preferred Generic	001010	
S5884	162	0		29	10	S5884_162_0	3	5	Specialty Tier	010010	
S5884	163	0		29	10	S5884_163_0	3	1	Preferred Generic	001010	
S5884	163	0		29	10	S5884_163_0	3	2	Non-Preferred Generic	000101	
S5884	163	0		29	10	S5884_163_0	3	3	Preferred Brand	000101	
S5884	163	0		29	10	S5884_163_0	3	4	Non-Preferred Brand	110000	
S5884	163	0		29	10	S5884_163_0	3	5	Specialty Tier	010010	
S5884	164	0		29	10	S5884_164_0	3	1	Preferred Generic	001010	
S5884	164	0		29	10	S5884_164_0	3	2	Non-Preferred Generic	000101	
S5884	164	0		29	10	S5884_164_0	3	3	Preferred Brand	000101	
S5884	164	0		29	10	S5884_164_0	3	4	Non-Preferred Brand	110000	
S5884	164	0		29	10	S5884_164_0	3	5	Specialty Tier	010010	
S5884	165	0		29	10	S5884_165_0	3	2	Non-Preferred Generic	000101	
S5884	165	0		29	10	S5884_165_0	3	1	Preferred Generic	001010	
S5884	165	0		29	10	S5884_165_0	3	3	Preferred Brand	000101	
S5884	165	0		29	10	S5884_165_0	3	5	Specialty Tier	010010	
S5884	165	0		29	10	S5884_165_0	3	4	Non-Preferred Brand	110000	
S5884	166	0		29	10	S5884_166_0	3	4	Non-Preferred Brand	110000	
S5884	166	0		29	10	S5884_166_0	3	3	Preferred Brand	000101	
S5884	166	0		29	10	S5884_166_0	3	2	Non-Preferred Generic	000101	
S5884	166	0		29	10	S5884_166_0	3	1	Preferred Generic	001010	
S5884	166	0		29	10	S5884_166_0	3	5	Specialty Tier	010010	
S5884	167	0		29	10	S5884_167_0	3	4	Non-Preferred Brand	110000	
S5884	167	0		29	10	S5884_167_0	3	3	Preferred Brand	000101	
S5884	167	0		29	10	S5884_167_0	3	2	Non-Preferred Generic	000101	
S5884	167	0		29	10	S5884_167_0	3	1	Preferred Generic	001010	
S5884	167	0		29	10	S5884_167_0	3	5	Specialty Tier	010010	
S5884	168	0		29	10	S5884_168_0	3	1	Preferred Generic	001010	
S5884	168	0		29	10	S5884_168_0	3	2	Non-Preferred Generic	000101	
S5884	168	0		29	10	S5884_168_0	3	3	Preferred Brand	000101	
S5884	168	0		29	10	S5884_168_0	3	4	Non-Preferred Brand	110000	
S5884	168	0		29	10	S5884_168_0	3	5	Specialty Tier	010010	
S5884	169	0		29	10	S5884_169_0	3	1	Preferred Generic	001010	
S5884	169	0		29	10	S5884_169_0	3	2	Non-Preferred Generic	000101	
S5884	169	0		29	10	S5884_169_0	3	4	Non-Preferred Brand	110000	
S5884	169	0		29	10	S5884_169_0	3	3	Preferred Brand	000101	
S5884	169	0		29	10	S5884_169_0	3	5	Specialty Tier	010010	
S5884	170	0		29	10	S5884_170_0	3	2	Non-Preferred Generic	000101	
S5884	170	0		29	10	S5884_170_0	3	3	Preferred Brand	000101	
S5884	170	0		29	10	S5884_170_0	3	4	Non-Preferred Brand	110000	
S5884	170	0		29	10	S5884_170_0	3	5	Specialty Tier	010010	
S5884	170	0		29	10	S5884_170_0	3	1	Preferred Generic	001010	
S5884	171	0		29	10	S5884_171_0	3	5	Specialty Tier	010010	
S5884	171	0		29	10	S5884_171_0	3	2	Non-Preferred Generic	000101	
S5884	171	0		29	10	S5884_171_0	3	3	Preferred Brand	000101	
S5884	171	0		29	10	S5884_171_0	3	4	Non-Preferred Brand	110000	
S5884	171	0		29	10	S5884_171_0	3	1	Preferred Generic	001010	
S5884	172	0		29	10	S5884_172_0	3	1	Preferred Generic	001010	
S5884	172	0		29	10	S5884_172_0	3	5	Specialty Tier	010010	
S5884	172	0		29	10	S5884_172_0	3	4	Non-Preferred Brand	110000	
S5884	172	0		29	10	S5884_172_0	3	2	Non-Preferred Generic	000101	
S5884	172	0		29	10	S5884_172_0	3	3	Preferred Brand	000101	
S5884	173	0		29	10	S5884_173_0	3	2	Non-Preferred Generic	000101	
S5884	173	0		29	10	S5884_173_0	3	1	Preferred Generic	001010	
S5884	173	0		29	10	S5884_173_0	3	3	Preferred Brand	000101	
S5884	173	0		29	10	S5884_173_0	3	4	Non-Preferred Brand	110000	
S5884	173	0		29	10	S5884_173_0	3	5	Specialty Tier	010010	
S5884	174	0		29	10	S5884_174_0	3	4	Non-Preferred Brand	110000	
S5884	174	0		29	10	S5884_174_0	3	5	Specialty Tier	010010	
S5884	174	0		29	10	S5884_174_0	3	1	Preferred Generic	001010	
S5884	174	0		29	10	S5884_174_0	3	2	Non-Preferred Generic	000101	
S5884	174	0		29	10	S5884_174_0	3	3	Preferred Brand	000101	
S5884	175	0		29	10	S5884_175_0	3	5	Specialty Tier	010010	
S5884	175	0		29	10	S5884_175_0	3	1	Preferred Generic	001010	
S5884	175	0		29	10	S5884_175_0	3	2	Non-Preferred Generic	000101	
S5884	175	0		29	10	S5884_175_0	3	3	Preferred Brand	000101	
S5884	175	0		29	10	S5884_175_0	3	4	Non-Preferred Brand	110000	
S5884	176	0		29	10	S5884_176_0	3	1	Preferred Generic	001010	
S5884	176	0		29	10	S5884_176_0	3	2	Non-Preferred Generic	000101	
S5884	176	0		29	10	S5884_176_0	3	3	Preferred Brand	000101	
S5884	176	0		29	10	S5884_176_0	3	4	Non-Preferred Brand	110000	
S5884	176	0		29	10	S5884_176_0	3	5	Specialty Tier	010010	
S5884	177	0		29	10	S5884_177_0	3	5	Specialty Tier	010010	
S5884	177	0		29	10	S5884_177_0	3	3	Preferred Brand	000101	
S5884	177	0		29	10	S5884_177_0	3	2	Non-Preferred Generic	000101	
S5884	177	0		29	10	S5884_177_0	3	1	Preferred Generic	001010	
S5884	177	0		29	10	S5884_177_0	3	4	Non-Preferred Brand	110000	
S5884	178	0		29	10	S5884_178_0	3	5	Specialty Tier	010010	
S5884	178	0		29	10	S5884_178_0	3	4	Non-Preferred Brand	110000	
S5884	178	0		29	10	S5884_178_0	3	3	Preferred Brand	000101	
S5884	178	0		29	10	S5884_178_0	3	2	Non-Preferred Generic	000101	
S5884	178	0		29	10	S5884_178_0	3	1	Preferred Generic	001010	
S5884	179	0		29	10	S5884_179_0	3	3	Preferred Brand	000101	
S5884	179	0		29	10	S5884_179_0	3	5	Specialty Tier	010010	
S5884	179	0		29	10	S5884_179_0	3	4	Non-Preferred Brand	110000	
S5884	179	0		29	10	S5884_179_0	3	1	Preferred Generic	001010	
S5884	179	0		29	10	S5884_179_0	3	2	Non-Preferred Generic	000101	
S5884	180	0		29	10	S5884_180_0	3	4	Non-Preferred Brand	110000	
S5884	180	0		29	10	S5884_180_0	3	3	Preferred Brand	000101	
S5884	180	0		29	10	S5884_180_0	3	2	Non-Preferred Generic	000101	
S5884	180	0		29	10	S5884_180_0	3	1	Preferred Generic	001010	
S5884	180	0		29	10	S5884_180_0	3	5	Specialty Tier	010010	
S5904	001	0		29	10	S5904_001_0	8	5	Specialty Tier	101101	
S5904	001	0		29	10	S5904_001_0	8	4	Non-Preferred Brand	110000	
S5904	001	0		29	10	S5904_001_0	8	3	Preferred Brand	000001	
S5904	001	0		29	10	S5904_001_0	8	2	Non-Preferred Generic	000100	
S5904	001	0		29	10	S5904_001_0	8	1	Preferred Generic	001000	
S5904	002	0		29	10	S5904_002_0	5	2	Non-Preferred Generic	000100	1
S5904	002	0		29	10	S5904_002_0	5	5	Specialty Tier	101101	2
S5904	002	0		29	10	S5904_002_0	5	1	Preferred Generic	001000	1
S5904	002	0		29	10	S5904_002_0	5	5	Specialty Tier	101101	
S5904	002	0		29	10	S5904_002_0	5	4	Non-Preferred Brand	110000	
S5904	002	0		29	10	S5904_002_0	5	3	Preferred Brand	000001	
S5904	002	0		29	10	S5904_002_0	5	2	Non-Preferred Generic	000100	
S5904	002	0		29	10	S5904_002_0	5	1	Preferred Generic	001000	
S5907	001	0		29	10	S5907_001_0	10	5	Specialty Tier	100100	
S5907	001	0		29	10	S5907_001_0	10	1	Preferred Generic	001000	
S5907	001	0		29	10	S5907_001_0	10	2	Non-Preferred Generic	000100	
S5907	001	0		29	10	S5907_001_0	10	3	Preferred Brand	000001	
S5907	001	0		29	10	S5907_001_0	10	4	Non-Preferred Brand	100000	
S5907	002	0		29	10	S5907_002_0	9	1	Preferred Generic	001000	1
S5907	002	0		29	10	S5907_002_0	9	2	Non-Preferred Generic	000100	1
S5907	002	0		29	10	S5907_002_0	9	5	Specialty Tier	100100	
S5907	002	0		29	10	S5907_002_0	9	1	Preferred Generic	001000	
S5907	002	0		29	10	S5907_002_0	9	2	Non-Preferred Generic	000100	
S5907	002	0		29	10	S5907_002_0	9	3	Preferred Brand	000001	
S5907	002	0		29	10	S5907_002_0	9	4	Non-Preferred Brand	100000	
S5916	001	0		29	10	S5916_001_0	4	5	Specialty Tier	010010	
S5916	001	0		29	10	S5916_001_0	4	4	Non-Preferred Brand	100000	
S5916	001	0		29	10	S5916_001_0	4	3	Preferred Brand	000001	
S5916	001	0		29	10	S5916_001_0	4	2	Non-Preferred Generic	000100	
S5916	001	0		29	10	S5916_001_0	4	1	Preferred Generic	001000	
S5916	002	0		29	10	S5916_002_0	4	5	Specialty Tier	010010	
S5916	002	0		29	10	S5916_002_0	4	4	Non-Preferred Brand	100000	
S5916	002	0		29	10	S5916_002_0	4	3	Preferred Brand	000001	
S5916	002	0		29	10	S5916_002_0	4	2	Non-Preferred Generic	000100	
S5916	002	0		29	10	S5916_002_0	4	1	Preferred Generic	001000	1
S5916	002	0		29	10	S5916_002_0	4	1	Preferred Generic	001000	
S5921	003	0		29	10	S5921_003_0	4	3	Preferred Brand	010001	
S5921	003	0		29	10	S5921_003_0	4	4	Non-Preferred Brand	100100	
S5921	003	0		29	10	S5921_003_0	4	1	Preferred Generic	001000	
S5921	003	0		29	10	S5921_003_0	4	2	Non-Preferred Generic	000100	
S5921	003	0		29	10	S5921_003_0	4	2	Non-Preferred Generic	000100	1
S5921	003	0		29	10	S5921_003_0	4	1	Preferred Generic	001000	1
S5921	003	0		29	10	S5921_003_0	4	5	Specialty Tier	010010	
S5921	003	0		29	10	S5921_003_0	4	3	Preferred Brand	010001	2
S5921	003	0		29	10	S5921_003_0	4	4	Non-Preferred Brand	100100	2
S5921	003	0		29	10	S5921_003_0	4	5	Specialty Tier	010010	2
S5921	013	0		29	10	S5921_013_0	4	5	Specialty Tier	010010	
S5921	013	0		29	10	S5921_013_0	4	1	Preferred Generic	001000	1
S5921	013	0		29	10	S5921_013_0	4	2	Non-Preferred Generic	000100	1
S5921	013	0		29	10	S5921_013_0	4	4	Non-Preferred Brand	100100	
S5921	013	0		29	10	S5921_013_0	4	2	Non-Preferred Generic	000100	
S5921	013	0		29	10	S5921_013_0	4	5	Specialty Tier	010010	2
S5921	013	0		29	10	S5921_013_0	4	4	Non-Preferred Brand	100100	2
S5921	013	0		29	10	S5921_013_0	4	3	Preferred Brand	010001	2
S5921	013	0		29	10	S5921_013_0	4	1	Preferred Generic	001000	
S5921	013	0		29	10	S5921_013_0	4	3	Preferred Brand	010001	
S5921	023	0		29	10	S5921_023_0	4	4	Non-Preferred Brand	100100	2
S5921	023	0		29	10	S5921_023_0	4	3	Preferred Brand	010001	2
S5921	023	0		29	10	S5921_023_0	4	2	Non-Preferred Generic	000100	1
S5921	023	0		29	10	S5921_023_0	4	1	Preferred Generic	001000	1
S5921	023	0		29	10	S5921_023_0	4	5	Specialty Tier	010010	
S5921	023	0		29	10	S5921_023_0	4	3	Preferred Brand	010001	
S5921	023	0		29	10	S5921_023_0	4	2	Non-Preferred Generic	000100	
S5921	023	0		29	10	S5921_023_0	4	1	Preferred Generic	001000	
S5921	023	0		29	10	S5921_023_0	4	4	Non-Preferred Brand	100100	
S5921	023	0		29	10	S5921_023_0	4	5	Specialty Tier	010010	2
S5921	033	0		29	10	S5921_033_0	4	1	Preferred Generic	001000	
S5921	033	0		29	10	S5921_033_0	4	2	Non-Preferred Generic	000100	
S5921	033	0		29	10	S5921_033_0	4	3	Preferred Brand	010001	
S5921	033	0		29	10	S5921_033_0	4	4	Non-Preferred Brand	100100	
S5921	033	0		29	10	S5921_033_0	4	5	Specialty Tier	010010	2
S5921	033	0		29	10	S5921_033_0	4	1	Preferred Generic	001000	1
S5921	033	0		29	10	S5921_033_0	4	2	Non-Preferred Generic	000100	1
S5921	033	0		29	10	S5921_033_0	4	3	Preferred Brand	010001	2
S5921	033	0		29	10	S5921_033_0	4	4	Non-Preferred Brand	100100	2
S5921	033	0		29	10	S5921_033_0	4	5	Specialty Tier	010010	
S5921	043	0		29	10	S5921_043_0	4	1	Preferred Generic	001000	
S5921	043	0		29	10	S5921_043_0	4	2	Non-Preferred Generic	000100	
S5921	043	0		29	10	S5921_043_0	4	3	Preferred Brand	010001	
S5921	043	0		29	10	S5921_043_0	4	4	Non-Preferred Brand	100100	
S5921	043	0		29	10	S5921_043_0	4	5	Specialty Tier	010010	
S5921	043	0		29	10	S5921_043_0	4	1	Preferred Generic	001000	1
S5921	043	0		29	10	S5921_043_0	4	2	Non-Preferred Generic	000100	1
S5921	043	0		29	10	S5921_043_0	4	3	Preferred Brand	010001	2
S5921	043	0		29	10	S5921_043_0	4	4	Non-Preferred Brand	100100	2
S5921	043	0		29	10	S5921_043_0	4	5	Specialty Tier	010010	2
S5921	053	0		29	10	S5921_053_0	4	4	Non-Preferred Brand	100100	
S5921	053	0		29	10	S5921_053_0	4	1	Preferred Generic	001000	1
S5921	053	0		29	10	S5921_053_0	4	2	Non-Preferred Generic	000100	
S5921	053	0		29	10	S5921_053_0	4	1	Preferred Generic	001000	
S5921	053	0		29	10	S5921_053_0	4	3	Preferred Brand	010001	
S5921	053	0		29	10	S5921_053_0	4	2	Non-Preferred Generic	000100	1
S5921	053	0		29	10	S5921_053_0	4	3	Preferred Brand	010001	2
S5921	053	0		29	10	S5921_053_0	4	4	Non-Preferred Brand	100100	2
S5921	053	0		29	10	S5921_053_0	4	5	Specialty Tier	010010	2
S5921	053	0		29	10	S5921_053_0	4	5	Specialty Tier	010010	
S5921	063	0		29	10	S5921_063_0	4	5	Specialty Tier	010010	
S5921	063	0		29	10	S5921_063_0	4	4	Non-Preferred Brand	100100	
S5921	063	0		29	10	S5921_063_0	4	3	Preferred Brand	010001	
S5921	063	0		29	10	S5921_063_0	4	2	Non-Preferred Generic	000100	
S5921	063	0		29	10	S5921_063_0	4	2	Non-Preferred Generic	000100	1
S5921	063	0		29	10	S5921_063_0	4	1	Preferred Generic	001000	
S5921	063	0		29	10	S5921_063_0	4	4	Non-Preferred Brand	100100	2
S5921	063	0		29	10	S5921_063_0	4	5	Specialty Tier	010010	2
S5921	063	0		29	10	S5921_063_0	4	3	Preferred Brand	010001	2
S5921	063	0		29	10	S5921_063_0	4	1	Preferred Generic	001000	1
S5921	073	0		29	10	S5921_073_0	4	2	Non-Preferred Generic	000100	
S5921	073	0		29	10	S5921_073_0	4	1	Preferred Generic	001000	
S5921	073	0		29	10	S5921_073_0	4	5	Specialty Tier	010010	2
S5921	073	0		29	10	S5921_073_0	4	4	Non-Preferred Brand	100100	2
S5921	073	0		29	10	S5921_073_0	4	3	Preferred Brand	010001	2
S5921	073	0		29	10	S5921_073_0	4	2	Non-Preferred Generic	000100	1
S5921	073	0		29	10	S5921_073_0	4	1	Preferred Generic	001000	1
S5921	073	0		29	10	S5921_073_0	4	5	Specialty Tier	010010	
S5921	073	0		29	10	S5921_073_0	4	3	Preferred Brand	010001	
S5921	073	0		29	10	S5921_073_0	4	4	Non-Preferred Brand	100100	
S5921	083	0		29	10	S5921_083_0	4	4	Non-Preferred Brand	100100	
S5921	083	0		29	10	S5921_083_0	4	5	Specialty Tier	010010	
S5921	083	0		29	10	S5921_083_0	4	1	Preferred Generic	001000	1
S5921	083	0		29	10	S5921_083_0	4	2	Non-Preferred Generic	000100	1
S5921	083	0		29	10	S5921_083_0	4	3	Preferred Brand	010001	
S5921	083	0		29	10	S5921_083_0	4	4	Non-Preferred Brand	100100	2
S5921	083	0		29	10	S5921_083_0	4	5	Specialty Tier	010010	2
S5921	083	0		29	10	S5921_083_0	4	1	Preferred Generic	001000	
S5921	083	0		29	10	S5921_083_0	4	2	Non-Preferred Generic	000100	
S5921	083	0		29	10	S5921_083_0	4	3	Preferred Brand	010001	2
S5921	093	0		29	10	S5921_093_0	4	4	Non-Preferred Brand	100100	2
S5921	093	0		29	10	S5921_093_0	4	3	Preferred Brand	010001	2
S5921	093	0		29	10	S5921_093_0	4	2	Non-Preferred Generic	000100	1
S5921	093	0		29	10	S5921_093_0	4	1	Preferred Generic	001000	1
S5921	093	0		29	10	S5921_093_0	4	5	Specialty Tier	010010	
S5921	093	0		29	10	S5921_093_0	4	4	Non-Preferred Brand	100100	
S5921	093	0		29	10	S5921_093_0	4	5	Specialty Tier	010010	2
S5921	093	0		29	10	S5921_093_0	4	3	Preferred Brand	010001	
S5921	093	0		29	10	S5921_093_0	4	2	Non-Preferred Generic	000100	
S5921	093	0		29	10	S5921_093_0	4	1	Preferred Generic	001000	
S5921	103	0		29	10	S5921_103_0	4	5	Specialty Tier	010010	
S5921	103	0		29	10	S5921_103_0	4	4	Non-Preferred Brand	100100	
S5921	103	0		29	10	S5921_103_0	4	3	Preferred Brand	010001	
S5921	103	0		29	10	S5921_103_0	4	2	Non-Preferred Generic	000100	
S5921	103	0		29	10	S5921_103_0	4	1	Preferred Generic	001000	1
S5921	103	0		29	10	S5921_103_0	4	5	Specialty Tier	010010	2
S5921	103	0		29	10	S5921_103_0	4	4	Non-Preferred Brand	100100	2
S5921	103	0		29	10	S5921_103_0	4	3	Preferred Brand	010001	2
S5921	103	0		29	10	S5921_103_0	4	2	Non-Preferred Generic	000100	1
S5921	103	0		29	10	S5921_103_0	4	1	Preferred Generic	001000	
S5921	113	0		29	10	S5921_113_0	4	1	Preferred Generic	001000	
S5921	113	0		29	10	S5921_113_0	4	5	Specialty Tier	010010	2
S5921	113	0		29	10	S5921_113_0	4	4	Non-Preferred Brand	100100	2
S5921	113	0		29	10	S5921_113_0	4	3	Preferred Brand	010001	2
S5921	113	0		29	10	S5921_113_0	4	2	Non-Preferred Generic	000100	1
S5921	113	0		29	10	S5921_113_0	4	1	Preferred Generic	001000	1
S5921	113	0		29	10	S5921_113_0	4	5	Specialty Tier	010010	
S5921	113	0		29	10	S5921_113_0	4	4	Non-Preferred Brand	100100	
S5921	113	0		29	10	S5921_113_0	4	3	Preferred Brand	010001	
S5921	113	0		29	10	S5921_113_0	4	2	Non-Preferred Generic	000100	
S5921	123	0		29	10	S5921_123_0	4	1	Preferred Generic	001000	
S5921	123	0		29	10	S5921_123_0	4	5	Specialty Tier	010010	
S5921	123	0		29	10	S5921_123_0	4	4	Non-Preferred Brand	100100	
S5921	123	0		29	10	S5921_123_0	4	3	Preferred Brand	010001	
S5921	123	0		29	10	S5921_123_0	4	2	Non-Preferred Generic	000100	1
S5921	123	0		29	10	S5921_123_0	4	1	Preferred Generic	001000	1
S5921	123	0		29	10	S5921_123_0	4	5	Specialty Tier	010010	2
S5921	123	0		29	10	S5921_123_0	4	4	Non-Preferred Brand	100100	2
S5921	123	0		29	10	S5921_123_0	4	3	Preferred Brand	010001	2
S5921	123	0		29	10	S5921_123_0	4	2	Non-Preferred Generic	000100	
S5921	133	0		29	10	S5921_133_0	4	4	Non-Preferred Brand	100100	2
S5921	133	0		29	10	S5921_133_0	4	3	Preferred Brand	010001	2
S5921	133	0		29	10	S5921_133_0	4	2	Non-Preferred Generic	000100	1
S5921	133	0		29	10	S5921_133_0	4	2	Non-Preferred Generic	000100	
S5921	133	0		29	10	S5921_133_0	4	1	Preferred Generic	001000	
S5921	133	0		29	10	S5921_133_0	4	1	Preferred Generic	001000	1
S5921	133	0		29	10	S5921_133_0	4	5	Specialty Tier	010010	
S5921	133	0		29	10	S5921_133_0	4	5	Specialty Tier	010010	2
S5921	133	0		29	10	S5921_133_0	4	3	Preferred Brand	010001	
S5921	133	0		29	10	S5921_133_0	4	4	Non-Preferred Brand	100100	
S5921	143	0		29	10	S5921_143_0	4	3	Preferred Brand	010001	2
S5921	143	0		29	10	S5921_143_0	4	4	Non-Preferred Brand	100100	2
S5921	143	0		29	10	S5921_143_0	4	5	Specialty Tier	010010	2
S5921	143	0		29	10	S5921_143_0	4	1	Preferred Generic	001000	
S5921	143	0		29	10	S5921_143_0	4	2	Non-Preferred Generic	000100	
S5921	143	0		29	10	S5921_143_0	4	3	Preferred Brand	010001	
S5921	143	0		29	10	S5921_143_0	4	4	Non-Preferred Brand	100100	
S5921	143	0		29	10	S5921_143_0	4	5	Specialty Tier	010010	
S5921	143	0		29	10	S5921_143_0	4	1	Preferred Generic	001000	1
S5921	143	0		29	10	S5921_143_0	4	2	Non-Preferred Generic	000100	1
S5921	153	0		29	10	S5921_153_0	4	2	Non-Preferred Generic	000100	
S5921	153	0		29	10	S5921_153_0	4	1	Preferred Generic	001000	
S5921	153	0		29	10	S5921_153_0	4	2	Non-Preferred Generic	000100	1
S5921	153	0		29	10	S5921_153_0	4	1	Preferred Generic	001000	1
S5921	153	0		29	10	S5921_153_0	4	5	Specialty Tier	010010	2
S5921	153	0		29	10	S5921_153_0	4	4	Non-Preferred Brand	100100	
S5921	153	0		29	10	S5921_153_0	4	3	Preferred Brand	010001	
S5921	153	0		29	10	S5921_153_0	4	4	Non-Preferred Brand	100100	2
S5921	153	0		29	10	S5921_153_0	4	3	Preferred Brand	010001	2
S5921	153	0		29	10	S5921_153_0	4	5	Specialty Tier	010010	
S5921	163	0		29	10	S5921_163_0	4	1	Preferred Generic	001000	
S5921	163	0		29	10	S5921_163_0	4	2	Non-Preferred Generic	000100	
S5921	163	0		29	10	S5921_163_0	4	3	Preferred Brand	010001	
S5921	163	0		29	10	S5921_163_0	4	4	Non-Preferred Brand	100100	
S5921	163	0		29	10	S5921_163_0	4	5	Specialty Tier	010010	
S5921	163	0		29	10	S5921_163_0	4	1	Preferred Generic	001000	1
S5921	163	0		29	10	S5921_163_0	4	2	Non-Preferred Generic	000100	1
S5921	163	0		29	10	S5921_163_0	4	3	Preferred Brand	010001	2
S5921	163	0		29	10	S5921_163_0	4	4	Non-Preferred Brand	100100	2
S5921	163	0		29	10	S5921_163_0	4	5	Specialty Tier	010010	2
S5921	173	0		29	10	S5921_173_0	4	5	Specialty Tier	010010	2
S5921	173	0		29	10	S5921_173_0	4	4	Non-Preferred Brand	100100	2
S5921	173	0		29	10	S5921_173_0	4	2	Non-Preferred Generic	000100	1
S5921	173	0		29	10	S5921_173_0	4	3	Preferred Brand	010001	2
S5921	173	0		29	10	S5921_173_0	4	1	Preferred Generic	001000	1
S5921	173	0		29	10	S5921_173_0	4	5	Specialty Tier	010010	
S5921	173	0		29	10	S5921_173_0	4	4	Non-Preferred Brand	100100	
S5921	173	0		29	10	S5921_173_0	4	3	Preferred Brand	010001	
S5921	173	0		29	10	S5921_173_0	4	2	Non-Preferred Generic	000100	
S5921	173	0		29	10	S5921_173_0	4	1	Preferred Generic	001000	
S5921	183	0		29	10	S5921_183_0	4	4	Non-Preferred Brand	100100	
S5921	183	0		29	10	S5921_183_0	4	5	Specialty Tier	010010	
S5921	183	0		29	10	S5921_183_0	4	1	Preferred Generic	001000	1
S5921	183	0		29	10	S5921_183_0	4	2	Non-Preferred Generic	000100	1
S5921	183	0		29	10	S5921_183_0	4	3	Preferred Brand	010001	
S5921	183	0		29	10	S5921_183_0	4	4	Non-Preferred Brand	100100	2
S5921	183	0		29	10	S5921_183_0	4	5	Specialty Tier	010010	2
S5921	183	0		29	10	S5921_183_0	4	1	Preferred Generic	001000	
S5921	183	0		29	10	S5921_183_0	4	2	Non-Preferred Generic	000100	
S5921	183	0		29	10	S5921_183_0	4	3	Preferred Brand	010001	2
S5921	193	0		29	10	S5921_193_0	4	5	Specialty Tier	010010	
S5921	193	0		29	10	S5921_193_0	4	1	Preferred Generic	001000	1
S5921	193	0		29	10	S5921_193_0	4	2	Non-Preferred Generic	000100	1
S5921	193	0		29	10	S5921_193_0	4	3	Preferred Brand	010001	2
S5921	193	0		29	10	S5921_193_0	4	4	Non-Preferred Brand	100100	2
S5921	193	0		29	10	S5921_193_0	4	5	Specialty Tier	010010	2
S5921	193	0		29	10	S5921_193_0	4	3	Preferred Brand	010001	
S5921	193	0		29	10	S5921_193_0	4	4	Non-Preferred Brand	100100	
S5921	193	0		29	10	S5921_193_0	4	2	Non-Preferred Generic	000100	
S5921	193	0		29	10	S5921_193_0	4	1	Preferred Generic	001000	
S5921	213	0		29	10	S5921_213_0	4	1	Preferred Generic	001000	
S5921	213	0		29	10	S5921_213_0	4	2	Non-Preferred Generic	000100	
S5921	213	0		29	10	S5921_213_0	4	3	Preferred Brand	010001	
S5921	213	0		29	10	S5921_213_0	4	4	Non-Preferred Brand	100100	
S5921	213	0		29	10	S5921_213_0	4	5	Specialty Tier	010010	2
S5921	213	0		29	10	S5921_213_0	4	1	Preferred Generic	001000	1
S5921	213	0		29	10	S5921_213_0	4	2	Non-Preferred Generic	000100	1
S5921	213	0		29	10	S5921_213_0	4	3	Preferred Brand	010001	2
S5921	213	0		29	10	S5921_213_0	4	4	Non-Preferred Brand	100100	2
S5921	213	0		29	10	S5921_213_0	4	5	Specialty Tier	010010	
S5921	223	0		29	10	S5921_223_0	4	1	Preferred Generic	001000	
S5921	223	0		29	10	S5921_223_0	4	2	Non-Preferred Generic	000100	
S5921	223	0		29	10	S5921_223_0	4	3	Preferred Brand	010001	
S5921	223	0		29	10	S5921_223_0	4	4	Non-Preferred Brand	100100	
S5921	223	0		29	10	S5921_223_0	4	5	Specialty Tier	010010	
S5921	223	0		29	10	S5921_223_0	4	1	Preferred Generic	001000	1
S5921	223	0		29	10	S5921_223_0	4	2	Non-Preferred Generic	000100	1
S5921	223	0		29	10	S5921_223_0	4	3	Preferred Brand	010001	2
S5921	223	0		29	10	S5921_223_0	4	4	Non-Preferred Brand	100100	2
S5921	223	0		29	10	S5921_223_0	4	5	Specialty Tier	010010	2
S5921	233	0		29	10	S5921_233_0	4	1	Preferred Generic	001000	1
S5921	233	0		29	10	S5921_233_0	4	5	Specialty Tier	010010	
S5921	233	0		29	10	S5921_233_0	4	4	Non-Preferred Brand	100100	
S5921	233	0		29	10	S5921_233_0	4	3	Preferred Brand	010001	
S5921	233	0		29	10	S5921_233_0	4	2	Non-Preferred Generic	000100	1
S5921	233	0		29	10	S5921_233_0	4	1	Preferred Generic	001000	
S5921	233	0		29	10	S5921_233_0	4	5	Specialty Tier	010010	2
S5921	233	0		29	10	S5921_233_0	4	4	Non-Preferred Brand	100100	2
S5921	233	0		29	10	S5921_233_0	4	3	Preferred Brand	010001	2
S5921	233	0		29	10	S5921_233_0	4	2	Non-Preferred Generic	000100	
S5921	235	0		29	10	S5921_235_0	4	2	Non-Preferred Generic	000100	
S5921	235	0		29	10	S5921_235_0	4	5	Specialty Tier	010010	2
S5921	235	0		29	10	S5921_235_0	4	4	Non-Preferred Brand	100100	2
S5921	235	0		29	10	S5921_235_0	4	3	Preferred Brand	010001	2
S5921	235	0		29	10	S5921_235_0	4	2	Non-Preferred Generic	000100	1
S5921	235	0		29	10	S5921_235_0	4	1	Preferred Generic	001000	1
S5921	235	0		29	10	S5921_235_0	4	5	Specialty Tier	010010	
S5921	235	0		29	10	S5921_235_0	4	4	Non-Preferred Brand	100100	
S5921	235	0		29	10	S5921_235_0	4	3	Preferred Brand	010001	
S5921	235	0		29	10	S5921_235_0	4	1	Preferred Generic	001000	
S5921	239	0		29	10	S5921_239_0	4	5	Specialty Tier	010010	2
S5921	239	0		29	10	S5921_239_0	4	2	Non-Preferred Generic	000100	
S5921	239	0		29	10	S5921_239_0	4	1	Preferred Generic	001000	
S5921	239	0		29	10	S5921_239_0	4	5	Specialty Tier	010010	
S5921	239	0		29	10	S5921_239_0	4	2	Non-Preferred Generic	000100	1
S5921	239	0		29	10	S5921_239_0	4	1	Preferred Generic	001000	1
S5921	239	0		29	10	S5921_239_0	4	3	Preferred Brand	010001	
S5921	239	0		29	10	S5921_239_0	4	4	Non-Preferred Brand	100100	2
S5921	239	0		29	10	S5921_239_0	4	3	Preferred Brand	010001	2
S5921	239	0		29	10	S5921_239_0	4	4	Non-Preferred Brand	100100	
S5921	249	0		29	10	S5921_249_0	4	5	Specialty Tier	010010	
S5921	249	0		29	10	S5921_249_0	4	4	Non-Preferred Brand	100100	
S5921	249	0		29	10	S5921_249_0	4	3	Preferred Brand	010001	
S5921	249	0		29	10	S5921_249_0	4	2	Non-Preferred Generic	000100	
S5921	249	0		29	10	S5921_249_0	4	1	Preferred Generic	001000	
S5921	249	0		29	10	S5921_249_0	4	5	Specialty Tier	010010	2
S5921	249	0		29	10	S5921_249_0	4	2	Non-Preferred Generic	000100	1
S5921	249	0		29	10	S5921_249_0	4	1	Preferred Generic	001000	1
S5921	249	0		29	10	S5921_249_0	4	4	Non-Preferred Brand	100100	2
S5921	249	0		29	10	S5921_249_0	4	3	Preferred Brand	010001	2
S5921	263	0		29	10	S5921_263_0	4	4	Non-Preferred Brand	100100	
S5921	263	0		29	10	S5921_263_0	4	3	Preferred Brand	010001	
S5921	263	0		29	10	S5921_263_0	4	1	Preferred Generic	001000	
S5921	263	0		29	10	S5921_263_0	4	2	Non-Preferred Generic	000100	
S5921	263	0		29	10	S5921_263_0	4	5	Specialty Tier	010010	2
S5921	263	0		29	10	S5921_263_0	4	4	Non-Preferred Brand	100100	2
S5921	263	0		29	10	S5921_263_0	4	3	Preferred Brand	010001	2
S5921	263	0		29	10	S5921_263_0	4	2	Non-Preferred Generic	000100	1
S5921	263	0		29	10	S5921_263_0	4	1	Preferred Generic	001000	1
S5921	263	0		29	10	S5921_263_0	4	5	Specialty Tier	010010	
S5921	273	0		29	10	S5921_273_0	4	1	Preferred Generic	001000	
S5921	273	0		29	10	S5921_273_0	4	2	Non-Preferred Generic	000100	
S5921	273	0		29	10	S5921_273_0	4	3	Preferred Brand	010001	
S5921	273	0		29	10	S5921_273_0	4	4	Non-Preferred Brand	100100	2
S5921	273	0		29	10	S5921_273_0	4	5	Specialty Tier	010010	2
S5921	273	0		29	10	S5921_273_0	4	2	Non-Preferred Generic	000100	1
S5921	273	0		29	10	S5921_273_0	4	1	Preferred Generic	001000	1
S5921	273	0		29	10	S5921_273_0	4	5	Specialty Tier	010010	
S5921	273	0		29	10	S5921_273_0	4	4	Non-Preferred Brand	100100	
S5921	273	0		29	10	S5921_273_0	4	3	Preferred Brand	010001	2
S5921	293	0		29	10	S5921_293_0	4	4	Non-Preferred Brand	100100	
S5921	293	0		29	10	S5921_293_0	4	5	Specialty Tier	010010	
S5921	293	0		29	10	S5921_293_0	4	1	Preferred Generic	001000	1
S5921	293	0		29	10	S5921_293_0	4	2	Non-Preferred Generic	000100	1
S5921	293	0		29	10	S5921_293_0	4	3	Preferred Brand	010001	2
S5921	293	0		29	10	S5921_293_0	4	4	Non-Preferred Brand	100100	2
S5921	293	0		29	10	S5921_293_0	4	5	Specialty Tier	010010	2
S5921	293	0		29	10	S5921_293_0	4	1	Preferred Generic	001000	
S5921	293	0		29	10	S5921_293_0	4	2	Non-Preferred Generic	000100	
S5921	293	0		29	10	S5921_293_0	4	3	Preferred Brand	010001	
S5921	303	0		29	10	S5921_303_0	4	5	Specialty Tier	010010	2
S5921	303	0		29	10	S5921_303_0	4	1	Preferred Generic	001000	1
S5921	303	0		29	10	S5921_303_0	4	5	Specialty Tier	010010	
S5921	303	0		29	10	S5921_303_0	4	4	Non-Preferred Brand	100100	
S5921	303	0		29	10	S5921_303_0	4	3	Preferred Brand	010001	
S5921	303	0		29	10	S5921_303_0	4	2	Non-Preferred Generic	000100	
S5921	303	0		29	10	S5921_303_0	4	1	Preferred Generic	001000	
S5921	303	0		29	10	S5921_303_0	4	3	Preferred Brand	010001	2
S5921	303	0		29	10	S5921_303_0	4	4	Non-Preferred Brand	100100	2
S5921	303	0		29	10	S5921_303_0	4	2	Non-Preferred Generic	000100	1
S5921	323	0		29	10	S5921_323_0	4	2	Non-Preferred Generic	000100	1
S5921	323	0		29	10	S5921_323_0	4	4	Non-Preferred Brand	100100	
S5921	323	0		29	10	S5921_323_0	4	3	Preferred Brand	010001	
S5921	323	0		29	10	S5921_323_0	4	2	Non-Preferred Generic	000100	
S5921	323	0		29	10	S5921_323_0	4	5	Specialty Tier	010010	
S5921	323	0		29	10	S5921_323_0	4	1	Preferred Generic	001000	1
S5921	323	0		29	10	S5921_323_0	4	1	Preferred Generic	001000	
S5921	323	0		29	10	S5921_323_0	4	3	Preferred Brand	010001	2
S5921	323	0		29	10	S5921_323_0	4	4	Non-Preferred Brand	100100	2
S5921	323	0		29	10	S5921_323_0	4	5	Specialty Tier	010010	2
S5921	333	0		29	10	S5921_333_0	4	2	Non-Preferred Generic	000100	1
S5921	333	0		29	10	S5921_333_0	4	4	Non-Preferred Brand	100100	2
S5921	333	0		29	10	S5921_333_0	4	5	Specialty Tier	010010	
S5921	333	0		29	10	S5921_333_0	4	4	Non-Preferred Brand	100100	
S5921	333	0		29	10	S5921_333_0	4	3	Preferred Brand	010001	
S5921	333	0		29	10	S5921_333_0	4	3	Preferred Brand	010001	2
S5921	333	0		29	10	S5921_333_0	4	1	Preferred Generic	001000	
S5921	333	0		29	10	S5921_333_0	4	2	Non-Preferred Generic	000100	
S5921	333	0		29	10	S5921_333_0	4	1	Preferred Generic	001000	1
S5921	333	0		29	10	S5921_333_0	4	5	Specialty Tier	010010	2
S5921	348	0		29	10	S5921_348_0	3	3	Preferred Brand	010001	
S5921	348	0		29	10	S5921_348_0	3	2	Non-Preferred Generic	000100	
S5921	348	0		29	10	S5921_348_0	3	1	Preferred Generic	001000	
S5921	348	0		29	10	S5921_348_0	3	4	Non-Preferred Brand	100100	
S5921	348	0		29	10	S5921_348_0	3	5	Specialty Tier	010010	
S5921	349	0		29	10	S5921_349_0	3	5	Specialty Tier	010010	
S5921	349	0		29	10	S5921_349_0	3	4	Non-Preferred Brand	100100	
S5921	349	0		29	10	S5921_349_0	3	3	Preferred Brand	010001	
S5921	349	0		29	10	S5921_349_0	3	2	Non-Preferred Generic	000100	
S5921	349	0		29	10	S5921_349_0	3	1	Preferred Generic	001000	
S5921	350	0		29	10	S5921_350_0	3	5	Specialty Tier	010010	
S5921	350	0		29	10	S5921_350_0	3	1	Preferred Generic	001000	
S5921	350	0		29	10	S5921_350_0	3	2	Non-Preferred Generic	000100	
S5921	350	0		29	10	S5921_350_0	3	3	Preferred Brand	010001	
S5921	350	0		29	10	S5921_350_0	3	4	Non-Preferred Brand	100100	
S5921	351	0		29	10	S5921_351_0	3	5	Specialty Tier	010010	
S5921	351	0		29	10	S5921_351_0	3	1	Preferred Generic	001000	
S5921	351	0		29	10	S5921_351_0	3	2	Non-Preferred Generic	000100	
S5921	351	0		29	10	S5921_351_0	3	3	Preferred Brand	010001	
S5921	351	0		29	10	S5921_351_0	3	4	Non-Preferred Brand	100100	
S5921	352	0		29	10	S5921_352_0	3	1	Preferred Generic	001000	
S5921	352	0		29	10	S5921_352_0	3	2	Non-Preferred Generic	000100	
S5921	352	0		29	10	S5921_352_0	3	3	Preferred Brand	010001	
S5921	352	0		29	10	S5921_352_0	3	4	Non-Preferred Brand	100100	
S5921	352	0		29	10	S5921_352_0	3	5	Specialty Tier	010010	
S5921	353	0		29	10	S5921_353_0	3	1	Preferred Generic	001000	
S5921	353	0		29	10	S5921_353_0	3	2	Non-Preferred Generic	000100	
S5921	353	0		29	10	S5921_353_0	3	3	Preferred Brand	010001	
S5921	353	0		29	10	S5921_353_0	3	4	Non-Preferred Brand	100100	
S5921	353	0		29	10	S5921_353_0	3	5	Specialty Tier	010010	
S5921	354	0		29	10	S5921_354_0	3	3	Preferred Brand	010001	
S5921	354	0		29	10	S5921_354_0	3	5	Specialty Tier	010010	
S5921	354	0		29	10	S5921_354_0	3	4	Non-Preferred Brand	100100	
S5921	354	0		29	10	S5921_354_0	3	2	Non-Preferred Generic	000100	
S5921	354	0		29	10	S5921_354_0	3	1	Preferred Generic	001000	
S5921	355	0		29	10	S5921_355_0	3	1	Preferred Generic	001000	
S5921	355	0		29	10	S5921_355_0	3	2	Non-Preferred Generic	000100	
S5921	355	0		29	10	S5921_355_0	3	3	Preferred Brand	010001	
S5921	355	0		29	10	S5921_355_0	3	4	Non-Preferred Brand	100100	
S5921	355	0		29	10	S5921_355_0	3	5	Specialty Tier	010010	
S5921	356	0		29	10	S5921_356_0	3	5	Specialty Tier	010010	
S5921	356	0		29	10	S5921_356_0	3	2	Non-Preferred Generic	000100	
S5921	356	0		29	10	S5921_356_0	3	3	Preferred Brand	010001	
S5921	356	0		29	10	S5921_356_0	3	1	Preferred Generic	001000	
S5921	356	0		29	10	S5921_356_0	3	4	Non-Preferred Brand	100100	
S5921	357	0		29	10	S5921_357_0	3	3	Preferred Brand	010001	
S5921	357	0		29	10	S5921_357_0	3	5	Specialty Tier	010010	
S5921	357	0		29	10	S5921_357_0	3	2	Non-Preferred Generic	000100	
S5921	357	0		29	10	S5921_357_0	3	1	Preferred Generic	001000	
S5921	357	0		29	10	S5921_357_0	3	4	Non-Preferred Brand	100100	
S5921	358	0		29	10	S5921_358_0	3	1	Preferred Generic	001000	
S5921	358	0		29	10	S5921_358_0	3	3	Preferred Brand	010001	
S5921	358	0		29	10	S5921_358_0	3	2	Non-Preferred Generic	000100	
S5921	358	0		29	10	S5921_358_0	3	4	Non-Preferred Brand	100100	
S5921	358	0		29	10	S5921_358_0	3	5	Specialty Tier	010010	
S5921	359	0		29	10	S5921_359_0	3	1	Preferred Generic	001000	
S5921	359	0		29	10	S5921_359_0	3	2	Non-Preferred Generic	000100	
S5921	359	0		29	10	S5921_359_0	3	3	Preferred Brand	010001	
S5921	359	0		29	10	S5921_359_0	3	4	Non-Preferred Brand	100100	
S5921	359	0		29	10	S5921_359_0	3	5	Specialty Tier	010010	
S5921	360	0		29	10	S5921_360_0	3	1	Preferred Generic	001000	
S5921	360	0		29	10	S5921_360_0	3	2	Non-Preferred Generic	000100	
S5921	360	0		29	10	S5921_360_0	3	3	Preferred Brand	010001	
S5921	360	0		29	10	S5921_360_0	3	4	Non-Preferred Brand	100100	
S5921	360	0		29	10	S5921_360_0	3	5	Specialty Tier	010010	
S5921	361	0		29	10	S5921_361_0	3	4	Non-Preferred Brand	100100	
S5921	361	0		29	10	S5921_361_0	3	3	Preferred Brand	010001	
S5921	361	0		29	10	S5921_361_0	3	2	Non-Preferred Generic	000100	
S5921	361	0		29	10	S5921_361_0	3	1	Preferred Generic	001000	
S5921	361	0		29	10	S5921_361_0	3	5	Specialty Tier	010010	
S5921	362	0		29	10	S5921_362_0	3	1	Preferred Generic	001000	
S5921	362	0		29	10	S5921_362_0	3	2	Non-Preferred Generic	000100	
S5921	362	0		29	10	S5921_362_0	3	3	Preferred Brand	010001	
S5921	362	0		29	10	S5921_362_0	3	4	Non-Preferred Brand	100100	
S5921	362	0		29	10	S5921_362_0	3	5	Specialty Tier	010010	
S5921	363	0		29	10	S5921_363_0	3	1	Preferred Generic	001000	
S5921	363	0		29	10	S5921_363_0	3	2	Non-Preferred Generic	000100	
S5921	363	0		29	10	S5921_363_0	3	3	Preferred Brand	010001	
S5921	363	0		29	10	S5921_363_0	3	4	Non-Preferred Brand	100100	
S5921	363	0		29	10	S5921_363_0	3	5	Specialty Tier	010010	
S5921	364	0		29	10	S5921_364_0	3	4	Non-Preferred Brand	100100	
S5921	364	0		29	10	S5921_364_0	3	3	Preferred Brand	010001	
S5921	364	0		29	10	S5921_364_0	3	2	Non-Preferred Generic	000100	
S5921	364	0		29	10	S5921_364_0	3	1	Preferred Generic	001000	
S5921	364	0		29	10	S5921_364_0	3	5	Specialty Tier	010010	
S5921	365	0		29	10	S5921_365_0	3	2	Non-Preferred Generic	000100	
S5921	365	0		29	10	S5921_365_0	3	1	Preferred Generic	001000	
S5921	365	0		29	10	S5921_365_0	3	3	Preferred Brand	010001	
S5921	365	0		29	10	S5921_365_0	3	4	Non-Preferred Brand	100100	
S5921	365	0		29	10	S5921_365_0	3	5	Specialty Tier	010010	
S5921	366	0		29	10	S5921_366_0	3	1	Preferred Generic	001000	
S5921	366	0		29	10	S5921_366_0	3	2	Non-Preferred Generic	000100	
S5921	366	0		29	10	S5921_366_0	3	3	Preferred Brand	010001	
S5921	366	0		29	10	S5921_366_0	3	4	Non-Preferred Brand	100100	
S5921	366	0		29	10	S5921_366_0	3	5	Specialty Tier	010010	
S5921	367	0		29	10	S5921_367_0	3	2	Non-Preferred Generic	000100	
S5921	367	0		29	10	S5921_367_0	3	1	Preferred Generic	001000	
S5921	367	0		29	10	S5921_367_0	3	3	Preferred Brand	010001	
S5921	367	0		29	10	S5921_367_0	3	5	Specialty Tier	010010	
S5921	367	0		29	10	S5921_367_0	3	4	Non-Preferred Brand	100100	
S5921	368	0		29	10	S5921_368_0	3	1	Preferred Generic	001000	
S5921	368	0		29	10	S5921_368_0	3	2	Non-Preferred Generic	000100	
S5921	368	0		29	10	S5921_368_0	3	3	Preferred Brand	010001	
S5921	368	0		29	10	S5921_368_0	3	4	Non-Preferred Brand	100100	
S5921	368	0		29	10	S5921_368_0	3	5	Specialty Tier	010010	
S5921	369	0		29	10	S5921_369_0	3	1	Preferred Generic	001000	
S5921	369	0		29	10	S5921_369_0	3	2	Non-Preferred Generic	000100	
S5921	369	0		29	10	S5921_369_0	3	4	Non-Preferred Brand	100100	
S5921	369	0		29	10	S5921_369_0	3	3	Preferred Brand	010001	
S5921	369	0		29	10	S5921_369_0	3	5	Specialty Tier	010010	
S5921	370	0		29	10	S5921_370_0	3	5	Specialty Tier	010010	
S5921	370	0		29	10	S5921_370_0	3	4	Non-Preferred Brand	100100	
S5921	370	0		29	10	S5921_370_0	3	3	Preferred Brand	010001	
S5921	370	0		29	10	S5921_370_0	3	2	Non-Preferred Generic	000100	
S5921	370	0		29	10	S5921_370_0	3	1	Preferred Generic	001000	
S5921	371	0		29	10	S5921_371_0	3	4	Non-Preferred Brand	100100	
S5921	371	0		29	10	S5921_371_0	3	2	Non-Preferred Generic	000100	
S5921	371	0		29	10	S5921_371_0	3	3	Preferred Brand	010001	
S5921	371	0		29	10	S5921_371_0	3	1	Preferred Generic	001000	
S5921	371	0		29	10	S5921_371_0	3	5	Specialty Tier	010010	
S5921	372	0		29	10	S5921_372_0	3	5	Specialty Tier	010010	
S5921	372	0		29	10	S5921_372_0	3	1	Preferred Generic	001000	
S5921	372	0		29	10	S5921_372_0	3	2	Non-Preferred Generic	000100	
S5921	372	0		29	10	S5921_372_0	3	3	Preferred Brand	010001	
S5921	372	0		29	10	S5921_372_0	3	4	Non-Preferred Brand	100100	
S5921	373	0		29	10	S5921_373_0	3	4	Non-Preferred Brand	100100	
S5921	373	0		29	10	S5921_373_0	3	5	Specialty Tier	010010	
S5921	373	0		29	10	S5921_373_0	3	3	Preferred Brand	010001	
S5921	373	0		29	10	S5921_373_0	3	2	Non-Preferred Generic	000100	
S5921	373	0		29	10	S5921_373_0	3	1	Preferred Generic	001000	
S5921	374	0		29	10	S5921_374_0	3	2	Non-Preferred Generic	000100	
S5921	374	0		29	10	S5921_374_0	3	1	Preferred Generic	001000	
S5921	374	0		29	10	S5921_374_0	3	5	Specialty Tier	010010	
S5921	374	0		29	10	S5921_374_0	3	4	Non-Preferred Brand	100100	
S5921	374	0		29	10	S5921_374_0	3	3	Preferred Brand	010001	
S5921	375	0		29	10	S5921_375_0	3	1	Preferred Generic	001000	
S5921	375	0		29	10	S5921_375_0	3	2	Non-Preferred Generic	000100	
S5921	375	0		29	10	S5921_375_0	3	3	Preferred Brand	010001	
S5921	375	0		29	10	S5921_375_0	3	4	Non-Preferred Brand	100100	
S5921	375	0		29	10	S5921_375_0	3	5	Specialty Tier	010010	
S5921	376	0		29	10	S5921_376_0	3	1	Preferred Generic	001000	
S5921	376	0		29	10	S5921_376_0	3	3	Preferred Brand	010001	
S5921	376	0		29	10	S5921_376_0	3	4	Non-Preferred Brand	100100	
S5921	376	0		29	10	S5921_376_0	3	2	Non-Preferred Generic	000100	
S5921	376	0		29	10	S5921_376_0	3	5	Specialty Tier	010010	
S5921	377	0		29	10	S5921_377_0	3	1	Preferred Generic	001000	
S5921	377	0		29	10	S5921_377_0	3	5	Specialty Tier	010010	
S5921	377	0		29	10	S5921_377_0	3	2	Non-Preferred Generic	000100	
S5921	377	0		29	10	S5921_377_0	3	3	Preferred Brand	010001	
S5921	377	0		29	10	S5921_377_0	3	4	Non-Preferred Brand	100100	
S5921	378	0		29	10	S5921_378_0	3	4	Non-Preferred Brand	100100	
S5921	378	0		29	10	S5921_378_0	3	5	Specialty Tier	010010	
S5921	378	0		29	10	S5921_378_0	3	3	Preferred Brand	010001	
S5921	378	0		29	10	S5921_378_0	3	2	Non-Preferred Generic	000100	
S5921	378	0		29	10	S5921_378_0	3	1	Preferred Generic	001000	
S5921	379	0		29	10	S5921_379_0	3	4	Non-Preferred Brand	100100	
S5921	379	0		29	10	S5921_379_0	3	3	Preferred Brand	010001	
S5921	379	0		29	10	S5921_379_0	3	2	Non-Preferred Generic	000100	
S5921	379	0		29	10	S5921_379_0	3	1	Preferred Generic	001000	
S5921	379	0		29	10	S5921_379_0	3	5	Specialty Tier	010010	
S5921	380	0		29	10	S5921_380_0	3	1	Preferred Generic	001000	
S5921	380	0		29	10	S5921_380_0	3	2	Non-Preferred Generic	000100	
S5921	380	0		29	10	S5921_380_0	3	3	Preferred Brand	010001	
S5921	380	0		29	10	S5921_380_0	3	4	Non-Preferred Brand	100100	
S5921	380	0		29	10	S5921_380_0	3	5	Specialty Tier	010010	
S5921	381	0		29	10	S5921_381_0	3	1	Preferred Generic	001000	
S5921	381	0		29	10	S5921_381_0	3	2	Non-Preferred Generic	000100	
S5921	381	0		29	10	S5921_381_0	3	3	Preferred Brand	010001	
S5921	381	0		29	10	S5921_381_0	3	4	Non-Preferred Brand	100100	
S5921	381	0		29	10	S5921_381_0	3	5	Specialty Tier	010010	
S5953	001	0		29	10	S5953_001_0	5	1	Preferred Generic	001000	
S5953	001	0		29	10	S5953_001_0	5	5	Specialty Tier	010010	
S5953	001	0		29	10	S5953_001_0	5	4	Non-Preferred Brand	110000	
S5953	001	0		29	10	S5953_001_0	5	3	Preferred Brand	000001	
S5953	001	0		29	10	S5953_001_0	5	2	Non-Preferred Generic	000100	
S5953	002	0		29	10	S5953_002_0	5	1	Preferred Generic	001000	1
S5953	002	0		29	10	S5953_002_0	5	5	Specialty Tier	010010	
S5953	002	0		29	10	S5953_002_0	5	4	Non-Preferred Brand	110000	
S5953	002	0		29	10	S5953_002_0	5	3	Preferred Brand	000001	
S5953	002	0		29	10	S5953_002_0	5	2	Non-Preferred Generic	000100	
S5953	002	0		29	10	S5953_002_0	5	2	Non-Preferred Generic	000100	1
S5953	002	0		29	10	S5953_002_0	5	1	Preferred Generic	001000	
S5960	108	0		29	10	S5960_108_0	3	5	Injectable Drugs	010010	
S5960	108	0		29	10	S5960_108_0	3	6	Specialty Tier	010010	
S5960	108	0		29	10	S5960_108_0	3	2	Non-Preferred Generic	000100	
S5960	108	0		29	10	S5960_108_0	3	1	Preferred Generic	001000	
S5960	108	0		29	10	S5960_108_0	3	3	Preferred Brand	000101	
S5960	108	0		29	10	S5960_108_0	3	4	Non-Preferred Brand	100100	
S5960	109	0		29	10	S5960_109_0	2	1	Preferred Generic	001000	
S5960	109	0		29	10	S5960_109_0	2	2	Non-Preferred Generic	000100	
S5960	109	0		29	10	S5960_109_0	2	3	Preferred Brand	000101	
S5960	109	0		29	10	S5960_109_0	2	6	Specialty Tier	010010	
S5960	109	0		29	10	S5960_109_0	2	5	Injectable Drugs	010010	
S5960	109	0		29	10	S5960_109_0	2	4	Non-Preferred Brand	100100	
S5960	110	0		29	10	S5960_110_0	3	1	Preferred Generic	001000	
S5960	110	0		29	10	S5960_110_0	3	2	Non-Preferred Generic	000100	
S5960	110	0		29	10	S5960_110_0	3	4	Non-Preferred Brand	100100	
S5960	110	0		29	10	S5960_110_0	3	3	Preferred Brand	000101	
S5960	110	0		29	10	S5960_110_0	3	5	Injectable Drugs	010010	
S5960	110	0		29	10	S5960_110_0	3	6	Specialty Tier	010010	
S5960	111	0		29	10	S5960_111_0	3	3	Preferred Brand	000101	
S5960	111	0		29	10	S5960_111_0	3	2	Non-Preferred Generic	000100	
S5960	111	0		29	10	S5960_111_0	3	1	Preferred Generic	001000	
S5960	111	0		29	10	S5960_111_0	3	6	Specialty Tier	010010	
S5960	111	0		29	10	S5960_111_0	3	4	Non-Preferred Brand	100100	
S5960	111	0		29	10	S5960_111_0	3	5	Injectable Drugs	010010	
S5960	112	0		29	10	S5960_112_0	4	6	Specialty Tier	010010	
S5960	112	0		29	10	S5960_112_0	4	4	Non-Preferred Brand	100100	
S5960	112	0		29	10	S5960_112_0	4	3	Preferred Brand	000101	
S5960	112	0		29	10	S5960_112_0	4	1	Preferred Generic	001000	
S5960	112	0		29	10	S5960_112_0	4	2	Non-Preferred Generic	000100	
S5960	112	0		29	10	S5960_112_0	4	5	Injectable Drugs	010010	
S5960	114	0		29	10	S5960_114_0	3	1	Preferred Generic	001000	
S5960	114	0		29	10	S5960_114_0	3	2	Non-Preferred Generic	000100	
S5960	114	0		29	10	S5960_114_0	3	6	Specialty Tier	010010	
S5960	114	0		29	10	S5960_114_0	3	4	Non-Preferred Brand	100100	
S5960	114	0		29	10	S5960_114_0	3	3	Preferred Brand	000101	
S5960	114	0		29	10	S5960_114_0	3	5	Injectable Drugs	010010	
S5960	115	0		29	10	S5960_115_0	3	3	Preferred Brand	000101	
S5960	115	0		29	10	S5960_115_0	3	2	Non-Preferred Generic	000100	
S5960	115	0		29	10	S5960_115_0	3	1	Preferred Generic	001000	
S5960	115	0		29	10	S5960_115_0	3	4	Non-Preferred Brand	100100	
S5960	115	0		29	10	S5960_115_0	3	5	Injectable Drugs	010010	
S5960	115	0		29	10	S5960_115_0	3	6	Specialty Tier	010010	
S5960	117	0		29	10	S5960_117_0	3	6	Specialty Tier	010010	
S5960	117	0		29	10	S5960_117_0	3	4	Non-Preferred Brand	100100	
S5960	117	0		29	10	S5960_117_0	3	3	Preferred Brand	000101	
S5960	117	0		29	10	S5960_117_0	3	2	Non-Preferred Generic	000100	
S5960	117	0		29	10	S5960_117_0	3	1	Preferred Generic	001000	
S5960	117	0		29	10	S5960_117_0	3	5	Injectable Drugs	010010	
S5960	118	0		29	10	S5960_118_0	3	1	Preferred Generic	001000	
S5960	118	0		29	10	S5960_118_0	3	2	Non-Preferred Generic	000100	
S5960	118	0		29	10	S5960_118_0	3	3	Preferred Brand	000101	
S5960	118	0		29	10	S5960_118_0	3	4	Non-Preferred Brand	100100	
S5960	118	0		29	10	S5960_118_0	3	5	Injectable Drugs	010010	
S5960	118	0		29	10	S5960_118_0	3	6	Specialty Tier	010010	
S5960	119	0		29	10	S5960_119_0	3	1	Preferred Generic	001000	
S5960	119	0		29	10	S5960_119_0	3	2	Non-Preferred Generic	000100	
S5960	119	0		29	10	S5960_119_0	3	3	Preferred Brand	000101	
S5960	119	0		29	10	S5960_119_0	3	4	Non-Preferred Brand	100100	
S5960	119	0		29	10	S5960_119_0	3	5	Injectable Drugs	010010	
S5960	119	0		29	10	S5960_119_0	3	6	Specialty Tier	010010	
S5960	123	0		29	10	S5960_123_0	3	5	Injectable Drugs	010010	
S5960	123	0		29	10	S5960_123_0	3	6	Specialty Tier	010010	
S5960	123	0		29	10	S5960_123_0	3	1	Preferred Generic	001000	
S5960	123	0		29	10	S5960_123_0	3	2	Non-Preferred Generic	000100	
S5960	123	0		29	10	S5960_123_0	3	3	Preferred Brand	000101	
S5960	123	0		29	10	S5960_123_0	3	4	Non-Preferred Brand	100100	
S5960	125	0		29	10	S5960_125_0	3	5	Injectable Drugs	010010	
S5960	125	0		29	10	S5960_125_0	3	6	Specialty Tier	010010	
S5960	125	0		29	10	S5960_125_0	3	1	Preferred Generic	001000	
S5960	125	0		29	10	S5960_125_0	3	2	Non-Preferred Generic	000100	
S5960	125	0		29	10	S5960_125_0	3	3	Preferred Brand	000101	
S5960	125	0		29	10	S5960_125_0	3	4	Non-Preferred Brand	100100	
S5960	126	0		29	10	S5960_126_0	3	1	Preferred Generic	001000	
S5960	126	0		29	10	S5960_126_0	3	2	Non-Preferred Generic	000100	
S5960	126	0		29	10	S5960_126_0	3	3	Preferred Brand	000101	
S5960	126	0		29	10	S5960_126_0	3	4	Non-Preferred Brand	100100	
S5960	126	0		29	10	S5960_126_0	3	5	Injectable Drugs	010010	
S5960	126	0		29	10	S5960_126_0	3	6	Specialty Tier	010010	
S5960	127	0		29	10	S5960_127_0	3	1	Preferred Generic	001000	
S5960	127	0		29	10	S5960_127_0	3	2	Non-Preferred Generic	000100	
S5960	127	0		29	10	S5960_127_0	3	3	Preferred Brand	000101	
S5960	127	0		29	10	S5960_127_0	3	4	Non-Preferred Brand	100100	
S5960	127	0		29	10	S5960_127_0	3	5	Injectable Drugs	010010	
S5960	127	0		29	10	S5960_127_0	3	6	Specialty Tier	010010	
S5960	128	0		29	10	S5960_128_0	3	1	Preferred Generic	001000	
S5960	128	0		29	10	S5960_128_0	3	2	Non-Preferred Generic	000100	
S5960	128	0		29	10	S5960_128_0	3	3	Preferred Brand	000101	
S5960	128	0		29	10	S5960_128_0	3	4	Non-Preferred Brand	100100	
S5960	128	0		29	10	S5960_128_0	3	5	Injectable Drugs	010010	
S5960	128	0		29	10	S5960_128_0	3	6	Specialty Tier	010010	
S5960	129	0		29	10	S5960_129_0	3	1	Preferred Generic	001000	
S5960	129	0		29	10	S5960_129_0	3	2	Non-Preferred Generic	000100	
S5960	129	0		29	10	S5960_129_0	3	6	Specialty Tier	010010	
S5960	129	0		29	10	S5960_129_0	3	4	Non-Preferred Brand	100100	
S5960	129	0		29	10	S5960_129_0	3	5	Injectable Drugs	010010	
S5960	129	0		29	10	S5960_129_0	3	3	Preferred Brand	000101	
S5960	130	0		29	10	S5960_130_0	3	6	Specialty Tier	010010	
S5960	130	0		29	10	S5960_130_0	3	3	Preferred Brand	000101	
S5960	130	0		29	10	S5960_130_0	3	4	Non-Preferred Brand	100100	
S5960	130	0		29	10	S5960_130_0	3	1	Preferred Generic	001000	
S5960	130	0		29	10	S5960_130_0	3	2	Non-Preferred Generic	000100	
S5960	130	0		29	10	S5960_130_0	3	5	Injectable Drugs	010010	
S5960	131	0		29	10	S5960_131_0	3	1	Preferred Generic	001000	
S5960	131	0		29	10	S5960_131_0	3	5	Injectable Drugs	010010	
S5960	131	0		29	10	S5960_131_0	3	4	Non-Preferred Brand	100100	
S5960	131	0		29	10	S5960_131_0	3	3	Preferred Brand	000101	
S5960	131	0		29	10	S5960_131_0	3	6	Specialty Tier	010010	
S5960	131	0		29	10	S5960_131_0	3	2	Non-Preferred Generic	000100	
S5960	132	0		29	10	S5960_132_0	3	4	Non-Preferred Brand	100100	
S5960	132	0		29	10	S5960_132_0	3	3	Preferred Brand	000101	
S5960	132	0		29	10	S5960_132_0	3	2	Non-Preferred Generic	000100	
S5960	132	0		29	10	S5960_132_0	3	1	Preferred Generic	001000	
S5960	132	0		29	10	S5960_132_0	3	5	Injectable Drugs	010010	
S5960	132	0		29	10	S5960_132_0	3	6	Specialty Tier	010010	
S5960	134	0		29	10	S5960_134_0	3	1	Preferred Generic	001000	
S5960	134	0		29	10	S5960_134_0	3	2	Non-Preferred Generic	000100	
S5960	134	0		29	10	S5960_134_0	3	6	Specialty Tier	010010	
S5960	134	0		29	10	S5960_134_0	3	5	Injectable Drugs	010010	
S5960	134	0		29	10	S5960_134_0	3	4	Non-Preferred Brand	100100	
S5960	134	0		29	10	S5960_134_0	3	3	Preferred Brand	000101	
S5960	136	0		29	10	S5960_136_0	3	1	Preferred Generic	001000	
S5960	136	0		29	10	S5960_136_0	3	2	Non-Preferred Generic	000100	
S5960	136	0		29	10	S5960_136_0	3	3	Preferred Brand	000101	
S5960	136	0		29	10	S5960_136_0	3	4	Non-Preferred Brand	100100	
S5960	136	0		29	10	S5960_136_0	3	5	Injectable Drugs	010010	
S5960	136	0		29	10	S5960_136_0	3	6	Specialty Tier	010010	
S5960	137	0		29	10	S5960_137_0	3	1	Preferred Generic	001000	
S5960	137	0		29	10	S5960_137_0	3	3	Preferred Brand	000101	
S5960	137	0		29	10	S5960_137_0	3	4	Non-Preferred Brand	100100	
S5960	137	0		29	10	S5960_137_0	3	5	Injectable Drugs	010010	
S5960	137	0		29	10	S5960_137_0	3	2	Non-Preferred Generic	000100	
S5960	137	0		29	10	S5960_137_0	3	6	Specialty Tier	010010	
S5960	139	0		29	10	S5960_139_0	3	5	Injectable Drugs	010010	
S5960	139	0		29	10	S5960_139_0	3	1	Preferred Generic	001000	
S5960	139	0		29	10	S5960_139_0	3	2	Non-Preferred Generic	000100	
S5960	139	0		29	10	S5960_139_0	3	6	Specialty Tier	010010	
S5960	139	0		29	10	S5960_139_0	3	4	Non-Preferred Brand	100100	
S5960	139	0		29	10	S5960_139_0	3	3	Preferred Brand	000101	
S5960	140	0		29	10	S5960_140_0	3	6	Specialty Tier	010010	
S5960	140	0		29	10	S5960_140_0	3	5	Injectable Drugs	010010	
S5960	140	0		29	10	S5960_140_0	3	4	Non-Preferred Brand	100100	
S5960	140	0		29	10	S5960_140_0	3	3	Preferred Brand	000101	
S5960	140	0		29	10	S5960_140_0	3	2	Non-Preferred Generic	000100	
S5960	140	0		29	10	S5960_140_0	3	1	Preferred Generic	001000	
S5960	147	0		29	10	S5960_147_0	4	6	Specialty Tier	010010	
S5960	147	0		29	10	S5960_147_0	4	5	Injectable Drugs	010010	
S5960	147	0		29	10	S5960_147_0	4	4	Non-Preferred Brand	100100	
S5960	147	0		29	10	S5960_147_0	4	3	Preferred Brand	000101	
S5960	147	0		29	10	S5960_147_0	4	2	Non-Preferred Generic	000100	
S5960	147	0		29	10	S5960_147_0	4	1	Preferred Generic	001000	1
S5960	147	0		29	10	S5960_147_0	4	1	Preferred Generic	001000	
S5960	157	0		29	10	S5960_157_0	4	1	Preferred Generic	001000	
S5960	157	0		29	10	S5960_157_0	4	2	Non-Preferred Generic	000100	
S5960	157	0		29	10	S5960_157_0	4	3	Preferred Brand	000101	
S5960	157	0		29	10	S5960_157_0	4	1	Preferred Generic	001000	1
S5960	157	0		29	10	S5960_157_0	4	5	Injectable Drugs	010010	
S5960	157	0		29	10	S5960_157_0	4	6	Specialty Tier	010010	
S5960	157	0		29	10	S5960_157_0	4	4	Non-Preferred Brand	100100	
S5966	001	0		29	10	S5966_001_0	4	1	Preferred Generic	001000	
S5966	001	0		29	10	S5966_001_0	4	4	Specialty Tier	010010	
S5966	001	0		29	10	S5966_001_0	4	3	Preferred Brand	000001	
S5966	001	0		29	10	S5966_001_0	4	2	Non-Preferred Generic	000100	
S5967	138	0		29	10	S5967_138_0	5	1	Preferred Generic	001000	
S5967	138	0		29	10	S5967_138_0	5	2	Non-Preferred Generic	000100	
S5967	138	0		29	10	S5967_138_0	5	3	Preferred Brand	010001	
S5967	138	0		29	10	S5967_138_0	5	4	Non-Preferred Brand	110000	
S5967	138	0		29	10	S5967_138_0	5	5	Specialty Tier	010010	
S5967	139	0		29	10	S5967_139_0	5	1	Preferred Generic	001000	
S5967	139	0		29	10	S5967_139_0	5	2	Non-Preferred Generic	000100	
S5967	139	0		29	10	S5967_139_0	5	3	Preferred Brand	010001	
S5967	139	0		29	10	S5967_139_0	5	4	Non-Preferred Brand	110000	
S5967	139	0		29	10	S5967_139_0	5	5	Specialty Tier	010010	
S5967	140	0		29	10	S5967_140_0	5	1	Preferred Generic	001000	
S5967	140	0		29	10	S5967_140_0	5	4	Non-Preferred Brand	110000	
S5967	140	0		29	10	S5967_140_0	5	3	Preferred Brand	010001	
S5967	140	0		29	10	S5967_140_0	5	2	Non-Preferred Generic	000100	
S5967	140	0		29	10	S5967_140_0	5	5	Specialty Tier	010010	
S5967	141	0		29	10	S5967_141_0	5	4	Non-Preferred Brand	110000	
S5967	141	0		29	10	S5967_141_0	5	1	Preferred Generic	001000	
S5967	141	0		29	10	S5967_141_0	5	2	Non-Preferred Generic	000100	
S5967	141	0		29	10	S5967_141_0	5	3	Preferred Brand	010001	
S5967	141	0		29	10	S5967_141_0	5	5	Specialty Tier	010010	
S5967	142	0		29	10	S5967_142_0	5	5	Specialty Tier	010010	
S5967	142	0		29	10	S5967_142_0	5	4	Non-Preferred Brand	110000	
S5967	142	0		29	10	S5967_142_0	5	1	Preferred Generic	001000	
S5967	142	0		29	10	S5967_142_0	5	2	Non-Preferred Generic	000100	
S5967	142	0		29	10	S5967_142_0	5	3	Preferred Brand	010001	
S5967	143	0		29	10	S5967_143_0	5	5	Specialty Tier	010010	
S5967	143	0		29	10	S5967_143_0	5	4	Non-Preferred Brand	110000	
S5967	143	0		29	10	S5967_143_0	5	2	Non-Preferred Generic	000100	
S5967	143	0		29	10	S5967_143_0	5	3	Preferred Brand	010001	
S5967	143	0		29	10	S5967_143_0	5	1	Preferred Generic	001000	
S5967	144	0		29	10	S5967_144_0	5	4	Non-Preferred Brand	110000	
S5967	144	0		29	10	S5967_144_0	5	5	Specialty Tier	010010	
S5967	144	0		29	10	S5967_144_0	5	3	Preferred Brand	010001	
S5967	144	0		29	10	S5967_144_0	5	2	Non-Preferred Generic	000100	
S5967	144	0		29	10	S5967_144_0	5	1	Preferred Generic	001000	
S5967	145	0		29	10	S5967_145_0	5	4	Non-Preferred Brand	110000	
S5967	145	0		29	10	S5967_145_0	5	2	Non-Preferred Generic	000100	
S5967	145	0		29	10	S5967_145_0	5	1	Preferred Generic	001000	
S5967	145	0		29	10	S5967_145_0	5	3	Preferred Brand	010001	
S5967	145	0		29	10	S5967_145_0	5	5	Specialty Tier	010010	
S5967	146	0		29	10	S5967_146_0	5	5	Specialty Tier	010010	
S5967	146	0		29	10	S5967_146_0	5	1	Preferred Generic	001000	
S5967	146	0		29	10	S5967_146_0	5	4	Non-Preferred Brand	110000	
S5967	146	0		29	10	S5967_146_0	5	3	Preferred Brand	010001	
S5967	146	0		29	10	S5967_146_0	5	2	Non-Preferred Generic	000100	
S5967	147	0		29	10	S5967_147_0	5	2	Non-Preferred Generic	000100	
S5967	147	0		29	10	S5967_147_0	5	3	Preferred Brand	010001	
S5967	147	0		29	10	S5967_147_0	5	4	Non-Preferred Brand	110000	
S5967	147	0		29	10	S5967_147_0	5	5	Specialty Tier	010010	
S5967	147	0		29	10	S5967_147_0	5	1	Preferred Generic	001000	
S5967	148	0		29	10	S5967_148_0	5	1	Preferred Generic	001000	
S5967	148	0		29	10	S5967_148_0	5	2	Non-Preferred Generic	000100	
S5967	148	0		29	10	S5967_148_0	5	3	Preferred Brand	010001	
S5967	148	0		29	10	S5967_148_0	5	5	Specialty Tier	010010	
S5967	148	0		29	10	S5967_148_0	5	4	Non-Preferred Brand	110000	
S5967	149	0		29	10	S5967_149_0	5	5	Specialty Tier	010010	
S5967	149	0		29	10	S5967_149_0	5	3	Preferred Brand	010001	
S5967	149	0		29	10	S5967_149_0	5	4	Non-Preferred Brand	110000	
S5967	149	0		29	10	S5967_149_0	5	2	Non-Preferred Generic	000100	
S5967	149	0		29	10	S5967_149_0	5	1	Preferred Generic	001000	
S5967	150	0		29	10	S5967_150_0	5	1	Preferred Generic	001000	
S5967	150	0		29	10	S5967_150_0	5	2	Non-Preferred Generic	000100	
S5967	150	0		29	10	S5967_150_0	5	3	Preferred Brand	010001	
S5967	150	0		29	10	S5967_150_0	5	4	Non-Preferred Brand	110000	
S5967	150	0		29	10	S5967_150_0	5	5	Specialty Tier	010010	
S5967	151	0		29	10	S5967_151_0	5	1	Preferred Generic	001000	
S5967	151	0		29	10	S5967_151_0	5	2	Non-Preferred Generic	000100	
S5967	151	0		29	10	S5967_151_0	5	3	Preferred Brand	010001	
S5967	151	0		29	10	S5967_151_0	5	4	Non-Preferred Brand	110000	
S5967	151	0		29	10	S5967_151_0	5	5	Specialty Tier	010010	
S5967	152	0		29	10	S5967_152_0	5	1	Preferred Generic	001000	
S5967	152	0		29	10	S5967_152_0	5	2	Non-Preferred Generic	000100	
S5967	152	0		29	10	S5967_152_0	5	3	Preferred Brand	010001	
S5967	152	0		29	10	S5967_152_0	5	4	Non-Preferred Brand	110000	
S5967	152	0		29	10	S5967_152_0	5	5	Specialty Tier	010010	
S5967	154	0		29	10	S5967_154_0	5	4	Non-Preferred Brand	110000	
S5967	154	0		29	10	S5967_154_0	5	3	Preferred Brand	010001	
S5967	154	0		29	10	S5967_154_0	5	2	Non-Preferred Generic	000100	
S5967	154	0		29	10	S5967_154_0	5	1	Preferred Generic	001000	
S5967	154	0		29	10	S5967_154_0	5	5	Specialty Tier	010010	
S5967	155	0		29	10	S5967_155_0	5	1	Preferred Generic	001000	
S5967	155	0		29	10	S5967_155_0	5	2	Non-Preferred Generic	000100	
S5967	155	0		29	10	S5967_155_0	5	3	Preferred Brand	010001	
S5967	155	0		29	10	S5967_155_0	5	4	Non-Preferred Brand	110000	
S5967	155	0		29	10	S5967_155_0	5	5	Specialty Tier	010010	
S5967	156	0		29	10	S5967_156_0	5	4	Non-Preferred Brand	110000	
S5967	156	0		29	10	S5967_156_0	5	3	Preferred Brand	010001	
S5967	156	0		29	10	S5967_156_0	5	2	Non-Preferred Generic	000100	
S5967	156	0		29	10	S5967_156_0	5	1	Preferred Generic	001000	
S5967	156	0		29	10	S5967_156_0	5	5	Specialty Tier	010010	
S5967	157	0		29	10	S5967_157_0	5	5	Specialty Tier	010010	
S5967	157	0		29	10	S5967_157_0	5	2	Non-Preferred Generic	000100	
S5967	157	0		29	10	S5967_157_0	5	3	Preferred Brand	010001	
S5967	157	0		29	10	S5967_157_0	5	4	Non-Preferred Brand	110000	
S5967	157	0		29	10	S5967_157_0	5	1	Preferred Generic	001000	
S5967	158	0		29	10	S5967_158_0	5	5	Specialty Tier	010010	
S5967	158	0		29	10	S5967_158_0	5	4	Non-Preferred Brand	110000	
S5967	158	0		29	10	S5967_158_0	5	2	Non-Preferred Generic	000100	
S5967	158	0		29	10	S5967_158_0	5	3	Preferred Brand	010001	
S5967	158	0		29	10	S5967_158_0	5	1	Preferred Generic	001000	
S5967	159	0		29	10	S5967_159_0	5	5	Specialty Tier	010010	
S5967	159	0		29	10	S5967_159_0	5	1	Preferred Generic	001000	
S5967	159	0		29	10	S5967_159_0	5	4	Non-Preferred Brand	110000	
S5967	159	0		29	10	S5967_159_0	5	3	Preferred Brand	010001	
S5967	159	0		29	10	S5967_159_0	5	2	Non-Preferred Generic	000100	
S5967	160	0		29	10	S5967_160_0	5	2	Non-Preferred Generic	000100	
S5967	160	0		29	10	S5967_160_0	5	3	Preferred Brand	010001	
S5967	160	0		29	10	S5967_160_0	5	4	Non-Preferred Brand	110000	
S5967	160	0		29	10	S5967_160_0	5	5	Specialty Tier	010010	
S5967	160	0		29	10	S5967_160_0	5	1	Preferred Generic	001000	
S5967	161	0		29	10	S5967_161_0	5	2	Non-Preferred Generic	000100	
S5967	161	0		29	10	S5967_161_0	5	3	Preferred Brand	010001	
S5967	161	0		29	10	S5967_161_0	5	4	Non-Preferred Brand	110000	
S5967	161	0		29	10	S5967_161_0	5	5	Specialty Tier	010010	
S5967	161	0		29	10	S5967_161_0	5	1	Preferred Generic	001000	
S5967	162	0		29	10	S5967_162_0	5	5	Specialty Tier	010010	
S5967	162	0		29	10	S5967_162_0	5	4	Non-Preferred Brand	110000	
S5967	162	0		29	10	S5967_162_0	5	3	Preferred Brand	010001	
S5967	162	0		29	10	S5967_162_0	5	2	Non-Preferred Generic	000100	
S5967	162	0		29	10	S5967_162_0	5	1	Preferred Generic	001000	
S5967	163	0		29	10	S5967_163_0	5	3	Preferred Brand	010001	
S5967	163	0		29	10	S5967_163_0	5	4	Non-Preferred Brand	110000	
S5967	163	0		29	10	S5967_163_0	5	5	Specialty Tier	010010	
S5967	163	0		29	10	S5967_163_0	5	2	Non-Preferred Generic	000100	
S5967	163	0		29	10	S5967_163_0	5	1	Preferred Generic	001000	
S5967	164	0		29	10	S5967_164_0	5	2	Non-Preferred Generic	000100	
S5967	164	0		29	10	S5967_164_0	5	3	Preferred Brand	010001	
S5967	164	0		29	10	S5967_164_0	5	4	Non-Preferred Brand	110000	
S5967	164	0		29	10	S5967_164_0	5	1	Preferred Generic	001000	
S5967	164	0		29	10	S5967_164_0	5	5	Specialty Tier	010010	
S5967	165	0		29	10	S5967_165_0	5	2	Non-Preferred Generic	000100	
S5967	165	0		29	10	S5967_165_0	5	1	Preferred Generic	001000	
S5967	165	0		29	10	S5967_165_0	5	3	Preferred Brand	010001	
S5967	165	0		29	10	S5967_165_0	5	4	Non-Preferred Brand	110000	
S5967	165	0		29	10	S5967_165_0	5	5	Specialty Tier	010010	
S5967	166	0		29	10	S5967_166_0	5	2	Non-Preferred Generic	000100	
S5967	166	0		29	10	S5967_166_0	5	4	Non-Preferred Brand	110000	
S5967	166	0		29	10	S5967_166_0	5	3	Preferred Brand	010001	
S5967	166	0		29	10	S5967_166_0	5	5	Specialty Tier	010010	
S5967	166	0		29	10	S5967_166_0	5	1	Preferred Generic	001000	
S5967	167	0		29	10	S5967_167_0	5	2	Non-Preferred Generic	000100	
S5967	167	0		29	10	S5967_167_0	5	1	Preferred Generic	001000	
S5967	167	0		29	10	S5967_167_0	5	3	Preferred Brand	010001	
S5967	167	0		29	10	S5967_167_0	5	4	Non-Preferred Brand	110000	
S5967	167	0		29	10	S5967_167_0	5	5	Specialty Tier	010010	
S5967	168	0		29	10	S5967_168_0	5	1	Preferred Generic	001000	
S5967	168	0		29	10	S5967_168_0	5	2	Non-Preferred Generic	000100	
S5967	168	0		29	10	S5967_168_0	5	3	Preferred Brand	010001	
S5967	168	0		29	10	S5967_168_0	5	4	Non-Preferred Brand	110000	
S5967	168	0		29	10	S5967_168_0	5	5	Specialty Tier	010010	
S5967	169	0		29	10	S5967_169_0	5	1	Preferred Generic	001000	
S5967	169	0		29	10	S5967_169_0	5	2	Non-Preferred Generic	000100	
S5967	169	0		29	10	S5967_169_0	5	3	Preferred Brand	010001	
S5967	169	0		29	10	S5967_169_0	5	4	Non-Preferred Brand	110000	
S5967	169	0		29	10	S5967_169_0	5	5	Specialty Tier	010010	
S5967	170	0		29	10	S5967_170_0	4	2	Non-Preferred Generic	000100	
S5967	170	0		29	10	S5967_170_0	4	3	Preferred Brand	010001	
S5967	170	0		29	10	S5967_170_0	4	1	Preferred Generic	001000	
S5967	170	0		29	10	S5967_170_0	4	4	Non-Preferred Brand	110000	
S5967	170	0		29	10	S5967_170_0	4	5	Specialty Tier	010010	
S5967	171	0		29	10	S5967_171_0	5	1	Preferred Generic	001000	
S5967	171	0		29	10	S5967_171_0	5	2	Non-Preferred Generic	000100	
S5967	171	0		29	10	S5967_171_0	5	3	Preferred Brand	010001	
S5967	171	0		29	10	S5967_171_0	5	4	Non-Preferred Brand	110000	
S5967	171	0		29	10	S5967_171_0	5	5	Specialty Tier	010010	
S5967	173	0		29	10	S5967_173_0	4	4	Non-Preferred Brand	100000	
S5967	173	0		29	10	S5967_173_0	4	3	Preferred Brand	000001	
S5967	173	0		29	10	S5967_173_0	4	2	Non-Preferred Generic	000100	
S5967	173	0		29	10	S5967_173_0	4	1	Preferred Generic	001000	
S5967	173	0		29	10	S5967_173_0	4	5	Specialty Tier	010010	
S5967	174	0		29	10	S5967_174_0	4	1	Preferred Generic	001000	
S5967	174	0		29	10	S5967_174_0	4	3	Preferred Brand	000001	
S5967	174	0		29	10	S5967_174_0	4	4	Non-Preferred Brand	100000	
S5967	174	0		29	10	S5967_174_0	4	2	Non-Preferred Generic	000100	
S5967	174	0		29	10	S5967_174_0	4	5	Specialty Tier	010010	
S5967	175	0		29	10	S5967_175_0	4	1	Preferred Generic	001000	
S5967	175	0		29	10	S5967_175_0	4	3	Preferred Brand	000001	
S5967	175	0		29	10	S5967_175_0	4	4	Non-Preferred Brand	100000	
S5967	175	0		29	10	S5967_175_0	4	2	Non-Preferred Generic	000100	
S5967	175	0		29	10	S5967_175_0	4	5	Specialty Tier	010010	
S5967	176	0		29	10	S5967_176_0	4	1	Preferred Generic	001000	
S5967	176	0		29	10	S5967_176_0	4	3	Preferred Brand	000001	
S5967	176	0		29	10	S5967_176_0	4	4	Non-Preferred Brand	100000	
S5967	176	0		29	10	S5967_176_0	4	2	Non-Preferred Generic	000100	
S5967	176	0		29	10	S5967_176_0	4	5	Specialty Tier	010010	
S5967	177	0		29	10	S5967_177_0	4	1	Preferred Generic	001000	
S5967	177	0		29	10	S5967_177_0	4	3	Preferred Brand	000001	
S5967	177	0		29	10	S5967_177_0	4	4	Non-Preferred Brand	100000	
S5967	177	0		29	10	S5967_177_0	4	2	Non-Preferred Generic	000100	
S5967	177	0		29	10	S5967_177_0	4	5	Specialty Tier	010010	
S5967	178	0		29	10	S5967_178_0	4	1	Preferred Generic	001000	
S5967	178	0		29	10	S5967_178_0	4	3	Preferred Brand	000001	
S5967	178	0		29	10	S5967_178_0	4	4	Non-Preferred Brand	100000	
S5967	178	0		29	10	S5967_178_0	4	2	Non-Preferred Generic	000100	
S5967	178	0		29	10	S5967_178_0	4	5	Specialty Tier	010010	
S5967	179	0		29	10	S5967_179_0	4	1	Preferred Generic	001000	
S5967	179	0		29	10	S5967_179_0	4	5	Specialty Tier	010010	
S5967	179	0		29	10	S5967_179_0	4	2	Non-Preferred Generic	000100	
S5967	179	0		29	10	S5967_179_0	4	3	Preferred Brand	000001	
S5967	179	0		29	10	S5967_179_0	4	4	Non-Preferred Brand	100000	
S5967	180	0		29	10	S5967_180_0	4	3	Preferred Brand	000001	
S5967	180	0		29	10	S5967_180_0	4	4	Non-Preferred Brand	100000	
S5967	180	0		29	10	S5967_180_0	4	1	Preferred Generic	001000	
S5967	180	0		29	10	S5967_180_0	4	2	Non-Preferred Generic	000100	
S5967	180	0		29	10	S5967_180_0	4	5	Specialty Tier	010010	
S5967	181	0		29	10	S5967_181_0	4	4	Non-Preferred Brand	100000	
S5967	181	0		29	10	S5967_181_0	4	3	Preferred Brand	000001	
S5967	181	0		29	10	S5967_181_0	4	2	Non-Preferred Generic	000100	
S5967	181	0		29	10	S5967_181_0	4	1	Preferred Generic	001000	
S5967	181	0		29	10	S5967_181_0	4	5	Specialty Tier	010010	
S5967	182	0		29	10	S5967_182_0	4	1	Preferred Generic	001000	
S5967	182	0		29	10	S5967_182_0	4	2	Non-Preferred Generic	000100	
S5967	182	0		29	10	S5967_182_0	4	3	Preferred Brand	000001	
S5967	182	0		29	10	S5967_182_0	4	4	Non-Preferred Brand	100000	
S5967	182	0		29	10	S5967_182_0	4	5	Specialty Tier	010010	
S5967	183	0		29	10	S5967_183_0	4	1	Preferred Generic	001000	
S5967	183	0		29	10	S5967_183_0	4	2	Non-Preferred Generic	000100	
S5967	183	0		29	10	S5967_183_0	4	3	Preferred Brand	000001	
S5967	183	0		29	10	S5967_183_0	4	4	Non-Preferred Brand	100000	
S5967	183	0		29	10	S5967_183_0	4	5	Specialty Tier	010010	
S5967	184	0		29	10	S5967_184_0	4	2	Non-Preferred Generic	000100	
S5967	184	0		29	10	S5967_184_0	4	1	Preferred Generic	001000	
S5967	184	0		29	10	S5967_184_0	4	5	Specialty Tier	010010	
S5967	184	0		29	10	S5967_184_0	4	3	Preferred Brand	000001	
S5967	184	0		29	10	S5967_184_0	4	4	Non-Preferred Brand	100000	
S5967	185	0		29	10	S5967_185_0	4	4	Non-Preferred Brand	100000	
S5967	185	0		29	10	S5967_185_0	4	3	Preferred Brand	000001	
S5967	185	0		29	10	S5967_185_0	4	2	Non-Preferred Generic	000100	
S5967	185	0		29	10	S5967_185_0	4	1	Preferred Generic	001000	
S5967	185	0		29	10	S5967_185_0	4	5	Specialty Tier	010010	
S5967	186	0		29	10	S5967_186_0	4	5	Specialty Tier	010010	
S5967	186	0		29	10	S5967_186_0	4	4	Non-Preferred Brand	100000	
S5967	186	0		29	10	S5967_186_0	4	2	Non-Preferred Generic	000100	
S5967	186	0		29	10	S5967_186_0	4	3	Preferred Brand	000001	
S5967	186	0		29	10	S5967_186_0	4	1	Preferred Generic	001000	
S5967	187	0		29	10	S5967_187_0	4	5	Specialty Tier	010010	
S5967	187	0		29	10	S5967_187_0	4	3	Preferred Brand	000001	
S5967	187	0		29	10	S5967_187_0	4	2	Non-Preferred Generic	000100	
S5967	187	0		29	10	S5967_187_0	4	4	Non-Preferred Brand	100000	
S5967	187	0		29	10	S5967_187_0	4	1	Preferred Generic	001000	
S5967	188	0		29	10	S5967_188_0	4	1	Preferred Generic	001000	
S5967	188	0		29	10	S5967_188_0	4	2	Non-Preferred Generic	000100	
S5967	188	0		29	10	S5967_188_0	4	3	Preferred Brand	000001	
S5967	188	0		29	10	S5967_188_0	4	5	Specialty Tier	010010	
S5967	188	0		29	10	S5967_188_0	4	4	Non-Preferred Brand	100000	
S5967	189	0		29	10	S5967_189_0	4	3	Preferred Brand	000001	
S5967	189	0		29	10	S5967_189_0	4	2	Non-Preferred Generic	000100	
S5967	189	0		29	10	S5967_189_0	4	1	Preferred Generic	001000	
S5967	189	0		29	10	S5967_189_0	4	4	Non-Preferred Brand	100000	
S5967	189	0		29	10	S5967_189_0	4	5	Specialty Tier	010010	
S5967	190	0		29	10	S5967_190_0	4	1	Preferred Generic	001000	
S5967	190	0		29	10	S5967_190_0	4	2	Non-Preferred Generic	000100	
S5967	190	0		29	10	S5967_190_0	4	3	Preferred Brand	000001	
S5967	190	0		29	10	S5967_190_0	4	4	Non-Preferred Brand	100000	
S5967	190	0		29	10	S5967_190_0	4	5	Specialty Tier	010010	
S5967	191	0		29	10	S5967_191_0	4	1	Preferred Generic	001000	
S5967	191	0		29	10	S5967_191_0	4	2	Non-Preferred Generic	000100	
S5967	191	0		29	10	S5967_191_0	4	3	Preferred Brand	000001	
S5967	191	0		29	10	S5967_191_0	4	4	Non-Preferred Brand	100000	
S5967	191	0		29	10	S5967_191_0	4	5	Specialty Tier	010010	
S5967	192	0		29	10	S5967_192_0	4	1	Preferred Generic	001000	
S5967	192	0		29	10	S5967_192_0	4	2	Non-Preferred Generic	000100	
S5967	192	0		29	10	S5967_192_0	4	3	Preferred Brand	000001	
S5967	192	0		29	10	S5967_192_0	4	4	Non-Preferred Brand	100000	
S5967	192	0		29	10	S5967_192_0	4	5	Specialty Tier	010010	
S5967	193	0		29	10	S5967_193_0	4	1	Preferred Generic	001000	
S5967	193	0		29	10	S5967_193_0	4	2	Non-Preferred Generic	000100	
S5967	193	0		29	10	S5967_193_0	4	5	Specialty Tier	010010	
S5967	193	0		29	10	S5967_193_0	4	4	Non-Preferred Brand	100000	
S5967	193	0		29	10	S5967_193_0	4	3	Preferred Brand	000001	
S5967	194	0		29	10	S5967_194_0	4	5	Specialty Tier	010010	
S5967	194	0		29	10	S5967_194_0	4	3	Preferred Brand	000001	
S5967	194	0		29	10	S5967_194_0	4	4	Non-Preferred Brand	100000	
S5967	194	0		29	10	S5967_194_0	4	2	Non-Preferred Generic	000100	
S5967	194	0		29	10	S5967_194_0	4	1	Preferred Generic	001000	
S5967	195	0		29	10	S5967_195_0	4	4	Non-Preferred Brand	100000	
S5967	195	0		29	10	S5967_195_0	4	3	Preferred Brand	000001	
S5967	195	0		29	10	S5967_195_0	4	5	Specialty Tier	010010	
S5967	195	0		29	10	S5967_195_0	4	1	Preferred Generic	001000	
S5967	195	0		29	10	S5967_195_0	4	2	Non-Preferred Generic	000100	
S5967	196	0		29	10	S5967_196_0	4	5	Specialty Tier	010010	
S5967	196	0		29	10	S5967_196_0	4	3	Preferred Brand	000001	
S5967	196	0		29	10	S5967_196_0	4	4	Non-Preferred Brand	100000	
S5967	196	0		29	10	S5967_196_0	4	1	Preferred Generic	001000	
S5967	196	0		29	10	S5967_196_0	4	2	Non-Preferred Generic	000100	
S5967	197	0		29	10	S5967_197_0	4	1	Preferred Generic	001000	
S5967	197	0		29	10	S5967_197_0	4	2	Non-Preferred Generic	000100	
S5967	197	0		29	10	S5967_197_0	4	5	Specialty Tier	010010	
S5967	197	0		29	10	S5967_197_0	4	4	Non-Preferred Brand	100000	
S5967	197	0		29	10	S5967_197_0	4	3	Preferred Brand	000001	
S5967	198	0		29	10	S5967_198_0	4	1	Preferred Generic	001000	
S5967	198	0		29	10	S5967_198_0	4	2	Non-Preferred Generic	000100	
S5967	198	0		29	10	S5967_198_0	4	3	Preferred Brand	000001	
S5967	198	0		29	10	S5967_198_0	4	4	Non-Preferred Brand	100000	
S5967	198	0		29	10	S5967_198_0	4	5	Specialty Tier	010010	
S5967	199	0		29	10	S5967_199_0	4	4	Non-Preferred Brand	100000	
S5967	199	0		29	10	S5967_199_0	4	3	Preferred Brand	000001	
S5967	199	0		29	10	S5967_199_0	4	1	Preferred Generic	001000	
S5967	199	0		29	10	S5967_199_0	4	5	Specialty Tier	010010	
S5967	199	0		29	10	S5967_199_0	4	2	Non-Preferred Generic	000100	
S5967	200	0		29	10	S5967_200_0	4	1	Preferred Generic	001000	
S5967	200	0		29	10	S5967_200_0	4	2	Non-Preferred Generic	000100	
S5967	200	0		29	10	S5967_200_0	4	5	Specialty Tier	010010	
S5967	200	0		29	10	S5967_200_0	4	4	Non-Preferred Brand	100000	
S5967	200	0		29	10	S5967_200_0	4	3	Preferred Brand	000001	
S5967	201	0		29	10	S5967_201_0	4	3	Preferred Brand	000001	
S5967	201	0		29	10	S5967_201_0	4	4	Non-Preferred Brand	100000	
S5967	201	0		29	10	S5967_201_0	4	5	Specialty Tier	010010	
S5967	201	0		29	10	S5967_201_0	4	2	Non-Preferred Generic	000100	
S5967	201	0		29	10	S5967_201_0	4	1	Preferred Generic	001000	
S5967	202	0		29	10	S5967_202_0	4	5	Specialty Tier	010010	
S5967	202	0		29	10	S5967_202_0	4	4	Non-Preferred Brand	100000	
S5967	202	0		29	10	S5967_202_0	4	1	Preferred Generic	001000	
S5967	202	0		29	10	S5967_202_0	4	2	Non-Preferred Generic	000100	
S5967	202	0		29	10	S5967_202_0	4	3	Preferred Brand	000001	
S5967	203	0		29	10	S5967_203_0	4	1	Preferred Generic	001000	
S5967	203	0		29	10	S5967_203_0	4	4	Non-Preferred Brand	100000	
S5967	203	0		29	10	S5967_203_0	4	5	Specialty Tier	010010	
S5967	203	0		29	10	S5967_203_0	4	2	Non-Preferred Generic	000100	
S5967	203	0		29	10	S5967_203_0	4	3	Preferred Brand	000001	
S5967	204	0		29	10	S5967_204_0	4	3	Preferred Brand	000001	
S5967	204	0		29	10	S5967_204_0	4	1	Preferred Generic	001000	
S5967	204	0		29	10	S5967_204_0	4	2	Non-Preferred Generic	000100	
S5967	204	0		29	10	S5967_204_0	4	4	Non-Preferred Brand	100000	
S5967	204	0		29	10	S5967_204_0	4	5	Specialty Tier	010010	
S5967	205	0		29	10	S5967_205_0	4	1	Preferred Generic	001000	
S5967	205	0		29	10	S5967_205_0	4	2	Non-Preferred Generic	000100	
S5967	205	0		29	10	S5967_205_0	4	3	Preferred Brand	000001	
S5967	205	0		29	10	S5967_205_0	4	5	Specialty Tier	010010	
S5967	205	0		29	10	S5967_205_0	4	4	Non-Preferred Brand	100000	
S5983	004	0		29	10	S5983_004_0	2	1	Preferred Generic	001010	
S5983	004	0		29	10	S5983_004_0	2	2	Non-Preferred Generic	000110	
S5983	004	0		29	10	S5983_004_0	2	3	Preferred Brand	010001	
S5983	004	0		29	10	S5983_004_0	2	4	Non-Preferred Brand	110000	
S5983	004	0		29	10	S5983_004_0	2	5	Specialty Tier	010010	
S5983	006	0		29	10	S5983_006_0	2	1	Preferred Generic	001010	
S5983	006	0		29	10	S5983_006_0	2	2	Non-Preferred Generic	000110	
S5983	006	0		29	10	S5983_006_0	2	3	Preferred Brand	010001	
S5983	006	0		29	10	S5983_006_0	2	4	Non-Preferred Brand	110000	
S5983	006	0		29	10	S5983_006_0	2	5	Specialty Tier	010010	
S5993	001	0		29	10	S5993_001_0	5	1	Preferred Generic	001000	
S5993	001	0		29	10	S5993_001_0	5	5	Specialty Tier	010010	
S5993	001	0		29	10	S5993_001_0	5	4	Non-Preferred Brand	110000	
S5993	001	0		29	10	S5993_001_0	5	3	Preferred Brand	000001	
S5993	001	0		29	10	S5993_001_0	5	2	Non-Preferred Generic	000100	
S5993	003	0		29	10	S5993_003_0	6	1	Preferred Generic	001000	1
S5993	003	0		29	10	S5993_003_0	6	5	Specialty Tier	010010	
S5993	003	0		29	10	S5993_003_0	6	4	Non-Preferred Brand	110000	
S5993	003	0		29	10	S5993_003_0	6	3	Preferred Brand	000001	
S5993	003	0		29	10	S5993_003_0	6	2	Non-Preferred Generic	000100	
S5993	003	0		29	10	S5993_003_0	6	2	Non-Preferred Generic	000100	1
S5993	003	0		29	10	S5993_003_0	6	1	Preferred Generic	001000	
S6506	001	0		29	10	S6506_001_0	4	1	Preferred Generic	001000	
S6506	001	0		29	10	S6506_001_0	4	2	Non-Preferred Generic	000100	
S6506	001	0		29	10	S6506_001_0	4	3	Preferred Brand	000001	
S6506	001	0		29	10	S6506_001_0	4	4	Non-Preferred Brand	110000	
S6506	002	0		29	10	S6506_002_0	4	1	Preferred Generic	001000	
S6506	002	0		29	10	S6506_002_0	4	2	Non-Preferred Generic	000100	
S6506	002	0		29	10	S6506_002_0	4	3	Preferred Brand	000001	
S6506	002	0		29	10	S6506_002_0	4	4	Non-Preferred Brand	110000	
S7230	001	0		29	10	S7230_001_0	1	2	Non-Preferred Generic	000100	
S7230	001	0		29	10	S7230_001_0	1	1	Preferred Generic	001000	
S7230	001	0		29	10	S7230_001_0	1	3	Preferred Brand	000001	
S7230	001	0		29	10	S7230_001_0	1	4	Non-Preferred Brand	100000	
S7230	001	0		29	10	S7230_001_0	1	5	Specialty Tier	100000	
S7230	002	0		29	10	S7230_002_0	1	2	Non-Preferred Generic	000100	
S7230	002	0		29	10	S7230_002_0	1	1	Preferred Generic	001000	
S7230	002	0		29	10	S7230_002_0	1	3	Preferred Brand	000001	
S7230	002	0		29	10	S7230_002_0	1	5	Specialty Tier	100000	
S7230	002	0		29	10	S7230_002_0	1	4	Non-Preferred Brand	100000	
S7230	003	0		29	10	S7230_003_0	1	1	Preferred Generic	001000	
S7230	003	0		29	10	S7230_003_0	1	2	Non-Preferred Generic	000100	
S7230	003	0		29	10	S7230_003_0	1	4	Non-Preferred Brand	100000	
S7230	003	0		29	10	S7230_003_0	1	3	Preferred Brand	000001	
S7230	003	0		29	10	S7230_003_0	1	5	Specialty Tier	100000	
S7610	001	0		29	10	S7610_001_0	1	1	Preferred Generic	001000	
S7610	001	0		29	10	S7610_001_0	1	2	Non-Preferred Generic	000100	
S7610	001	0		29	10	S7610_001_0	1	5	Specialty Tier	100000	
S7610	001	0		29	10	S7610_001_0	1	4	Non-Preferred Brand	100000	
S7610	001	0		29	10	S7610_001_0	1	3	Preferred Brand	000001	
S7694	001	0		29	10	S7694_001_0	2	5	Specialty Tier	010010	
S7694	001	0		29	10	S7694_001_0	2	6	Select Care Drugs	000010	
S7694	001	0		29	10	S7694_001_0	2	1	Preferred Generic	001000	
S7694	001	0		29	10	S7694_001_0	2	2	Non-Preferred Generic	000100	
S7694	001	0		29	10	S7694_001_0	2	3	Preferred Brand	000001	
S7694	001	0		29	10	S7694_001_0	2	4	Non-Preferred Brand	100000	
S7694	002	0		29	10	S7694_002_0	2	2	Non-Preferred Generic	000100	
S7694	002	0		29	10	S7694_002_0	2	1	Preferred Generic	001000	
S7694	002	0		29	10	S7694_002_0	2	5	Specialty Tier	010010	
S7694	002	0		29	10	S7694_002_0	2	4	Non-Preferred Brand	100000	
S7694	002	0		29	10	S7694_002_0	2	3	Preferred Brand	000001	
S7694	002	0		29	10	S7694_002_0	2	6	Select Care Drugs	000010	
S7694	003	0		29	10	S7694_003_0	2	1	Preferred Generic	001000	
S7694	003	0		29	10	S7694_003_0	2	2	Non-Preferred Generic	000100	
S7694	003	0		29	10	S7694_003_0	2	3	Preferred Brand	000001	
S7694	003	0		29	10	S7694_003_0	2	4	Non-Preferred Brand	100000	
S7694	003	0		29	10	S7694_003_0	2	5	Specialty Tier	010010	
S7694	003	0		29	10	S7694_003_0	2	6	Select Care Drugs	000010	
S7694	004	0		29	10	S7694_004_0	2	3	Preferred Brand	000001	
S7694	004	0		29	10	S7694_004_0	2	2	Non-Preferred Generic	000100	
S7694	004	0		29	10	S7694_004_0	2	1	Preferred Generic	001000	
S7694	004	0		29	10	S7694_004_0	2	6	Select Care Drugs	000010	
S7694	004	0		29	10	S7694_004_0	2	4	Non-Preferred Brand	100000	
S7694	004	0		29	10	S7694_004_0	2	5	Specialty Tier	010010	
S7694	005	0		29	10	S7694_005_0	2	6	Select Care Drugs	000010	
S7694	005	0		29	10	S7694_005_0	2	5	Specialty Tier	010010	
S7694	005	0		29	10	S7694_005_0	2	4	Non-Preferred Brand	100000	
S7694	005	0		29	10	S7694_005_0	2	3	Preferred Brand	000001	
S7694	005	0		29	10	S7694_005_0	2	2	Non-Preferred Generic	000100	
S7694	005	0		29	10	S7694_005_0	2	1	Preferred Generic	001000	
S7694	006	0		29	10	S7694_006_0	2	6	Select Care Drugs	000010	
S7694	006	0		29	10	S7694_006_0	2	5	Specialty Tier	010010	
S7694	006	0		29	10	S7694_006_0	2	4	Non-Preferred Brand	100000	
S7694	006	0		29	10	S7694_006_0	2	2	Non-Preferred Generic	000100	
S7694	006	0		29	10	S7694_006_0	2	3	Preferred Brand	000001	
S7694	006	0		29	10	S7694_006_0	2	1	Preferred Generic	001000	
S7694	007	0		29	10	S7694_007_0	2	3	Preferred Brand	000001	
S7694	007	0		29	10	S7694_007_0	2	2	Non-Preferred Generic	000100	
S7694	007	0		29	10	S7694_007_0	2	1	Preferred Generic	001000	
S7694	007	0		29	10	S7694_007_0	2	4	Non-Preferred Brand	100000	
S7694	007	0		29	10	S7694_007_0	2	5	Specialty Tier	010010	
S7694	007	0		29	10	S7694_007_0	2	6	Select Care Drugs	000010	
S7694	008	0		29	10	S7694_008_0	2	4	Non-Preferred Brand	100000	
S7694	008	0		29	10	S7694_008_0	2	2	Non-Preferred Generic	000100	
S7694	008	0		29	10	S7694_008_0	2	3	Preferred Brand	000001	
S7694	008	0		29	10	S7694_008_0	2	1	Preferred Generic	001000	
S7694	008	0		29	10	S7694_008_0	2	5	Specialty Tier	010010	
S7694	008	0		29	10	S7694_008_0	2	6	Select Care Drugs	000010	
S7694	009	0		29	10	S7694_009_0	2	3	Preferred Brand	000001	
S7694	009	0		29	10	S7694_009_0	2	2	Non-Preferred Generic	000100	
S7694	009	0		29	10	S7694_009_0	2	1	Preferred Generic	001000	
S7694	009	0		29	10	S7694_009_0	2	4	Non-Preferred Brand	100000	
S7694	009	0		29	10	S7694_009_0	2	5	Specialty Tier	010010	
S7694	009	0		29	10	S7694_009_0	2	6	Select Care Drugs	000010	
S7694	010	0		29	10	S7694_010_0	2	2	Non-Preferred Generic	000100	
S7694	010	0		29	10	S7694_010_0	2	3	Preferred Brand	000001	
S7694	010	0		29	10	S7694_010_0	2	4	Non-Preferred Brand	100000	
S7694	010	0		29	10	S7694_010_0	2	5	Specialty Tier	010010	
S7694	010	0		29	10	S7694_010_0	2	6	Select Care Drugs	000010	
S7694	010	0		29	10	S7694_010_0	2	1	Preferred Generic	001000	
S7694	011	0		29	10	S7694_011_0	2	2	Non-Preferred Generic	000100	
S7694	011	0		29	10	S7694_011_0	2	3	Preferred Brand	000001	
S7694	011	0		29	10	S7694_011_0	2	1	Preferred Generic	001000	
S7694	011	0		29	10	S7694_011_0	2	5	Specialty Tier	010010	
S7694	011	0		29	10	S7694_011_0	2	6	Select Care Drugs	000010	
S7694	011	0		29	10	S7694_011_0	2	4	Non-Preferred Brand	100000	
S7694	012	0		29	10	S7694_012_0	2	2	Non-Preferred Generic	000100	
S7694	012	0		29	10	S7694_012_0	2	3	Preferred Brand	000001	
S7694	012	0		29	10	S7694_012_0	2	4	Non-Preferred Brand	100000	
S7694	012	0		29	10	S7694_012_0	2	5	Specialty Tier	010010	
S7694	012	0		29	10	S7694_012_0	2	6	Select Care Drugs	000010	
S7694	012	0		29	10	S7694_012_0	2	1	Preferred Generic	001000	
S7694	014	0		29	10	S7694_014_0	2	6	Select Care Drugs	000010	
S7694	014	0		29	10	S7694_014_0	2	5	Specialty Tier	010010	
S7694	014	0		29	10	S7694_014_0	2	4	Non-Preferred Brand	100000	
S7694	014	0		29	10	S7694_014_0	2	3	Preferred Brand	000001	
S7694	014	0		29	10	S7694_014_0	2	2	Non-Preferred Generic	000100	
S7694	014	0		29	10	S7694_014_0	2	1	Preferred Generic	001000	
S7694	015	0		29	10	S7694_015_0	2	1	Preferred Generic	001000	
S7694	015	0		29	10	S7694_015_0	2	3	Preferred Brand	000001	
S7694	015	0		29	10	S7694_015_0	2	4	Non-Preferred Brand	100000	
S7694	015	0		29	10	S7694_015_0	2	5	Specialty Tier	010010	
S7694	015	0		29	10	S7694_015_0	2	6	Select Care Drugs	000010	
S7694	015	0		29	10	S7694_015_0	2	2	Non-Preferred Generic	000100	
S7694	016	0		29	10	S7694_016_0	2	1	Preferred Generic	001000	
S7694	016	0		29	10	S7694_016_0	2	6	Select Care Drugs	000010	
S7694	016	0		29	10	S7694_016_0	2	5	Specialty Tier	010010	
S7694	016	0		29	10	S7694_016_0	2	4	Non-Preferred Brand	100000	
S7694	016	0		29	10	S7694_016_0	2	3	Preferred Brand	000001	
S7694	016	0		29	10	S7694_016_0	2	2	Non-Preferred Generic	000100	
S7694	017	0		29	10	S7694_017_0	2	6	Select Care Drugs	000010	
S7694	017	0		29	10	S7694_017_0	2	5	Specialty Tier	010010	
S7694	017	0		29	10	S7694_017_0	2	4	Non-Preferred Brand	100000	
S7694	017	0		29	10	S7694_017_0	2	3	Preferred Brand	000001	
S7694	017	0		29	10	S7694_017_0	2	2	Non-Preferred Generic	000100	
S7694	017	0		29	10	S7694_017_0	2	1	Preferred Generic	001000	
S7694	018	0		29	10	S7694_018_0	2	6	Select Care Drugs	000010	
S7694	018	0		29	10	S7694_018_0	2	5	Specialty Tier	010010	
S7694	018	0		29	10	S7694_018_0	2	4	Non-Preferred Brand	100000	
S7694	018	0		29	10	S7694_018_0	2	3	Preferred Brand	000001	
S7694	018	0		29	10	S7694_018_0	2	2	Non-Preferred Generic	000100	
S7694	018	0		29	10	S7694_018_0	2	1	Preferred Generic	001000	
S7694	019	0		29	10	S7694_019_0	2	1	Preferred Generic	001000	
S7694	019	0		29	10	S7694_019_0	2	2	Non-Preferred Generic	000100	
S7694	019	0		29	10	S7694_019_0	2	3	Preferred Brand	000001	
S7694	019	0		29	10	S7694_019_0	2	4	Non-Preferred Brand	100000	
S7694	019	0		29	10	S7694_019_0	2	5	Specialty Tier	010010	
S7694	019	0		29	10	S7694_019_0	2	6	Select Care Drugs	000010	
S7694	020	0		29	10	S7694_020_0	2	1	Preferred Generic	001000	
S7694	020	0		29	10	S7694_020_0	2	2	Non-Preferred Generic	000100	
S7694	020	0		29	10	S7694_020_0	2	6	Select Care Drugs	000010	
S7694	020	0		29	10	S7694_020_0	2	4	Non-Preferred Brand	100000	
S7694	020	0		29	10	S7694_020_0	2	5	Specialty Tier	010010	
S7694	020	0		29	10	S7694_020_0	2	3	Preferred Brand	000001	
S7694	021	0		29	10	S7694_021_0	2	5	Specialty Tier	010010	
S7694	021	0		29	10	S7694_021_0	2	6	Select Care Drugs	000010	
S7694	021	0		29	10	S7694_021_0	2	1	Preferred Generic	001000	
S7694	021	0		29	10	S7694_021_0	2	2	Non-Preferred Generic	000100	
S7694	021	0		29	10	S7694_021_0	2	3	Preferred Brand	000001	
S7694	021	0		29	10	S7694_021_0	2	4	Non-Preferred Brand	100000	
S7694	022	0		29	10	S7694_022_0	2	4	Non-Preferred Brand	100000	
S7694	022	0		29	10	S7694_022_0	2	5	Specialty Tier	010010	
S7694	022	0		29	10	S7694_022_0	2	3	Preferred Brand	000001	
S7694	022	0		29	10	S7694_022_0	2	2	Non-Preferred Generic	000100	
S7694	022	0		29	10	S7694_022_0	2	1	Preferred Generic	001000	
S7694	022	0		29	10	S7694_022_0	2	6	Select Care Drugs	000010	
S7694	023	0		29	10	S7694_023_0	2	2	Non-Preferred Generic	000100	
S7694	023	0		29	10	S7694_023_0	2	1	Preferred Generic	001000	
S7694	023	0		29	10	S7694_023_0	2	3	Preferred Brand	000001	
S7694	023	0		29	10	S7694_023_0	2	6	Select Care Drugs	000010	
S7694	023	0		29	10	S7694_023_0	2	5	Specialty Tier	010010	
S7694	023	0		29	10	S7694_023_0	2	4	Non-Preferred Brand	100000	
S7694	024	0		29	10	S7694_024_0	2	1	Preferred Generic	001000	
S7694	024	0		29	10	S7694_024_0	2	2	Non-Preferred Generic	000100	
S7694	024	0		29	10	S7694_024_0	2	5	Specialty Tier	010010	
S7694	024	0		29	10	S7694_024_0	2	4	Non-Preferred Brand	100000	
S7694	024	0		29	10	S7694_024_0	2	3	Preferred Brand	000001	
S7694	024	0		29	10	S7694_024_0	2	6	Select Care Drugs	000010	
S7694	025	0		29	10	S7694_025_0	2	5	Specialty Tier	010010	
S7694	025	0		29	10	S7694_025_0	2	4	Non-Preferred Brand	100000	
S7694	025	0		29	10	S7694_025_0	2	3	Preferred Brand	000001	
S7694	025	0		29	10	S7694_025_0	2	2	Non-Preferred Generic	000100	
S7694	025	0		29	10	S7694_025_0	2	1	Preferred Generic	001000	
S7694	025	0		29	10	S7694_025_0	2	6	Select Care Drugs	000010	
S7694	026	0		29	10	S7694_026_0	2	5	Specialty Tier	010010	
S7694	026	0		29	10	S7694_026_0	2	4	Non-Preferred Brand	100000	
S7694	026	0		29	10	S7694_026_0	2	3	Preferred Brand	000001	
S7694	026	0		29	10	S7694_026_0	2	2	Non-Preferred Generic	000100	
S7694	026	0		29	10	S7694_026_0	2	1	Preferred Generic	001000	
S7694	026	0		29	10	S7694_026_0	2	6	Select Care Drugs	000010	
S7694	027	0		29	10	S7694_027_0	2	5	Specialty Tier	010010	
S7694	027	0		29	10	S7694_027_0	2	4	Non-Preferred Brand	100000	
S7694	027	0		29	10	S7694_027_0	2	3	Preferred Brand	000001	
S7694	027	0		29	10	S7694_027_0	2	2	Non-Preferred Generic	000100	
S7694	027	0		29	10	S7694_027_0	2	1	Preferred Generic	001000	
S7694	027	0		29	10	S7694_027_0	2	6	Select Care Drugs	000010	
S7694	028	0		29	10	S7694_028_0	2	1	Preferred Generic	001000	
S7694	028	0		29	10	S7694_028_0	2	2	Non-Preferred Generic	000100	
S7694	028	0		29	10	S7694_028_0	2	3	Preferred Brand	000001	
S7694	028	0		29	10	S7694_028_0	2	4	Non-Preferred Brand	100000	
S7694	028	0		29	10	S7694_028_0	2	5	Specialty Tier	010010	
S7694	028	0		29	10	S7694_028_0	2	6	Select Care Drugs	000010	
S7694	029	0		29	10	S7694_029_0	2	1	Preferred Generic	001000	
S7694	029	0		29	10	S7694_029_0	2	2	Non-Preferred Generic	000100	
S7694	029	0		29	10	S7694_029_0	2	3	Preferred Brand	000001	
S7694	029	0		29	10	S7694_029_0	2	4	Non-Preferred Brand	100000	
S7694	029	0		29	10	S7694_029_0	2	5	Specialty Tier	010010	
S7694	029	0		29	10	S7694_029_0	2	6	Select Care Drugs	000010	
S7694	030	0		29	10	S7694_030_0	2	2	Non-Preferred Generic	000100	
S7694	030	0		29	10	S7694_030_0	2	1	Preferred Generic	001000	
S7694	030	0		29	10	S7694_030_0	2	3	Preferred Brand	000001	
S7694	030	0		29	10	S7694_030_0	2	4	Non-Preferred Brand	100000	
S7694	030	0		29	10	S7694_030_0	2	5	Specialty Tier	010010	
S7694	030	0		29	10	S7694_030_0	2	6	Select Care Drugs	000010	
S7694	031	0		29	10	S7694_031_0	2	1	Preferred Generic	001000	
S7694	031	0		29	10	S7694_031_0	2	2	Non-Preferred Generic	000100	
S7694	031	0		29	10	S7694_031_0	2	3	Preferred Brand	000001	
S7694	031	0		29	10	S7694_031_0	2	4	Non-Preferred Brand	100000	
S7694	031	0		29	10	S7694_031_0	2	5	Specialty Tier	010010	
S7694	031	0		29	10	S7694_031_0	2	6	Select Care Drugs	000010	
S7694	032	0		29	10	S7694_032_0	2	2	Non-Preferred Generic	000100	
S7694	032	0		29	10	S7694_032_0	2	1	Preferred Generic	001000	
S7694	032	0		29	10	S7694_032_0	2	3	Preferred Brand	000001	
S7694	032	0		29	10	S7694_032_0	2	6	Select Care Drugs	000010	
S7694	032	0		29	10	S7694_032_0	2	5	Specialty Tier	010010	
S7694	032	0		29	10	S7694_032_0	2	4	Non-Preferred Brand	100000	
S7694	033	0		29	10	S7694_033_0	2	1	Preferred Generic	001000	
S7694	033	0		29	10	S7694_033_0	2	2	Non-Preferred Generic	000100	
S7694	033	0		29	10	S7694_033_0	2	3	Preferred Brand	000001	
S7694	033	0		29	10	S7694_033_0	2	4	Non-Preferred Brand	100000	
S7694	033	0		29	10	S7694_033_0	2	5	Specialty Tier	010010	
S7694	033	0		29	10	S7694_033_0	2	6	Select Care Drugs	000010	
S7694	034	0		29	10	S7694_034_0	2	1	Preferred Generic	001000	
S7694	034	0		29	10	S7694_034_0	2	2	Non-Preferred Generic	000100	
S7694	034	0		29	10	S7694_034_0	2	5	Specialty Tier	010010	
S7694	034	0		29	10	S7694_034_0	2	4	Non-Preferred Brand	100000	
S7694	034	0		29	10	S7694_034_0	2	3	Preferred Brand	000001	
S7694	034	0		29	10	S7694_034_0	2	6	Select Care Drugs	000010	
S7694	070	0		29	10	S7694_070_0	2	1	Preferred Generic	001000	
S7694	070	0		29	10	S7694_070_0	2	2	Non-Preferred Generic	000100	
S7694	070	0		29	10	S7694_070_0	2	6	Select Care Drugs	000010	
S7694	070	0		29	10	S7694_070_0	2	4	Non-Preferred Brand	100000	
S7694	070	0		29	10	S7694_070_0	2	5	Specialty Tier	010010	
S7694	070	0		29	10	S7694_070_0	2	3	Preferred Brand	000001	
S8067	001	0		29	10	S8067_001_0	5	4	Specialty Tier	010010	
S8067	001	0		29	10	S8067_001_0	5	3	Preferred Brand	000001	
S8067	001	0		29	10	S8067_001_0	5	2	Non-Preferred Generic	000100	
S8067	001	0		29	10	S8067_001_0	5	1	Preferred Generic	001000	
S8067	003	0		29	10	S8067_003_0	4	4	Non-Preferred Brand	100000	
S8067	003	0		29	10	S8067_003_0	4	3	Preferred Brand	000001	
S8067	003	0		29	10	S8067_003_0	4	2	Non-Preferred Generic	000100	
S8067	003	0		29	10	S8067_003_0	4	5	Specialty Tier	010010	
S8067	003	0		29	10	S8067_003_0	4	1	Preferred Generic	001000	
S9014	002	0		29	10	S9014_002_0	2	1	Preferred Generic	001000	
S9014	002	0		29	10	S9014_002_0	2	2	Non-Preferred Generic	000100	
S9014	002	0		29	10	S9014_002_0	2	3	Preferred Brand	000001	
S9014	002	0		29	10	S9014_002_0	2	4	Specialty Tier	010010	
S9014	002	0		29	10	S9014_002_0	2	1	Preferred Generic	001000	1
S9014	002	0		29	10	S9014_002_0	2	2	Non-Preferred Generic	000100	1
S9014	004	0		29	10	S9014_004_0	2	1	Preferred Generic	001000	
S9014	004	0		29	10	S9014_004_0	2	2	Non-Preferred Generic	000100	
S9014	004	0		29	10	S9014_004_0	2	3	Preferred Brand	000001	
S9014	004	0		29	10	S9014_004_0	2	4	Specialty Tier	010010	
S9014	004	0		29	10	S9014_004_0	2	1	Preferred Generic	001000	1
S9014	004	0		29	10	S9014_004_0	2	2	Non-Preferred Generic	000100	1
S9579	001	0		29	10	S9579_001_0	4	1	Preferred Generic	001000	
S9579	001	0		29	10	S9579_001_0	4	2	Non-Preferred Generic	000100	
S9579	001	0		29	10	S9579_001_0	4	3	Preferred Brand	000001	
S9579	001	0		29	10	S9579_001_0	4	4	Non-Preferred Brand	100000	
S9579	001	0		29	10	S9579_001_0	4	5	Specialty Tier	010010	
S9579	002	0		29	10	S9579_002_0	4	5	Specialty Tier	010010	
S9579	002	0		29	10	S9579_002_0	4	4	Non-Preferred Brand	100000	
S9579	002	0		29	10	S9579_002_0	4	3	Preferred Brand	000001	
S9579	002	0		29	10	S9579_002_0	4	2	Non-Preferred Generic	000100	
S9579	002	0		29	10	S9579_002_0	4	1	Preferred Generic	001000	
S9579	003	0		29	10	S9579_003_0	4	3	Preferred Brand	000001	
S9579	003	0		29	10	S9579_003_0	4	2	Non-Preferred Generic	000100	
S9579	003	0		29	10	S9579_003_0	4	1	Preferred Generic	001000	
S9579	003	0		29	10	S9579_003_0	4	4	Non-Preferred Brand	100000	
S9579	003	0		29	10	S9579_003_0	4	5	Specialty Tier	010010	
S9579	004	0		29	10	S9579_004_0	4	5	Specialty Tier	010010	
S9579	004	0		29	10	S9579_004_0	4	4	Non-Preferred Brand	100000	
S9579	004	0		29	10	S9579_004_0	4	3	Preferred Brand	000001	
S9579	004	0		29	10	S9579_004_0	4	2	Non-Preferred Generic	000100	
S9579	004	0		29	10	S9579_004_0	4	1	Preferred Generic	001000	
S9579	005	0		29	10	S9579_005_0	4	5	Specialty Tier	010010	
S9579	005	0		29	10	S9579_005_0	4	4	Non-Preferred Brand	100000	
S9579	005	0		29	10	S9579_005_0	4	1	Preferred Generic	001000	
S9579	005	0		29	10	S9579_005_0	4	2	Non-Preferred Generic	000100	
S9579	005	0		29	10	S9579_005_0	4	3	Preferred Brand	000001	
S9579	006	0		29	10	S9579_006_0	4	1	Preferred Generic	001000	
S9579	006	0		29	10	S9579_006_0	4	5	Specialty Tier	010010	
S9579	006	0		29	10	S9579_006_0	4	4	Non-Preferred Brand	100000	
S9579	006	0		29	10	S9579_006_0	4	3	Preferred Brand	000001	
S9579	006	0		29	10	S9579_006_0	4	2	Non-Preferred Generic	000100	
S9579	007	0		29	10	S9579_007_0	4	1	Preferred Generic	001000	
S9579	007	0		29	10	S9579_007_0	4	5	Specialty Tier	010010	
S9579	007	0		29	10	S9579_007_0	4	3	Preferred Brand	000001	
S9579	007	0		29	10	S9579_007_0	4	4	Non-Preferred Brand	100000	
S9579	007	0		29	10	S9579_007_0	4	2	Non-Preferred Generic	000100	
S9579	008	0		29	10	S9579_008_0	4	1	Preferred Generic	001000	
S9579	008	0		29	10	S9579_008_0	4	2	Non-Preferred Generic	000100	
S9579	008	0		29	10	S9579_008_0	4	3	Preferred Brand	000001	
S9579	008	0		29	10	S9579_008_0	4	5	Specialty Tier	010010	
S9579	008	0		29	10	S9579_008_0	4	4	Non-Preferred Brand	100000	
S9579	009	0		29	10	S9579_009_0	4	4	Non-Preferred Brand	100000	
S9579	009	0		29	10	S9579_009_0	4	5	Specialty Tier	010010	
S9579	009	0		29	10	S9579_009_0	4	3	Preferred Brand	000001	
S9579	009	0		29	10	S9579_009_0	4	1	Preferred Generic	001000	
S9579	009	0		29	10	S9579_009_0	4	2	Non-Preferred Generic	000100	
S9579	010	0		29	10	S9579_010_0	4	2	Non-Preferred Generic	000100	
S9579	010	0		29	10	S9579_010_0	4	3	Preferred Brand	000001	
S9579	010	0		29	10	S9579_010_0	4	1	Preferred Generic	001000	
S9579	010	0		29	10	S9579_010_0	4	5	Specialty Tier	010010	
S9579	010	0		29	10	S9579_010_0	4	4	Non-Preferred Brand	100000	
S9579	011	0		29	10	S9579_011_0	4	1	Preferred Generic	001000	
S9579	011	0		29	10	S9579_011_0	4	3	Preferred Brand	000001	
S9579	011	0		29	10	S9579_011_0	4	2	Non-Preferred Generic	000100	
S9579	011	0		29	10	S9579_011_0	4	4	Non-Preferred Brand	100000	
S9579	011	0		29	10	S9579_011_0	4	5	Specialty Tier	010010	
S9579	012	0		29	10	S9579_012_0	4	1	Preferred Generic	001000	
S9579	012	0		29	10	S9579_012_0	4	2	Non-Preferred Generic	000100	
S9579	012	0		29	10	S9579_012_0	4	3	Preferred Brand	000001	
S9579	012	0		29	10	S9579_012_0	4	4	Non-Preferred Brand	100000	
S9579	012	0		29	10	S9579_012_0	4	5	Specialty Tier	010010	
S9579	013	0		29	10	S9579_013_0	4	4	Non-Preferred Brand	100000	
S9579	013	0		29	10	S9579_013_0	4	5	Specialty Tier	010010	
S9579	013	0		29	10	S9579_013_0	4	1	Preferred Generic	001000	
S9579	013	0		29	10	S9579_013_0	4	2	Non-Preferred Generic	000100	
S9579	013	0		29	10	S9579_013_0	4	3	Preferred Brand	000001	
S9579	014	0		29	10	S9579_014_0	4	4	Non-Preferred Brand	100000	
S9579	014	0		29	10	S9579_014_0	4	3	Preferred Brand	000001	
S9579	014	0		29	10	S9579_014_0	4	2	Non-Preferred Generic	000100	
S9579	014	0		29	10	S9579_014_0	4	1	Preferred Generic	001000	
S9579	014	0		29	10	S9579_014_0	4	5	Specialty Tier	010010	
S9579	015	0		29	10	S9579_015_0	4	1	Preferred Generic	001000	
S9579	015	0		29	10	S9579_015_0	4	2	Non-Preferred Generic	000100	
S9579	015	0		29	10	S9579_015_0	4	3	Preferred Brand	000001	
S9579	015	0		29	10	S9579_015_0	4	4	Non-Preferred Brand	100000	
S9579	015	0		29	10	S9579_015_0	4	5	Specialty Tier	010010	
S9579	016	0		29	10	S9579_016_0	4	4	Non-Preferred Brand	100000	
S9579	016	0		29	10	S9579_016_0	4	3	Preferred Brand	000001	
S9579	016	0		29	10	S9579_016_0	4	2	Non-Preferred Generic	000100	
S9579	016	0		29	10	S9579_016_0	4	1	Preferred Generic	001000	
S9579	016	0		29	10	S9579_016_0	4	5	Specialty Tier	010010	
S9579	017	0		29	10	S9579_017_0	4	2	Non-Preferred Generic	000100	
S9579	017	0		29	10	S9579_017_0	4	1	Preferred Generic	001000	
S9579	017	0		29	10	S9579_017_0	4	3	Preferred Brand	000001	
S9579	017	0		29	10	S9579_017_0	4	4	Non-Preferred Brand	100000	
S9579	017	0		29	10	S9579_017_0	4	5	Specialty Tier	010010	
S9579	018	0		29	10	S9579_018_0	4	2	Non-Preferred Generic	000100	
S9579	018	0		29	10	S9579_018_0	4	1	Preferred Generic	001000	
S9579	018	0		29	10	S9579_018_0	4	3	Preferred Brand	000001	
S9579	018	0		29	10	S9579_018_0	4	5	Specialty Tier	010010	
S9579	018	0		29	10	S9579_018_0	4	4	Non-Preferred Brand	100000	
S9579	019	0		29	10	S9579_019_0	4	1	Preferred Generic	001000	
S9579	019	0		29	10	S9579_019_0	4	2	Non-Preferred Generic	000100	
S9579	019	0		29	10	S9579_019_0	4	4	Non-Preferred Brand	100000	
S9579	019	0		29	10	S9579_019_0	4	3	Preferred Brand	000001	
S9579	019	0		29	10	S9579_019_0	4	5	Specialty Tier	010010	
S9579	020	0		29	10	S9579_020_0	4	1	Preferred Generic	001000	
S9579	020	0		29	10	S9579_020_0	4	4	Non-Preferred Brand	100000	
S9579	020	0		29	10	S9579_020_0	4	3	Preferred Brand	000001	
S9579	020	0		29	10	S9579_020_0	4	2	Non-Preferred Generic	000100	
S9579	020	0		29	10	S9579_020_0	4	5	Specialty Tier	010010	
S9579	021	0		29	10	S9579_021_0	4	4	Non-Preferred Brand	100000	
S9579	021	0		29	10	S9579_021_0	4	1	Preferred Generic	001000	
S9579	021	0		29	10	S9579_021_0	4	2	Non-Preferred Generic	000100	
S9579	021	0		29	10	S9579_021_0	4	3	Preferred Brand	000001	
S9579	021	0		29	10	S9579_021_0	4	5	Specialty Tier	010010	
S9579	022	0		29	10	S9579_022_0	4	5	Specialty Tier	010010	
S9579	022	0		29	10	S9579_022_0	4	4	Non-Preferred Brand	100000	
S9579	022	0		29	10	S9579_022_0	4	1	Preferred Generic	001000	
S9579	022	0		29	10	S9579_022_0	4	2	Non-Preferred Generic	000100	
S9579	022	0		29	10	S9579_022_0	4	3	Preferred Brand	000001	
S9579	023	0		29	10	S9579_023_0	4	5	Specialty Tier	010010	
S9579	023	0		29	10	S9579_023_0	4	2	Non-Preferred Generic	000100	
S9579	023	0		29	10	S9579_023_0	4	3	Preferred Brand	000001	
S9579	023	0		29	10	S9579_023_0	4	4	Non-Preferred Brand	100000	
S9579	023	0		29	10	S9579_023_0	4	1	Preferred Generic	001000	
S9579	024	0		29	10	S9579_024_0	4	1	Preferred Generic	001000	
S9579	024	0		29	10	S9579_024_0	4	2	Non-Preferred Generic	000100	
S9579	024	0		29	10	S9579_024_0	4	5	Specialty Tier	010010	
S9579	024	0		29	10	S9579_024_0	4	4	Non-Preferred Brand	100000	
S9579	024	0		29	10	S9579_024_0	4	3	Preferred Brand	000001	
S9579	025	0		29	10	S9579_025_0	4	1	Preferred Generic	001000	
S9579	025	0		29	10	S9579_025_0	4	2	Non-Preferred Generic	000100	
S9579	025	0		29	10	S9579_025_0	4	3	Preferred Brand	000001	
S9579	025	0		29	10	S9579_025_0	4	4	Non-Preferred Brand	100000	
S9579	025	0		29	10	S9579_025_0	4	5	Specialty Tier	010010	
S9579	026	0		29	10	S9579_026_0	4	5	Specialty Tier	010010	
S9579	026	0		29	10	S9579_026_0	4	3	Preferred Brand	000001	
S9579	026	0		29	10	S9579_026_0	4	4	Non-Preferred Brand	100000	
S9579	026	0		29	10	S9579_026_0	4	1	Preferred Generic	001000	
S9579	026	0		29	10	S9579_026_0	4	2	Non-Preferred Generic	000100	
S9579	027	0		29	10	S9579_027_0	4	5	Specialty Tier	010010	
S9579	027	0		29	10	S9579_027_0	4	1	Preferred Generic	001000	
S9579	027	0		29	10	S9579_027_0	4	3	Preferred Brand	000001	
S9579	027	0		29	10	S9579_027_0	4	4	Non-Preferred Brand	100000	
S9579	027	0		29	10	S9579_027_0	4	2	Non-Preferred Generic	000100	
S9579	028	0		29	10	S9579_028_0	4	4	Non-Preferred Brand	100000	
S9579	028	0		29	10	S9579_028_0	4	1	Preferred Generic	001000	
S9579	028	0		29	10	S9579_028_0	4	2	Non-Preferred Generic	000100	
S9579	028	0		29	10	S9579_028_0	4	3	Preferred Brand	000001	
S9579	028	0		29	10	S9579_028_0	4	5	Specialty Tier	010010	
S9579	029	0		29	10	S9579_029_0	4	5	Specialty Tier	010010	
S9579	029	0		29	10	S9579_029_0	4	4	Non-Preferred Brand	100000	
S9579	029	0		29	10	S9579_029_0	4	1	Preferred Generic	001000	
S9579	029	0		29	10	S9579_029_0	4	2	Non-Preferred Generic	000100	
S9579	029	0		29	10	S9579_029_0	4	3	Preferred Brand	000001	
S9579	030	0		29	10	S9579_030_0	4	4	Non-Preferred Brand	100000	
S9579	030	0		29	10	S9579_030_0	4	3	Preferred Brand	000001	
S9579	030	0		29	10	S9579_030_0	4	2	Non-Preferred Generic	000100	
S9579	030	0		29	10	S9579_030_0	4	1	Preferred Generic	001000	
S9579	030	0		29	10	S9579_030_0	4	5	Specialty Tier	010010	
S9579	031	0		29	10	S9579_031_0	4	4	Non-Preferred Brand	100000	
S9579	031	0		29	10	S9579_031_0	4	3	Preferred Brand	000001	
S9579	031	0		29	10	S9579_031_0	4	2	Non-Preferred Generic	000100	
S9579	031	0		29	10	S9579_031_0	4	1	Preferred Generic	001000	
S9579	031	0		29	10	S9579_031_0	4	5	Specialty Tier	010010	
S9579	032	0		29	10	S9579_032_0	4	1	Preferred Generic	001000	
S9579	032	0		29	10	S9579_032_0	4	2	Non-Preferred Generic	000100	
S9579	032	0		29	10	S9579_032_0	4	3	Preferred Brand	000001	
S9579	032	0		29	10	S9579_032_0	4	4	Non-Preferred Brand	100000	
S9579	032	0		29	10	S9579_032_0	4	5	Specialty Tier	010010	
S9579	033	0		29	10	S9579_033_0	4	1	Preferred Generic	001000	
S9579	033	0		29	10	S9579_033_0	4	2	Non-Preferred Generic	000100	
S9579	033	0		29	10	S9579_033_0	4	3	Preferred Brand	000001	
S9579	033	0		29	10	S9579_033_0	4	4	Non-Preferred Brand	100000	
S9579	033	0		29	10	S9579_033_0	4	5	Specialty Tier	010010	
S9579	034	0		29	10	S9579_034_0	5	1	Preferred Generic	001000	
S9579	034	0		29	10	S9579_034_0	5	2	Non-Preferred Generic	000100	
S9579	034	0		29	10	S9579_034_0	5	3	Preferred Brand	000001	
S9579	034	0		29	10	S9579_034_0	5	4	Non-Preferred Brand	100000	
S9579	034	0		29	10	S9579_034_0	5	5	Specialty Tier	010010	
S9579	035	0		29	10	S9579_035_0	5	2	Non-Preferred Generic	000100	
S9579	035	0		29	10	S9579_035_0	5	1	Preferred Generic	001000	
S9579	035	0		29	10	S9579_035_0	5	3	Preferred Brand	000001	
S9579	035	0		29	10	S9579_035_0	5	4	Non-Preferred Brand	100000	
S9579	035	0		29	10	S9579_035_0	5	5	Specialty Tier	010010	
S9579	036	0		29	10	S9579_036_0	5	1	Preferred Generic	001000	
S9579	036	0		29	10	S9579_036_0	5	2	Non-Preferred Generic	000100	
S9579	036	0		29	10	S9579_036_0	5	3	Preferred Brand	000001	
S9579	036	0		29	10	S9579_036_0	5	4	Non-Preferred Brand	100000	
S9579	036	0		29	10	S9579_036_0	5	5	Specialty Tier	010010	
S9579	037	0		29	10	S9579_037_0	5	2	Non-Preferred Generic	000100	
S9579	037	0		29	10	S9579_037_0	5	1	Preferred Generic	001000	
S9579	037	0		29	10	S9579_037_0	5	3	Preferred Brand	000001	
S9579	037	0		29	10	S9579_037_0	5	5	Specialty Tier	010010	
S9579	037	0		29	10	S9579_037_0	5	4	Non-Preferred Brand	100000	
S9579	038	0		29	10	S9579_038_0	5	1	Preferred Generic	001000	
S9579	038	0		29	10	S9579_038_0	5	2	Non-Preferred Generic	000100	
S9579	038	0		29	10	S9579_038_0	5	3	Preferred Brand	000001	
S9579	038	0		29	10	S9579_038_0	5	4	Non-Preferred Brand	100000	
S9579	038	0		29	10	S9579_038_0	5	5	Specialty Tier	010010	
S9579	039	0		29	10	S9579_039_0	5	1	Preferred Generic	001000	
S9579	039	0		29	10	S9579_039_0	5	2	Non-Preferred Generic	000100	
S9579	039	0		29	10	S9579_039_0	5	4	Non-Preferred Brand	100000	
S9579	039	0		29	10	S9579_039_0	5	3	Preferred Brand	000001	
S9579	039	0		29	10	S9579_039_0	5	5	Specialty Tier	010010	
S9579	040	0		29	10	S9579_040_0	5	1	Preferred Generic	001000	
S9579	040	0		29	10	S9579_040_0	5	2	Non-Preferred Generic	000100	
S9579	040	0		29	10	S9579_040_0	5	3	Preferred Brand	000001	
S9579	040	0		29	10	S9579_040_0	5	4	Non-Preferred Brand	100000	
S9579	040	0		29	10	S9579_040_0	5	5	Specialty Tier	010010	
S9579	041	0		29	10	S9579_041_0	5	1	Preferred Generic	001000	
S9579	041	0		29	10	S9579_041_0	5	5	Specialty Tier	010010	
S9579	041	0		29	10	S9579_041_0	5	4	Non-Preferred Brand	100000	
S9579	041	0		29	10	S9579_041_0	5	2	Non-Preferred Generic	000100	
S9579	041	0		29	10	S9579_041_0	5	3	Preferred Brand	000001	
S9579	042	0		29	10	S9579_042_0	5	1	Preferred Generic	001000	
S9579	042	0		29	10	S9579_042_0	5	2	Non-Preferred Generic	000100	
S9579	042	0		29	10	S9579_042_0	5	3	Preferred Brand	000001	
S9579	042	0		29	10	S9579_042_0	5	4	Non-Preferred Brand	100000	
S9579	042	0		29	10	S9579_042_0	5	5	Specialty Tier	010010	
S9579	043	0		29	10	S9579_043_0	5	5	Specialty Tier	010010	
S9579	043	0		29	10	S9579_043_0	5	3	Preferred Brand	000001	
S9579	043	0		29	10	S9579_043_0	5	4	Non-Preferred Brand	100000	
S9579	043	0		29	10	S9579_043_0	5	1	Preferred Generic	001000	
S9579	043	0		29	10	S9579_043_0	5	2	Non-Preferred Generic	000100	
S9579	044	0		29	10	S9579_044_0	5	3	Preferred Brand	000001	
S9579	044	0		29	10	S9579_044_0	5	1	Preferred Generic	001000	
S9579	044	0		29	10	S9579_044_0	5	2	Non-Preferred Generic	000100	
S9579	044	0		29	10	S9579_044_0	5	5	Specialty Tier	010010	
S9579	044	0		29	10	S9579_044_0	5	4	Non-Preferred Brand	100000	
S9579	045	0		29	10	S9579_045_0	5	1	Preferred Generic	001000	
S9579	045	0		29	10	S9579_045_0	5	2	Non-Preferred Generic	000100	
S9579	045	0		29	10	S9579_045_0	5	5	Specialty Tier	010010	
S9579	045	0		29	10	S9579_045_0	5	4	Non-Preferred Brand	100000	
S9579	045	0		29	10	S9579_045_0	5	3	Preferred Brand	000001	
S9579	046	0		29	10	S9579_046_0	5	5	Specialty Tier	010010	
S9579	046	0		29	10	S9579_046_0	5	4	Non-Preferred Brand	100000	
S9579	046	0		29	10	S9579_046_0	5	3	Preferred Brand	000001	
S9579	046	0		29	10	S9579_046_0	5	1	Preferred Generic	001000	
S9579	046	0		29	10	S9579_046_0	5	2	Non-Preferred Generic	000100	
S9579	047	0		29	10	S9579_047_0	5	1	Preferred Generic	001000	
S9579	047	0		29	10	S9579_047_0	5	2	Non-Preferred Generic	000100	
S9579	047	0		29	10	S9579_047_0	5	3	Preferred Brand	000001	
S9579	047	0		29	10	S9579_047_0	5	4	Non-Preferred Brand	100000	
S9579	047	0		29	10	S9579_047_0	5	5	Specialty Tier	010010	
S9579	048	0		29	10	S9579_048_0	5	1	Preferred Generic	001000	
S9579	048	0		29	10	S9579_048_0	5	5	Specialty Tier	010010	
S9579	048	0		29	10	S9579_048_0	5	2	Non-Preferred Generic	000100	
S9579	048	0		29	10	S9579_048_0	5	3	Preferred Brand	000001	
S9579	048	0		29	10	S9579_048_0	5	4	Non-Preferred Brand	100000	
S9579	049	0		29	10	S9579_049_0	5	1	Preferred Generic	001000	
S9579	049	0		29	10	S9579_049_0	5	2	Non-Preferred Generic	000100	
S9579	049	0		29	10	S9579_049_0	5	3	Preferred Brand	000001	
S9579	049	0		29	10	S9579_049_0	5	4	Non-Preferred Brand	100000	
S9579	049	0		29	10	S9579_049_0	5	5	Specialty Tier	010010	
S9579	050	0		29	10	S9579_050_0	5	1	Preferred Generic	001000	
S9579	050	0		29	10	S9579_050_0	5	2	Non-Preferred Generic	000100	
S9579	050	0		29	10	S9579_050_0	5	3	Preferred Brand	000001	
S9579	050	0		29	10	S9579_050_0	5	4	Non-Preferred Brand	100000	
S9579	050	0		29	10	S9579_050_0	5	5	Specialty Tier	010010	
S9579	051	0		29	10	S9579_051_0	5	1	Preferred Generic	001000	
S9579	051	0		29	10	S9579_051_0	5	2	Non-Preferred Generic	000100	
S9579	051	0		29	10	S9579_051_0	5	3	Preferred Brand	000001	
S9579	051	0		29	10	S9579_051_0	5	4	Non-Preferred Brand	100000	
S9579	051	0		29	10	S9579_051_0	5	5	Specialty Tier	010010	
S9579	052	0		29	10	S9579_052_0	5	1	Preferred Generic	001000	
S9579	052	0		29	10	S9579_052_0	5	2	Non-Preferred Generic	000100	
S9579	052	0		29	10	S9579_052_0	5	3	Preferred Brand	000001	
S9579	052	0		29	10	S9579_052_0	5	5	Specialty Tier	010010	
S9579	052	0		29	10	S9579_052_0	5	4	Non-Preferred Brand	100000	
S9579	053	0		29	10	S9579_053_0	5	3	Preferred Brand	000001	
S9579	053	0		29	10	S9579_053_0	5	2	Non-Preferred Generic	000100	
S9579	053	0		29	10	S9579_053_0	5	1	Preferred Generic	001000	
S9579	053	0		29	10	S9579_053_0	5	4	Non-Preferred Brand	100000	
S9579	053	0		29	10	S9579_053_0	5	5	Specialty Tier	010010	
S9579	054	0		29	10	S9579_054_0	5	5	Specialty Tier	010010	
S9579	054	0		29	10	S9579_054_0	5	4	Non-Preferred Brand	100000	
S9579	054	0		29	10	S9579_054_0	5	1	Preferred Generic	001000	
S9579	054	0		29	10	S9579_054_0	5	2	Non-Preferred Generic	000100	
S9579	054	0		29	10	S9579_054_0	5	3	Preferred Brand	000001	
S9579	055	0		29	10	S9579_055_0	5	4	Non-Preferred Brand	100000	
S9579	055	0		29	10	S9579_055_0	5	5	Specialty Tier	010010	
S9579	055	0		29	10	S9579_055_0	5	1	Preferred Generic	001000	
S9579	055	0		29	10	S9579_055_0	5	2	Non-Preferred Generic	000100	
S9579	055	0		29	10	S9579_055_0	5	3	Preferred Brand	000001	
S9579	056	0		29	10	S9579_056_0	5	1	Preferred Generic	001000	
S9579	056	0		29	10	S9579_056_0	5	4	Non-Preferred Brand	100000	
S9579	056	0		29	10	S9579_056_0	5	3	Preferred Brand	000001	
S9579	056	0		29	10	S9579_056_0	5	2	Non-Preferred Generic	000100	
S9579	056	0		29	10	S9579_056_0	5	5	Specialty Tier	010010	
S9579	057	0		29	10	S9579_057_0	5	1	Preferred Generic	001000	
S9579	057	0		29	10	S9579_057_0	5	3	Preferred Brand	000001	
S9579	057	0		29	10	S9579_057_0	5	4	Non-Preferred Brand	100000	
S9579	057	0		29	10	S9579_057_0	5	5	Specialty Tier	010010	
S9579	057	0		29	10	S9579_057_0	5	2	Non-Preferred Generic	000100	
S9579	058	0		29	10	S9579_058_0	5	1	Preferred Generic	001000	
S9579	058	0		29	10	S9579_058_0	5	2	Non-Preferred Generic	000100	
S9579	058	0		29	10	S9579_058_0	5	3	Preferred Brand	000001	
S9579	058	0		29	10	S9579_058_0	5	4	Non-Preferred Brand	100000	
S9579	058	0		29	10	S9579_058_0	5	5	Specialty Tier	010010	
S9579	059	0		29	10	S9579_059_0	5	5	Specialty Tier	010010	
S9579	059	0		29	10	S9579_059_0	5	4	Non-Preferred Brand	100000	
S9579	059	0		29	10	S9579_059_0	5	3	Preferred Brand	000001	
S9579	059	0		29	10	S9579_059_0	5	2	Non-Preferred Generic	000100	
S9579	059	0		29	10	S9579_059_0	5	1	Preferred Generic	001000	
S9579	060	0		29	10	S9579_060_0	5	1	Preferred Generic	001000	
S9579	060	0		29	10	S9579_060_0	5	2	Non-Preferred Generic	000100	
S9579	060	0		29	10	S9579_060_0	5	3	Preferred Brand	000001	
S9579	060	0		29	10	S9579_060_0	5	4	Non-Preferred Brand	100000	
S9579	060	0		29	10	S9579_060_0	5	5	Specialty Tier	010010	
S9579	061	0		29	10	S9579_061_0	5	2	Non-Preferred Generic	000100	
S9579	061	0		29	10	S9579_061_0	5	1	Preferred Generic	001000	
S9579	061	0		29	10	S9579_061_0	5	3	Preferred Brand	000001	
S9579	061	0		29	10	S9579_061_0	5	5	Specialty Tier	010010	
S9579	061	0		29	10	S9579_061_0	5	4	Non-Preferred Brand	100000	
S9579	062	0		29	10	S9579_062_0	5	1	Preferred Generic	001000	
S9579	062	0		29	10	S9579_062_0	5	2	Non-Preferred Generic	000100	
S9579	062	0		29	10	S9579_062_0	5	4	Non-Preferred Brand	100000	
S9579	062	0		29	10	S9579_062_0	5	3	Preferred Brand	000001	
S9579	062	0		29	10	S9579_062_0	5	5	Specialty Tier	010010	
S9579	063	0		29	10	S9579_063_0	5	2	Non-Preferred Generic	000100	
S9579	063	0		29	10	S9579_063_0	5	1	Preferred Generic	001000	
S9579	063	0		29	10	S9579_063_0	5	3	Preferred Brand	000001	
S9579	063	0		29	10	S9579_063_0	5	5	Specialty Tier	010010	
S9579	063	0		29	10	S9579_063_0	5	4	Non-Preferred Brand	100000	
S9579	064	0		29	10	S9579_064_0	5	2	Non-Preferred Generic	000100	
S9579	064	0		29	10	S9579_064_0	5	1	Preferred Generic	001000	
S9579	064	0		29	10	S9579_064_0	5	3	Preferred Brand	000001	
S9579	064	0		29	10	S9579_064_0	5	4	Non-Preferred Brand	100000	
S9579	064	0		29	10	S9579_064_0	5	5	Specialty Tier	010010	
S9579	065	0		29	10	S9579_065_0	5	2	Non-Preferred Generic	000100	
S9579	065	0		29	10	S9579_065_0	5	1	Preferred Generic	001000	
S9579	065	0		29	10	S9579_065_0	5	3	Preferred Brand	000001	
S9579	065	0		29	10	S9579_065_0	5	5	Specialty Tier	010010	
S9579	065	0		29	10	S9579_065_0	5	4	Non-Preferred Brand	100000	
S9579	066	0		29	10	S9579_066_0	4	1	Preferred Generic	001000	
S9579	066	0		29	10	S9579_066_0	4	2	Non-Preferred Generic	000100	
S9579	066	0		29	10	S9579_066_0	4	3	Preferred Brand	000001	
S9579	066	0		29	10	S9579_066_0	4	4	Non-Preferred Brand	100000	
S9579	066	0		29	10	S9579_066_0	4	5	Specialty Tier	010010	
