CVALIDITYFLG=1     0001 202304011  B950    B951    B9561                                                                                                                                                                                                                           000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=2     0002 202304011  D7218                                                                                                                                                                                                                                           000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=3     0003 202304011  G90519                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=00000 GVF=03 GRC=03              04.1.23000000303                                                                                  %
CVALIDITYFLG=4     0004 202304011  V0001XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=00000 GVF=04 GRC=03              04.1.23000000403                                                                                  %
CVALIDITYFLG=5     0005 202304011  A400    O030                                                                                                                                                                                                                                    000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=1KA11 GVF=05 GRC=00              04.1.231KA110500                                                                                  %
CVALIDITYFLG=6     0006 202304011  XXXXXXX                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=00000 GVF=06 GRC=03              04.1.23000000603                                                                                  %
CVALIDITYFLG=7     0007 202304011                                                                                                                                                                                                                                                  000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=00000 GVF=07 GRC=03              04.1.23000000703                                                                                  %
CVALIDITYFLG=5     0008 202304011  A400    O080                                                                                                                                                                                                                                    000000000100000000000000                                                                                                                                                                                                                                                          VER=04.1.23 HIPPS=1KA11 GVF=05 GRC=00              04.1.231KA110500                                                                                  %
NOST_NA_NA_NA RC03 0009 202301011  T74A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T74A1XA INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0010 202304011  T74A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0011 202304011  A001    T74A1XA                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T74A1XA GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0012 202301011  T74A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0013 202303031  T74A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0014 202303021  T74A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0015 202301011  T74A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T74A1XD INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0016 202304011  T74A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0017 202304011  A001    T74A1XD                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T74A1XD GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0018 202301011  T74A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0019 202303031  T74A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0020 202303021  T74A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0021 202301011  T74A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T74A1XS INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0022 202304011  T74A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0023 202304011  A001    T74A1XS                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T74A1XS GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0024 202301011  T74A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0025 202303031  T74A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0026 202303021  T74A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0027 202301011  T74A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T74A2XA INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0028 202304011  T74A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0029 202304011  A001    T74A2XA                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T74A2XA GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0030 202301011  T74A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0031 202303031  T74A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0032 202303021  T74A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0033 202301011  T74A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T74A2XD INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0034 202304011  T74A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0035 202304011  A001    T74A2XD                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T74A2XD GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0036 202301011  T74A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0037 202303031  T74A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0038 202303021  T74A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0039 202301011  T74A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T74A2XS INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0040 202304011  T74A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0041 202304011  A001    T74A2XS                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T74A2XS GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0042 202301011  T74A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0043 202303031  T74A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0044 202303021  T74A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0045 202301011  T76A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T76A1XA INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0046 202304011  T76A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0047 202304011  A001    T76A1XA                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T76A1XA GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0048 202301011  T76A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0049 202303031  T76A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0050 202303021  T76A1XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0051 202301011  T76A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T76A1XD INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0052 202304011  T76A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0053 202304011  A001    T76A1XD                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T76A1XD GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0054 202301011  T76A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0055 202303031  T76A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0056 202303021  T76A1XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0057 202301011  T76A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T76A1XS INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0058 202304011  T76A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0059 202304011  A001    T76A1XS                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T76A1XS GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0060 202301011  T76A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0061 202303031  T76A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0062 202303021  T76A1XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0063 202301011  T76A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T76A2XA INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0064 202304011  T76A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0065 202304011  A001    T76A2XA                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T76A2XA GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0066 202301011  T76A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0067 202303031  T76A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0068 202303021  T76A2XA                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0069 202301011  T76A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T76A2XD INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0070 202304011  T76A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0071 202304011  A001    T76A2XD                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T76A2XD GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0072 202301011  T76A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0073 202303031  T76A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0074 202303021  T76A2XD                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0075 202301011  T76A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    T76A2XS INVALID FROM DATE PREVIOUS DATE FOR A                         VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0076 202304011  T76A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    CLINICAL_GROUP=NA PDX POS                                             VER=04.1.23 HIPPS=00000 GVF=00 GRC=05              04.1.23000000005                                                                                  %
CE_INFECT_Low_No   0077 202304011  A001    T76A2XS                                                                                                                                                                                                                                 000000000100000000000000                                                                                                                                                                                    T76A2XS GROUP=NA Add IN SDX CLINICAL_GROUP=NA PDX POS                 VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0078 202301011  T76A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0079 202303031  T76A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0080 202303021  T76A2XS                                                                                                                                                                                                                                         000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0081 202301011  Y07010                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    Y07010 INVALID FROM DATE PREVIOUS DATE FOR A                          VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0082 202304011  Y07010                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    ECOI_FLAG_CURRENT=1 PDX Restriction                                   VER=04.1.23 HIPPS=00000 GVF=04 GRC=03              04.1.23000000403                                                                                  %
CE_INFECT_Low_No   0083 202304011  A001    Y07010                                                                                                                                                                                                                                  000000000100000000000000                                                                                                                                                                                    Y07010 GROUP=NA Add IN SDX ECOI_FLAG_CURRENT=1                        VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0084 202301011  Y07010                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0085 202303031  Y07010                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0086 202303021  Y07010                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0087 202301011  Y07011                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    Y07011 INVALID FROM DATE PREVIOUS DATE FOR A                          VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0088 202304011  Y07011                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    ECOI_FLAG_CURRENT=1 PDX Restriction                                   VER=04.1.23 HIPPS=00000 GVF=04 GRC=03              04.1.23000000403                                                                                  %
CE_INFECT_Low_No   0089 202304011  A001    Y07011                                                                                                                                                                                                                                  000000000100000000000000                                                                                                                                                                                    Y07011 GROUP=NA Add IN SDX ECOI_FLAG_CURRENT=1                        VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0090 202301011  Y07011                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0091 202303031  Y07011                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0092 202303021  Y07011                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0093 202301011  Y07020                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    Y07020 INVALID FROM DATE PREVIOUS DATE FOR A                          VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0094 202304011  Y07020                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    ECOI_FLAG_CURRENT=1 PDX Restriction                                   VER=04.1.23 HIPPS=00000 GVF=04 GRC=03              04.1.23000000403                                                                                  %
CE_INFECT_Low_No   0095 202304011  A001    Y07020                                                                                                                                                                                                                                  000000000100000000000000                                                                                                                                                                                    Y07020 GROUP=NA Add IN SDX ECOI_FLAG_CURRENT=1                        VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0096 202301011  Y07020                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0097 202303031  Y07020                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0098 202303021  Y07020                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0099 202301011  Y07021                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    Y07021 INVALID FROM DATE PREVIOUS DATE FOR A                          VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0100 202304011  Y07021                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    ECOI_FLAG_CURRENT=1 PDX Restriction                                   VER=04.1.23 HIPPS=00000 GVF=04 GRC=03              04.1.23000000403                                                                                  %
CE_INFECT_Low_No   0101 202304011  A001    Y07021                                                                                                                                                                                                                                  000000000100000000000000                                                                                                                                                                                    Y07021 GROUP=NA Add IN SDX ECOI_FLAG_CURRENT=1                        VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0102 202301011  Y07021                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CE_INFECT_Low_No   0103 202303031  Y07021                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    <30 days spanning claim                                               VER=04.0.23 GVF=00 GRC=05                          04.0.23000000005                                                                                  %
NOST_NA_NA_NA RC00 0104 202303021  Y07021                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    30 days not spanning claim                                            VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC03 0105 202301011  Y07030                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    Y07030 INVALID FROM DATE PREVIOUS DATE FOR A                          VER=04.0.23 HIPPS=00000 GRC=03                     04.0.23000000003                                                                                  %
NOST_NA_NA_NA RC05 0106 202304011  Y07030                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    ECOI_FLAG_CURRENT=1 PDX Restriction                                   VER=04.1.23 HIPPS=00000 GVF=04 GRC=03              04.1.23000000403                                                                                  %
CE_INFECT_Low_No   0107 202304011  A001    Y07030                                                                                                                                                                                                                                  000000000100000000000000                                                                                                                                                                                    Y07030 GROUP=NA Add IN SDX ECOI_FLAG_CURRENT=1                        VER=04.1.23 HIPPS=1KA11 GVF=00 GRC=00              04.1.231KA110000                                                                                  %
CE_INFECT_Low_No   0108 202301011  Y07030                                                                                                                                                                                                                                          000000000100000000000000                                                                                                                                                                                    >30 days not spanning claim                                           VER=04.0.23 GVF=00 GRC=03                          04.0.23000000003                                                                                  %
CVALIDITYFLG=5     0109 20230401161A400    O030                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0110 20230401161A400    O031                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0111 20230401161A400    O032                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0112 20230401161A400    O0330                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0113 20230401161A400    O0331                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0114 20230401161A400    O0332                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0115 20230401161A400    O0333                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0116 20230401161A400    O0334                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0117 20230401161A400    O0335                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0118 20230401161D642    T6594XA                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0119 20230401161D642    T6594XD                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0120 20230401161D642    T6594XS                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=2KB11 GVF=05 GRC=00              04.1.232KB110500                                                                                  %
CVALIDITYFLG=5     0121 20230401161D6942   Q872                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=05 GRC=05              04.1.23000000505                                                                                  %
CVALIDITYFLG=5     0122 20230401161D7218   C9312                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0123 20230401161D7581   C50529                                                                                                                                                                                                                                  111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0124 20230401161D77     B650                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0125 20230401161D77     B651                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0126 20230401161D77     B652                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0127 20230401161D77     B653                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0128 20230401161D77     B658                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0129 20230401161D77     B659                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0130 20230401161D77     B500                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0131 20230401161D77     B508                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0132 20230401161M4980   A011                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0133 20230401161M4980   A012                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0134 20230401161M4980   A013                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0135 20230401161M4980   A014                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0136 20230401161M4980   A020                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0137 20230401161M4980   A021                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0138 20230401161M4980   A0220                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0139 20230401161M4980   A0221                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0140 20230401161M4980   A0222                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0141 20230401161M4980   A0223                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0142 20230401161M4980   A0224                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0143 20230401161M4980   A0225                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0144 20230401161M4980   A0229                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0145 20230401161R6510   S70261A                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0146 20230401161R6510   S70261D                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0147 20230401161R6510   S70261S                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0148 20230401161R6510   S70262A                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0149 20230401161R6510   S70262D                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0150 20230401161R6510   S70262S                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0151 20230401161R6510   S70269A                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0152 20230401161R6510   S70269D                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0153 20230401161R6510   S70269S                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0154 20230401161R6510   S70271A                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0155 20230401161R6510   S70271D                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0156 20230401161R6510   S70271S                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0157 20230401161Z91120  T50Z96S                                                                                                                                                                                                                                 111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=05 GRC=05              04.1.23000000505                                                                                  %
CVALIDITYFLG=5     0158 20230401161Z9183   F70                                                                                                                                                                                                                                     111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0159 20230401161Z9183   F71                                                                                                                                                                                                                                     111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0160 20230401161Z9183   F72                                                                                                                                                                                                                                     111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0161 20230401161Z9183   F73                                                                                                                                                                                                                                     111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0162 20230401161Z9183   F78A1                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0163 20230401161Z9183   F78A9                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0164 20230401161Z9183   F79                                                                                                                                                                                                                                     111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0165 20230401161Z9183   F03918                                                                                                                                                                                                                                  111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0166 20230401161Z9183   F03A4                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0167 20230401161Z9183   F03B3                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0168 20230401161Z9183   F03C2                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0169 20230401161Z9183   F842                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0170 20230401161Z9183   G309                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=02 GRC=03              04.1.23000000203                                                                                  %
CVALIDITYFLG=5     0171 20230401161Z9282   I2102                                                                                                                                                                                                                                   111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0172 20230401161Z9282   I221                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0173 20230401161Z9282   I63433                                                                                                                                                                                                                                  111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=01 GRC=03              04.1.23000000103                                                                                  %
CVALIDITYFLG=5     0174 20230401161Z993    E669                                                                                                                                                                                                                                    111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=05 GRC=05              04.1.23000000505                                                                                  %
CVALIDITYFLG=5     0175 20230401161Z993    G71035                                                                                                                                                                                                                                  111111111002020202020102                                                                                                                                                                                    Code First w/ Condition PDX                                           VER=04.1.23 HIPPS=00000 GVF=05 GRC=05              04.1.23000000505                                                                                  %
